Use of Motor Learning Strategies in Occupational Therapy for Children and Youth with Acquired Brain Injury

Motor learning strategies (MLS) can be used to promote motor skills acquisition in children and youth with acquired brain injury (ABI). While occupational therapists (OTs) likely use MLS in clinical practice, research has not investigated the extent and variety of their application. Aims: This study explored MLS use by OTs in pediatric ABI and factors influencing their application. Method: Individual video-recorded occupational therapy sessions for a sample of eight children/youth (ages 4-16) with ABI were evaluated via mixed methods approach. The Motor Learning Strategies Rating Instrument (MLSRI-22) quantified the extent of MLS use in each video. Directed content analysis of the videos explored the factors influencing how and when MLS were applied. Results: The most frequently used MLS were promoting problem solving, encouragement, directing attention to the body, permitting errors as part of learning, repetitive practice, and whole practice. Three themes described how and when the OTs used MLS: 1) Getting buy-in, 2) Going with the flow, and 3) Movement and thinking go hand-in-hand. Conclusions: The OTs frequently used MLS with children with ABI, appearing to select MLS based on factors related to the child, task, and environment. These findings are fundamental to future exploration of OT decision-making and evaluation of MLS effectiveness.