CHAPTER 1 22 is limited to elementary school aged children. In addition, the PEDI is not a performance-based measurement, but asks parents for their opinion. An observation- based assessment would be preferable because it gives more objective information. As an alternative, James et al.67 mention the Assessment of Motor and Process Skills (AMPS)68 as the best measure for all age groups. However, occupational therapists in practice experience difficulties choosing AMPS standardized tasks that fit the preferences of the child and fit with the usual way of performing the tasks. In addition, the outcome of the AMPS is norm-referenced, which doesn’t distinguish enough within the group children with a mitochondrial disorder. The difference between norm-referenced and criterion-referenced tests is important in this case. Whereas in norm-referenced tests the outcome is measured against another group of children, for example age-referenced or diagnose-referenced, the outcome for criterion-referenced measures is dependent on a formulated criterion and not compared to others69. Therefore, the latter one seems to fit better with person- centred health-care, when the criterion is also formulated on a personal level. With this knowledge, Brink et al.70 performed a review focusing on measuring quality of occupational performance for children with mitochondrial disorder. They concluded that two assessments showed, specific for this target group, the best potential; the Short Children Occupational Profile (SCOPE)71, 72 and the Perceive, Recall, Plan, and Perform System of Task Analysis (PRPP-Assessment)73, 74. In addition, they also mentioned that the PRPP-Assessment focused the most on quality of occupational performance. Therefore, the PRPP-Assessment shows the best potential to be applied to the whole target group of children with mitochondrial disorder in measuring meaningful occupational performance. The PRPP-Assessment and its potential for using in children with a mitochondrial disorder The PRPP-Assessment is a criterion-referenced assessment, which is developed to assess the occupational performance in people with information-processing difficulties73-75. Its theoretical framework is the Occupational Performance Model (Australia) (OPM(A)) which illustrates the complex network of factors involved in human occupational performance76 (Figure 3). Prior to the PRPP-Assessment, the client and the professional, agree on which meaningful activitywill be observed andwhen they are satisfied on task performance (the criterion). A standardized task analysis is performed in Stage One of the PRPP-Assessment, in which the observed relevant occupational task is broken down into steps and errors in the performance are identified, resulting in a performance mastery score reflecting quality of occupational performance. In
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