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Öhrvall AM, Hofgren C, Lindquist B, Bergqvist L, Himmelmann K, Opheim A, Sjöwall D, Brock K, Peny-Dahlstrand M. Intervention with the CO-OP Approach leads to a transfer effect over time to untrained goals for children with cerebral palsy or spina bifida. Disabil Rehabil 2024; 46:2512-2521. [PMID: 37353883 DOI: 10.1080/09638288.2023.2225875] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 06/09/2023] [Indexed: 06/25/2023]
Abstract
PURPOSE This study aims to investigate whether the treatment effects, in terms of goal attainment, transfer effects and impact on executive functions, of an intervention in children with cerebral palsy or spina bifida using the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach are maintained over time, from immediately after the intervention to three months afterwards. METHOD A three-month follow-up study, from an intervention using CO-OP. Thirty-four children (7-16 years) each identified four goals (one untrained to examine transfer) and participated in an eleven-session intervention. Assessments were performed at baseline, immediately after the intervention and at a three-month follow-up using the Canadian Occupational Performance Measure and the Performance Quality Rating Scale. Executive function and self-rated competence were assessed at the same timepoints. RESULTS Statistically significant and clinically relevant improvements in goal achievement were demonstrated for both trained and untrained goals after the intervention and were maintained at follow-up. The clinically relevant improvement in untrained goals continued to increase until follow-up. Self-rated competence increased after the intervention and was maintained at follow-up. CONCLUSION The CO-OP intervention was effective in achieving and maintaining the children's own goals over time. The transfer effect was confirmed by higher goal attainment for the untrained goals.
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Affiliation(s)
- Ann-Marie Öhrvall
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Caisa Hofgren
- Region Västra Götaland, Habilitation & Health, Gothenburg, Sweden
- Department of Rehabilitation Medicine, Institute of Neuroscience and Physiology Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Barbro Lindquist
- Department of Habilitation, Halmstad County Hospital, Halmstad, Sweden
| | - Lena Bergqvist
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Occupational Therapy Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kate Himmelmann
- Region Västra Götaland, Sahlgrenska University Hospital, Queen Silvia Children's Hospital, Regional Rehabilitation Centre, Gothenburg, Sweden
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Arve Opheim
- Region Västra Götaland, Habilitation & Health, Gothenburg, Sweden
| | - Douglas Sjöwall
- Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Karolinska Institutet, Stockholm, Sweden
- Habilitation and Health, Region Stockholm, Sweden
| | - Katarina Brock
- The Sachsska, Children's and Adolescents' clinic, assessment team Nacka, Sweden
| | - Marie Peny-Dahlstrand
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Occupational Therapy Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Queen Silvia Children's Hospital, Regional Rehabilitation Centre, Gothenburg, Sweden
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Ryan AK, Miller L, Rose TA, Johnston LM. Child-led goal setting and evaluation tools for children with a disability: A scoping review. Dev Med Child Neurol 2024. [PMID: 38760984 DOI: 10.1111/dmcn.15959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/25/2024] [Accepted: 04/22/2024] [Indexed: 05/20/2024]
Abstract
AIM To examine child-led goal setting and evaluation tools and approaches for children with a disability or developmental delay. METHOD Six databases were searched for studies that included population (children aged less than 18 years with disability or developmental delay); construct (child-led goal setting tool or approach); and context (developmental therapy or rehabilitation). The utility of tools and approaches across the goal setting and evaluation process was investigated using abductive content analysis. RESULTS Fifty articles met the inclusion criteria. Three approaches and four tools for child-led goal setting and evaluation were identified. No studies reported the clinimetric properties of tools specifically for child self-respondents. Qualitative analysis revealed six distinct goal phases in which tools and approaches were used, which were synthesized into a new framework for child-led goal setting and evaluation titled DECIDE: Direct children to goal setting; Elicit goal topics and priorities; Construct a goal statement; Indicate baseline goal performance; Develop an action plan to address the goal; and Evaluate goal progress after the intervention. INTERPRETATION Children actively participated in goal setting and evaluation across six DECIDE goal phases. Further clinimetric information is required to support use of goal setting and evaluation tools with child self-respondents. Future research should emphasize the development of multi-phase goal setting tools and approaches for diverse populations of children.
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Affiliation(s)
- Aisling K Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Laura Miller
- School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Children's Health Queensland Hospital and Health Services, Brisbane, Queensland, Australia
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Curtin M, Wakefield T, Herman R, Morgan G, Cruice M. "It doesn't matter if we're the most amazing professionals in the world…" A qualitative study of professionals' perspectives on parent-child interaction assessment with deaf infants. Front Psychol 2024; 15:1315220. [PMID: 38500650 PMCID: PMC10944883 DOI: 10.3389/fpsyg.2024.1315220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction Parent child interaction (PCI) is positively associated with deaf children's language development. However, there are no known, deaf-specific tools to observe how a parent interacts with their deaf child aged 0-3 years. Without a framework for professionals to use with families, it is unknown how professionals assess PCI, what they assess, why they assess, and how the assessment results relate to case management. Methods Eighteen hearing and deaf professionals, who work with deaf and hard of hearing infants aged 0-3 years and their families, attended online focus groups. The aim of the study was to gain insight into the professional assessment of PCI. Data were analyzed using thematic analysis. Findings Six themes were generated from the dataset. Professionals discussed how central parents were in the support offered to families in the home, the importance of knowing and understanding the individual family, and accounting for and supporting parental wellbeing. Descriptions on how to administer a best practice PCI assessment included which parent behaviors to assess and how to make adaptations for different populations. Professionals shared how the assessment and review process could be used to inform and upskill parents through video reflection and goal setting. Discussion This study provides insight into the mechanisms and motivations for professionals assessing the interactive behaviors of parents who have deaf children aged 0-3. Professionals acknowledged that family life is multi-faceted, and that support is most meaningful to families when professionals worked with these differences and incorporated them into assessment, goal setting, and intervention plans.
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Affiliation(s)
- Martina Curtin
- Speech and Language Therapy, Homerton Healthcare NHS Foundation Trust, London, United Kingdom
- Language and Communication Science, City, University of London, London, United Kingdom
| | - Tina Wakefield
- National Deaf Children’s Society, London, United Kingdom
| | - Rosalind Herman
- Language and Communication Science, City, University of London, London, United Kingdom
| | - Gary Morgan
- Universitat Oberta de Catalunya, Psychology and Education Sciences, Barcelona, Spain
| | - Madeline Cruice
- Language and Communication Science, City, University of London, London, United Kingdom
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Perinatal stroke: mapping and modulating developmental plasticity. Nat Rev Neurol 2021; 17:415-432. [PMID: 34127850 DOI: 10.1038/s41582-021-00503-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 02/04/2023]
Abstract
Most cases of hemiparetic cerebral palsy are caused by perinatal stroke, resulting in lifelong disability for millions of people. However, our understanding of how the motor system develops following such early unilateral brain injury is increasing. Tools such as neuroimaging and brain stimulation are generating informed maps of the unique motor networks that emerge following perinatal stroke. As a focal injury of defined timing in an otherwise healthy brain, perinatal stroke represents an ideal human model of developmental plasticity. Here, we provide an introduction to perinatal stroke epidemiology and outcomes, before reviewing models of developmental plasticity after perinatal stroke. We then examine existing therapeutic approaches, including constraint, bimanual and other occupational therapies, and their potential synergy with non-invasive neurostimulation. We end by discussing the promise of exciting new therapies, including novel neurostimulation, brain-computer interfaces and robotics, all focused on improving outcomes after perinatal stroke.
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Metzler MJ, Haspels E, Brunton L, Andersen J, Pritchard L, Herrero M, Hodge J, Kirton A. Goals of children with unilateral cerebral palsy in a brain stimulation arm rehabilitation trial. Dev Med Child Neurol 2021; 63:584-591. [PMID: 33368181 DOI: 10.1111/dmcn.14763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 01/10/2023]
Abstract
AIM To explore relationships between category classifications for children's rehabilitation goals, outcomes, and participant characteristics. METHOD Children with hemiparetic cerebral palsy due to perinatal stroke rated self-selected goals with the Canadian Occupational Performance Measure (COPM) and completed the Assisting Hand Assessment (AHA) and Box and Block Test (BBT), at baseline and 6 months, in a randomized, controlled 10-day neuromodulation rehabilitation trial using repetitive transcranial magnetic stimulation. Goals were classified with the Canadian Model of Occupational Performance and Engagement and the International Classification of Functioning, Disability and Health. Analysis included standard linear regression. RESULTS Data for 45 participants (mean age 11y 7mo, SD 3y 10mo, range 6-19y, 29 males, 16 females) on 186 goals were included. Self-care goal percentage corresponded with baseline BBT by age (standardized ß=-0.561, p=0.004). Leisure goal percentage corresponded with baseline BBT (standardized ß=0.419, p=0.010). AHA change corresponded with productivity goals (standardized ß=0.327, p=0.029) and age (standardized ß=0.481, p=0.002). COPM change corresponded with baseline COPM and age by AHA change (p<0.05). INTERPRETATION Younger children with lower motor function were more likely to select self-care goals while those with better function tended to select leisure goals. Functional improvement corresponded with older age and productivity goals. COPM change scores reflected functional improvement among older children. Children chose functionally and developmentally appropriate goals. Consequently, children should be free to set goals that matter to them. WHAT THIS PAPER ADDS Children in a brain stimulation trial chose divergent upper extremity functional goals. Younger children with lower ability chose more self-care goals. Children with higher ability chose more leisure goals. Older children's goal ratings reflected objective functional motor gains. Children chose goals appropriate to their function and level of development.
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Affiliation(s)
- Megan J Metzler
- Department of Clinical Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Eva Haspels
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Faculty of Science, University of Amsterdam, Amsterdam, the Netherlands
| | - Laura Brunton
- School of Physical Therapy, Western University, London, ON, Canada
| | - John Andersen
- Child Health, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada.,Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Lesley Pritchard
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Mia Herrero
- Department of Clinical Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada
| | - Jacquie Hodge
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Adam Kirton
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Calgary Pediatric Stroke Program, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Clinical Neuroscience, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada
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Verkerk GJ, van der Molen-Meulmeester L, Alsem MW. How children and their parents value using the Canadian Occupational Performance Measure (COPM) with children themselves. J Pediatr Rehabil Med 2021; 14:7-17. [PMID: 33104046 PMCID: PMC8075379 DOI: 10.3233/prm-190604] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Although the Canadian Occupational Performance Measure (COPM) is used with children, it is unclear how they and their parents experience this. This study aims to investigate the opinions of children and their parents about the COPM when it is used with children. METHODS Semi-structured interviews were performed with 23 children varying in age between 8 and 18 years. The transcripts of the interviews were analysed using MAXQDA software to discover overarching themes. Parents' responses to an eight-item multiple-choice questionnaire were analysed using SPSS software. RESULTS Five themes extracted from the interviews with the children show: My way of doing the COPM; The COPM shows my own problems and wishes for change; The COPM is important for identifying the support I need; The influence of my parents and my therapist; and The COPM is suitable for me. The children experienced the COPM as a valuable tool for determining and measuring the impact of an intervention. The parents experienced the COPM as suitable for their child and judged that the child's scores were useful for showing the outcome of an intervention. CONCLUSION Both the children and their parents valued the COPM as an outcome measure for intervention.
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Affiliation(s)
- Gijs J.Q. Verkerk
- Corresponding author: Gijs J.Q. Verkerk, Department of Rehabilitation, A-01-414, Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Tel.: +31 20 5663345; Fax: +31 20 5669154; E-mail:
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Yu Y, Yang L, Sun Y, Jin C, Zhang Y. Intervention on Externalizing Problems of Undercontrolled Personality Types in Primary School Students. Front Psychol 2020; 11:1233. [PMID: 32714227 PMCID: PMC7344270 DOI: 10.3389/fpsyg.2020.01233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 05/12/2020] [Indexed: 11/25/2022] Open
Abstract
Three personality types (resilient, overcontrolled, and undercontrolled) have been repeatedly verified across different languages and cultures, different personality models, and different stages of development. Undercontrollers are socially maladapted types with high impulsivity and low self-control. Research shows they are at risk for externalizing problems, such as aggressiveness, impulsivity, and antisocial behavior. The aim of this study was to develop an intervention to reduce externalizing problems of undercontrolled personality types in primary school students. Participants were 69 undercontrolled primary school students from two primary schools in North China. The experimental group underwent 14 weeks of systematic experiential mental health activities, while the control group performed typical daily classroom activities. Personality and externalizing problem behaviors were measured before the intervention, at the end of the intervention, and 4 months post-intervention. The results showed that the intervention significantly reduced the level of externalizing problems of undercontrolled primary school students. The effects of the intervention were maintained at the 4-month follow-up. This study provides some reference and suggestions on how to intervene in the externalizing problem behaviors of undercontrolled primary school students.
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Affiliation(s)
- Yongjin Yu
- School of Philosophy and Sociology, Jilin University, Changchun, China
| | - Lizhu Yang
- College of Psychology, Liaoning Normal University, Dalian, China
| | - Yan Sun
- College of Psychology, Liaoning Normal University, Dalian, China
| | | | - Ying Zhang
- Shidao Street Primary School, Dalian, China
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Pritchard L, Phelan S, McKillop A, Andersen J. Child, parent, and clinician experiences with a child-driven goal setting approach in paediatric rehabilitation. Disabil Rehabil 2020; 44:1042-1049. [PMID: 32650674 DOI: 10.1080/09638288.2020.1788178] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To explore child, parent, and clinician experiences with a child-driven approach to rehabilitation goal setting. METHODS Nine children receiving inpatient and outpatient rehabilitation aged 5.0-12.3 years (x¯ = 8.3, SD = 2.3; 5 females) and their parents (n = 9) participated in a goal setting process intended to maximize child engagement with their physical or occupational therapist. Qualitative interviews were conducted with children (n = 7), their parents (n = 9), occupational therapists (n = 2), a nurse practitioner and a physician to explore their experience with the child-driven approach to goal setting. RESULTS Three themes that reflect child, parent, and clinician experience with a child-driven approach to goal setting were identified: (1) children have voice and insight, (2) child identified goals are rewarding and motivating for children, and (3) we are a team: goal setting as a co-constructed process. CONCLUSIONS Engagement in goal setting resulted in the identification of functional goals that were perceived as motivating for children. Children described feeling valued and heard. Parents and clinicians recognized they had previously underestimated the capacity of children to identify their own goals. Parents wanted input from therapists, particularly related to shaping their goals to focus on shorter-term outcomes. Relational autonomy, which emphasizes the social and relational aspects of decision-making, may be more useful than traditional, individualistic views of autonomy for conceptualizing clinician roles in collaborative goal setting.IMPLICATIONS FOR REHABILITATIONChildren are often not optimally involved in setting their own rehabilitation goals.In this qualitative study, we report that children, parents, and clinicians recognized the value of optimizing child engagement in goal setting including children feeling heard, valued and more motivated to participate in therapy.Parents expressed a need for a collaborative approach to goal setting that respects child, parent, and clinician input.Relational autonomy may be a useful framework for reframing the role of clinicians in collaborative goal setting processes.
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Affiliation(s)
- Lesley Pritchard
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - Shanon Phelan
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, Canada
| | - Ashley McKillop
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - John Andersen
- Department of Pediatrics, University of Alberta, Edmonton, Canada.,Glenrose Rehabilitation Hospital, Edmonton, Canada
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Löwing K, Holmström L, Almeida R, Eliasson AC. Do Infants at Risk of Developing Cerebral Palsy or Other Neurodevelopmental Disorders Learn What They Practice? J Clin Med 2020; 9:jcm9072041. [PMID: 32610634 PMCID: PMC7409007 DOI: 10.3390/jcm9072041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 12/04/2022] Open
Abstract
Through secondary analyses of the Small Step. Randomized Control Trial, we tested the hypothesis that children at risk of developing cerebral palsy (CP) or other neurodevelopmental disorders would learn what they practice, i.e., that they would have a more rapid development within the specifically trained foci (hand use or mobility) of each time period compared to the development rate within the foci not trained at that time. Nineteen infants (6.3 (1.62) months corrected age) included in the Small Step program were assessed at six time points during the intervention. For statistical analysis, general and mixed linear models were used, and the independent variables were the Peabody Developmental Motor scale (stationary, locomotion, grasping and visuomotor sub scales), the Gross Motor Function Measure-66 and the Hand Assessment for Infants. Outcomes related to gross motor function improved significantly more after mobility training than after hand use training, while fine motor function was improved to the same extent following both training types. Significantly higher improvements after the first training period were seen in one out of three outcome measures in both gross and fine motor assessments. The improvements observed were all independent of diagnosis at two years. The concept “you learn what you practice” was most clearly confirmed in the case of gross motor development.
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Affiliation(s)
- Kristina Löwing
- Neuropediatric Unit, Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 76 Stockholm, Sweden; (K.L.); (L.H.)
| | - Linda Holmström
- Neuropediatric Unit, Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 76 Stockholm, Sweden; (K.L.); (L.H.)
| | - Rita Almeida
- Stockholm University Brain Imaging Center (SUBIC), Stockholm University, SE-106 91 Stockholm, Sweden;
| | - Ann-Christin Eliasson
- Neuropediatric Unit, Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 76 Stockholm, Sweden; (K.L.); (L.H.)
- Correspondence: ; Tel.: +46702538648
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Dehghanizadeh M, Khalafbeigi M, Akbarfahimi M, Yazdani F, Zareiyan A. Exploring the contributing factors that influence the volition of adolescents with cerebral palsy: A directed content analysis. Scand J Occup Ther 2020; 28:553-563. [PMID: 32089013 DOI: 10.1080/11038128.2020.1723686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Communication, behavioural disturbances and low motivation influence the functional potential and the effectiveness of interventions in adolescents with cerebral palsy (CP). While the model of human occupation (MOHO) is a conceptual model in occupational therapy, no research on the volition of adolescents with CP in daily activities has been undertaken. AIM To explore the elements contributing to the volition of adolescents with CP based on their own experience. METHODS A qualitative approach using directed content analysis with volition of MOHO as a framework was applied. Semi-structured in-depth interviews were carried out with five adolescents with CP and five parents of the same adolescents. RESULTS In this study primary codes were categorized into eight categories: family and community-related values, individual values, individual perceptions of ability level, sense of control over conditions, enjoying performing activities, enjoying interpersonal relationships, physical context features and social context features. CONCLUSIONS Personal causation in interaction with environmental features is strongly influenced by adolescents' motivation. SIGNIFICANCE Occupational therapists could improve the motivation of adolescents with CP in interaction with the individual's volition with focussing on self-efficacy for promoting personal causation. Adapting to the physical environment and changing the attitudes of others to these adolescents is necessary.
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Affiliation(s)
- Moslem Dehghanizadeh
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Khalafbeigi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Malahat Akbarfahimi
- Department of Occupational Therapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Yazdani
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Armin Zareiyan
- Department of Public Health Nursing, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
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Interrater Reliability of Activity Questionnaires After an Intensive Motor-Skill Learning Intervention for Children With Cerebral Palsy. Arch Phys Med Rehabil 2019; 100:1655-1662. [PMID: 30790557 DOI: 10.1016/j.apmr.2018.12.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/07/2018] [Accepted: 12/17/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the reliability of parents-reported activity questionnaires after a motor-skill learning intervention for children with cerebral palsy (CP). We hypothesize that the intervention process might influence parental judgment. DESIGN Double-blind randomized trial. SETTING Conventional therapy was delivered in the usual context while intensive intervention was provided at the Catholic University of Louvain. PARTICIPANTS Children with CP (N=41; age range 5-18y, Gross Motor Function Classification System I-IV) were randomized to a control group (CG) (n=21, 2 dropouts) receiving conventional therapy or an intervention group (IG) (n=20) receiving hand-arm bimanual intensive therapy-including lower extremities (HABIT-ILE). INTERVENTIONS Conventional therapy (mostly neurodevelopmental) was delivered as ongoing treatment (1-5 times/wk). HABIT-ILE, based on motor-skill learning, was delivered over 2 weeks. All children were assessed at T1 (baseline), T2 (3wk after baseline) and T3 (4mo after baseline). MAIN OUTCOMES MEASURES ABILHAND-Kids and ACTIVLIM-CP questionnaires rated by parents (perception) and 2 examiners (videotapes). RESULTS Agreement (level/range) between examiners was systematically almost perfect (P≤.001). At baseline, moderate to almost perfect agreement (level/range) was observed between parents and examiners (P≤.001). At T2 and T3, a similar agreement (level/range) was observed for the CG. For the IG, a similar level of agreement was observed, but the range of agreement varied from poor to almost perfect (P≤.001), with parents estimating higher performance measures compared to examiners after intervention. Higher performance was associated with higher satisfaction scores of the child's functional goals at T3. CONCLUSION Parents and examiners have a similar perception of the child's performance at baseline and during conventional therapy. Their perceptions are less congruent after a motor-skill learning intervention, probably due to the goal-oriented process of the intervention. Therefore, our results favor the use of blind observations of home-videotaped items after intensive motor-skill learning interventions.
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