Accommodations and therapeutic techniques used during the administration of the Child Occupational Self Assessment

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Introduction: Paediatric occupational therapists can elicit children's perspectives and provide children with the opportunity to participate in decision making by administering self-reports. This study sought to identify the techniques that practitioners used to foster the effective and appropriate administration of one occupational therapy self-report, the Child Occupational Self Assessment (COSA).

Method: Focus groups were held in the United States and the United Kingdom to explore therapists' experiences using the COSA. Thirty-three clinicians, including 28 occupational therapists, participated across five focus groups. Descriptive codes were generated using line-by-line coding, and codes were refined and reorganised using a constant comparative approach and triangulation with multiple coders.

Findings: Therapists used two main techniques while administering the COSA: providing accommodations and interacting with clients in a therapeutic manner. Occupational therapists provided accommodations by adapting or adjusting the administration of the COSA to meet the individual needs of clients better. Therapists enacted a therapeutic use of self by developing rapport and empowering children during the administration process.

Conclusion: This study illustrates that therapists use multiple therapeutic techniques aligned with the literature during the process of administering the COSA self-report. Further, those therapeutic techniques are enhanced by the simultaneous use of accommodations that ensure children are able to access and complete self-reports.


Document Type: Research Article


Publication date: November 1, 2012

More about this publication?
  • The British Journal of Occupational Therapy (BJOT) is the official journal of the College of Occupational Therapists. Its purpose is to publish articles relevant to theory, practice, research, education and management in occupational therapy internationally.

    BJOT publishes research articles, critical reviews, practice analyses, opinion pieces, editorials, letters to the editor, book reviews and an annual index. Please refer to the author's guide at

    Submissions can be made at

    The 2013 Impact Factor for The British Journal of Occupational Therapy is 0.897.

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