title: Ingredients and change processes in occupational therapy for children: a grounded theory study.
abstract: BACKGROUND
  There is limited evidence about the effectiveness of occupational therapy interventions for participation outcomes in children with coordination difficulties. Developing theory about the interventions, i.e. their ingredients and change processes, is the first step to advance the evidence base.
  
  
  OBJECTIVE
  To develop theory about the key ingredients of occupational therapy interventions for children with coordination difficulties and the processes through which change in participation might happen.
  
  
  METHODS
  Grounded theory methodology, as described by Kathy Charmaz, was used to develop the theory. Children and parents participated in semi-structured interviews to share their experiences of occupational therapy and processes of change. Data collection and analysis were completed concurrently using constant comparison methods.
  
  
  RESULTS
  Five key ingredients of interventions were described: performing activities and tasks; achieving; carer support; helping and supporting the child; and labelling. Ingredients related to participation by changing children's mastery experience, increasing capability beliefs and sense of control. Parents' knowledge, skills, positive emotions, sense of empowerment and capability beliefs also related to children's participation.
  
  
  CONCLUSIONS
  The results identify intervention ingredients and change pathways within occupational therapy to increase participation. It is unclear how explicitly and often therapists consider and make use of these ingredients and pathway.
authors.affiliation: a Samantha Armitage, Occupational Therapist , Sheffield Children's NHS Foundation Trust , Sheffield , UK.
authors.forename: Samantha
authors.initials: S
authors.lastname: Armitage
authors.affiliation: b Veronica Swallow, Associate Professor, Academic Unit: Adult , Child and Mental Health Nursing, University of Leeds , Leeds , UK.
authors.forename: Veronica
authors.initials: V
authors.lastname: Swallow
authors.affiliation: c Niina Kolehmainen, Senior Research Fellow , Newcastle University, and Honorary Consultant Allied Health Professional, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK.
authors.forename: Niina
authors.initials: N
authors.lastname: Kolehmainen
mesh_terms: D002648:Child; D005260:Female; D066296:Grounded Theory; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D019957:Motor Skills Disorders / Q000628:therapy*; D009788:Occupational Therapy / Q000379:methods*; D010290:Parents / Q000523:psychology; D010988:Play and Playthings / Q000523:psychology
keywords: Coordination difficulties; interventions; participation