Case Study Research Exploring the Impact of Material Poverty on a Child’s Patterns of Occupation
Poverty breaches tamariki/children’s rights and is socially unjust, as it has negative effects on their health and well-being that could be prevented. Growing up in poverty is associated with a sense of loss, feelings of shame, and restricted participation in occupations that may amount to occupational deprivation. However, despite the wealth of literature about the ways poverty impacts children’s health and well-being, an occupational perspective is lacking. In particular, little consideration has been given to its effects on a child’s patterns of occupation (i.e., habits, roles, family routines), which is important as habits learned in childhood may carry through to adult life, helping to explain the long-term health and socio-economic implications. To address this gap, this thesis attempts to answer the question: How does material poverty affect a child’s patterns of occupation? To gain an in-depth and contextualised understanding of the phenomenon, the study utilised case study research methodology guided by Stake, with a single case design. The case comprised a child and her parents, living in material poverty in a city in New Zealand, who were recruited through an organisation providing support services. Two additional adults who supported the child’s occupations were recruited by the family. A range of data gathering methods were used (i.e., interviews, observations, document review), including child friendly approaches such as photo elicitation, a weekly activity diary and physically mapping the location, frequency and transport options used to access regular occupations. Interpretive data analysis strategies developed by Stake (1995) and Merriam (1998) included direct interpretation (i.e., deriving meaning from a specific instance in the case) and categorical aggregation (i.e., creating categories or codes that develop from a case). Through this process meanings emerged, which lead to naturalistic generalisations that helped to answer the research question. The results of the study show the way in which the whānau/family’s limited and insecure income, lack of material resources to support occupational choices, cramped housing, the father’s shift work, and reliance on school breakfasts disrupted and impoverished the child’s patterns of occupation. These included habits and routines that created an unhealthy lifestyle (e.g., a predominance of sedentary occupations, impeded study habits). Parental safety concerns and lack of space in the home restricted participation in social occupations (e.g., time spent with friends). Despite considerable support from community agencies (school, church, social services), constraints on choices of and opportunities for participation in tamariki/children’s occupations also involved limitations in free play, school trips, clubs, competitive sports teams, shopping and organised entertainment, time spent together as a whānau/family, and access to digital technology. Whilst the study has limitations (e.g., a single case study), the results provide emerging evidence that child poverty is occupationally unjust and creates occupational deprivation. The findings contribute clarity to the potential for occupational therapy practice in this field (i.e., help focus interventions) and brings an occupational perspective to the discourse about child poverty that has implications for policy to address the issue.