Feasibility of Pediatric CIMT by Televideo

The Feasibility of Intervention Measure (FIM) will assess intervention feasibility with a four-item measure. The measure includes four statements about the plausibility of implementing the intervention (the intervention seems implementable; the intervention seems doable; the intervention seems possible; the intervention seems easy to use). Individuals rate the extent to which the agree with each statement on a five-level scale (completely disagree, disagree, neither agree or disagree, agree, completely agree).

Acceptability of Intervention will be assessed through a four-item measure (AIM). The measure includes four statements about the appeal of the intervention (e.g. I like the intervention; I welcome the intervention; the intervention meets my approval; the intervention is appealing to me). Individuals rate the extent to which the agree with each statement on a five-level scale (completely disagree, disagree, neither agree or disagree, agree, completely agree).

Intervention Appropriateness will be assessed through a four-item measure (IAM). The measure includes four statements about the relevance or pertinence of the intervention (e.g. the intervention seems suitable; the intervention seems applicable; the intervention seems fitting; the intervention seems like a good match). Individuals rate the extent to which the agree with each statement on a five-level scale (completely disagree, disagree, neither agree or disagree, agree, completely agree).

The Usability of the remote delivery system (use of the iPad, Kubi robot; video upload) will be assessed with the UUD assessment. Usability includes three major components: usefulness, desirability, and usability. The UUD gathers data on usability (ease of use of the telehealth technology) (9 items), usefulness (value, relevance, and applicability of the telehealth technology) (10 items), and desirability (overall appeal or interest of the telehealth technology) (4 items). Items are rated a five-point Likert-type scale.

This instrument assesses the extent to which the therapist adhered to fifteen core constructs of the intervention protocol. Evidence of adherence to high quality pediatric rehabilitation elements includes 6 constructs that are scored as Present (present-some and present-strong) or Absent. Includes items such as "collaboration between parent and therapist" and "aligning therapy with child's goals". Evidence of core components of pediatric constraint induced movement therapy is scored as Present or Absent. Includes items such as "high intensity of intervention" and occurs in "natural environment". Total score is number of core components present.

Fidelity to remote assessment procedures will be determined through video coding of recorded remote assessment. The following will be coded: adherence to administration procedures, length of assessment, number of sessions to complete assessment, number of assessment items completed, and percentage of items completed.

A semi-structured interview will be used to assess the perceptions of therapists, assessors, and parents about the process of remote delivery. There are fourteen open-ended questions about the remote assessment process, the remote intervention process, and the technology used to gather information and conduct the remote assessments and intervention. These will will be coded qualitatively and analyzed by content analysis to determine common perceptions of strengths and areas for improvement.

This measures assesses the satisfaction regarding communication between the therapist and the family, with particular emphasis on preparation of the parent for engaging with their child during therapy activities.. The measures includes 21 questions rated on a four-point scale about the parent role in therapy, the preparation and training for parent participation in therapy, and goal setting. Additional questions ask for a description of the characteristics that the parent role, what were positive experiences with the parent-therapist relationship, and suggestions for how to improve the therapist-parent relationship.

ABILHAND-kids is a parent reported measure of manual ability in children with Cerebral Palsy. Parents estimate their child's ease/difficulty with performing 21 selected activities of daily living. Parents rate their child's difficulty on a three-level scale: "Impossible", "Difficult", or "Easy".

The Box and Block assesses manual dexterity. It has strong psychometric properties. The child is instructed to move 1-inch square blocks from one side of a wooden box over a partition to the other side. The scoring is based on the number of blocks moved over within 60 seconds.

The Structured Activity Session identifies a variety of age-appropriate activities and behaviors that can be coded for quality and frequency of movement, as well as the number of activities and behaviors completed. The activity session will include a 1. dressing activity (e.g. donning and doffing and zippered sweatshirt), 2. a snack activity (e.g. opening a beverage container, opening and eating a snack with small food items like goldfish, and opening and eating a snack with a utensil like applesauce or pudding), and gross motor activities (like catching a ball, jumping).