PRPP-ASSESSMENT BASED ON PARENT-PROVIDED VIDEOS 147 6 PRPP-Assessment of Children with very Limited Functional Abilities Knowledge of child development. OTs were tempted to use knowledge of child development or the child’s disabilities to score phase 2 of the PRPP-Assessment. For instance, they would score inadequate behavior correct with the argument that ‘it is not expected at this age’ or ‘the child cannot do better due to their condition’. However, if it impacts the criterion set by child and parents, inadequate behavior should be scored as ineffective strategy use. It was found to be helpful to use adults as a frame of reference in scoring the PRPP-Assessment (e.g., think ‘What if an adult did this? How would I score it?’). Knowledge of interventions. Knowledge on possible interventions should not influence scoring of the PRPP-Assessment. For instance, some OTs felt that children could be better organized and therefore scored the descriptor ‘organizes’ as ineffective strategy use, while the organization did not impact the criterion. The rule of thumb is that you only score what impacts the task and criterion. It is important to be aware of the connection between phase 1 and phase 2: if the score in phase 1 is 100 percent, the score in phase 2 is also 100 percent, as there are no errors in phase 1 that need to be explained in phase 2. Behavior versus activity. In the Netherlands, OTs are not familiar with use of the PRPP-Assessment for children with very limited functional abilities. They found it difficult when a parent or caregiver provided a lot of support during the activity and the criterion focused on the behavior of the child—for example, cooperating when getting dressed. It can be helpful when scoring children that have lower abilities on a behavioral criterion to perform a task analysis of behavior in phase 1 instead of the activity—for instance ‘allows mother to lift arm’, ‘sits quietly’, ‘looks at mother’s gestures’, ‘allows mother to straighten shirt’. Discussion This study aimed to overcome implementation challenges by studying the process of gaining video material and the way OTs assessed children with the PRPP-Assessment based on parent-provided videos. Two important stages in the process were uncovered and optimized. Firstly, the process of gaining video material was optimized, which involved optimizing data collection by parents through improving instructions to parents and making the process feasible and ethically approved. Secondly, use of the PRPP-Assessment by OTs based on video material was improved. Overall, the large amount of data and experiences led to the development of a Dutch manual that can be used by OTs when implementing the PRPP-Assessment based on parent-provided videos. Subsequently, the manual could be transferred to other
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