96 Participants Needed

Child-Oriented Goal-Setting for Pediatric Rehabilitation

Recruiting at 5 trial locations
LP
ST
Overseen BySandy Thompson-Hodgetts, PhD
Age: < 18
Sex: Any
Trial Phase: Academic
Sponsor: University of Alberta
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 1 JurisdictionThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

Children with disabilities often access rehabilitation services to improve their abilities to participate in everyday activities. Goal-directed therapy is considered an important therapeutic strategy to achieve outcomes that are meaningful to families. Not a lot is known about the effects of goal setting on rehabilitation outcomes. Strategies to help children participate in the goal-setting process are rarely used in clinical practice. The aim of this project is to test the effects of a child-focussed goal setting approach, Enhancing Child Engagement in Goal Setting (ENGAGE), on therapy outcomes. Service use and the cost vs. benefits of the ENGAGE approach compared to usual practice will also be examined. Children with neurodevelopmental disabilities aged 5-12 years old (n=96) who access paediatric rehabilitation services at six rehabilitation sites will participate. Therapists (n=24) at participating sites in Alberta, Canada will be randomized into 1) the ENGAGE intervention group or 2) the usual therapy practice control group. Children will participate in the ENGAGE approach to goal setting or usual practice based on the allocation of their therapist. This study will determine if the ENGAGE approach to goal setting affects child goal performance, satisfaction with goal performance, functional abilities, participation, and parent and child quality of life. The investigators will also evaluate differences in parent and child quality of life in relation to parent costs (e.g., absenteeism, presenteeism, travel costs) and compare amount of therapy time between the two groups to see which approach is more cost-effective and efficient. After the study, children, parents and therapists will be asked to discuss aspects that influenced effective implementation of the ENGAGE approach. This study could provide evidence to improve meaningful child and family outcomes in paediatric rehabilitation and improve efficiency of paediatric rehabilitation services.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, if your child has uncontrolled seizures, they cannot participate in the trial.

What safety data exists for child-oriented goal-setting in pediatric rehabilitation?

The provided research does not explicitly mention safety data for child-oriented goal-setting in pediatric rehabilitation. The studies focus on the effectiveness, experiences, and implementation of the approach, but do not address safety concerns or data directly.12345

Is the ENGAGE approach a promising treatment for pediatric rehabilitation?

Yes, the ENGAGE approach is promising because it focuses on setting goals that are important to the child, which can increase their motivation and engagement in therapy. This approach may lead to better therapy outcomes and more efficient service delivery.12367

What data supports the idea that Child-Oriented Goal-Setting for Pediatric Rehabilitation is an effective treatment?

The available research shows that Child-Oriented Goal-Setting for Pediatric Rehabilitation, also known as the ENGAGE approach, may improve child motivation, engagement in therapy, and outcomes related to therapy. It also suggests that this approach can make the delivery of services more efficient compared to usual practices. Additionally, studies indicate that individualized goal setting, which is a part of this approach, engages families more actively in therapy and is associated with positive outcomes. This suggests that the ENGAGE approach is effective in pediatric rehabilitation.12368

Who Is on the Research Team?

LP

Lesley Pritchard-Wiart, PhD

Principal Investigator

University of Alberta, Faculty of Rehabilitation Medicine

Are You a Good Fit for This Trial?

This trial is for children aged 5-12 with neurodevelopmental disabilities like autism or cerebral palsy, who are referred to physical or occupational therapy and can participate in goal-setting. They must speak English, as should their guardian. Children with developmental regression or uncontrolled seizures are excluded.

Inclusion Criteria

My child can participate in setting therapy goals.
My child is between 5-12 years old and has a diagnosed disability.
My child has been referred for physical or occupational therapy.

Exclusion Criteria

My child has been diagnosed with developmental regression.
My child has had a seizure in the last 2 months.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Children participate in the ENGAGE approach to goal setting or usual practice based on the allocation of their therapist. Treatment block lengths vary from 3-8 sessions over 2-8 weeks.

2-8 weeks

Post-treatment Assessment

Identical assessments are conducted within 10 days of completing therapy to evaluate goal performance, satisfaction, and other outcomes.

Within 10 days

Follow-up

Participants are monitored for changes in goal performance, satisfaction, and quality of life at 3 months post-treatment.

3 months

What Are the Treatments Tested in This Trial?

Interventions

  • ENGAGE approach (child-oriented goal-setting)
Trial Overview The ENGAGE approach focuses on child-oriented goal-setting in pediatric rehabilitation. The study compares the effectiveness of ENGAGE against usual therapy practices by assessing improvements in children's abilities, participation levels, and quality of life for both the child and family.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: ENGAGE approach (child-oriented goal-setting)Experimental Treatment1 Intervention
Therapists will receive training on our principles-based goal setting approach and strategies in the goal setting toolbox. Training will include an overview of tools and strategies including the Perceived Efficacy and Goal Setting Tool (PEGS) and the Pediatric Activity Card Sort (PACS). In addition, we will provide training on Goal Attainment Scaling and administration of the Canadian Occupational Performance Measure (COPM). We will introduce simple strategies to assist children in identifying goals and to ensure ongoing focus on goals using principles of motivational interviewing, strategies to assess and nurture perceived competence (self-efficacy), and child-friendly feedback strategies on goal-related performance.
Group II: Usual careActive Control1 Intervention
The control group will comprise of usual care.

ENGAGE approach (child-oriented goal-setting) is already approved in Canada for the following indications:

🇨🇦
Approved in Canada as ENGAGE approach for:
  • Paediatric rehabilitation for neurodevelopmental disabilities

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Alberta

Lead Sponsor

Trials
957
Recruited
437,000+

Alberta Health services

Collaborator

Trials
168
Recruited
658,000+

Published Research Related to This Trial

The ENGAGE approach to goal-setting in pediatric rehabilitation aims to enhance child motivation and engagement, potentially leading to better therapy outcomes compared to usual care, with a total of 96 children aged 5-12 participating in the trial.
This study will not only assess the effectiveness of the ENGAGE method but also explore its cost-effectiveness and identify barriers to implementation, providing valuable insights for improving child-focused rehabilitation practices.
A multi-center, pragmatic, effectiveness-implementation (hybrid I) cluster randomized controlled trial to evaluate a child-oriented goal-setting approach in paediatric rehabilitation (the ENGAGE approach): a study protocol.Pritchard-Wiart, L., Thompson-Hodgetts, S., McKillop, AB., et al.[2023]
Involving children in setting their own rehabilitation goals leads to increased motivation and a sense of being valued, as reported by both the children and their parents in a study with 9 children aged 5 to 12 years.
Parents and clinicians recognized the importance of collaboration in goal setting, suggesting that a relational autonomy approach, which emphasizes teamwork and shared decision-making, may enhance the rehabilitation process.
Child, parent, and clinician experiences with a child-driven goal setting approach in paediatric rehabilitation.Pritchard, L., Phelan, S., McKillop, A., et al.[2022]
A review of various goal-setting theories highlights their importance in pediatric rehabilitation, emphasizing the need for a structured approach that considers the evolving roles of parents, siblings, and caregivers as well as the child's developmental capacity.
Key implications for practice include the necessity of setting specific and meaningful goals for children, enhancing self-efficacy, and adapting goal-setting processes to accommodate changing family dynamics over time.
A review of goal setting theories relevant to goal setting in paediatric rehabilitation.Pritchard-Wiart, L., Thompson-Hodgetts, S., McKillop, AB.[2022]

Citations

A multi-center, pragmatic, effectiveness-implementation (hybrid I) cluster randomized controlled trial to evaluate a child-oriented goal-setting approach in paediatric rehabilitation (the ENGAGE approach): a study protocol. [2023]
Child, parent, and clinician experiences with a child-driven goal setting approach in paediatric rehabilitation. [2022]
A review of goal setting theories relevant to goal setting in paediatric rehabilitation. [2022]
Addressing the challenges of collaborative goal setting with children and their families. [2022]
Goal-setting in paediatric rehabilitation: perceptions of parents and professional. [2010]
Using child- and family-centred goal setting as an outcome measure in residential rehabilitation for children and youth with acquired brain injuries: The challenge of predicting expected levels of achievement. [2020]
Using the capability, opportunity, and motivation model of behaviour to assess provider perception of implementing solution-focused goal-setting in paediatric rehabilitation. [2023]
Goal setting in paediatric rehabilitation for children with motor disabilities: a scoping review. [2019]
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