Descriptive evaluation of community based children's occupational therapy services using COPM.

Records were reviewed retrospectively from a single service, so the findings depend on what was written in the files and describe this one service rather than children's occupational therapy generally. There was no comparison group and children were not randomly assigned, so the study cannot show that occupational therapy caused the improvements parents reported. Children spent about a year in the service, and the authors say the gains could reflect maturation, other therapies or starting preschool rather than the occupational therapy itself. Only 60 children took part; the authors say this is too small to draw firm conclusions about service effectiveness, and that a larger study might have detected a link between the number of sessions and outcomes. Most families spoke English at home and were born in Australia, and all lived in one region with higher socioeconomic disadvantage, so how the service runs may not match yours. The researchers could not look at why families chose the goals they did, because the data came from existing files.

The authors received no funding for the work. The project formed part of the second author's honours degree, supervised by the first and last authors, and the data analysis formed part of another author's honours thesis. Three of the authors were employed by the health service being evaluated at the time of the project, and two of them were employed in the service where the data were collected.

Do not read the rise in parent-rated scores as proof that occupational therapy caused it. There was no comparison group, every child was in the service for a long stretch, and the authors say the gains could be due to maturation, other therapies or starting preschool. Do not read it as a dose response either: children who had more sessions did not improve more, and the authors say a larger study might have found a link.