Category: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Pediatric Rehabilitation
Measure participation in non-school occupations and utilize patient-centered goals for a school-aged pediatric population.
Criterion standard and case series. A well established tool was utilized to assist with goal-writing for school-aged children. The tool assists with establishing a participation baseline for patients since their injury. Following completion of the assessment, patients and their occupational therapist identified a client-centered goal to address during therapy.
Shirley Ryan AbilityLab DayRehab™: an intensive outpatient rehabilitation program where patients receive at least two disciplines 2-5 days weekly, receiving 2-6 hours of therapy daily.
Participants (or Animals, Specimens, Cadavers) :
Population-based sample: inclusion criteria: current patient at DayRehab™, aged 6-21 years, enrolled/planned to be enrolled in grades K-12, patient assent and parental consent. Exclusion criteria: unable to consistently and accurately answer questions.
Main Outcome Measure(s) :
Children’s Assessment of Participation and Enjoyment and the Preferences for Activities of Children (CAPE/PAC). The CAPE/PAC is an occupation-based, child-report, tool for assessing 55 non-school based activities across domains of participation, categories of recreation and leisure activities, and activity type for children with/without disabilities. The CAPE/PAC measures innate participation and not levels of assistance or equipment required for an activity.
Baseline participation scores for a sample of nine participants (n=9) was obtained between ages 6-18 years old. Patients reported low-moderate participation diversity (range 5-24/55) with low overall intensity (range 0.6-2.3/7.0). Patients primarily participated in solitary activities (range 1.9-2.8/5.0) which were home-based (range 1.0-2.5/6.0). Patients reported moderate-high enjoyment for activities in which participating (range 2.8-4.8/5.0). Patients identified preferences for a variety of occupations throughout multiple activity types. Patients selected occupation focused goals with emphasis on areas they previously enjoyed or wanted to pursue further, creating descriptive goals which identified activity preferences while remaining specific and measurable. Client-centered goals exposed patient rehabilitation priorities.
Use of the CAPE/PAC shows participation in non-school occupations through 6 domains, provides current activity preferences, and assists in establishing a participation baseline. The CAPE/PAC can be used to involve pediatric patients into their plan of care by assisting with identification of client-centered goals to be addressed.
Additional study would be beneficial for determining usage of CAPE/PAC as an outcome measure to detect changes in participation from evaluation to discharge following completion of an intensive outpatient therapy program.