Communities with participation-enabling skills: A study of children with traumatic brain injury and their shared occupations

Abstract

Many ideas about participation in rehabilitation literature focus inwards towards individuals, or individuals and their family, acting in but apart from their environment. Authors position individuals as “participating in” occupations or social settings, or point towards the outcomes for those who do or do not participate. This perspective arguably contributes to occupational injustices, hampering positive change. Literature has not furnished a broader gaze that appreciates individuals and their participation context as one. Actions that occur amongst people collectively with context, in an ongoing cycle of change, receive little attention. Guided by a Deweyan transactional perspective, six case studies exploring the participation of 9–12 year old children with traumatic brain injury generated more contextualised understandings. Interviews with children and community members, photographs, observations, and document-review provided information about actions and changes occurring amongst children and their environment, where these were seen as continuous with one another. This paper describes the Participation-enabling skills that were revealed amongst children and adults who shared in occupations. Community members demonstrated varying ability in using actions that facilitated both themselves and others to take part in occupations. The Participation-enabling skills were fostered during shared occupation. The congruence of the skills with themes in occupational science and therapy literature is explored, and their relevance to social change is proposed.