Integrative Neural Networks: A Novel Frame of Reference to Support Occupational Engagement in Caregivers

The Integrative Neural Networks (INN) frame of reference is an integrated approach to support occupational engagement in parents and primary caregivers of children and youth with complex health care needs (CYSHCN) guided by principles of family-centered care. Given the potential influence of prolonged, cumulative, and or repeated stress on physiological, affective/cognitive, and social/spiritual health, it is imperative that occupational therapists partner with parents and primary caregivers to positively impact occupational engagement across contexts. Further, this frame of reference provides an avenue to identify potential health and occupational disparities historically under-recognized as independent from the needs of the child. Based on the structure put forth by Mosey, Hinojosa, and Kramer, this article describes the INN frame of reference from philosophical assumptions and the theoretical base to function-dysfunction continua and implications for occupational engagement. In addition, it includes a guide for evaluation of occupational disparities and resources for collaboration across health care professionals. The postulates regarding change and application to practice appear in a companion article. The overall goal is to assist occupational therapists in identifying parents/caregivers in need of intervention, supporting holistic health while positively impacting occupational engagement for the “whole” parent.