Participation as Co-Occupation Between Parents and Adult Children With Profound Intellectual and Multiple Disabilities

Adults with profound intellectual and multiple disabilities (PIMD) require high levels of assistance to participate in occupations. Otherwise, they experience low occupational engagement. This study aimed to explore how parents describe participation in occupations for their adult children with PIMD. Semi-structured interviews ( n = 9) were conducted to understand how parents described their adult children’s participation in occupations. Data were analyzed using the theory of co-occupation to identify themes and triangulate findings with the literature. Parents described participation as co-occupation in “essential” versus “non-essential” occupations. Participation in essential co-occupations emphasized shared physicality, while non-essential co-occupations focused on joint meaning (shared intentionality) and emotional responses (shared emotionality). Findings illustrate a way to conceptualize participation in essential versus non-essential co-occupations for adults with PIMD, highlight the importance of recognizing and illuminating subjective experiences of adults with PIMD, and provide a foundation for occupational therapists to increase occupational engagement within this population.