Collaborative goal setting with and for children as part of therapeutic intervention

Abstract

Purpose: This study explored collaborative goal setting with children, parents, and teachers, and children’s reasons for their goals based on their perceived self-efficacy, using the Austrian–German Perceived Efficacy and Goal Setting System (AG-PEGS).

Method: Thirty-eight children from age 5 to 10 years (referred to occupational therapists because of difficulties in performing everyday activities), their parents and teachers participated in this mixed methods study. Participants’ goals were analyzed using descriptive statistics and content analysis. Data were grouped into thematic categories, and attributed to health factors according to the International Classification of Functioning, Disability, and Health-Children & Youth Version (ICF-CY).

Results: Children’s responses underlined the significance of self-efficacy and participation for a child’s health and well-being. They gave priority to their independence, competence, and joy in meaningful everyday activities and indicated social motives such as belonging to and being accepted by others for their mainly participation-oriented goals. Parents’ main concerns were related to school task performance, whereas teachers mainly chose body functions and school activities to be the focus of occupational therapy intervention.

Conclusions: Exploring clients’ priorities, the meanings they attributed to activities in daily life, and their underlying motives for goals should be part of therapeutic intervention. Children and their caregivers are valid and important sources for therapeutic goal setting. Basic human needs, e.g., for relatedness, competence (self-efficacy), autonomy, and meaningful personal orientation, should be considered when prioritizing goals for intervention.

Implications for Rehabilitation

• Children are a valid and important source for therapeutic goal setting.

• Children’s goals focused on activities and participation in all life areas, and half of the parents’ goals on activities as relevant for productivity (followed by self-care and leisure), while teachers tended to prioritize goals at the body functions and structures level.

• The experience of their task performance affecting participation, and the basic needs for independence, relatedness (belonging to and being accepted by others), competence (self-efficacy), and joy through engagement in personally meaningful activities are main motives for children with developmental disabilities to choose their goals for intervention.

• A client-centred approach in working with children with developmental disabilities requires time and attention for exploring meaning-attributed activities for children and their proxies when collaboratively setting goals.

Keywords:

• Participation
• perceived efficacy and goal setting system
• occupational therapy

Acknowledgements

The authors cordially thank: all the children, parents, and teachers participating in this study; the participating OTs in Austria and South Tyrol (Italy) for their essential contribution in working with this first German version of the PEGS; Prof. Dr. Olga Baloueff, Dr. Doris Daurer, and Anne-Mie Engelen for their valuable input and proof-reading; Dr. Michael Harrer and Dr. Birgit Prodinger for reflections; Prof. Dr. Cheryl Missiuna, Dr. Nancy Pollock, and Prof. Dr. Mary Law from Mc Master University; Pearson Publishing (Harcourt Assessment Inc., PsychCorp, Pearson, Texas/USA) for permission to translate the PEGS into German and to use it for this study.

Disclosure statement

There was no conflict of interest from the authors.