Sibling Participation in Occupational Therapy for Children with Physical Disabilities: A Case Report

This case report describes the implementation of participation-based occupational therapy for children with physical disabilities and their siblings in two families. Case 1 was a girl with myelomeningocele spina bifida and her brother, and case 2 was a boy with cerebral palsy and his sister. Goals targeted joint participation in play. The Sibling Participation in Occupational Therapy (SPOT) approach adapted the Collaborative Process for Action Plans to Achieve Children’s Participation Goals in order to assess goal-related factors and develop actionable steps to achieve the goal. Corresponding interventions addressing performance skills differed across cases and related to all children’s ages, interests, and functional abilities. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) measured sibling dyad’s achievement of their family’s goal, and participants completed an experiential questionnaire. Parent COPM ratings demonstrated a meaningful increase in performance and satisfaction, and the therapist and parent ratings of the GAS met or exceeded expected achievement. Parents and sibling dyads reported positive experiences in SPOT. The outcomes support the use of a participation-based approach inclusive of siblings that is consistent with family-centered practice to facilitate participation in meaningful joint sibling activities with families who have a child with a physical disability.