Bakgrund: Autismspektrumtillstånd (AST) är en funktionsnedsättning som påverkar social interaktion, kommunikation och beteende. Arbetsterapeutiska interventioner kan hjälpa barn och unga med AST att förbättra sin förmåga att delta i dagliga aktiviteter. Trots denna viktiga funktion, saknas fortfarande en sammanställning av forskning gällande vilka arbetsterapeutiska interventioner erbjuds i dagsläget för barn och unga med AST. Syfte: Syftet med denna studie var att sammanställa och beskriva arbetsterapeutiska interventioner för barn och unga med AST. Metod: Denna studie är genomförd som en litteraturöversikt. En systematisk sökning genomfördes i databaser PubMed, CINAHL och AMED för att hitta relevanta studier. Endast kvantitativa studier inkluderades, där interventionerna utfördes av arbetsterapeuter. Dataanalysen för de 10 artiklarna i denna studie genomfördes i enlighet med Friberg (2022) och baserades på OTIPM:s (Fisher &Marterella, 2019) fyra interventionsmodeller som ett ramverk för att strukturera informationen. Resultat: Resultaten visade tre modeller av arbetsterapeutiska interventioner: pedagogisk modell, modell för aktivitetsträning och kompensatorisk modell. Pedagogisk modell inkluderade social färdighetsträning, coaching för aktivitetsutförande (OPC) och I-ADL träning med hjälp av teknik. Modellen för aktivitetsträning inkluderade sensorisk integrationsterapi med eller utan hjälpmedel och intervention med användning av ett robottdjur. Kompensatorisk modell inkluderade användning av teknik, anpassningar av miljön och användning av hjälpmedel. Slutsats: Studiens resultat visade att det finns en betydande inriktning mot föräldrar och anhöriga i de beskrivna interventionerna, vilket betonar deras viktiga roll. Möjligheten att kombinera olika interventionsmodeller och använda arbetsterapeutiska praxismodeller som stöd i interventionens planering och utförande har också identifierats. Dessa interventioner bör vara individanpassade och syftar till att skapa optimala förutsättningar för att uppnå önskade mål och förbättra livskvalitén för barn och unga med AST. / Background: Autism Spectrum Disorder (ASD) is a disability that affects social interaction, communication and behavior. Occupational therapy interventions can help children and adolescents with ASD to improve their ability to participate in daily activities. Despite this important function, there is still a lack of compiled research on which occupational therapy interventions are currently offered to children and adolescents with ASD. Objective: The purpose of this study was to compile and describe occupational therapy interventions for children and adolescents with ASD. Method: This study was conducted as a literature review. A systematic search was performed in databases PubMed, CINAHL and AMED to find relevant studies. Only quantitative studies were included, where the interventions were carried out by occupational therapists. The data analysis of the 10 articles in this study was conducted in accordance with Friberg (2022) and based on OTIPM's (Fisher & Marterella, 2019) four intervention models as a structure for organizing the information. Results: The results revealed three models of occupational therapy interventions: education and teaching model, acquisitional model for occupational skills training and compensatory model. Education and teaching model included social skills training, Occupational Performance Coaching (OPC) and technology-assisted I-ADL training. Acquisitional model for occupational skills training included sensory integration therapy with or without assistive devices and intervention utilizing a robotic animal. Compensatory model included the use of assistive technology, environmental adaptations, and assistive devices. Conclusion: The results of the study showed a significant focus on parents and caregivers in the described interventions, emphasizing their important role. The possibility of combining different intervention models and using occupational therapy practice models as support in the planning and carrying out of the intervention was also identified. These interventions should be individualized and aim to create optimal conditions for children and youth with ASD to achieve desired goals and improve quality of life.

Chronic Heart Failure (CHF) is known to have a substantial impact on activities of daily living (ADL) and symptoms such as breathlessness and fatigue are characteristic. Despite this, research in occupational therapy concerning people with CHF is rare. The overall aim of this thesis was to increase the knowledge of ADL ability and fatigue among those with CHF, to describe experiences of limitations in occupational performance and the strategies that these elderly people use to manage their daily activities and also to describe a programme including energy conservation for clients with CHF in primary healthcare. Method Three groups of older people with a verified diagnosis of CHF and one group of occupational therapists (OTs), all recruited from primary healthcare, were analyzed. The ADL ability of 40 participants was described, with reference to dependence on others, perceived strain and quality of occupational performance. The association between ADL ability and the New York Heart Association Classification (NYHA), a functional classification for people with CHF, was analyzed. Fatigue and its association to ADL ability, use of assistive devices and community support were also analyzed. Ten respondents were then interviewed and asked to describe the strategies they used to manage ADL. The interview results were combined with the current body of research and CHF guidelines to form a base for the development of an intervention programme, including energy conservation, for people with CHF. The programme, based on the Occupational Therapy Intervention Process Model (OTIPM), was used by OTs in primary healthcare, and the clients’ ADL, goal achievements and use of energy conservation strategies were described, as well as the five clients’ and two OTs’ experiences of the program. Results Most participants were independent in personal ADL activities (PADL). A majority was dependent in one or more instrumental ADL activities (IADL) and perceived strain when performing the activities independently. The Assessment of Motor and Process Skills (AMPS) showed a reduced quality of occupational performance compared with healthy people of the same age. Age had a significant impact on ADL performance. Despite this, participants in NYHA III/IV showed significantly increased effort (under motor cutoff) when performing ADL tasks compared with those in NYHA I/II. Fatigue was common and greater fatigue was associated significant with increased dependence and decreased quality of occupational performance, with the exception of shopping. Participants who used assistive devices and home care estimated higher physical fatigue, but no correlation was found with community mobility services. Comorbidities, which can affect occupational performance, were common in all the studies. The participants experiences of limitations in occupational performance and the strategies that they used to manage their daily activities were described as redefining an active life, aware of one’s impaired body and planning activities and balancing the degree of effort. During the interventions according to the programme the clients’ increased their participation and independence in daily activities, consciously gave up what were less meaningful activities for them and deteriorated because of the progression of the CHF. Most goals were achieved and many energy conservation strategies were used by the clients. The clients’ experiences were described as working in collaboration to manage daily activities and using professional support from OTs to enhance their activities. The OTs’ experiences of the programme were described as being supported with specific knowledge and a structured way of working and finding clinical benefits from working according to the program, but doubt the possibilitiy of using it, due to constraints in clinical practice. Discussion The participants' physical fatigue and breathlessness had a negative impact on their ADL-ability. Age affected ADL performance, but the impact of a more severe CHF remained adjusted for age. An ongoing process of occupational adaptation due to periodical physical decline and fluctuating day-to-day ability was described. Many of the strategies used by the participants to handle daily activities could be described as energy conservation strategies, an indication that occupational therapy interventions including energy conservation management would be beneficial for clients with CHF. Both the OTs and the clients described that the specialized programme provided structure for the OTs’ work, knowledge about CHF and about valuable energy conservation strategies. The programme seemed to support the OTs to work in a more comprehensive client-centered way. Conclusion The work with this thesis has increased the limited existing knowledge about elderly people with CHF and their ADL ability, fatigue and the adaptation of occupational performance that they use to manage their daily activities. The experiences indicated that a specialized programme including energy conservation for occupational therapy in primary healthcare seemed to support the OTs work in a more comprehensive client-centered way. The programme needs to be further evaluated.

Background: Kawa is a client-centered and culturally sensitive occupational therapy model. Discussion has aroused if Kawa would be a suitable model for the clientele, which is culturally more diverse than before. Aim: To investigate how occupational therapists have applied Kawa for the occupational therapy process. Material and Methods: This qualitative study involved 15 occupational therapists, who had applied Kawa to their clients. They got selected on social media by ‘snowball sampling’. Data was collected using an electronic questionnaire. Directed content analysis was conducted, guided by The Occupational Therapy Intervention Process Model. Results: Kawa was considered a client-centered model enhancing therapeutic relationships. By using Kawa, therapists gained relevant information through the client’s subjective self-report. However, observation of the client’s occupational performance omitted. Kawa did not provide sufficient tools, and therapists had to apply knowledge from other models. Conclusions: Kawa provided a strong starting point for the occupational therapy process by enhancing the therapeutic relationships and the client’s subjective self-report, but it did not guide the therapist to complete the whole occupational therapy process. Significance: This study proved that Kawa is a useful model for developing therapeutic rapport and gaining information through self-report. The study suggests that Kawa should be developed further or combined with occupation-based models.