Adapting Interventions for Occupational Therapy Practice: Application of the FRAME Coding Structure

Occupational therapy practitioners often adapt evidence-based interventions for implementation into practice, yet these adaptations are seldom captured systematically. The purpose of this study was to apply the Framework for Reporting Adaptations and Modifications–Expanded (FRAME) to describe adaptations to one intervention modified for teletherapy in the wake of COVID-19. An embedded multiple case study design was used to track adaptations made to a vestibular and bilateral integration (VBI) protocol—traditionally delivered in-person—that was implemented via teletherapy in a pediatric outpatient clinic. The “Modification and Adaptation Checklist” was used to track protocol adaptations. Data were examined through descriptive analyses; 63 adaptations were made to the VBI protocol. The most frequently noted adaptation was “Repeating protocol activities,” whereas the “Integrating another treatment approach with the VBI protocol” was the least common adaptation. The FRAME may be useful for tracking adaptations and evaluating how adaptations influence intervention effectiveness.