Using Ecological Momentary Assessment to Document and Investigate Caregiver Practices Between Pediatric Therapy...

Area of Science:

• Pediatric therapy services
• Childhood disability research
• Caregiver-delivered interventions

Background:

• Appropriate dosage of pediatric occupational therapy, physical therapy, and speech-language pathology is crucial for children with disabilities.
• Therapy dosage reporting is inconsistent, and caregiver practice between sessions is underdocumented.
• Ecological momentary assessment (EMA) offers a method to capture real-time caregiver practice and influencing factors.

Purpose of the Study:

• To pilot the use of EMA for measuring caregiver practices between therapy sessions.
• To compare EMA-reported practices with caregiver recall.
• To examine factors influencing caregiver practice.

Main Methods:

• A pilot prospective cohort study involving caregivers of children receiving therapy services.
• Baseline survey with recalled home practice, followed by 30 days of EMA logging.
• Semistructured follow-up interviews to explore experiences.

Main Results:

• Five participants completed 150 days of EMA data (82 completed entries, 55%).
• EMA-reported practice (23.2 min/day) was substantially lower than recalled practice (71.2 min/day).
• Caregiver practice occurred in short, frequent bouts integrated into daily routines, facilitated by routine integration and child engagement.

Conclusions:

• EMA-reported practice differs significantly from caregiver recall, emphasizing the need for brief, engaging strategies.
• EMA is acceptable to some caregivers, but attrition indicates significant feasibility barriers.
• Further investigation is needed to address participation barriers and optimize EMA implementation.