Title. Finnish children's understanding of the items in Child Occupational Self Assessment (COSA)

Background. The Child Occupational Self Assessment (COSA) is an assessment tool that gathers self reported information from children about their sense of competence and values in everyday activities. As pediatric occupational therapy in Finland is currently lacking in valid instruments to elicit children's perspectives on their needs and goals within occupational therapy assessments, a valid translation of COSA to Finnish is being developed by Metropolia University of Applied Sciences.

Aim. The aim of this study was to explore the understandings of typically developed Finnish children on the Finnish COSA, and whether their interpretations fit the intended meanings of the items.

Material and methods. Six typically developed Finnish children participated. Data were collected using the Three-Step Test-Interview -method and analyzed qualitatively using the constant comparative method.

Results. The results show variations of appropriate understandings in relation to children's experienced level of competence, as well as discrepancies in understandings related to language, translation and item context.

Conclusions and significance. The results suggest the therapist should actively provide the children with explanations of COSA items’ intended meanings. Additionally, the results suggest further development and research to validate the Finnish translation of COSA, to support the goal-setting and client-centred pediatric occupational therapy in Finland.