INSIGHT INTO DAILY ACTIVITIES OF CHILD WITH MULTIPLE DISABILITIES 123 5 Discussion This case study explores whether the combined use of TM and the PRPP-Assessment of parent-provided videos is feasible to gain insight into which everyday activities are meaningful for children with multiple disabilities and to analyze their level of functioning in these meaningful activities in the daily environment. Findings show that the combination of both instruments gave insight into the child’s everyday functioning in the meaningful activities expressed by the child, despite his communication problems. This made goal-setting on performing these meaningful activities in their daily living environment based on both TM and PRPP-Assessment possible. Lessons learned focused on the conditions to facilitate the use of TM in everyday practice, the considerations when selecting the activities to observe, the considerations of taping, storing and transferring video material of children’s everyday activities by parents and the challenges of scoring the video material. The use of TM in this case study was experienced positively by the child, the parents and the OT. TM gave more structure to the conversation and helped Jerome to elaborate on the activities. This is congruent with the review of Stans et al. (2019): it facilitates communication, which involves facilitating expression (opinions, thoughts, feelings), interaction and thinking and understanding. However, they state that one study ( Hallberg, Mellgren, Hartelius, & Ferm, 2013) found that TM was experienced as time-consuming. This was confirmed by the OT for daily practice in our study, who proposed limiting the selection of activity cards; however, this could lead to bias. Although TM can be time-consuming, no better option is available yet for childrenwith limited communication and cognitive abilities to determinemeaningful activities from the child’s perspective. Therefore, it is suggested that an overview of all the TM activity cards be sent to parents so that they can select the activities that are known by the child. In this case report, the PRPP-Assessment was considered to be ecologically valid by the parents and the OT and both experienced added value for insight into the quality of performance of everyday activities. However, challenges were discovered when conducting the PRPP-Assessment by parent-provided videos. Although some of these challenges are part of the PRPP guidelines, they could be emphasized or specified more in the instructions for parents when using video material. The first administration step of the PRPP-Assessment is that tasks should be essential to role performance and difficult for the client (i.e., present qualitative difficulties in performance from the perspective of the client and/or others) (Chapparo & Ranka, 1996, 2008). This was recognized in this case, although the OT emphasized that the challenge should be in the cognitive part of the task in particular because the PRPP
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