CHAPTER 9 234 tackle this challenge earlier; in the education of paediatric occupational therapists. Based on our experiences within this thesis, linked student projects70, 83, and literature69, 71, 77, 81 I can formulate five recommendations to address to enhance the successful implementation of the PRPP-Assessment; 1) train OTs in the criterium- referenced thinking, 2) train OTs in scoring behaviour (next to activities), which is especially relevant for individuals with very limited functional abilities, 3) develop directives for drafting an eligible criterion, 4) enabling time for development of competence with PRPP-Assessment scoring, preferably with others, and 5) develop a tool how to guide parents in defining the criterion in respect to the child’s perspective. Several authors69, 84-86 mention the use of Knowledge Brokers and Knowledge Translation Activities as a good alternative for implementing knowledge into practice. Further research is needed to establish if these strategies can be supportive utilizing the value of the PRPP-Assessment in OT-practice and overall in person-centred care. While the PRPP-System of Task Analysis and Intervention focuses on the use of cognitive strategies in performing daily activities, it is just as worthwhile for children with physical disabilities. Children, with and without disabilities, face ‘problems’ in their everyday life, for instance when they can’t reach the counter top because they are not big enough, or when they do not know how to solve a calculation, or when they can’t do things due to their disabilities. As mentioned before, there were activities in which the criterion was set on the motor aspect of the task (for instance; being able to slice the cheese, write neatly or apply mascara without messing)38, 54. As the criterion was integrated in the procedural task analyses (stage 1) it enabled observing this motor oriented objectives. The PRPP-Assessment did not focus on the quality of the motor performance, but on the ability to manage with existing motor (dis)abilities. This fits with theory stating that the ability to generate numerous thinking strategies when a problem is presented predicts generalization87, and success in subsequent learning88. In fact, the PRPP-System of Task Analysis and Intervention is developed based on the information processing model of learning, which traces the flow of information during the learning process89. The PRPP- Intervention is a task-oriented cognitive strategy approach that simultaneously focuses on task training and strategy training within the concept of everyday performance62. The intervention targets children being able to establish a goal, keep it in mind and process information in relation to achieving the goal or use other cognitive strategies be sucessful62. The body of evidence for this PRPP-Intervention is growing90-92 and in our study using the PRPP-Intervention as a base for the home-based video coaching children improved their occupational performance54. In this study, the children did not improve their motor or cognitive function in the 6-weeks intervention, but were more able to cope with their (dis) abilities as they improved their cognitive strategy use, which resulted in better
RkJQdWJsaXNoZXIy MjY0ODMw