PRPP-ASSESSMENT TO MEASURE CHANGE 201 8 The PRPP-Assessment incorporates a task analysis procedure in Stage 1, in which an observed task is divided into relevant steps and types of errors are measured. The mastery score (in this article, referred to as PRPP-M) of the task can be calculated by dividing the number of error-free steps by the total number of steps in the task. This gives a score for the level of the assessed activity: how well the child can perform this activity according to the criterion set beforehand. Stage 2 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 2). 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; this results in a total score of 35–105 (higher scores indicate more effective cognitive strategy application). Here, we refer to this Stage 2 sum score as PRPP-S32, 39. In this study, the Dutch version of the PRPP-Assessment was used, with scoring criteria according to the PRPP-Assessment manual used in the five-day PRPP- Assessment course for OTs40. Other measurements The COPM37 is a reliable, valid and responsive instrument for measuring the perceived quality of performance and level of satisfaction41-43 in which a 2-point difference (at the 10-point scale) indicates a clinically relevant change37, 42, 44. For analysis, the COPM-Performance (COPM-P) is used because this measures the same construct (activity performance) as Stage 1 of the PRPP-Assessment but subjectively, from a patient perspective. The GAS is an individualized, criterion-referenced measure of change on individual goals45-47 that uses a scale from -3 (deterioration) to +2 (progress two steps beyond the goal). The GAS measures the same construct (activity-performance) as Stage 1 of the PRPP-Assessment. The GRS is reliable for measuring change in a child’s overall health status12, 48 . The question, ‘How is your child’s general health currently?’, was scored on a 10-point scale, with higher scores indicating better health. Analysis Following the COSMIN guidelines33, 49-51, 15 hypotheses (presented in table 1) were formulated a priori to support responsiveness. An acceptance of 75% of the
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