Children with disabilities often are at a greater risk for health problems that can be

prevented.3 These children also tend to lose functionality and find it difficult to perform

everyday activities. Occupational therapy help them to regain functionality of their sensory

and motor functions.4 Thus, it is clear that occupational therapy is needed to improve the

quality and functionality of life in these children. This essay will focus on the health

promotion aspects of occupational therapy for disabled children.

In the first section, the discussion will establish occupational therapy as a health

promotion topic and correlate its significance to disabled children. The second section will

examine occupational therapy intervention for disabled children as a health promotion

programme specifically. The final section will describe briefly some personal insights and

discoveries acquired from the research process.

Before discussing the issues surrounding occupational therapy, an understanding on

occupational therapy for disabled children as a health promotion topic needs to be

established. Health promotion is, as defined by the World Health Organisation Ottawa

Charter 1986, “the process of enabling people to increase control over, and to improve their

health”.5 The charter also states that people cannot achieve their fullest health potential unless

they are able to take control of things which determine their health.5

Therefore, an argument can be made that occupational therapy for disabled children is

therefore a true embodiment of ‘health promotion’.

Children with disabilities are particularly vulnerable to secondary conditions, co-morbid conditions, and

higher rates of premature deaths.

Disability results additional financial burden due to ill health. Drug

expenditure would be increased as most disabled children are on some form of prescribed

medication. For example, children with cerebral palsy accounted for $39.7 million in direct

costs (drug expenditure) and $342 million in indirect costs (mortality and morbidity cost) in

Canada in 2000-2001.14

Understanding the upstream determinants and risk factors of disability in children

would aid in appreciating how occupational therapy for disabled children works.

Figure 1. Upstream factors.15

Determinants/ Upstream

factorsDisability Burden of ill-

health

Upstream Factors

Macroeconomic policies

Culture, ethnicity and

values

Governance

Income and social status

Education and literacy

Early childhood development

well as aid a child in interacting and communicating with others should be facilitated as ell.20

There have been no reported adverse effects of occupational therapy involving

disabled children. However, it is stipulated that some disabled children might become

aggressive or violent while being handled by an occupational therapist. This poses harm to

the occupational therapist and the child himself/herself.29

Occupational therapy is relatively safe if it is being performed by a trained

occupational therapist. Nevertheless, this does not guarantee that an adverse event will never

happen in the hands of a trained occupational therapist. It is always best to take precautionary

steps to prevent an adverse event.

Ethical issues are unavoidable when it comes to a health promotion program. Two

main ethical issues that are directly involved when it comes to occupational therapy

intervention for disabled children would be the failure to communicate and breach of

confidentiality.30

Lack of communication between occupational therapists and disabled children or

failure to share important information is a critical ethical issue that is often witnessed in

occupational therapy interventions. However, it should be noted that this mainly occurs due to

the physical condition of a disabled child. Circumstances require a third person that is more

comfortable with handling the disabled child to mediate communication between

occupational therapists and disabled children.30 In this case, the mediator happens to be the

staff of PPKKCTM.

The involvement of a mediator leads to the second ethical issue at play here; breach of

confidentiality. Breach of confidentiality leads to a limitation of service provided by

occupational therapist as the mediator might not agree with certain methods an occupational

therapist might employ when providing service.30 This might result in a decrease efficacy of

the occupational therapy intervention being provided and directly impacting the health

outcomes of disabled children.30

Occupational therapy involves a team approach that includes the disabled children,

caregivers, educators, health care professionals, community organization staff and

governmental agency staff. As a result, occupational therapists often have to work together

with other members of the community to deliver their service. This may sometimes result in

differing opinions on how a particular situation or child should be handled. Execution of

service might be delayed and the progress of a child might be slowed down.

Nevertheless, overall reception of the community towards occupational therapy

program has been positive. The program has been well received and implemented in several

different settings such as school, childcare centers and hospitals.6

However, there is a lack of certified occupational therapists to cater the entire disabled

children’s population.6 More efforts should be put to train people to become certified

occupational therapists to ensure more disabled children benefit from the occupational

therapy program. Occupational therapists should be employed by governmental agencies to

ensure their services are provided on several platforms and settings.

A rigorous program that addresses the barriers to the implementation of occupational

therapy in different settings and the implementation of the occupational therapy program

itself will ultimately have a direct impact on the burden of ill health due to disability and the

cost of co-morbidities can be reduced.

This assignment has given me the opportunity to discover the various number of ways

in which the quality of life of disabled children at PPKKCTM could be improved. The

inability of disabled children at PPKKCTM to look out for themselves, which renders them

completely dependent on others, fueled the objective of this health promotion program.

The multiple social factors affecting lives of disabled children and their outer circle

has a direct impact on the health outcomes of these children. The health promotion program

discussed in this report aims to alter some of those social factors to ensure improved quality

of life in disabled children.

Several aspects of the health promotion program was scrutinized meticulously to

deduce the best way this program could be implemented in PPKKCTM to ensure long lasting

health benefit of disabled children at PPKKCTM. Previously successful similar health

promotion programs in different countries were used as models to implement occupational

therapy intervention in PPKKCTM.

Health promotion programmes requires intervention in the medical,

behavioural and socio-environmental aspects of an individual. Occupational therapy

intervention is a health promotion program that covers these three aspects.

It is expected that this health promotion program be implemented in

PPKKCTM to benefit the disabled children that make up the client cohort of

PPKKCTM. The implementations of this health promotion program will certainly

improved the quality of life of disabled children and thereby positively impact the

health outcomes of these children.