Decision-Making in Pediatric Occupational Therapy Dosing: An Exploratory Mixed-Methods Study

This study examined the conceptual domains underlying occupational therapists' dosing decisions in pediatric outpatient practice. A cross-sectional exploratory survey was administered to a convenience sample of practicing pediatric occupational therapists recruited via social media, email, and snowball sampling. Descriptive statistics summarized demographics and dosing factors across frequency, intensity, duration, and service delivery method. Exploratory factor analysis and hierarchical and k-means cluster analyses examined conceptual groupings among dosing considerations. Qualitative responses were analyzed using thematic analysis and triangulated with quantitative findings. Ninety-eight participants from 27 states and one U.S. territory completed the survey. Five conceptual domains emerged, with convergence across factor and cluster analyses. Qualitative and quantitative findings were largely consistent, with facility guidelines aligning with logistical and financial constraints. Pediatric occupational therapy dosing decisions are complex and dynamic, reflecting multidimensional, conceptually organized considerations that integrate clinical, contextual, and systemic factors.