CHAPTER 7 158 through task performance[16, 17]. The cognitive strategies that are described in the PRPP-Assessment align with the information-processing model presented by Lerner[17]. Assessing cognitive strategies is not only relevant for children with limitations in cognition but could also be useful in assessing how children use cognitive strategies to cope with motor limitations or fatigue. Prior to the PRPP- assessment, the client and the therapist, and in the case of children with involvement of a parent, agree on a meaningful task to be observed and what a satisfactory level of task performance would be in their unique context (the criterion). The PRPP- Assessment can be performed in-person or via observation of parent-provided videos[15, 18, 19] which aligns well with current COVID-19 restrictions. The psychometric properties of the PRPP-Assessment have been studied in several homogenic and heterogenic target groups, for example adults and children, with and without disabilities[20, 21] children with learning difficulties[22], school- aged children[23], children with autism and intellectual disabilities[24], and adults with traumatic brain injury[25, 26, 27], Parkinson’s’ disease[28, 29], schizophrenia[30] and dementia[31, 32]. Based on these studies, psychometric properties of the PRPP-Assessment have been demonstrated to be sufficient to good. Because of the multidimensional and heterogeneous limitations in children with mitochondrial disorders, the PRPP-Assessment seems a promising tailor-made instrument to evaluate their performance in everyday activities in their own context which can enhance personalized and value-based care. However, the psychometric properties of the PRPP-Assessment in a heterogeneous group of children with physical, cognitive and communication disabilities is not known. Therefore, the objective of this study was to evaluate the internal consistency, inter- and intra-rater reliability and construct validity of the PRPP-Assessment for children with mitochondrial disorders by parent-provided videos. Methods This study used a cross-sectional design using quantitative data from standardized ratings of parent-provided videos of children who performed meaningful everyday activities. Parents provided videos of three to seven activities per child, thus 65 videos of occupational performance in total. Performance was rated with the Canadian Occupational Performance Measure (COPM) by children and parents, and the videos were rated by OTs using the PRPP-Assessment. In addition, parents and expert opinions were collected.
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