*3.8. Focus on "My Abilities First"*

The COVID-19 pandemic might accelerate a global change towards inclusive and empathic healthcare encounters, using telemedicine or in person. A change about views of disability and how healthcare services are provided is needed globally [14,15]. Individuals experiencing disabilities have often voiced their unsatisfying and emotionally detached interactions with healthcare professionals [14].

A recently created electronic tool—called My Abilities First—breaks with the traditional view of disability and educates about the experience of living with a disability [6]. The rationale for the need of developing this novel abilities-oriented approach tool was based on lessons learned from a qualitative study that sought children's opinions about their strengths and limitations in performing day-to-day activities [16]. Overall, children and youth with disabilities focused primarily on their abilities and strengths, cheering ageappropriate interests [16]. As a result, My Abilities First was created allowing children and youth with disabilities to use their own words to describe themselves and their functional needs. Moreover, My Abilities First operationalizes a rights-based approach in medical

education and practice, emphasizing that users' opinions about themselves and their needs should be routinely sought [17].

My Abilities First can be accessed from mobile devices and it can be used in telehealth during or post the COVID-19 lockdown. Information gathered using this electronic tool can start a conversation with children and adults with disabilities about their needs for interventions or teleintervention.

My Abilities First could be used along the RBM strategies with families of all children with disabilities, regardless the age or underlying health condition. The web-based animations included in My Abilities First educate healthcare students, professionals, and the general public, changing common societal, incorrect assumptions about disability [16,18], thus enhancing the global impact of using a positive language in healthcare. As such, the global adoption of My Abilities First—during and post COVID-19 lockdown—could bring shared purpose, proximity, empowerment, trust, and joy in healthcare.

Specifically, My Abilities First consists of three web-based animations [6] (Access to animations provided in Supplementary Material S1). The first video introduces how to apply an abilities-oriented approach in healthcare encounters. It proposes the creation of a "my abilities identification card" which can be included in every health record. The target audience of this video includes health and health- allied professionals (My Abilities identification card animation available here https://youtu.be/WyW6ey3kHvM (accessed on 24 April 2020)).

The second web-animation included in My Abilities First describes the personal experience of a person living with a chronic health condition during healthcare encounters. This animation highlights the importance of applying a holistic approach in routine healthcare encounters, asking questions to identify the strengths of the person and capabilities performing daily routines. The audience of this video includes clinicians, researchers, educators, administrators, and students (My Abilities First—Getting to know me animation available here https://youtu.be/Dnn\_-0IEe\_Q (accessed on 1 May2020)).

Finally, the third video promotes a change in attitudes towards disability from a child's perspective. In this animation, a typical developing child advocates for social inclusion of children with disabilities, illustrating the importance of focusing on abilities and changing societal attitudes towards disability. The target audience of this video is the general public, school-aged children, and peers (My Abilities First for peers animation available here https://youtu.be/myHFKggNeGc (accessed on 1 May 2020)).

### **4. Global Impact of Routines-Based Model and My Abilities First**

RBM has been implemented in 10 countries over the past 30 years. The model provides actual practices for implementing a family-centered approach in person or virtually [5,8,19]. The model has been modified to include cultural adaptations in different countries and RBM tools are available in languages other than English.

Professionals applying RBM reported improved goals, in terms of functionality and measurability, improved team functioning, and more collaborative consultation [9,20]. Moreover, the short and long-term effectiveness of the RBM collaborative interventions has been shown in randomized controlled trials [21–23].

On the other hand, My Abilities First was recently created; it was published in April 2020 [6]. Since its publication, the e-tool has received global attention; it has been downloaded more than 800 times from all continents. It is currently being translated into Spanish, Portuguese, Chinese, and Polish. A pilot study checking satisfaction and change in healthcare attitudes using My Abilities First is underway in Taiwan (led by Professor Hua-Fang Liao, from the National Taiwan University) and in Brazil (led by Professor Egmar Longo, from the Federal University of Rio Grande do Norte). Furthermore, My Abilities First has been included in the pool of innovative resources listed in the International Alliance of Academies of Childhood Disability (IAACD) COVID-19 Task Force page (IAACD COVID-19 Task Force page https://iaacd.net/iaacd-covid-19-task-force/ (accessed on 5 July 2020)). This international initiative is collecting and sharing information related to the

impact of COVID-19 on people with disabilities around the world. Finally, My Abilities First has been selected as the theme of a global campaign launched by the European Academy of Childhood Disability (EACD), inviting children and young adults with disabilities from around the globe—to share their abilities and major facilitators influencing optimal functioning. This campaign is part of the Global Partnership Day (Global Partnership Day, EACD, My Abilities First https://eacd2021.com/my-abilities-first/ (accessed on 30 January 2021)) organized by the EACD in 2021.
