CHAPTER 8 204 able to implement the intervention scheme of six sessions and practiced the activities weekly. Xandra’s mother videotaped the activities during the intervention and the OT gave specific instructions on how to improve guidance for the activities, which enabled Xandra to learn. Xandra improved on all three activities measured with the PRPP-Assessment, the parent-rated COPM-P and the GAS. The GRS was stable. Yara Yara is an adolescent girl who is extremely delayed in cognitive development and has ataxia. She is able to walk in and around the house and uses a wheelchair for long distances but is sufficiently self-dependent. Despite minor speech problems, she is effective in communication. Yara chose her own activities to work on, which were applying make-up, putting in earrings and tying shoelaces. Yara was videotaped on each activity once in the waiting period. During the intervention period, Yara practiced the activities with her personal caregiver (who is a volunteer and supports Yara in her activities) and both were able to live up to the intervention scheme. After six sessions, she improved on all three activities measured with the PRPP-Assessment, the parent- and child-rated COPM-P and the GAS. The GRS was stable. Zach Zach is a boy of school age with an average cognitive development. He is delayed in motor development but able to walk in and around the house. He is effective in communication and is sufficiently self-dependent. Zach chose his own activities to work on, which were tying shoelaces, drawing a dinosaur and modeling his hair. Mother and Zach videotaped each activity once in the waiting period. During the intervention period, mother and Zach were not able to integrate the intervention scheme within their daily lives. They had difficulty establishing a video connection with the therapist and after three partially successful connections they decided to stop the intervention. They did practice modeling hair and tying shoelaces a few times, but drawing a dinosaur was not practiced. Zach reported that he felt more tired during and after the intervention period than before the intervention. His GRS post-intervention dropped by 1 point (from 8 to 7). Post-intervention measurement showed that Zach improved on tying shoelaces and modeling hair measured with the PRPP-Assessment, the parent-rated COPM-P and the GAS, but not on the child-rated COPM-P. He stayed stable on the PRPP-Assessment for drawing a dinosaur but the child- and parent-rated COPM-P and the GAS improved by 1 point.
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