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Higher levels of participation in school are linked to greater academic performance, better health and well-being and positive long-term outcomes for young people. Evidence shows that for students with emotional and behavioural difficulties (EBD), participation in school-based occupations is often restricted in comparison to their peers. Given the recent advancements towards introducing a new model of school-based occupational therapy in Ireland, this paper aims to discuss how occupational therapy can support students with EBD to increase their participation within the post-primary school context. The opinions in this paper are derived from the authors’ experience in the development of this practice in the Republic of Ireland.

The authors reviewed current literature and reflected on current practice to describe the unique role of occupational therapy in supporting students with EBD in the school environment.

Occupational therapists have potential to play a key role in school-based support for students with EBD. The authors describe how occupational therapists can promote whole school understanding of EBD and enable skill development, self-regulation, participation and school belonging, among youths with EBD. There is a significant lack of literature guiding practice in this area. Further research is required to explore professional issues and identify best practice.

This paper aims to provoke consideration of how school-based occupational therapists can play a crucial role in supporting students with EBD who are otherwise at risk of occupational injustice.

This study aims to investigate teacher perspectives on teaching handwriting to children with autistic spectrum disorder (ASD) and collaboration with occupational therapists.

A descriptive design was applied. Purpose-designed surveys were distributed to teachers of children with ASD (aged 4-12 years) in the Republic of Ireland. A response rate of 35 per cent (N = 75) was obtained, with 25 responses analysed using descriptive statistics of closed questions and content analysis of open-ended questions.

Of 139 children with ASD, 80 (58 per cent) were reported to have difficulties with handwriting. Teachers reported specific difficulties with pencil grasp, letter formation and task concept among the children with ASD. Fourteen (56 per cent, N = 25) respondents did not give handwriting as homework. Teachers valued occupational therapy advice, individualised programmes and ongoing consultation during implementation. Interest in occupational therapy education regarding handwriting was reported.

Occupational therapy collaboration to address handwriting difficulties for children with ASD should include involvement in teacher education, coordination of teacher–parent collaboration and the need for involvement in early intervention provision within an emergent literacy framework.

Handwriting development is challenging for children with ASD. There is limited information on teaching or teacher–occupational therapy collaborative practices to address handwriting difficulties of children with ASD.

The purpose of this paper is to gain consensus regarding the clinical priorities and tasks required in supporting communication needs in those living with semantic dementia and their families, by specialist speech and language therapists (SLTs), working in clinical practice within dementia care settings in the UK.

A nominal group technique was used, followed by further exploration and refinement of issues using a modified Delphi technique with a group of six SLTs who specialised in dementia care and who had experience of working with individuals with semantic dementia and their families.

The findings in the study demonstrate a broader scope of practice than is evident within the research literature with this client group. Therapists identified a range of psychosocial issues for both the person with semantic dementia and their family, in particular finding ways to support activity and participation in conversation and explore barriers and facilitators within the communication environment.

This represents the first study to explore everyday practice in this rarer dementia and the information gathered here will be of use to a variety of health and social care professions interested in supporting those with semantic dementia and their families.

Work is good for one’s health and well-being. Work for people with disabilities should be encouraged because it is therapeutic and improves participation in the society, leading to better health outcomes. It develops interpersonal relationships and enhances life quality. Work is an aspiration for many people with intellectual disability. Within research literature, there appears to be a lack of research into the experience of occupational therapists in Ireland who refer adults with intellectual disabilities to supported employment services. The purpose of this paper was to explore the experience of Irish occupational therapists who refer adults with intellectual disabilities to supported employment services.

Semi-structured, in-depth interviews were conducted with four occupational therapists recruited through the Association of Occupational Therapists of Ireland (AOTI). Data were analysed using thematic analysis.

Themes that emerged were as follows: occupational therapy participants did not directly refer adults to supported employment but received referrals; occupational therapy roles included assessments, task analysis and development of client’s skills are major components of current practice; pragmatics involved factors that facilitate and challenge; and future roles.

This paper contributes to occupational therapy practice knowledge by providing a perspective on supported employment in Ireland. Occupational therapists should continue to work in the area of supported employment to support social inclusion and enable participation. Further research with occupational therapists working in this field is required to inform practice.

Late life depression is often associated with a poor response to antidepressants; therefore an alternative strategy for therapy is required. Although several studies have reported that phosphatidylserine (PS) may be effective for late life depression and that omega-3 fatty acids DHA and EPA have also proven beneficial for many higher mental functions, including depression, no concrete conclusion has been reached. This study was performed to clarify the effect of PS and omega-3 fatty acid-containing supplement for late life depression by not only clinical evaluation but also salivary cortisol levels. Eighteen elderly subjects with major depression were selected for the study. In all, insufficient improvement had been obtained by antidepressant therapy for at least 6 months. The exclusion criteria from prior brain magnetic resonance images (MRI) included the presence of structural MRI findings compatible with stroke or other gross brain lesions or malformations, but not white matter hypersensitivities. They took a supplement containing PS 100 mg, DHA 119 mg and EPA 70 mg three times a day for 12 weeks. The effects of the supplement were assessed using the 17-item Hamilton depression scale (HAMD17) and the basal levels and circadian rhythm of salivary cortisol. The study adopted them as indices because: salivary cortisol levels are high in patients with depression, their circadian rhythm related to salivary cortisol is often irregular, and these symptoms are alleviated as depression improves. The mean HAM-D17 in all subjects taking the supplement was significantly improved after 12 weeks of taking the supplement. These subjects were divided into 10 non-responders and 8 responders. The basal levels and circadian rhythm of salivary cortisol were normalized in the responders while not in non-responders. PS and omega-3 fatty acids, or other elements of the supplement, may be effective for late life depression, associated with the correction of basal levels and circadian rhythm of salivary cortisol.

The assessment of fitness to drive after stroke is an emerging area of occupational therapy practice in Ireland. Despite this, little is known about occupational therapists’ evaluation practices, and there are no internationally agreed clinical guidelines to inform best practice. The purpose of this paper is to investigate occupational therapy evaluation practices for fitness to drive after stroke in Ireland.

This is a cross-sectional study design targeting occupational therapists working with people after stroke using an online survey. Summary and descriptive statistics were used to analyse the returned surveys.

In total, 47 occupational therapists participated. Off-road driving assessment was completed by 68 per cent of respondents. Functional assessment and non-driving-specific assessments were most widely used and perceived to be the most useful in informing the off-road assessment. A total of 89 per cent referred clients for on-road assessments; however, some referred without first completing an off-road assessment. The therapists who completed formal post graduate education/training in driving assessment reported greater confidence and competence in their skills and ability to assess fitness to drive. A vast majority of participants agreed that clinical guidelines regarding best practice in this area would be beneficial.

A majority of occupational therapists are assessing fitness to drive after stroke in Ireland with non-driving-specific assessments and functional observations; however, there are many gaps and wide variations between services. Education/training in evaluating fitness to drive after stroke is recommended. The development of clinical guidelines to inform practice would facilitate a consistent approach nationally.

This is the first study completed in Ireland to investigate occupational therapy evaluation practices for fitness to drive after stroke.

The purpose of this study was to provide an outline of the process of developing an on-road driving test route and rating form. Comprehensive evaluation of medical fitness to drive should comprise of an off-road and an on-road assessment. Much research attention has focussed on the off-road phase of assessment, while there is less standardisation evident in the completion and measurement of the on-road phase of fitness-to-drive assessment.

A scholarship of practice approach was used to inform the development of an on-road test route and an associated generic on-road assessment tool that was guided by research evidence and best practice recommendations.

A step-by-step guide, outlining seven recommended phases in the development of an on-road route for the assessment of fitness to drive that aligns with best practice recommendations, was developed. A preliminary generic on-road assessment tool (the Maynooth–Trinity Driving Test) that includes higher-order cognition alongside element of strategic, tactical and operational driving ability was developed and piloted alongside the newly developed on-road test route.

This paper offers an overview of an approach to developing evidence-based on-road test routes and an associated generic assessment tool that may assist occupational therapists and on-road driving assessors establish a standard practice for testing on-road behaviour as part of a comprehensive approach to evaluate fitness to drive.

This chapter discusses how ‘hidden’ populations of women who use drugs (WWUD) in coastal Kenya became ‘visible’ through accessing health, harm reduction and rights services. This effort was facilitated by the Muslim Education and Welfare Association (MEWA) and their work with community leaders. Mapping undertaken by MEWA outreach workers identified women who use opioids and other substances in isolated drug use settings. MEWA introduced daily meals in identified sites, needle and syringe services and residential rehabilitation services for opioid withdrawal. The introduction of residential adherence services for HIV and tuberculosis and the provision of methadone enabled compliance with the 90-90-90 UN HIV cascade. These services achieved sustained HIV viral load suppression at 83% and a 100% cure rate for tuberculosis among WWUD. In addition, disclosure and partner risk tracing was established in the ‘drug dens’ for women who test positive for STIs. The introduction of women-only hours once per week at the drop-in centre contributed to a better understanding of drug dependency among outreach workers and clinicians. Policies on gender-based violence were also refined, leading to an increase in reported cases. Programmes targeting families were introduced to promote effective communication and improve parenting skills. Access barriers to social security programmes were tackled by a network of paralegal officers in partnership with Kenyan authorities. Finally, entrepreneurship training and mentorship programmes were implemented to build resilience among WWUD.

Hippotherapy is an emerging area of paediatric occupational therapy practice in Ireland. It is a treatment strategy used by specially trained occupational therapy practitioners, physical therapists and speech language pathologists as part of the intervention programme to facilitate functional gains. This paper aims to explore parents’ perspectives on children’s participation in home-based occupations following hippotherapy treatment.

Qualitative, semi-structured interviews were conducted with eight participants. Interviews were audio-recorded and transcribed verbatim. In accordance with thematic analysis, line-by-line coding was completed to identify codes. Codes were organised into categories, which were grouped to develop themes.

Three core themes were identified: lack of knowledge regarding hippotherapy as an occupational therapy intervention; children’s increased participation in home-based occupations secondary to improved physical, psychological, communication and social skills; and the unique hippotherapy environment as a motivating factor for children to engage in occupational therapy intervention.

Findings from this study support the growing body of evidence that hippotherapy is an effective means of intervention for increasing physical, psychological, social and communication skills. The participants report positive effects following hippotherapy on their children’s participation in home-based occupations. It highlights a link between the unique hippotherapy environment and children’s increased engagement in occupational therapy. Given that no published hippotherapy-specific literature related to occupational therapy exists in the Irish context, and given that hippotherapy is an emerging area of practice in Ireland, this paper contributes to the knowledge base.

This review aims to identify the commonly used nature-based therapies, the cohorts that benefit from these interventions, and the potential environmental impact of nature-based therapies.

An integrative review methodology was taken. The literature was analysed and synthesised through thematic analysis.

Three themes emerged from the analysis: categories of nature-based therapies; benefits of nature-based therapies; and the gains from nature-based therapies are not universal. Evidence of physiological, psychological, social, vocational and quality of life benefits from participation in nature-based therapies was evident in the literature. However, there was insufficient empirical evidence of the benefits for the environment.

Occupational therapists assist populations across the life course. Consequentially, they can be found working in a diverse range of clinical contexts. This review asserts that nature-based therapies could be a positive addition in many of these contexts. Further, while engagement in activities in natural environments is frequently used by occupational therapists practicing within institution environments, there is evidence to support its use in community service models and potentially in public health strategies.

This integrative review brings together evidence on a diverse range of nature-based therapies, cohorts, associated benefits and factors that influence these. The lack of empirical evidence on the benefits of nature-based therapies for the environment is acknowledged as a gap in the literature