Goal-oriented rehabilitation of preschoolers with cerebral palsy-a multi-case study of combined use of the Canadian Occupational Performance Measure (COPM) and the Goal Attainment Scaling (GAS)

Purpose: To explore setting and implementing goals as an ongoing process, using the COPM and the GAS in combination. Methods: Multi-case study of a goal-setting approach, involving parents and service providers of 13 children (aged 23-50 months) with mild-to-moderate CP enrolled in a 9-month rehabilitation programme consisting of two blocks of setting and implementing goals. The children's COPM reports and GAS goals and information from a questionnaire about implementation were analysed. Results: In the initial assessment, most problems prioritized by the parents in the COPM were phrased in terms of activities. The priorities for intervention changed during the process of setting and implementing goals. GAS goals were frequently integrated in everyday activities both at home and in kindergarten based on decisions on how to implement the goals. Changes in the children's performance were recognized by a high proportion of goal attainment and a small, but clear change in the parents' perception of performance. Parents and service providers reported many gains working towards concrete and measurable goals, but also some challenges. Conclusion: By using the COPM and GAS in combination, a dynamic and interactive process of setting and implementing goals in the context of everyday activities emerged.