Therapy behaviours in paediatric rehabilitation: essential attributes for intervention with children with physical disabilities

BACKGROUND: Paediatric rehabilitation involves the therapist delivering intervention-specific and non-specific behaviours. Non-specific (or general therapy) characteristics are a key part of family-centred service (FCS); however, little research identifies observable behaviours to examine intervention fidelity to FCS principles and their impact on outcomes. PURPOSE: To generate a list of observable general therapy attributes essential to FCS interventions for children with physical disabilities. METHODS: Attributes of general therapy behaviours were derived based on a Delphi Process with multidisciplinary researchers. A separate method identified attributes through the content analysis of semi-structured interviews with occupational therapists and physiotherapists. A triangulation procedure identified general therapy behaviours for FCS. RESULTS: Eight researchers participated in the Delphi Process. Seventeen therapists participated in semi-structured interviews. The Delphi Process generated 35 behavioural attributes divided into three categories: therapist behaviours (21), client behaviours (9) and client-therapist behaviours (5). Of the 19 attributes generated from the therapist interviews, 17 mapped onto those identified in the Delphi Process. General therapy attributes addressed a range of behaviours including characteristics of the intervention procedure and the therapeutic process. CONCLUSIONS: This work provides an improved understanding of how practitioners conceive essential and observable behaviours of FCS that will enable future researchers to identify their presence within an intervention session. IMPLICATIONS FOR REHABILITATION: This article broadens the focus of fidelity measurement of paediatric rehabilitation to include observable behaviours relevant to family-centred service. Attributes of the therapist's practice behaviour in family-centred service were identified. Attributes of paediatric rehabilitation involving the child's response to intervention, parent participation and child and therapist interaction were generated.