Development of a Community Focused Resource to Facilitate Aotearoa New Zealand Children’s Participation After Traumatic Brain Injury (TBI)
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Abstract
Children who sustain a TBI are at risk of poor participation outcomes, partly because people’s understandings and actions can restrict them from participating alongside peers. Previously developed approaches that address these barriers lack evidence of their feasibility and effectiveness. Findings from case study research conducted in New Zealand, and a critical review of approaches in the broader multidisciplinary literature informed the development of a community-focused resource to foster children’s participation after TBI. Strategies in the resource focused on the notion of shared occupation. Objectives To evaluate the conceptual basis and feasibility of the resource prior to its dissemination. Methods Ethical approval was gained. Action research principles (Reason and Bradbury, 2008) and cultural support guided the involvement of families, teachers, caregivers, and rehabilitation personnel (total n = 20) in a workshop. Two rounds of focus groups were held and data were analysed using a mapping process. The resource was modified and copies were returned to participants for further comment. Results Participants endorsed the strategies outlined in the resource. Reconnecting children to their community through occupation was likened to weaving and repairing a net, a traditional craft of indigenous peoples necessary to their wellbeing. After the TBI, working alongside others in their community, parents gradually repair and extend their child’s connections, and help them go out into the world. Conclusion Feedback affirmed the utility of the resource across multiple contexts. The resource has been modified to incorporate the notion of weaving a network of relationships to support children’s participation. Contribution to Evidence Base The study furnishes further evidence for occupational therapists, about how to enable children’s participation in shared occupations, by establishing community connections.