Occupational Therapists Enhance Comprehensive Health Assessments for Children in Foster Care

Children in foster care (CFC) have prevalent developmental health needs. Comprehensive health assessments (CHA) that include development evaluation are recommended for CFC. The impact of adding occupational therapy (OT) to multidisciplinary CHA teams is unknown. We aimed to describe findings from OT evaluations performed as part of CHA for CFC and determine if OT evaluation influences developmental health recommendations.

Retrospective study at a clinic for CFC that included 335 children with OT evaluation during their CHA and 217 without OT evaluation due to limited availability. OTs performed developmental components of CHA using observation and standardized testing. We used descriptive statistics, and chi-square and Fisher's exact tests to compare developmental health recommendations between patients with and without OT assessment.

Median age was 8.3 years (range 0, 19). At least one aspect of development was delayed in 230/335 (69%) children evaluated by OT. OTs provided strategies to strengthen development to 74% of evaluated youth. Children seen by OT received significantly more developmental referrals compared to controls (38% versus 58%, p<.001).

Our findings suggest rehabilitation specialists such as OTs can enhance detection of developmental needs and provide strategies to strengthen development when included in CHA for CFC.