“Doing together”: Mothers use co-occupation to scaffold the occupational engagement of their children with fetal alcohol spectrum disorder

ABSTRACT South Africa has the highest reported prevalence of fetal alcohol spectrum disorder (FASD) worldwide. This paper describes the contribution mothers make to engage their children with FASD in occupations through ‘doing together’. It draws on the findings of a qualitative descriptive study to provide an understanding of the diverse ways in which mothers used co-occupation to facilitate the occupational engagement of their children with FASD. Nine mothers were purposively and incrementally sampled in line with the sampling principle of maximum variation. Semi-structured and photo elicitation interviews (PEI) were used to gain descriptions of the ways that mothers scaffolded their children’s participation during occupations they did together. Data were transcribed verbatim and inductively analysed. The theme ‘Doing together’ captured the primary way in which mothers fostered opportunities for their children to engage in and develop their participation in occupations. Nested in the theme were five categories, each describing particular ways of scaffolding during co-occupation: casual inclusion, flexible expectations, grading support, maximising opportunities and involving others. The findings revealed that mothers continued to invest in fostering occupational engagement, even when their children became adults. The specific scaffolding strategies these mothers used are discussed in relation to occupational scaffolding and co-occupation literature, highlighting the dynamics of person-context relations in an underdeveloped rural community. Study findings reveal mothers expertise in supporting the development of their children as occupational beings.