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

• Published in: Child : care, health & development health & development, 2019-03, Vol.45 (2), p.286-291
• Main Authors: Kelly, Gemma, Dunford, Carolyn, Forsyth, Rob, Kavčič, Alja
• Format: Article
• Language: English
• Subjects: Achievement; Achievement Rating; Activities of Daily Living; adolescence; Adolescent; brain damage; Brain injured children; Brain Injuries - physiopathology; Brain Injuries - psychology; Brain Injuries - rehabilitation; Child; Child, Preschool; Classification; Communication; Disability; Disabled Persons - psychology; Disabled Persons - rehabilitation; Family (Sociological Unit); Family Nursing; family‐centred service; Female; Goal Orientation; Goal setting; Goals; Humans; Infant; Injuries; Male; Mobility; Objectives; Outcome Assessment, Health Care; Outcome Measures; paediatric; Rehabilitation; Rehabilitation Centers; Residential care; Resistance (Psychology); Retrospective Studies; Self care; Therapists; Uncertainty; Youth
• ISSN: 0305-1862; 1365-2214
• DOI: 10.1111/cch.12636

Purpose Collaborative, child‐ and family‐centred goal setting is essential in paediatric, acquired brain injury (ABI) rehabilitation. This study aims to understand which goals children and families prioritize and how accurately therapists predict expected levels of achievement for these goals. Methods Routinely collected Goal Attainment Scale‐Light data from 122 children with severe ABI receiving residential rehabilitation were retrospectively analysed. Goals were mapped onto the International Classification of Functioning, Disability and Health. Descriptive analysis of accuracy of therapists' prediction of goal achievement was conducted. Results Eight‐hundred sixty goals were set: 82% in activities and participation domains, most commonly mobility, self‐care, and communication chapters. Forty‐six per cent of therapist‐set expected levels of achievement for these goals were met at the expected level, and 24% were exceeded. Chapters with the highest prediction accuracy included two environmental chapters and one body structure and function. Accurate prediction of activity and participation goals varied (35% in general tasks and demands to 58.8% in major life areas). Conclusions Children and families prioritize mobility, self‐care, and communication during ABI residential rehabilitation. Setting expected outcomes for these goals is challenging, as demonstrated by the variety in accurate prediction rates between and within chapters. Families need to be aware of this uncertainty during goal‐setting discussions.