CHAPTER 9 228 impossible to learn to adapt your communication to a child, when the child is ‘acted’ by a peer. Therefore, practicewith ‘real’ childrenwithdifferent communication levels is necessary. In addition, learning by doing requires not only ‘real live’ practice, but also a good reflection on the ‘effectiveness’ or appropriateness of the used skills and techniques to the specific child and context. For this purpose, the use of self- and peer-assessment is considered effective34, 35 and this can be used with the framework presented in chapter 5 as guideline. However, it is known that for deep and sustainable learning, they need to create their own decision algorithm31. This can be reached by 1) collecting information on the framework in chapter five, 2) apply this framework in practice, 3) reflect on that experience and edit the framework by using their experiences, and 4) apply this new decision algorithm in practice. We have experienced that for the third step of reflection using video material was valuable. The reflection focused on the effectiveness of communication in uncovering the child’s perspective. Reflecting on that video material from different professional perspectives made it even more precious than solely the occupational therapy perspective, which is in line with knowledge on the power of reflection on video material of actual performance36, 37, and with knowledge that learning together with others facilitates learning of the individual30, 33. Therefore, it could be of great value to develop an interprofessional allied health care module on communicating with children with gaining experience with children in ‘actual’ practice and reflecting on video material of that practice from an interprofessional perspective. Children with mitochondrial disorder: do we focus on the disease or the developmental potential? One of the occasions to start this thesis, was the search for an universally applicable outcome measure for children with a mitochondrial disorder. The PRPP-Assessment seemed to be such an instrument to evaluate occupational performance in this heterogenous target group. Strikingly enough, in the reliability and validity study of the PRPP-Assessment based on parent-provided videos, we noticed that overall the children with mitochondrial disorder scored relatively high on their quality of performance38. Most children were able to state the desired quality of performance that could be used for the criterion; for instance, ‘I don’t want my earrings to drop so many times’ or ‘I hate it when I mess with my soup’. However, when parents were asked on their criterion for an activity focusing on the quality of performance, several parents stated ‘I don’t have expectations’. The common view among parents could be summarized as ‘I am happy with everything the child is able to do’. Yet, doesn’t every child have developmental potential? And does this mean that the children are underestimated or is there just a difference in paradigms?
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