Camrose

Researchers are evaluating a new child-focused goal-setting approach called ENGAGE in pediatric rehabilitation for children aged 5 to 12 years with neurodevelopmental disabilities such as autism spectrum disorder and cerebral palsy. The study aims to see if ENGAGE improves children's engagement in therapy, their goal performance and satisfaction, functional abilities, participation at home, school, or community, and quality of life for both children and caregivers. It also examines cost-effectiveness and service use compared to usual therapy practices. The study uses a pragmatic cluster randomized controlled trial design involving 24 therapists at six sites in Alberta, Canada. Therapists are randomized to either the ENGAGE intervention group, where they receive training on a principles-based goal-setting approach and strategies, or a control group receiving usual care. Treatment varies from 3 to 8 sessions over 2 to 8 weeks based on goals and family preferences. The ENGAGE therapists are monitored for adherence to the approach before recruiting children, and both groups document treatment details and co-interventions throughout the study. Children participate in assessments at three times: before treatment, within 10 days after completing therapy, and three months post-treatment. The primary outcome is goal performance and satisfaction measured by the Canadian Occupational Performance Measure (COPM). Additional evaluations include parent and child quality of life, therapy session costs, and service utilization. Qualitative interviews with children, parents, and therapists explore factors influencing ENGAGE implementation. Data analysis compares changes between groups over time to assess effectiveness and cost-benefit.