Practice, play, repeat – individualized outcomes after the “intensity matters!”-program for children with disabilities – a descriptive multicase study

Abstract

Purpose

To examine and categorize individual outcomes after the “Intensity matters!”-program, a new, cross-professional intensive intervention for children with disabilities across Norway.

Materials and methods

84 children and their parents/legal guardian were enrolled in this multicase study. Participants were active in defining goals, and hereby the content of the intervention. The pre-settled goals were grouped into the categories of body functions and structure, activities and participation inspired by the components of the International Classification of Functioning, Disability, and Health (ICF). The pre-settled goals were assessed pre- and post-intervention by using The Canadian Occupational Performance Measure (COPM). A clinically important change was predefined as a change ≥2 points.

Results

1004 pre-settled goals were categorized into focus areas, where 62.4% were categorized as activity; functional mobility (n = 626). Post-intervention assessment of the COPM ratings of child performance and satisfaction showed a mean change of 3.7 (range −0.25;8.5) and 3.8 (range 0.25;10), respectively.

Conclusion

The majority of participants in the “Intensity Matters!”-program had a clinically important change in their individual goals after only three weeks of intervention. This study supports the use of client-centered measures in rehabilitation for children with disabilities, but a further examination of long-term outcome is warranted.

IMPLICATIONS FOR REHABILITATION

• The “Intensity matters!”-program is a cross-professional, goal-directed, and intensive intervention with a high degree of user involvement.

• In a sample of 84 individual participants, this study shows that the majority of focus areas were found to be of clinically relevant improvement post intervention.

• Individual structured programs with high intensity in a group setting are likely to be successful for children with different health conditions, including cerebral palsy and other neurological or genetic disorders.

• Areas of concern formulated ahead of a three-week, intensive, goal-directed program were mainly linked to the ICF domain activity, and more specifically related to personal care and functional mobility.

• Rehabilitation professionals should emphasise participants’ priorities and involvement of children when planning and evaluating a therapeutic intervention.

Keywords:

• Children
• cerebral palsy
• COPM
• disabilities
• family-centered
• goal directed
• ICF
• intensive training
• pediatric rehabilitation
• user involvement

Disclosure statement

The authors have no conflict of interest to disclose. Jannike Rieber is member of the board of The GC Rieber Foundation, a non-profit organization which provided financial support for this project.

Additional information

Funding

The Directorate for Health and Social Affairs in Norway has financially supported the intervention. In addition, The GC Rieber Foundation has financially supported the work of categorizing and analyzing the collected data from the “Intensity Matters!”-program, and further funded the authors’ work during the writing process of this publication. The funding sources had no involvement in the study design, data collection, or interpretation of results.