Commentary on “Goal Attainment Scaling to Evaluate Intervention on Individual Gains for Children Born Extremely Preterm”
This study used goal attainment scaling (GAS) which provided a tool for evaluation of specific and meaningful functional tasks or activities at all levels of the International Classification of Functioning Disability and Health framework with input from the child's family. GAS can be used effectively in the absence of standardized tests or when seeking a measurement of change within a shorter intervention period. More specifically, this study demonstrated that group-based therapy could lead to individual gains in motor performance measured by GAS; however, goal attainment could not be directly linked to postural stability or limb strength. Boys should be more closely monitored in motor coordination, as their male gender appears to put them at increased risk for less favorable outcomes.
“What should I be mindful about when applying this information?”
Therapists should be mindful that the evidence related to the use of GAS in the pediatric setting may be limited to measures of short-term change rather than longer effects of intervention. Furthermore, the effect of a child's expected, or typical, maturation may be difficult to separate from the effect of an intervention when setting goals which are then used as the criteria for measuring improvement. Reliability of GAS remains unclear and cannot be ascertained from this study despite the authors' attempts to carefully follow published guidelines for each outcome measure to which the GAS was compared. Additionally, the long-term carryover and generalizability of motor skill gains remain unclear, as motor outcomes were only assessed immediately following intervention. Also unclear are the factors contributing to the observed trend between male gender and poorer motor outcomes.