Occupational Therapy for sleep disorders in children: A South African perspective

Introduction The restorative occupation of sleep has been related to appropriate development and occupational performance in a child’s routine and functioning. Intervention for sleep disorders among children with neurodevelopmental disorders and chronic conditions is offered by a small number of occupational therapists, even though the link between body function deficits, the environment and participation in sleep is well understood and described in occupational therapy models and frameworks. This study aimed to describe knowledge and training of occupational therapists as well as current occupational therapy practice for sleep interventions for children. Method A cross-sectional electronic questionnaire based on the Occupational Therapy Health Literacy Skills for Pain and/or Sleep Disorder Survey was used to collect data from South African occupational therapists treating children. Results Only a third of the 114 respondents in the study provided intervention for sleep disorders for children. While most respondents were aware of non-standardised assessments and strategies that could be used for sleep interventions, these addressed person or body functioning rather than environmental modification and participation impacting sleep as an occupation. Lack of training was reported to be the greatest barrier to implementing sleep interventions with children. Conclusion The lack of knowledge about standardised assessments and occupation-based treatment for sleep disorders in children with neurodevelopmental disorders and chronic conditions amongst South African occupational therapists impacts the implementation of sleep interventions defined scope of practice of occupational therapists. This is consistent with international trends in this field of practice. Implications for Practice Theory and knowledge concerning the occupational performance domain of sleep and sleep interventions should be included in undergraduate and postgraduate training. Awareness of and competence in the use of standardised assessment tools and treatment programmes to use in occupational therapy sleep intervention need to be increased. Research specific to sleep in the various South African cultures and practices needs to provide reliable evidence to inform occupational therapy interventions with children.