Empowering little lives: occupational therapists working with young children with complex needs

Introduction: With the increasing prevalence of children with complex needs globally, there is a demand for occupational therapists to respond dependably and practically to this group. Children with complex needs can include those who have developmental delay/s, a formal disability diagnosis, are pre-diagnostic with high needs, or are living with a chronic medical condition. In 2018, there were over 200,000 children in Australia with a severe or profound disability, and only around 4000 occupational therapists working with children. Objectives: To identify the scope of early childhood occupational therapy practice with children aged birth to 5 years who have complex needs. Methods: A scoping review and concept mapping was undertaken to establish the current context of occupational therapy practice with children 5 years and under who have complex needs. Concept mapping facilitated the more accurate identification and description of what constitutes complexity. Results: The scoping review findings have outlined the focus of occupational therapy intervention with children with complex needs, revealing that therapists working in this area require a broad repertoire of skills and knowledge to manage complexity. Understanding and managing intersectionality is also critical for these children, as intersectionality can be the reason for their complexity. Notably, there is a gap in exactly what therapy practices are used to support these children. Conclusion: There is a profound need for occupational therapists to ensure that young children with complex needs receive targeted supports to reach their potential. Further consideration of practice and the influence of research, policy, and education is needed.