# Occupation-Based Tele-Intervention for Children with Neurodevelopmental Disorders: A Pilot Study

## TL;DR

A pilot study shows that a telehealth occupational therapy program helps children with neurodevelopmental disorders improve their daily functioning.

## Contribution

The study adapts and evaluates a telehealth version of the CO-OP occupational therapy model for children with NDDs.

## Key findings

- Children showed clinically significant improvements in personal goal training after the telehealth intervention.
- Parents and therapists identified key factors like engagement and technology use that affect teleintervention success.
- High satisfaction rates suggest tele-CO-OP is a feasible and acceptable treatment option for children with NDDs.

## Abstract

What are the main findings?
Tele-CO-OP enables meaningful functional gains in children with NDDs through telehealth.

Tele-CO-OP enables meaningful functional gains in children with NDDs through telehealth.

What are the implications of the main findings?
Home-based delivery enhances the generalization of treatment to the child’s natural environment.Key facilitators and barriers identified can inform sustainable teleintervention.

Home-based delivery enhances the generalization of treatment to the child’s natural environment.

Key facilitators and barriers identified can inform sustainable teleintervention.

Background: There is a growing gap between the increasing prevalence of children with neurodevelopmental disorders (NDDs) and the limited availability of developmental services. This raises an urgent need for effective and accessible intervention models. Hybrid intervention offers an innovative and practical solution, yet evidence regarding its feasibility and efficacy for children remains limited. This study aimed to adapt an evidence-based occupational therapy (OT) intervention model for remote delivery and to examine its feasibility and preliminary efficacy among children with NDDs. Methods: Using a quasi-experimental pre–post, mixed-methods design, children aged 5–8 years with NDDs were recruited from child development units in southern Israel. The intervention comprised 12–15 weekly video-conference sessions utilizing the Cognitive Orientation to (daily) Occupational Performance (CO-OP) approach. Standardized outcome measures assessed feasibility and preliminary efficacy. Focus groups with parents and therapists explored facilitators and barriers to implementation. Results: Of the 26 participants enrolled, 14 children (71% boys) completed the intervention and reported high satisfaction. Clinically significant improvements were observed in personal goal training, reported by both children (80%) and parents (73.68%). Content analysis identified three key themes: parents’ engagement, ecological intervention, and technological literacy. Conclusions: Tele-CO-OP intervention was found to be feasible for children with NDDs and showed potential to improve occupational performance in personal goals. Findings provide a practical foundation for developing hybrid OT services as a valuable complement to in-person care for this growing population.