RELIABILITY & VALIDITY PRPP-ASSESSMENT IN CHILDREN 161 7 one, in which an observed task is divided into relevant steps and types of errors are measured. Level of independence in performing the task can be calculated by dividing the number of error-free steps by the number of all steps of the task. Stage two of the PRPP-Assessment uses a cognitive task analysis and incorporates 35 items divided into the subscales of the PRPP-Assessment, which connects to a specific conceptual stage of information processing (see figure 1). The 35 strategies include attention and sensory perception (Perceive Quadrant), memory (Recall Quadrant), response planning and evaluation (Plan Quadrant), and performance monitoring (Perform Quadrant). Each cognitive strategy is criterion-referenced and evaluated on a three-point scale indicating how effectively the child used that cognitive strategy (score 1 for ineffective use, score 2 for questionable use or slow use, and score 3 for effective use); resulting in a total score between 35 and 105 (higher scores indicate more effective cognitive strategy application), as well as a PRPP-Assessment quadrant score (max 24 for performance quadrant or max 27 for other quadrants). To illustrate, table 2 provides an example of a selected task with the criterion and the scoring of the observed performance based on each quadrant and for that PRPP-Assessment item. All scores can be transferred to percentages using the equation: number of points scored divided by the total number of points possible.[34, 35] In this study, the Dutch version of the PRPP-Assessment was used with scoring criteria according the PRPP-Assessment manual, that is instructed in the five-day PRPP-Assessment course for occupational therapists[36]. The PRPP-Assessment was administered based on video-material provided by the parents. The process of gaining eligible parent-provided video-material and standardized scoring of video-material has been previously studied[18]. Canadian Occupational Performance Measure (COPM) The COPM[37] is a reliable and valid instrument for measuring the perceived quality of occupational performance and level of satisfaction[38]. The COPM was rated by parents and if possible, separately by the child. For the children, the child version of the COPM was used [39]. In this study, the videotaped activities were assessed with a short version of the COPM. Both versions score activities on importance, performance, and satisfaction on a scale ranging from 1 to 10. Initially, it was planned to score these three domains for each activity. However, the level of parental burden due to COVID-19 and associated additional caring responsibilities required a change in the data collection, and resulted in the focus on scoring performance ratings only.
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