Introduction / Background
Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) is a neuroimmune condition characterised by the sudden onset of obsessive-compulsive symptoms, restricted eating, and other neuropsychiatric and somatic features. These abrupt changes have a profound impact on children’s ability to participate in daily activities, yet occupational performance remains largely overlooked in clinical frameworks. This review aimed to synthesise what is known about (1) the occupational performance challenges experienced by children with PANS, (2) the methods used to assess these challenges, and (3) the occupational therapy interventions described in the literature.

Method
A scoping review was conducted following Arksey and O’Malley’s framework and the PRISMA-ScR guidelines. Seven databases were searched from inception to May 2024 for peer-reviewed studies addressing PANS and functional outcomes within Occupational Therapy Practice Framework domains. Data were extracted and synthesised across three themes: occupational performance challenges, assessment methods, and occupational therapy interventions.

Outcomes
Forty studies met inclusion criteria. Findings revealed widespread disruption across education, communication, nutrition, rest and sleep, social participation, and toileting, with limited attention to play, leisure, and self-care. Most studies used skill-based rather than occupation-based assessments, and only two mentioned occupational therapy, without describing interventions. These findings highlight significant gaps in both evidence and clinical application.

Conclusion
PANS profoundly affects occupational performance. Occupational therapy should be recognised as a fourth pillar of PANS intervention, with future research focusing on occupation-centred assessment and intervention to enhance participation and quality of life.

Background: Social participation fosters cognitive, emotional, and behavioural development during childhood. Sensory/cognitive processing and self-regulation challenges may impact social skills for neurodivergent children. Nature-based interventions have shown promise, yet their potential in supporting neurodivergent children remains under explored. This pilot study evaluated an occupational therapy-led, outdoor, nature-based program to support social engagement in neurodivergent children.

Methods: A mixed-method case series design using retrospective file audit and interviews was employed. The Canadian Occupational Performance Measure (COPM) goal scores were used along with parent questionnaires rating child improvement across social domains pre- and post- intervention. Semi-structured parent interviews yielded information about parent perceptions. Quantitative file data were analysed using descriptive statistics and interview transcripts were analysed using thematic analysis with Wilcock’s framework of Doing, Being, Becoming and Belonging used as a guiding framework.

Discussion: Eight children and four parents participated. Seven of the children demonstrated clinically significant improvements on the COPM for performance and satisfaction. Gains were observed in play planning and flexibility, emotional regulation, and perspective taking. Three themes were identified: (1) The collaborative nature of the program supported children in becoming socially competent (2) The nature-based environment offered a sensory-regulating space to support being socially engaged (3) The nature-based environment and intervention design enabled a sense of belonging and self-agency through social participation.

Conclusion: A nature based social skills program improved performance and satisfaction for neurodivergent children. Parent interviews revealed that intervention was perceived to enhance autonomy, agency and aptitude in children in social settings.

Background
Screen use is now integral to childhood, influencing attention, social participation, and daily occupations in children aged 6–12. Occupational therapists require an understanding of screen types, their therapeutic and non-therapeutic impacts, and evidence-based frameworks to assess digital activities and guide therapeutic decision-making, particularly across neurodivergent and rural populations.

Method
Screen use was categorised into five types: passive viewing (e.g., YouTube), interactive gaming (e.g., Minecraft), social communication (e.g., Messenger Kids), educational platforms (e.g., Google Classroom), and therapeutic tools (e.g., Neurofit). A mapping review focuses on outcomes in attention, social skills, and activities of daily living (ADLs). Evidence was mapped across categories, outcomes, and populations.

Discussion and Outcomes
Over 70 studies were reviewed, the majority addressed attention, followed by social skills, and the smallest number on ADLs. Therapeutic tools demonstrated gains in motor coordination, executive functioning, and emotional regulation. Notable gaps included social outcomes for autistic children, ADL-focused interventions, and access to equity in rural settings. A visual gap map highlighted high evidence for attention across most categories but low evidence for social and ADL impacts in therapeutic and passive contexts.

Conclusion
This mapping review offers a practical five-category framework for clinical decision-making regarding screen use in children. The framework ensures that occupational therapists can use and recommend screen-based interventions to support meaningful participation and occupational goals. The review emphasizes the importance of conducting inclusive, locally relevant research. Collaborative, co-designed studies are essential for developing inclusive, evidence-based digital interventions that support meaningful occupational participation and goals.

Introduction
Many regulation-focused programs for children overlook the relational foundations of co-regulation, prioritising child behaviour or isolated skill areas over family-centred, neurodiversity-affirming support. This presentation traces the development of a therapist-guided caregiver education program, born from identified gaps in existing frameworks: limited scope, lack of relational focus, and minimal caregiver inclusion.
Objectives
Attendees will explore how occupational therapists can lead quality improvement initiatives that centre co-regulation as a relational, occupational process. The session will unpack how caregiver capacity-building, grounded in lived experience, emotional insight, and daily routines, can transform regulation support across home and therapy contexts.
Approach
Through case reflections, therapist learnings, and caregiver feedback, presenters will share the iterative development of a program that positions co-regulation as foundational to regulation development. The session will highlight how the program evolved to fill critical gaps in current practice, integrating family-centred coaching, neurodiversity-affirming principles, and practical strategies that honour both child and caregiver needs.
Practice Implications
Participants will gain insight into the program’s design, delivery, and emerging outcomes, including increased caregiver confidence, relational attunement, and sustainable changes in family routines. The presentation will offer a replicable framework for therapists seeking to embed co-regulation into their practice through collaborative, strengths-based quality improvement.
Conclusion
This session reframes regulation support as a relational endeavour, demonstrating how co-regulation, when placed at the heart of therapeutic design, can drive meaningful, lasting change for families.