Describing the Dose of Outpatient Occupational Therapy Services for Children With Myelomeningocele.

IMPORTANCE

Occupational therapy can help children with myelomeningocele (CWM) maximize their independence. However, the current dose of usual-care occupational therapy services provided is unknown. Defining the dose of occupational therapy services will lay the groundwork for future intervention studies by providing a starting point for the development of intervention protocols.

OBJECTIVE

To investigate the demographics and dosage (frequency, intensity, time, and type) of occupational therapy sessions for CWM and describe the usual-care outpatient hospital-based occupational therapy dosage at one institution.

DESIGN

Retrospective cohort study.

SETTING

Large urban-suburban pediatric hospital with eight outpatient clinics.

PARTICIPANTS

Twenty CWM, ages 0 to 18 yr (median = 4.85, interquartile range [IQR] = 3.75), receiving services from December 2021 through November 2023.

INTERVENTION: Usual care.

OUTCOMES AND MEASURES: Occupational therapy dose included frequency (total number of therapy sessions), intensity (Child Effort Rating Scale [CERS] scores), time (timed billing charges), and type (interventions and services).

RESULTS

Participants received 258 total occupational therapy treatment sessions during the study period. Median frequency of sessions was 5.0 (IQR = 9.75). The mean CERS score was 3.01 (SD = 0.27), indicating average effort toward goals. Each therapy appointment averaged 51.87 min (SD = 7.82). Neuromuscular and musculoskeletal approaches were the most frequently used intervention type for general visits.

CONCLUSIONS AND RELEVANCE: Participants' outpatient occupational therapy dosage at one pediatric hospital varied. This population has no dosage guidelines, and this article represents a step forward for the field by thoroughly describing the dose of usual-care therapy provided over 2 yr. Plain-Language Summary: Occupational therapy can help children with myelomeningocele (CWM) maximize their independence. However, the current dose of usual-care occupational therapy services that are provided is unknown. This study describes the outpatient occupational therapy dose for CWM at a large hospital with multiple clinic sites. The information gathered from this study can assist occupational therapy practitioners in understanding common intervention strategies for CWM. The study results also lay the groundwork for future intervention studies by providing a starting point for the development of intervention protocols.