Ruth Humphry

Occupation as Transactional Experience: A Critique of Individualism in Occupational Science

Abstract Occupational science uses various concepts to denote occupation as residing within the individual. That is, despite recognizing the role of a context for the individual and her or his occupation, occupational scientists have continued to implicitly or explicitly create a dualistic view of person and context (environment). The dualism creates a problem for understanding occupation as well as the relationship of person and context. In this paper we present occupationally‐focused case studies of two individuals and assert that existing concepts of occupation in the discipline cannot encompass the situations represented by these cases. We propose the Deweyan concept of transaction as an alternative perspective for understanding occupation. The relational perspective of transactionalism means that occupation is no longer seen as a thing or as a type of self‐action or inter‐action arising from within individuals. In this view, occupation is an important mode through which human beings, as organisms‐in‐environment‐as‐a‐whole, function in their complex totality. As such, occupations become more central to the scientific understanding of person‐context relations.

Neurodevelopmental, health, and growth status at age 6 years of children with birth weights less than 1001 grams

The neurodevelopmental, health, and growth outcomes for 28 six-year-old extremely low birth weight (ELBW) (birth weight less than 1001 gm) children were compared with those of 26 control children born at term. The two groups did not differ in mean weight or height, but the ELBW group had smaller head circumferences (p = 0.015). Kaufman mental processing scores correlated with head circumference (p = 0.0003). Significantly more of the ELBW children (61%) had mild or moderate to severe neurologic problems compared with control children (23%) (p = 0.003). Three ELBW children had mild spastic diplegia; one was blind. Eighteen (64%) of the ELBW children had required rehospitalization versus five (20%) of the comparison group. The mean Kaufman Mental Processing Composite was lower for the ELBW group, but when the data were analyzed by maternal education, only those children whose mothers had a twelfth-grade education had significantly lower scores (p = 0.0001). A similar pattern of group differences was seen for scores on visual-motor function (p = 0.0045), visual-perceptual abilities (p = 0.003), and attention span (p = 0.0001). No group differences were seen regarding hyperactivity or parental stress. Overall functional disability among the ELBW children was considered absent in 46%, mild in 36%, and moderate to severe in 18%. There was a significant association (p = 0.029) between classification of handicap at 12 to 34 months and classification at 6 years. No neonatal factors correlated with 6-year outcome. A significant proportion of ELBW children had no severe disabilities, but many had dysfunctions likely to affect learning and behavior in school.

Model of Processes Transforming Occupations: Exploring Societal and Social Influences

Abstract Occupational science brings unique insights that enrich the knowledge‐base regarding the development of everyday activities. Grounded in a synthesis of the literature, this paper articulates a contextual model of the processes that bring about the emergence of an occupation and transformations in how it is performed and experienced. Change originates from multiple synergistic forces described by three clusters of propositions. First, at the societal level propositions explain how a community creates occupational opportunities and supports the development of its members. A second cluster of propositions describe how dynamic social transactions and collaborating in an activity contributes to change. The final cluster summarizes how the self‐organizing process that underlies an individuals occupational engagement contributes to development of an occupation. Notes from observations made of toddlers and their teachers illustrate how development of occupation is simultaneously societal, social, and individual.

Transaction versus Interpretation, or Transaction and Interpretation? A Response to Michael Barber

(2006). Transaction versus Interpretation, or Transaction and Interpretation? A Response to Michael Barber. Journal of Occupational Science: Vol. 13, No. 1, pp. 97-99.

Development of everyday activities: A model for occupation-centered therapy

Models of practice serve to organize a disciplines knowledge and conceptual explanations for how changes occur. This article presents a model of practice in occupational therapy for children and identifies the professions area of interest as the development of everyday activities rather than child development. Changes in childrens engagement in activities are the product of the interdependent influences of a communitys investment in childhood activities and cultural practices of adults, interpersonal interactions with other people during activities, and young childrens effort to do the things that they find interesting or activities expected of them. Clinical reasoning and activity analysis focus on the childrens activities in their natural environments and the quality of their engagement. A case example illustrates how the model generates occupational therapy services centered on an everyday activity and enables a young childs satisfactory engagement in drawing as part of his inclusive child care program.

Impact of feeding problems on the parent—infant relationship

Fccding an infant is a two-person process in which parent and infant coordinate their behaviors to accomplish a basic and essential activity of daily living. The experience of feeding and being fed may contribute to the development of both the infant and parent and shape the parent-infant relationship. When an infant has problems eating, the subsequent difficulty has implications for the developing relationship. Direct and indirect consequences of feeding problems for the parent-infant relationship arc- explored through a review of the literature. The need to take a holistic view of feeding problems and to include an interaction-based approach to early intervention services is discussed.

A response and some facts about the Miller Assessment for Preschoolers

S chouten and Kirkpatrick (1993) raise concerns about the predictive validity of the Miller Assessment for Preschoolers (MAP) (Miller, 1988b). They suggest that reviews have emphasized the wrong statistical analysis and have drawn conclusions based on only some of the results. To support this assertion Schouten and Kirkpatrick focus their discussion on two review articles (Miller, Lemerand, & Cohn, 1987; Miller & Sprong, 1987) and a letter to the editor (Miller, 1987b) as sources of information on predictive validity. Other resources that discuss Millers study (Miller, 1987a; Miller, 1988a; Miller, 1988b) do not receive the same scrutiny since analyses used were not the ones Schouten and Kirkpatrick suggest should be emphasized. They also question if the data from the three original predictive validity studies have converging results. In addition to the information scattered in their article, results of two of the predictive validity studies in question (Cohn, 1986; Lemerand, 1985) are available to most occupational therapists only in the Miller

Foregrounding the transactional perspective’s community orientation

ABSTRACT More than 10 years after our publication in this journal introducing the transactional perspective on occupation, we take the opportunity with others in this special issue to critically examine and suggest enhancements to the perspective. Here we lay the groundwork for what could be a new phase in the transactional perspective’s development by arguing for the value of its community-level orientation toward processes of occupation, inquiry, and practice. Emphasizing the community orientation of the transactional perspective helps to more fully transcend the individual in theory, research, and practice. After providing a background that presents why we think there is a need for the community orientation of the transactional perspective to be foregrounded, we provide a synthesis of John Dewey’s social pragmatism. We discuss his core concepts of situation, inquiry, social reconstruction, social inquiry, and community, and we put that thinking in a methodological frame to connect theoretical and practical considerations. We then use a case example of work with the transactional perspective at the University of North Carolina at Chapel Hill for community research, education, and practice. Although others within the disciplines of occupational science and occupational therapy, particularly outside of the US, have studied community occupation and reported community projects and models, Dewey’s framework for social inquiry may be useful in assessing and adapting existing models for community building, advocacy, and change.

Educational Implications of Taking a Transactional Perspective of Occupation in Practice

In this chapter, we explore educational issues related to helping professional students apply a transactional perspective in the practice of occupational therapy with children. We address students’ and the literature’s persistent habit of locating development within the child. We offer a transactional description of a childhood occupation as a social process, then highlight how the essence of intervention lies in providing opportunities for children’s engagement with occupations in new ways, utilizing the relational and interdependent elements of occupational situations. We introduce an educational process that helps students see children and their occupational situations as a functioning whole system. We discuss how students are challenged to reflect critically on views of childhood, and we illustrate how through facilitated discussion students are led to adopt a highly contextualized perspective, particularly in terms of how children and their families experience their life situations. The use of storytelling, case-based groups and fieldwork assignments are shown as opportunities for applied learning, and we discuss the structure of assignments to guide thinking along transactional lines.

Developing Everyday Routines

This study obtains a deeper understanding of the processes supporting the formation of young childrens routines in a child care classroom. Eight infants and toddlers and their teachers from two child care classrooms were observed for 4 to 6 months during periods of regularly occurring activities. Detailed, moment-to-moment descriptions of their behaviors and interactions were analyzed. Eleven processes supported the development of childrens routines. Teachers structured and guided the childrens experiences in learning routines, and children initiated requests to do routines. The study also identified three processes where children invited, coached, and modeled, supporting one another in learning routines. Finally, familiar objects used in routines elicited the childrens engagement.