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

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.