CHAPTER 10 260 The assessed activities were chosen by the child and/or parents. At baseline activity goals were set with the Goal Attainment Scaling (GAS, clinician-rated) and measured with the COPM (child- and parent-rated). A General Rating Scale (GRS, parent-rated) was taken to monitor general health. Parents videotaped the current performance of the chosen meaningful activities to be scored with the PRPP- Assessment. During 6 weeks, children and their parents (or caregivers) participated in a home-based video coaching program where parents were coached in the implementation of the training, based on the PRPP-Intervention, by pediatric OTs on a weekly basis. Training took place through online meetings and video coaching: parents videotaped their interaction with the child during task performance and the pediatric OT tailored the program with the PRPP-Intervention, to the child’s current performance. A triple-action approach was used in the intervention. Post-Intervention parents videotaped the activities for scoring with the PRPP-Assessment and the researcher conducted the GAS (clinician-rated), COPM (child- and parent-rated) and GRS (parent-rated). The PRPP-Assessment was scored by independent OTs who did not know which videos were pre- or post-intervention. Each video was scored by four OTs with a pre-set fixed procedural task analysis. Semi-structured interviews focusing on the feasibility of the intervention were conducted with children, parents, and the two treating occupational therapists, and analyzed by directed content analysis. Following guidelines of the COSMIN47-50, a priori 15 hypotheses were formulated to support responsiveness, focusing on the direction of change and the sensitivity to change between the scores on the PRPP-Assessment phase 1 and phase 2, with the COPM and GAS and the longitudinal reproducibility. Results showed that all children improved in their occupational performance, representing improvement on eight of the nine activities. Analysis of data led to acceptance of 13 out of 15 hypothesis, demonstrating sound responsiveness. Two out of three children were able to integrate the intervention fully in their daily life, the other child participated in three sessions. The content of the intervention was experienced positively and acceptable by all participants. Interviews gave insights in facilitators and concerns on demand, implementation, practicality, integration, and adaptation. It should be noted that initially more children and parents gave their consent to participate in the study. However, they resigned due to a burdened family situation. This was also a common reason to not give consent to participate. We are worried that this overburdened families are not able to utilize the children’s developmental potential. Therefore, the possibility to adapt the home-based video coaching program for children in burdened family situation should be studied.
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