CHAPTER 10 262 heterogeneous groups can be even more beneficial to homogenic groups as it increases the external validity. This should be translated to the data-collection methods. Therefore, for future research I recommend to use a customized approach with justice to internal and external validity. In the discussion is pointed out what factors determine the high value of the PRPP-Assessment to evaluate occupational performance in children. I reflected on difficulties with the implementation of the PRPP-Assessment in practice and I acknowledged challenges that hinder utilizing the value of the PRPP-Assessment. In our studies, the most profound challenge was the deviation from norm-referenced or impairment-focused thinking to a criterium-referenced approach, and the necessity to have a clear criterion in conducting this approach. I gave four recommendations for enhancing implementation of the PRPP-Assessment in practice with the possibility of using Knowledge Translation models for support. As the PRPP-Intervention, integrated in a triple action approach home based video coaching program, was out of the scope of this thesis, but showed potential, I give specific recommendations for further research based on available data of the current thesis. Finally, I discussed the advantages of care-at-distance for OT-practice as it can contribute to ecological valid assessments and occupation- and context based interventions that are in potential more effective then interventions within hospital settings. However, several challenges are acknowledged in which the parental burden should receive the most attention when implementing care-at-distance. I suggest that future policies and research should focus on the feasibility of home-based intervention in paediatric OT-practice . Based on our results I summarize some future directions in three areas: 1) recommendations for practice and research to improve quality of person-centred care, 2) recommendations for practice and research to facilitate further implementation of and research on the PRPP-System of Task Analysis and Intervention, and 3) recommendations to improve Occupational Therapy education.
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