CHAPTER 5 122 The OT mentioned that if the parents had a specific question they would like to be answered it would be good to know and then you could refer to it in your report. Also, knowing if the activity is familiar to the child will help to score the recall and plan quadrant because then you know what is expected. Summarizing the lessons learned TM led to the expression of (a lot of) meaningful activities and gave the child a voice. A facilitator was that the conversation took place in the home environment. Even with the number of cards being reduced by the parents, the conversation was still time-consuming. This should be further explored when implementing TM in daily practice. The selected activities were rightly chosen to gain insight into meaningful activities and were chosen for their level of fun and relevance to his everyday life, character and future plans. Activities represented several occupational performance areas that gave various insights. In choosing activities it is sensible to be aware of the “fit conditions”: for instance, if the current weather is suitable for performing the activity. Furthermore, activities should contain enough of a cognitive challenge for the child to make it fit for scoring with the PRPP-Assessment. For example, if a child is able to dress himself, then this activity does not contain enough challenge. However, if he struggles with tying the laces of his shoes because he does not know how to start, then the observation should focus on dressing himself and putting his shoes on. When instructing parents to make videos it should be considered which type of device influences performance the least. In this case the parents used a phone to videotape. Although Jerome was aware of being filmed, he performed and continued his activity as he was used to, according to his parents, and therefore the videotaped activity was representative for the regular performance of the activity. It was shown that the use of videos enhanced insight in real everyday life (in contrast to observation of activities in the hospital). To make video material suitable for scoring with the PRPP-Assessment the whole task should be filmed from the beginning until the end, including the assignment or appointments/rules of the activity. To use parent-provided videos, parents should be able to save the videos on a device with enough storage capacity. Furthermore, they should be able to have an easy and safe way of transferring the video to the OT. Moreover, the OT should be able to watch the video material on a suitable device. In our case study the OT was not able to give specific advice to enhance meaningful performance because she did not have enough information on the familiarity of the activity for the child or on the guiding questions and concerns from the perspective of the parents. Thus, the procedure for obtaining this information from parents should be improved for future practice.
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