Project 462734

The Problem. One in 500 Canadian children have cerebral palsy (CP) and most have hand/arm limitations that impact their activities and participation. Optimizing hand/arm abilities is key to CP care. However, many families can't access in-person therapy due to travel, time, and other socioeconomic factors. Virtual care, delivered remotely via phone/video, can help. Like in-person care, virtual care must be guided by reliable assessment. Virtual therapies have been successfully innovated, but it is still hard to assess hand/arm skills virtually. This limits our ability to collect information to guide/assess virtual care for children with CP. We want to know: What hand-arm assessments can be done virtually? And, what are families' preferences/hopes for virtual assessment? The Plan. 100 children with CP affecting their hand/arm, their caregivers, and clinicians will take part in this stakeholder-guided study. Children and their parents will connect to a therapist via Zoom and under their guidance complete a series of hand/arm assessments at home. The assessments were carefully chosen to capture different aspects of hand/arm use and involve: standardized tasks, family-recorded videos of individualized tasks, and wrist-worn motion sensors. To check that these assessments are reliable for use, they will be repeated a few weeks later over Zoom and at a separate in-person session with the therapist. Family and clinician experience will be captured via questionnaires and interviews. We will consider gender, sex, socioeconomic status, and ethnicity in our analyses to better understand diverse participant experiences. Collectively, our results will inform use of virtual assessments and co-creation of training materials for clinicians and families. Impact. This study supports family-focused, hybrid (in-person/virtual) models of care and new directions towards assessing children in their everyday life. Learnings will be widely shared for clinical care and future research.