Occupational Therapy in paediatrics LATVIA

							                    Occupational
                  Therapy in LATVIA,
                    children care


  Signe Tomsone

Rehabilitation department,
 Riga Stradins University
           2011
          Latvia, basic information




Latvia is located in northeast Europe on the Baltic Sea coast. Latvia borders with the
Estonia, Lithuania, Russia and Belarus.
 Area- 64 589 sq. km. Forest form 44% total territory and there are some 2300 lakes
in Latvia.
Population – 2.32 million
Capital – Riga (736 000)
             A little of OT history...
•   1995 – modified education in OT started at Medical Academy of
    Latvia, with support of Swedish Association of OT;
•   1996- the first OT graduate the modified education (9 OT)
•   1996 – the first OT department was founded in National Rehabilitation
    centre Vaivari (6 occupational therapists start work);
•   1996 – 4 year Swedish–Latvian project to develop education
    programm (bachelor’s level) in OT at Medical Academy of Latvia
    started;
•   1996 – first students enrolled at a regular OT study programm at
    Medical Academy of Latvia;
•   1996 –Latvian Association of Occupational Therapists was founded ;
•   1998 - Latvian Association of Occupational Therapists became an
    associative member of WFOT;
•   2000 – state accreditation of bachelor’s level OT programm at Medical
    Academy of Latvia (16 OT);
•   2000 – first graduates from OT program started practice;
•   2001 - certification of occupational therapists with at least two year
    experience started;
•   2002 – Latvian Association of Occupational Therapists became
    member of WFOT and COTEC;
•   2002 – 2004 – cooperation programms with colleagues (Sweden, UK)
    to develop placements for clinical practice of OT in pediatrics,
    gerontology, psychiatry ;
•   2005- the cooperation among OT from Baltic countries started (student
    and teacher exchange, harmonization of OT sudy programms.
•   2010- developed Standart of Occupational Therapy profession in
    Latvia and submitted for acceptance in government.

The OT study programm from 2000 to 2010 graduated 147 occupational
  therapists.

The data for 01.01.2010. - 98 ( 68%) OT practice (in health care: hospitals,
  rehabilitation centres and ambulatory centres; in social care:
  community services and state institutions).
Children in Latvia
       Children with disabilities
• In the year 2009- 1437 children in age group till
  16 yrs. (2008 y.-1574).

• First time disability in 853 cases-94,6% from
  applications.

• Decision about need of special care - 740
  children -90,6% from all applications.

• Intensity of first time disability : 25,4 children on
  10000 children of population.
          Children with disabilities
                                                    2008     2009
                                                    (n, %)   (n, %)
1. Inherited malformations, deformities or chromosom 180-    214-25,1%
   mutations                                         19,4%

2. Psychiatric and behavioral disorders             164-     254-27,4%
                                                    19,2%
3. Neurological disorders                           106-     110-12,9%
                                                    11,4%
                    OT education
According to the National standarts for Higher professional education
  (second level) the study programm should be:
• At least 160 credit point amount (1 credit point- 40 hours/per week)

The obligatory demands for programm:
• General education- at least 20 credit points
• Basic theoretical subjects of the profession- at least 36 credit points
• Specific subjects of the profession- at least 60 credit points
• Free choice subjects- at least 6 credit points
• Practice- at least 26 credit points (1040 hours)
• State examination (including bachelour thesis work)- at least 12
  credit points

Choice, amount and content of study programm depend on profession
  standart.
   OT education, children care
• Second study year- the course
  “OT in paediatrics” (18 ECTS)

• Content:
- child normal development,
- development of daily activities
    among children,
- children and disability,
- OT frames of references in work
    with children,
- training of practical skills.

• During fourth study year students
  have clinical practice in different
  OT fields, including work with
  children
        OT practice with children
               Currently aprox. 10 OT work in paediatrics:


• Health care- OT work at secondary
  and tertiary health care levels;
Children hospitals, outpatient
  rehabilitation centres, rehabilitation
  clinics/ centres
• Welfare system- social care
  institutions, technical aid centre;
• Education- special clases for
  disabled children, special
  kindergartens.
• Privat practice!
      OT practice with children
• Collaboration with NGO in
  organisation summer
  camps for children with
  disabilities.
• Projects and cooperation
  with colleagues from other
  countries (Sweden,Estonia,
  UK)- experience exchange.
• EU funded projects.
• International conferences.
• Postgraduated education
  within the OT association.
Examples
Examples
          Theory in practice
• Canadian Model of
  Occupational
  Performace
• Model of Human
  Occupation
• Developmental
  approach
• Sensory integration
• ICF
                  Assesment
• MACS, GMFCS
• School Setting Interview
  (SSI)
• Paediatric Evaluation
  Disability Inventory (PEDI)
• Munich functional
  developmental
  diagnostics
• Canadian Occupational
  Performance Measure
  (COPM)
                Assesment
•   MOHO instruments
•   Revised Knox prescool play scale
•   Wee- FIM
•   Seating evaluation scale
•   Fine motor skills and manipulation test
                  Problems
• Availability of
  services- to develop
  CBR practice;

• Succession of
  services;

• Development of
  services based on
  parents needs
  assesment.
Questions?