Effectiveness of Occupational Therapy Teleintervention in Pediatric

Canadian Occupational Performance Measure - COPM (Law et al., 2017)

Hebrew version. The COPM is a widely used valid outcome measure in rehabilitation research, designed to measure the clients' self-perceptions of their activity performance and satisfaction with performance and detect changes over time. Participants in collaboration with the parents will be asked to identify goals and then rate their performance and satisfaction with performance on a scale of 1 to 10, where 10 indicates optimal performance or satisfaction. A minimal clinically significant difference is a 2-point change on the COPM performance ratings (Law et al., 2017).

Performance Quality Rating Scale - PQRS (Miller et al., 2001)

is an observational measure of performance quality of client-selected, personally meaningful activities (therapeutic goals) originally developed for children with NDD's. The PQRS complements the COPM by assessing actual rather than perceived performances of the activities that were identified. The therapist will score each activity, using a 10-point performance rating scale between 1 (unable to perform) and 10 (performs well). The instrument is commonly used in studies involving intervention according to the CO-OP approach (Polatajko, 2017)

The Child and Adolescent Scale of Participation (CASP; Bedell, 2004).

The CASP assesses children's extent of participation and restrictions in home, school and community life situations and activities compared to same-age peers as reported by family caregivers. The CASP consist of 20 items divided into four sub-sections: (1) Home participation; (2) School participation; (3) Community participation; and (4) Home and community living activities. Each item addresses a broad participation domain with examples provided for each domain. The items are rated on a 4-point scale (4 = 'Age expected/full participation', 3 = 'Somewhat limited', 2 = 'Very limited',1 = 'Unable') or as "Not applicable". There are additional open-ended questions that identify additional supports and barriers to participation. Total scores range from 0-100, with higher scores indicating better participation. The CASP was found to be f reliable and valid, with high internal consistency (α = 0.96).

Pediatric Quality of Life Inventory (PedsQL; Varni & Limbers, 2009).

The PedsQL is used to assess health-related quality of life in children and adolescents (ages 2-18). The PedsQL consists of a 23-item in 4 domains: physical, emotional, social and school functioning. The items are rated on a 5-point scale (0 = 'Never'; 4 = 'Almost always') and linearly transformed to 0-100 scale, with higher scores indicating better health-related quality of life. The PedsQL was found to be a reliable and valid measure (high internal consistency, discriminates between groups such as children with and without a chronic condition, and responsive to change over time).

Socio-Demographic and Clinical Characteristics

Demographic and medical details will be collected from the patients' personal medical records.

Feasibility Therapist Log Book

the occupational therapists who will conduct the intervention will write field notes following each session regarding the number, durations of the meetings performed, the number and reasons for cancellations cancelations. As well as the use of the key elements of the approach to ensure the implementation of the critical components of CO-OP, as described in the fidelity checklists (McEwen et al., 2012)

Parents as Partners in Intervention- Satisfaction Questionnaire - PAPI- Q (Hirsch, Waldman-Levy and Parush, 2005)

a structured questionnaire developed in Israel designed to assess (a) parental satisfaction and involvement with occupational therapy service, for example involvement in treatment procedure, sessions attendance and general satisfaction. In the present study will ask the parents to fulfill the questionnaire following the intervention. And (b) occupational therapist following the intervention aiming to assess the levels of cooperation and involvement of the child and his family throughout the treatment process. such as their presence, participation and implementation of the guidance provided. The questioners include 17 items rank on a 1-5 Likert scale, with a higher score indicating a higher level of satisfaction. Cronbach's alpha was good (α = 0.80), suggesting that the items were inter-related and related to the scale as a whole.

Qualitative feedback interview

a short structured interview will be conducted post intervention to obtain the parents' perception of the teleCO-OP intervention program. In the feedback interview, the parents will be asked three open-ended questions regarding a) their experience with the teleCO-OP intervention in general, b) the benefits or advantages, and c) disadvantages or barriers of this treatment method.