A transactional framework for pediatric rehabilitation: shifting the focus to situated contexts, transactional processes, and adaptive developmental outcomes
Creators: name: King, Gillian
name: Imms, Christine
name: Stewart, Debra
name: Freeman, Matt
name: Nguyen, Tram
Publisher: name: Taylor & Francis
Year: 2017
Subjects: subject: Space Science
subject: Medicine
subject: Genetics
subject: FOS: Biological sciences
subject: FOS: Biological sciences
subject: 59999 Environmental Sciences not elsewhere classified
subject: FOS: Earth and related environmental sciences
subject: FOS: Earth and related environmental sciences
subject: Sociology
subject: FOS: Sociology
subject: FOS: Sociology
subject: 69999 Biological Sciences not elsewhere classified
subject: Science Policy
subject: 111714 Mental Health
subject: FOS: Health sciences
subject: FOS: Health sciences

description: <b>Purpose:</b> A paradigm shift is taking place in pediatric rehabilitation research, practice, and policy – a shift towards the real-life contexts of clients rather than requiring clients to navigate the world of pediatric rehabilitation. This article proposes a conceptual framework to bring about a broader awareness of clients’ lives and transactional processes of change over the life course. <b>Method:</b> The framework draws attention to transactional processes by which individuals, situated in life contexts, change and adapt over the life course and, in turn, influence their contextual settings and broader environments. This framework is based on (a) basic tenets derived from foundational theories taking a life course perspective to change, and (b) transactional processes identified from relevant pediatric rehabilitation models that bring these foundational theories into the pediatric rehabilitation sphere. <b>Results:</b> The framework identifies three types of transactional processes relevant to pediatric rehabilitation: facilitative, resiliency, and socialization processes. These processes describe how contexts and people mutually influence each other via opportunities and situated experiences, thus facilitating capacity, adaptation to adversity, and socialization to new roles and life transitions. <b>Conclusions:</b> The utility of the framework is considered for research, practice, service organizations, and policy.Implications for RehabilitationThe framework supports practitioners going beyond <i>person</i> and <i>environment</i> as separate entities, to provide services to the “situated person” in real-life contextsThe framework shifts the focus from “body structures/functions” and “person in activity” to “person in changing and challenging life contexts”Working from a transactional perspective, practitioner-client conversations will change; practitioners will view client situations through a lens of opportunities and experiences, assess client experiences in real-life contexts, and strive to create context-based therapy opportunitiesThe framework suggests the benefit of greater focus on resiliency processes to support client self-efficacy, self-determination, and autonomy, and socialization processes to enhance ability to enact new life roles at times of transition The framework supports practitioners going beyond <i>person</i> and <i>environment</i> as separate entities, to provide services to the “situated person” in real-life contexts The framework shifts the focus from “body structures/functions” and “person in activity” to “person in changing and challenging life contexts” Working from a transactional perspective, practitioner-client conversations will change; practitioners will view client situations through a lens of opportunities and experiences, assess client experiences in real-life contexts, and strive to create context-based therapy opportunities The framework suggests the benefit of greater focus on resiliency processes to support client self-efficacy, self-determination, and autonomy, and socialization processes to enhance ability to enact new life roles at times of transition