Occupational therapy ccup

ational Therapy
Occupational therapy is a client-centred health profession concerned with promoting health
and well being through occupation. The primary goal of occupational therapy is to enable
people to participate in the activities of everyday life. Occupational therapists achieve this
outcome by working with people and communities to enhance their ability to engage in the
occupations they want to, need to, or are expected to do, or by modifying the occupation or
the environment to better support their occupational engagement. (WFOT 2012)
Definition "Occupation"
In occupational therapy, occupations refer to the everyday activities that people do as
individuals, in families and with communities to occupy time and bring meaning and purpose
to life. Occupations include things people need to, want to and are expected to do.

Where Occupational Therapists work

Occupational therapists work with all age groups and in a wide range of physical and
psychosocial areas.
Places of employment may include hospitals, clinics, day and rehabilitation centres, home
care programmes, special schools, industry and private enterprise.
Many occupational therapists work in private practice and as educators and consultants.

How Occupational Therapists work

Assessment
The occupational therapy process is based on initial and repeated assessments. The
occupational therapist together with the person they are working with focus on individual and
environmental abilities and problems related to activities in the person's daily life.
Assessment includes the use of standardised procedures, interviews, observations in a variety
of settings and consultation with significant people in the person's life.

Planning
The results of the assessment are the basis of the plan which includes short and long-term
aims of treatment. The plan should be relevant to the person's development stage, habits,
roles, life-style preferences and the environment.

Intervention
Intervention focuses on programs that are person oriented and environmental. These are
designed to facilitate the performance of everyday tasks and adaptation of settings in which
the person works, lives and socialises. Examples include teaching new techniques and
providing equipment which facilitate independence in personal care, reducing environmental
barriers and providing resources to lessen stress.

Cooperation
Occupational therapists recognise the importance of teamwork. Cooperation and coordination
with other professionals, families, caregivers and volunteers are important in the realisation of
the holistic approach.
Occupational Therapy in Obesity in Childhood and Adolescence

Occupational therapy services and interventions are important considerations for the
prevention, treatment and management of obesity in children and adolescents. The
comprehensive approaches used address elements of body functions and structures, activity
limitations, personal and environmental factors associated with obesity that impact
participation in life roles.

Statement of position being taken

Enhancing health and wellbeing through engagement in occupations, whatever the weight of
the child or adolescent is the focus of occupational therapy interventions.

Obesity prevention: Occupational therapists work with individuals, families and/or

communities to target modifiable risk factors associated with the development of obesity. For
example, occupational therapists can facilitate the development of dietary, physical activity,
and play activities enhancing occupational habits and routines.

Obesity treatment: Occupational therapy is an essential part of a multidisciplinary approach

to evidence based treatment options for obesity. This includes family-based multi-component
and lifestyle weight management/maintenance services for children and adolescents3 .
Occupational therapy is also part of the team who focus on lifestyle approaches for pre- and
post- surgical interventions for the treatment of obesity. This includes access to peer networks
and enabling children, adolescents and families to plan for the future.

Statement of the significance of position or issue to occupational therapy

Occupational therapists enable participation in occupations that promote health and well-
being including physical activity, healthy eating and sleep; focusing on occupations across the
lifespan including preconception and pregnancy care as recommended by the World Health
Organization (WHO). In addition, occupational therapists have the capacity to foster self-
determination and selfadvocacy skills that will enable making healthy choices .
Occupational therapists focus on promoting occupational outcomes that are meaningful for
children and adolescents and enhance motivation for sustainable health behaviour changes
that may or may not include weight loss. Occupational therapists address issues that reflect
the broad social determinants of health for groups and communities. Occupational therapists
advocate for, and make changes within, the social and built environment to promote access to
nutrient rich foods, safe spaces for play, and active recreation for children and adolescents of
all abilities. It is also acknowledged the need for culturally tailored interventions.

Statement of the significance of the position to the community or society

Obesity is associated with restricted participation in life events important in childhood and
adolescence including those associated with physical, psychosocial and vocational
development. The perspectives of occupational therapists on the interaction between the
person, environment and occupation to promote health and wellbeing are established practice.
This trained workforce could be readily utilised to promote an occupational perspective at a
societal level, alongside provision of individualised interventions for families. Occupational
therapists have an important contribution to make to public health messaging that is focused
on health and well-being associated with prevention, treatment, and minimisation of the
impact of obesity on children’s and adolescents’ lives. Occupational therapists are also
effective advocates to reduce weight bias and stigma associated with obesity and to promote
access to services and resources designed to meet the needs of people with obesity.

Role of occupational therapy in obesity in childhood and adolescence

Introduction to the purpose of this Statement

The purpose of this Statement is to describe the World Federation of Occupational Therapists’
(WFOT) position regarding occupational therapy’s role in the prevention, treatment and
minimisation of the impact of obesity on the daily lives of children and adolescents.
Occupational therapists are concerned with how people engage in meaningful everyday life
occupations, and how this influences their health and wellbeing. Occupations are more than
just paid employment; it is everything people do, such as eating a meal, getting ready to go
out, going to school or socialising with friends. Occupational therapists work with individuals,
communities and organisations when everyday life roles and associated occupations are
impacted (or have the potential to be impacted) or at risk by disability, illness, life
circumstances or changes experienced with ageing.

According to the World Health Organization (WHO), worldwide obesity has nearly tripled
since 1975. In 2016, 41 million children under the age of 5 and over 340 million children and
adolescents aged 5- 19 had a weight-for-height classified as overweight or obese. The WHO
definitions of overweight and obesity for children and adolescents are as follows:
Under 5 years:
•Overweight: Weight-for-height greater than 2 standard deviations above WHO Child Growth
Standards median
•Obesity: Weight-for-height greater than 3 standard deviations above the WHO Child Growth
Standards median
5 - 19 years:
•Overweight: BMI-for-age greater than 1 standard deviation above the WHO Growth
Reference median
•Obesity: Greater than 2 standard deviations above the WHO Growth Reference median.
Occupational therapy focuses on facilitating meaningful, active and engaging occupations for
children and adolescents such as play, studying, and self-care. The WFOT believe that
children and adolescents at risk for developing obesity or those living with obesity should
have access to occupational therapy approaches that can prevent, treat, and minimise the
impact of obesity on daily life and on adulthood.

Statement of the position being taken

Contributing to the prevention of obesity in children and adolescents, occupational therapists

work with individual families and/or communities to target modifiable risk factors associated
with the development of obesity. For example, occupational therapists can facilitate the
development of dietary, physical activity, and play activities enhancing occupational habits
and routines through goal setting; grading activity; health promotion and group work.
Enhancing health and wellbeing through engagement in occupations, whatever the weight of
the child or adolescent is the focus of occupational therapy interventions.

This includes family-based multi-component and lifestyle weight management/maintenance

services for children and adolescents. Occupational therapy is also part of the team who focus
on lifestyle approaches for pre- and post- surgical interventions for the treatment of obesity.
This includes access to peer networks and enabling children, adolescents and families to plan
for the future. We also recognise that children who have obesity are not necessarily referred to
occupational therapy services, yet occupational therapists see children who have obesity for
other issues relating to their engagement in occupations.

Statement of the significance of position or issue to occupational therapy

Occupational therapists have the skills and knowledge to promote participation in occupations
that promote health and well-being including physical activity, healthy eating and sleep;
focusing on occupations across the lifespan including preconception and pregnancy care as
recommended by WHO. In addition, occupational therapists have the capacity to foster self-
determination and selfadvocacy skills that will enable making healthy choices.

Occupational therapists can also address issues that reflect the wider social determinants of
health for groups and communities. For example, occupational therapists can advocate for,
and make changes within, the social and built environment to promote access to nutrient rich
foods, safe spaces for play, and active recreation for children and adolescents of all abilities.
Current evidence indicates that children in urban environments and from ethnically and
racially diverse backgrounds, those living in poverty, and children and adolescents with
disabilities are more likely to experience obesity related complications and barriers to healthy
lifestyles. We also acknowledge the need for culturally tailored interventions.

Obesity is associated with restricted participation in life events important in childhood and
adolescence including those associated with physical, psychosocial and vocational
development. The perspectives of occupational therapists on the interaction between the
person, environment and occupation to promote health and well-being are established
practice. This trained workforce could be readily utilised to promote an occupational
perspective at a societal level, alongside provision of individualised interventions for families.

Occupational therapists have an important contribution to make to public health messaging

that is focused on health and well-being associated with prevention, treatment, and
minimisation of the impact of obesity on children’s and adolescents’ lives. Occupational
therapists are also effective advocates to reduce weight bias and stigma associated with
obesity and to promote access to services and resources designed to meet the needs of people
with obesity.