Effectiveness of tele-occupational performance coaching in improving occupational performance and executive function in children with attention deficit hyperactivity disorder: a pilot randomised controlled trial

Background/Aims Occupational performance coaching is a family-centred intervention to enhance occupational performance in children. The remote variant, tele-occupational performance coaching, has become a viable option, especially for children with attention deficit hyperactivity disorder, addressing issues such as transportation and access to care. This study evaluates the effectiveness of tele-occupational performance coaching on occupational performance and executive function, among these children. Methods A randomised controlled trial of 30 children with attention deficit hyperactivity disorder, aged 6–11 years, used block randomisation to divide children into a control group ( n =15) and an intervention group ( n =15). Both groups participated in weekly sessions of standard occupational therapy for 10 weeks, and the mothers of the children in the intervention group also received weekly tele-occupational performance coaching. Key outcome measures included the Canadian Occupational Performance Measure, Goal Attainment Scale, and Behaviour Rating Inventory of Executive Function. Data analysis used analysis of covariance and repeated measures analysis of variance. Results The tele-occupational performance coaching group demonstrated significant improvements in occupational performance (mean difference: −3.4; 95% confidence interval: −4.24 to −2.56; P <0.001), satisfaction (mean difference: −3.66; 95% confidence interval: −4.43 to −2.89; P <0.001), and goal attainment (mean difference: −15.53; 95% confidence interval: −18.41 to −12.65; P <0.001) compared to the control group, with sustained effects at 2-week follow-up. Significant gains were also observed in executive function, particularly in cognitive and behavioural regulation ( P <0.001). Conclusions Tele-occupational performance coaching improves occupational performance, goal attainment, and executive function in children with attention deficit hyperactivity disorder. The effect size was large for these outcomes. Children's sensory profiles showed no significant change. Implications for practice Tele-OPC is a feasible and accessible option, especially where in-person therapy is limited. Tele-OPC, combined with occupational therapy, improves occupational performance, goal attainment, and executive function in children with attention deficit hyperactivity disorder.