The Engaged Child in Occupational Therapy.

Background.: Achieving optimal outcomes for children in occupational therapy settings is influenced, in part, by their engagement. The nature of child engagement from the occupational therapy perspective remains relatively unexplored.

Method.: A qualitative research methodology was adopted, using an interpretive description approach. Thirty-two occupational therapists participated in five focus groups and six individual interviews that were thematically analyzed.

Findings.: Four themes emerged from the data: (i) signs of child engagement and disengagement; (ii) it's about the child feeling safe; (iii) a sense of meaning and purpose; and (iv) service and therapist factors influencing child engagement.

Implications.: Helping the child feel safe; providing meaningful experiences; and being flexible and responsive were key means of connecting with, and supporting, child engagement. Strategies occupational therapists reportedly used to engage the child aligned with the tenets of self-determination theory (autonomy, relatedness, and competence).