Child Occupational Self-Assessment Research Articles

Effects of Ball-Vests for Children Exhibiting Sensory Seeking Behaviour: A Pragmatic Randomized Controlled Trial

ABSTRACT Children with challenges processing sensory information can have difficulties affecting their ability to participate in school activities, which may affect their potential for learning. The aim of this study was to examine the possible effects of an intervention with three weeks use of ball-vests that provide proprioceptive-tactile stimulation for children exhibiting sensory seeking behaviour. Methods: The study was a pragmatic randomized controlled trial that included 142 children (105 boys and 37 girls, mean age 8.9 years) with dysfunction in sensory processing and sensory seeking behaviour. The children´s ability for attention was measured with the “Test of Everyday Attention-Children” (TEA-Ch), their occupational competence in school activities with the “Child Occupational Self-Assessment” (COSA) and the extent of off-task behaviour with the “Observational off-task Behavior among School-children” (OBS-Children). Data was analysed using linear mixed model regression. Results: Children in the intervention group had a significantly larger increase in self-assessed occupational competence than children in the control group (B = 5.78, p = 0.004). No differences regarding attention or extent of off-task behaviour between intervention and control group were found. Trial registration: ClinicalTrials.gov identifier: NCT04173871..

Preliminary mixed-methods investigation: Impact and acceptability of a combined life skills and adventure therapy program for adolescents.

Meaningful occupational therapy interventions for neurodivergent, transition-age adolescents are understudied, and novel intervention approaches that are motivating to this population are needed. Accordingly, in this study we explored the acceptability and impact of a combined life skills/adventure therapy (LS/AT) intervention program for addressing self-identified goals for adolescents with regulation- and sensory-based challenges. We used a convergent mixed-methods design. All adolescents accepted into the intervention program were invited to participate. We described our sample using data from the Child Occupational Self-Assessment. Participants created and rated goals through a modified Canadian Occupational Performance Measure interview before intervention, after intervention and 3 months post-intervention and participated in semi-structured interviews pre- and post-intervention. We calculated COPM change scores, analysed qualitative interview data, and integrated findings into a joint display for interpretation following recommended procedures for mixed-methods data. Ten adolescents consented to participate (n = 6 males, n = 4 females; mean age 13.92 years, SD = 0.54). Mean COPM performance change scores were 3.72 (SD = 1.39) from pre- to post-intervention and 2.40 (SD = 1.19) from pre- to 3months post-intervention, with the largest change scores for goals related to life skills. Data from semi-structured interviews expanded on these findings, revealing that participants made changes related to being in the moment, finding a sense of purpose and achieving a sense of belonging. Participants reported high acceptability of the intervention. This exploratory research supports the use of combined LS/AT intervention with transition-age adolescents experiencing sensory and regulation-based limitations on participation. Preliminary data shows positive changes in performance and satisfaction in self-identified goal areas as well as changes related to mindfulness, a personal sense of competence and relatedness. In practice, occupational therapists should consider integrating elements of this LS/AT intervention to support this population, including addressing life skills through engagement in unique and motivating activities.

Comparing Telerehabilitation and In-Person Interventions in School-Based Occupational Therapy for Specific Learning Disorder A Randomized Controlled Trial.

This study investigated the efficacy of telerehabilitation (TR) in school-based Occupational Therapy (OT) for children with Specific Learning Disorder (SLD), focusing on occupational competence and parental satisfaction, aiming to contribute empirical insights to the discourse on the educational well-being of this population. The study adopted a Randomized Controlled Trial (RCT) design involving 31 children diagnosed with SLD, implementing TR and in-person interventions alongside a control group. Outcome measures included the School Self-Concept Inventory, Child Occupational Self-Assessment (COSA), and Canadian Occupational Performance Measurement (COMP), analyzed using descriptive and inferential statistics (ANOVA, post hoc tests). Both TR and in-person interventions exhibited significant enhancements in academic self-efficacy (F=23.96, p<0.001, Partial ȵ²=0.461), occupational competence (F=70.59, p<0.001, Partial ȵ²=0.716), and parent satisfaction (F=17.03, p<0.001, Partial ȵ²=0.378) compared to the control group. Notably, no significant differences emerged between the TR and in-person groups, emphasizing their comparable effectiveness in improving outcomes. In conclusion, the study demonstrated the efficacy of TR and in-person interventions in school-based OT for children with SLD. The cohesive outcomes in academic self-efficacy, occupational competence, and parental satisfaction highlight TR as a versatile modality. This research, grounded in robust methodology, encourages further exploration of TR's transformative role in enhancing the holistic well-being of children with SLDs.

Self-reported engagement in everyday activities following bilateral lung transplantation in paediatric cystic fibrosis: a single centre study

IntroductionFollowing lung transplantation, it is unknown how children/adolescents self-assess their performance in everyday activities, importance of these activities, and whether resumption of everyday activities influences self-reported quality of life. The...

Corrigendum to “Sattari M, Ahmadi Kahjoogh M. Concurrent validity of the Child Occupational Self-Assessment in children with attention-deficit/hyperactivity disorder. British Journal of Occupational Therapy. 2023. doi:10.1177/03080226221146460

Corrigendum to “Sattari M, Ahmadi Kahjoogh M. Concurrent validity of the Child Occupational Self-Assessment in children with attention-deficit/hyperactivity disorder. British Journal of Occupational Therapy. 2023. doi:10.1177/03080226221146460

Assessing occupational competency in children with leukaemia compared to typically developing peers using the Child Occupational Self-Assessment tool: a pilot study

Background/Aims Children with leukaemia are less able to perform activities of daily living and participate in leisure activities compared to typically developing children, which can affect their occupational competency. The aim of this study was to compare occupational competency and values between typically developing children and children with leukaemia. Methods In this pilot cross-sectional study, 102 children (52 typically developing children and 50 children with leukaemia) aged 7 to 13 years were assessed using the Child Occupational Self-Assessment tool, which includes occupational competency and occupational value scales for each item. Results The independent t -test analysis demonstrated that there was a significant difference between the two groups on the competency scale (P=0.02). However, there was no significant difference between the two groups in the value scale (P=0.07). Conclusions Children with leukaemia feel less competent in carrying out everyday activities than typically developing children. Occupational competency interventions should be prioritised in occupational therapy services.

The French-Canadian WheelCon for manual wheelchair users: paediatric adaptation and preliminary evaluation of its measurement properties

Purpose To adapt the Wheelchair Use Confidence Scale for Manual Wheelchair Users, French-Canadian Version (WheelCon-M-F) into a paediatric version (WheelCon-M-F-P) and to evaluate its validity. Methods A three-phase process was conducted: (1) item adaptation using secondary analysis of focus group data; (2) item refinement using a think-aloud process; and (3) preliminary validation of the WheelCon-M-F-P (i.e. internal consistency, test-retest reliability, standard error of measurement, smallest real difference, ceiling and floor effects, limits of agreement, and relations with other variables). Results Phase 1: The sample consisted of occupational therapists (n = 9), paediatric manual wheelchair users (PMWUs) (n = 12), and parents of PMWUs (n = 2). Of the 65 WheelCon-M-F items, 35 were removed, 25 modified and 6 were added for the WheelCon-M-F-P. Phase 2: 4 PMWUs helped refine 14 and remove 3 items. Phase 3: 22 PMWUs participated. Cronbach’s alpha, test-retest reliability, standard error of measurement, and smallest real difference were 0.846, 0.818, 3.05, and 8.45 respectively. No ceiling or floor effects were demonstrated. Pearson correlations between the WheelCon-M-F-P and the Wheelchair Skills Test Questionnaire (capacity, confidence, and performance), and the Child Occupational Self-Assessment were 0.688, 0.711, 0.584, and 0.687 respectively. Conclusions This study provides preliminary evidence of a valid and reliable WheelCon-M-F-P. IMPLICATIONS FOR REHABILITATION The Wheelchair Use Confidence Scale for Manual Wheelchair Users, French-Canadian Version (WheelCon-M-F-P) is an outcome measure that can be used clinically with pediatric manual wheelchair users. The WheelCon-M-F-P can help identify modifiable factors associated with wheelchair confidence. Identifying modifiable factors associated with wheelchair confidence can help guide clinicians in establishing a targeted intervention for their pediatric clients. Establishing a targeted intervention can help improve self-efficacy for wheelchair use and social participation of pediatric wheelchair users.

Comparison of the Executive Functions, Occupational Performance and Perceived Occupational Proficiency in Children with Neurodevelopmental Disorder

ABSTRACT This study aimed to compare the executive functions (EFs) and occupational performance and perceived occupational proficiency (POP) in children with neurodevelopmental disorders. In this study, 72 children diagnosed with cerebral palsy (CP; n = 22), specific learning disabilities (SpLD; n = 26) or attention deficit and hyperactivity disorder (ADHD; n = 24) were included in the study group and 84 typically developed children were included in the comparison group. All children were evaluated with the Child Occupational Self-Assessment (COSA) and all parents were evaluated with The Executive Function and Occupational Routines Scale (EFORTS) and the Canadian Occupational Performance Measure (COPM). Accordingly, statistically significant differences were found between the study group and the comparison group in terms of total scores of the COSA and EFORTS (p < 0.05). In addition, there was a significant difference between the CP, ADHD, and SpLD diagnosis groups and the comparison group in terms of sub-parameters of COSA and EFORTS score (p < 0.05). The findings showed that children with different diagnoses within neurodevelopmental disorders have difficulties in different EFs and occupational performance areas. Also, the pattern of association between EF and POP was different for each group. Therefore, therapists need to consider occupational performance and POP with EFs in their assessments before planning their intervention.

Concurrent validity of the Child Occupational Self-Assessment in children with attention-deficit/hyperactivity disorder

Background/aim: Occupational therapists use different models and measurements for assessing children with attention-deficit/hyperactivity disorder (ADHD). One of those measurements is the Child Occupational Self-Assessment. In this study, concurrent validity of the Child Occupational Self-Assessment with Pediatric Quality of Life was tested in children with ADHD. Methods: A correlational study was conducted. The Child Occupational Self-Assessment and Pediatric Quality of Life were filled by 128 children with ADHD aged between 8 and 11 years. Findings: The results indicated that in competency subscale the highest correlation coefficient was for the total score of Pediatric Quality of Life ( r = 0.56, p &lt; 0.01) and the lowest was for social performance ( r = −0.44, p &lt; 0.01). The highest and lowest correlation coefficient in value subscale were for the total score ( r = −0.46, p &lt; 0.01) and emotional performance of Pediatric Quality of Life ( r = −0.34, p &lt; 0.01), respectively. Conclusions: The Child Occupational Self-Assessment has an acceptable concurrent validity with Pediatric Quality of Life. It can be a suitable measurement for assessing of children with ADHD.

Enhancing a Rehabilitation Pathway for Pediatric Heart Transplant Recipients: An Improvement Project to Increase Adherence, Satisfaction, and Outcomes

Aims To refine a cardiac rehabilitation pathway for pediatric heart transplant recipients; assess clinician knowledge and adherence to the program; and evaluate patient outcomes. Methods The center has utilized a rehabilitation pathway for pediatric heart transplant recipients. Challenges in practice include access to centers, lack of data tracing, and adherence to the pathway. The quality initiative focused on program refinements: implementation of text templates to improve data collection, collection of the Pediatric Cardiac Quality of Life Inventory (PCQLI), Functional Independence Measure (WeeFIM) and Child Occupational Self-Assessment (COSA), development of an outreach program, and creation of an educational program for therapists to increase content knowledge and improve clinician satisfaction. Results In the evaluation of rehabilitation follow-up post-transplant, there was no statistical significance between the pre- and post-implementation groups. After the implementation of the refined pathway, there was an increase in the completion of the six-minute walk test post-transplant (p = 0.048). Clinicians’ responses post educational session noted familiarity with the pathway (88%), documentation (78.8%), and outcome measures (97%). Results of outcomes noted improvement in six-minute walk distances and a decrease in the rate of perceived exertion post-transplant. To ensure future pathway adherence, clinical support should be implemented, and key players identified to maintain sustainability.

The Relationship Between the Fine Motor Skills and Occupational Self-assessment of Children with Hemiplegic Cerebral Palsy

Background: Upper limb function can be correlated with the self-assessment of children with hemiplegic cerebral palsy. Objectives: This study aimed to determine the correlation between fine motor skills and occupational self-assessment in children with hemiplegic cerebral palsy. Methods: Fifty patients aged 8 - 13 with hemiplegic cerebral palsy, who had 1 of 3 levels (I to III) of hand skills based on the manual ability classification system (MACS), were selected. The Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) Questionnaire for the motor skills and Child Occupational Self-assessment (COSA) Questionnaire were given to participants. The Spearman correlation coefficient at a significance level of 0.05 was used to determine the relationship between the variables. Results: The mean and SD of occupational self-assessment and its subscales (i.e., occupational value and competence) at different levels of hand dysfunction (I - III) were 115.68 ± 14.04, 54.70 ± 8.83, and 60.98 ± 5.69, respectively. The mean and SD of fine motor skills and its subscales (i.e., visual-motor control, response speed, and upper-limb speed) and dexterity at different levels of hand dysfunction were 70.44 ± 14.76, 4.04 ± 2.44, 33.70 ± 6.19, and 32.70 ± 7.07, respectively. The spearman correlation showed a significant relationship between fine motor skills of hand and its subscales with occupational self-assessment and its subscales (P &lt; 0.05). Conclusions: The findings showed that to improve occupational self-assessment of cerebral palsy children, special attention should be paid to progress the function of the upper extremity through occupational therapy interventions. It can lead to improved quality of life, strong sense of self-efficacy, and greater independence.

Construct validity of the Persian version of the Child Occupational Self-Assessment in children with attention-deficit/hyperactivity disorder in Iran.

ObjectiveThis study aimed to assess the construct validity of the Child Occupational Self-Assessment, translated to Persian that could provide occupational therapists with a tool to evaluate occupational competence and values of children in Iran.MethodsA total of 250 children (87 girls and 163 boys) with attention deficit hyperactivity disorder aged 7.5–11 years referred from two specialised children’s hospitals were included. The researchers read the questions to the children and they identified their own answers. The data were analysed based on the Rasch Rating Scale Model.ResultsFour of the items showed misfit and as a result of deleting these items the Persian version of the questionnaire has 21 items with an appropriate validity.ConclusionThe Persian version of Child Occupational Self-Assessment can be used with new items format. It could be also useful to replace the missing question to develop the tool further.

Relationship between Child Occupational Self-Assessment and Quality of Life in Elementary School Children

ABSTRACTThe purpose of this study was to examine the relationship between the Child Occupational Self-Assessment (COSA) and quality of life (QoL) in elementary school children. A total of 77 children from a public elementary school were included in the study. A survey was conducted using the COSA and the Kid-KINDLR. The COSA consists of 25 items on occupational competence and value. The items are classified into four factor structures: challenging occupation, motivated occupation, daily life tasks, and expected tasks. The Kid-KINDLR is a scale consisting of 24 items in question form by which the QOL of children can be grasped in multiple dimensions. Groups that obtained high and low QoL levels showed a significant difference in COSA regarding the value score obtained in the challenging occupation factor. Tackling, trying to solve, or struggling with difficult tasks may improve QoL. Children actively working on mandatory activities, rather than doing given assignments, appear to have higher QoL.

Participation in Peer-Play Activities Among Children With Specific Learning Disability: A Randomized Controlled Trial.

Children with a specific learning disability (SLD) have deficits in social and academic competence and executive function (EF). In this study, we used the Model of Human Occupation to investigate the effect of peer-play activities on occupational values and competence as well as EF skills (i.e., behavior regulation and metacognition) in children with SLD. Forty-nine children ages 7-11 yr with SLD were randomly assigned to the peer-play and control groups. Outcome measures were the Behavior Rating Inventory of Executive Function and the Child Occupational Self-Assessment (COSA). Data analysis showed that the effects of the intervention on EF skills were medium to large. The occupational values and competence did not change according to the COSA. Occupational therapy practitioners can use peer-play activities to enhance EF in children with SLD; however, perceived occupational values and competence may not show any changes with the peer-play intervention using a self-assessment instrument.

Concurrent Validity of the Child Occupational Self-Assessment in Children with Attention Deficit Hyperactivity Disorder

Introduction: Independency in daily activities is one of the first achievements in childhood that can help the child promote his/her sense of independency and socialization. In this study, concurrent validity of the Child Occupational Self-Assessment (COSA) and the Pediatric Quality of Life Inventory, which evaluate daily activities, was assessed in children with attention deficit hyperactivity disorder (ADHD). Materials and Methods: This correlational study was conducted on 128 children with ADHD. Data analysis was performed and correlation coefficients were reported using SPSS software. Results: The highest correlation coefficient was that of the total competency and child quality of life (QOL) score (r = 0.566) and the lowest was that of social performance competency score (r = -0.444) (P < 0.01). The highest and lowest correlation coefficients in the value subscale were, respectively, that of the total child QOL score (r = -0.46) and emotional performance (r = -0.347) (P < 0.01). Conclusion: Based on the findings of this study, the COSA has an acceptable concurrent validity with the Pediatric Quality of Life Inventory, and thus, can be used for the assessment of children with ADHD.

Using Parent Assessment of Child Occupation (PACO) alongside the Child Occupational Self-Assessment; feasibility study

Objective: Although, Literature shows the significant role of parents in children’s lives, there have not been any studies carried out on the parents’ occupational assessments of their children. Materials and Methods: A modified version of the Child Occupational Self Awareness (COSA) was created (Parents Assessment of Child Occupational, PACO) to assess the parents’ assessment of their child’s occupation. This feasibility study aimed at identifying the practical and potential issues of applying the COSA alongside PACO. As well as testing the value of identifying the similarity of discrepancies between parents (here mothers) and their children in assessing a child’s occupational life. For this purpose, a convenient sample of 30 primary students aged between 9-10 years old, and their mothers were chosen. Results: The content analysis of the COSA and PACO besides the supplementary information gathered by the interviewer showed factors which need to be considered in the main future study. Conclusion: The findings indicate how mothers and their children have different interpretations of a child’s competency and values in carrying out some aspects of occupation. There are some considerations with reference to the environment and related items of the tool, scoring, and administration which need to be addressed in planning for the main study. Key Words: MOHO, COSA, PACO, Feasibility Study, Child competency, child valu

Test-Retest Reliability of the Child Occupational Self-Assessment (COSA).

We examined the test-retest reliability of the Child Occupational Self-Assessment (COSA). Fifty-two children ages 6-12 yr completed the COSA on two separate occasions 7-14 days apart. Participant data were analyzed using intraclass correlation coefficients (ICCs). Test-retest reliability was good for total Competence and Value scores (ICC2,1=.72-.77) and poor to good across category scores (ICC2,1=.44-.78). These findings suggest that the children's perceptions of their abilities and the value they placed on their everyday activities as reflected in the test items were fairly consistent over a short period of time.

Accommodations and Therapeutic Techniques Used during the Administration of the Child Occupational Self Assessment

Introduction: Paediatric occupational therapists can elicit children's perspectives and provide children with the opportunity to participate in decision making by administering self-reports. This study sought to identify the techniques that practitioners used to foster the effective and appropriate administration of one occupational therapy self-report, the Child Occupational Self Assessment (COSA). Method: Focus groups were held in the United States and the United Kingdom to explore therapists' experiences using the COSA. Thirty-three clinicians, including 28 occupational therapists, participated across five focus groups. Descriptive codes were generated using line-by-line coding, and codes were refined and reorganised using a constant comparative approach and triangulation with multiple coders. Findings: Therapists used two main techniques while administering the COSA: providing accommodations and interacting with clients in a therapeutic manner. Occupational therapists provided accommodations by adapting or adjusting the administration of the COSA to meet the individual needs of clients better. Therapists enacted a therapeutic use of self by developing rapport and empowering children during the administration process. Conclusion: This study illustrates that therapists use multiple therapeutic techniques aligned with the literature during the process of administering the COSA self-report. Further, those therapeutic techniques are enhanced by the simultaneous use of accommodations that ensure children are able to access and complete self-reports.

Dutch Children's Perspectives on the Constructs of the Child Occupational Self-Assessment (COSA)

The claim for the Child Occupational Self-Assessment (COSA) is that children may share their sense of competence for, and value of, everyday occupations. To establish whether self-report items meet their purpose, assurances regarding construct validity depend not only on quantitative methodology but also on qualitative methods. This study aimed to reveal how Dutch children with special needs interpret the translated American COSA items, and whether their answers fit the intended meaning. Six 8- to 12-year-old Dutch children with special needs participated in the research. Data were collected via the Three-Step Test-Interview (cognitive interviewing) and analyzed using the constant comparative method. Results showed variations in children's interpretation, discrepancies between scores and stories, and translation inaccuracies. These data can be used to improve the Dutch COSA. Cognitive interviewing enhances both the construct validity of this self-assessment and the collaborative process of reasoning, decision making, and goal setting with a child during self-assessment.

Using Mixed Methods to Establish the Social Validity of a Self-Report Assessment: An Illustration Using the Child Occupational Self-Assessment (COSA)

Social validity is the extent to which procedures, goals, and outcomes are acceptable and important to end users and is not commonly addressed during assessment development. This article pilots a process of triangulating multiple methods to evaluate the social validity of a self-report assessment. These procedures were piloted using the Child Occupational Self-Assessment (COSA), a self-report of everyday activities for children with disabilities. This study collected COSA responses from 502 children with disabilities and conducted observations and interviews with 5 additional children with cerebral palsy. Data were aligned with social validity benchmark statements and integrated using data displays. Social validity was evaluated by examining congruencies and discrepancies in the results. Implications and the legitimacy of design decisions are discussed.