Integrating Occupational Therapy into a Foster Care Clinic

Introduction: Entrance into foster care impacts all of a child’s occupations. Occupational therapy (OT) is well-equipped to address the occupational deficits and barriers to participation in meaningful activities that arise from entry into foster care. The goal was to determine the requirements to add OT to the foster care clinic and assess OT’s current utilization for the population. Methods: As a subset of the Cincinnati Children’s Hospital and Medical Center’s (CCHMC) ACUITY study, which assesses healthcare utilization in foster children, a retrospective chart review was completed on 100 electronic medical records (EMRs) within the CCHMC foster care clinic. EMRs were manually reviewed for reference to OT and occupational deficits. Results: Forty-four percent of participants have had OT. Top reasons for OT referral include sensory processing (n=23), fine motor impairments (n=20), and emotional regulation deficits (n=18). Most interventions took place in outpatient (n-21), early intervention (n=12), and inpatient psychiatry (n=11). Seventy-four percent of charts noted an occupational deficit, with only 6% of those currently being addressed by OT. About half of the participants note trauma-related sensory processing deficits, 15% show feeding deficits, and 11% show enuresis or difficulty with elimination. Discussion: There is a slowly increasing amount of research on occupational therapy services with foster care children. The high rate of occupational deficits found in children within the foster care system indicates the need for more OT services. Further research on the role of OT within the foster care system and the impact of OT services in needed.