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Abstract

Background: There is limited evidence about the effectiveness of occupational therapy interventions for participation outcomes in children with coordination difficulties. Developing theory about the interventions, i.e. their ingredients and change processes, is the first step to advance the evidence base. Aim: To develop theory about the key ingredients of occupational therapy interventions for children with coordination difficulties and the processes through which change in participation might happen. Material and methods: Grounded theory methodology, as described by Kathy Charmaz, was used to develop the theory. Children and parents participated in semi-structured interviews to share their experiences of occupational therapy and processes of change. Data collection and analysis were completed concurrently using constant comparison methods. Results: Five key ingredients of interventions were described: performing activities and tasks; achieving; carer support; helping and supporting the child; and labelling. Ingredients related to participation by changing children’s mastery experience, increasing capability beliefs and sense of control. Parents’ knowledge, skills, positive emotions, sense of empowerment and capability beliefs also related to children’s participation. Conclusion and significance: The results identify intervention ingredients and change pathways within occupational therapy to increase participation. It is unclear how explicitly and often therapists consider and make use of these ingredients and pathway.

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... The characteristics of the fifteen included papers are presented in Table 1. Six of the studies were conducted in the United Kingdom [31,45,[49][50][51][52], five in Canada [33,34,44,53,54], one in Austria/ Italy [55], one in Brazil [56], one in Belgium [57], and one in New Zealand [58]. In total, data from one hundred and nine participants were included in the qualitative synthesis. ...
... In total, data from one hundred and nine participants were included in the qualitative synthesis. Nine papers had participants with a mean age ranging from 6.9 years to 11 years [33,34,45,49,[54][55][56][57][58]. Five papers had participants with a mean age range of 13 years to 14.9 years [31,[50][51][52][53] and one study included young adults aged 19-25 years who reflected upon their experiences as an adolescent [44]. ...
... Ten studies presented the philosophical perspective on which the study was based and a methodological approach which was congruent with the perspective [31,34,44,51,52,[54][55][56][57][58]. However, the philosophical or theoretical perspective was not clearly represented in the remaining five papers [33,45,49,50,53]. The majority of studies described an appropriate qualitative methodology for addressing the research question or objectives. ...
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Background To date services for children with Developmental Coordination Disorder (DCD) have not been informed by the perspective of children with DCD. This study aimed to synthesise the findings of discrete qualitative studies reporting the lived experiences views and preferences of children and young with DCD using a meta-ethnographic approach to develop new conceptual understandings. Methods A systematic search of ten databases; Academic Search Complete, AMED, CINAHL, ERIC, MEDLINE, PsychArticles, PsychInfo, EMBASE, SPORTDiscus, and Web of Science, was conducted between March and April 2019, and updated in early June 2020. Meta-ethnography, following the method described by Noblit and Hare was used to synthesise included studies. The Joanna Briggs Institute Checklist was used to appraise all included papers. PROSPERO registration number CRD42019129178 . Results Fifteen studies met the inclusion criteria. Meta-ethnographic synthesis produced three themes; a) ‘It’s harder than it should be’: Navigating daily activities b) Fitting in, and c) ‘So what? I drop things’: Strategies and supports to mitigate challenges. Children with DCD describe a mismatch between their abilities and performance norms for daily activities that led to a cascade of negative consequences including negative self-appraisal, bullying and exclusion. In the face of these difficulties children described creative and successful strategies they enacted and supports they accessed including; assistance from others (parents, friends and teachers), focusing on their strengths and talents, accepting and embracing their difference, adopting a “just do it” attitude, setting personal goals, self-exclusion from some social activities, using humour or sarcasm, viewing performance expectations as a social construct, and enjoying friendships as a forum for fun, acceptance and protection against exclusion. Conclusion Service provision for children and young people with DCD should address the social and attitudinal environments, focus on friendship and social inclusion and address stigma-based bullying particularly within the school environment. Furthermore, practitioners should identify and foster children’s own strategies for navigating daily life activities with DCD. The identified themes resonate with contemporary disability theory and the International Classification of Functioning. The social and attitudinal environmental context of children and young people with DCD profoundly influences their experiences. Future intervention development and service provision for children and young people with DCD should consider opportunities to address social and attitudinal environmental factors.
... The data obtained was examined word-by-word and repeatedly read to determine the right code. The participants' expression represented their experience through symbols in the forms of speech and meaning (Armitage et al., 2017). The identification of results has been written as a code or a keyword. ...
... We obtained the data by examining word-by-word and repeatedly read to determine the right code. The participants' expression represented their experience through symbols in the forms of speech and meaning (Armitage et al., 2017). The identification of results has been written as code or a keyword. ...
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Shackling a person with schizophrenia violates human rights. This process is often carried out when the person has committed acts of violence and hostility. In this study, we focus on considering the shackling of a person with schizophrenia in Indonesia’s context. We used grounded theory (GT; Charmaz, 2011) with 23 participants located in the East Java Province, Indonesia. The participants consisted of people with schizophrenia who were shackled by their ankles, families treating people with schizophrenia, the cadre volunteers, prominent figures, and nurses. We used in-depth interviews using semi-structured questions. We identified five phases associated with the process of shackling a person with schizophrenia: (a) distress signal, (b) high demand for treatment, (c) a change of positive convictions, (d) loss of confidence and capability, and (e) restrictions. Understanding the process of shackling people with schizophrenia will help the Indonesian government prevent people with schizophrenia from being shackled by their ankles.
... Since the use of randomized controlled studies is challenging in children and young people with ABI, 42,74 single-participant and case-control research designs may be considered, as they offer control through systematic measurement and implementation, often under conditions that reflect the complexity and practicality of everyday practice. 75 In addition, grounded theory-driven research such as that of Armitage et al. 76 could provide insights into how principles of experience-dependent neural plasticity and related physical rehabilitation intervention characteristics should be shaped for clinical practice in the rehabilitation of children and young people with ABI. This offers opportunities for involvement of patients and the public in future research projects for children and young people with ABI. ...
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Aim To synthesize the evidence about the characteristics (frequency, intensity, time, type) and effects of physical rehabilitation interventions on functional recovery and performance in daily functioning in children and young people with acquired brain injury (ABI), including traumatic brain injuries (TBI) and non-TBI, during the subacute rehabilitation phase. Method Using scoping review methodology, a systematic literature search was performed using four databases. Articles were screened by title and abstract and data from eligible studies were extracted for synthesis. Results Nine of 3009 studies were included. The results demonstrated a variety of intervention characteristics: frequency varied between 1 and 7 days per week; time of intervention varied between 25 minutes and 6 hours a day; intervention types were specified in seven studies; and none of the included studies reported details of intensity of intervention. All studies reported positive results on the International Classification of Functioning, Disability and Health: Children and Youth (ICF-CY) levels of body function and activities after the intervention period, with study designs of included studies being cohort studies without concurrent controls (n=7) or case reports (n=2). Interpretation Inconsistency in results hampers generalizability to guide clinical practice. Physical interventions during subacute rehabilitation have potential to improve functional recovery with intervention characteristics as an important factor influencing its effectiveness. Future well-designed studies are indicated to gain knowledge and optimize rehabilitation practice in paediatric ABI and high-quality research including outcomes across all ICF-CY domains is needed.
... Engagement may be more necessary for effects to be shown for some types of interventions than others. Relatedly, the PRIME-P may be useful in understanding the therapeutic alliance and other specific aspects of the intervention process, including active ingredients and client change processes [45,48,49]. Since there is relatively little work on parents' expectations in pediatric rehabilitation services [50], further investigation of the role of parent outcome expectancies is warranted. ...
Article
Purpose To examine the psychometric properties of a parent-report measure of engagement in pediatric rehabilitation. Method 113 parents (of children 4 months to 18 years, varying in diagnoses) were recruited from standard outpatient/inpatient, early intervention, and life skills programs, sampled from different sites in Canada, the US, and Australia. Parents completed the Pediatric Rehabilitation Intervention Measure of Engagement—Parent version (PRIME-P) twice, after two therapy sessions approximately two weeks apart. Analyses examined factor structure, internal consistency, and test-retest reliability, and assessed construct validity hypotheses concerning participant characteristics and contextual factors. Results The resulting 11-item PRIME-P has three factors capturing engagement in terms of Plan Appropriateness, Partnering, and Positive Outcome Expectancy. The factors displayed strong internal consistency and test-retest reliability (Partnering demonstrated slightly weaker test-retest reliability). Construct validity was shown by significant associations between the PRIME-P scales and parents’ presence versus absence during the sessions, as well as service providers’ years of experience. Conclusions The PRIME-P captures parent engagement as a multifaceted construct involving appropriateness of the therapy plan, a sense of active partnership in the intervention process, and an expectation for a positive outcome. The PRIME-P has promise for research, clinical practice, and educational purposes. • IMPLICATIONS FOR REHABILITATION • The PRIME-P is a psychometrically sound tool that fills a gap in how researchers and practitioners can measure the engagement of parents in the therapy process. • To enhance parent engagement, service providers can encourage collaboration in planning, foster a sense of working in partnership, and convey a sense of hope. • The findings point to the need to pay attention to parents’ beliefs about the therapy plan and outcomes, in addition to their behavioral involvement. • The PRIME-P is a promising tool for pediatric rehabilitation that can be used to investigate the role of a crucial, yet poorly understood variable in the therapy process.
... Enabling the child and family to form a team to work on one participation goal appeared to increase the intensity and focus of the intervention. Notably active ingredients such as caregiver support and a supportive environment for the child have previously been recognized to improve CYP participation outcomes [24], echoing the value in identifying a supportive participation team to work on the goal with the child. ...
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Background: Children with acquired brain injury experience participation restrictions. Pathways and Resources for Participation and Engagement (PREP) is an innovative, participation focused intervention. Studies have examined PREP in Canadian research contexts, however little is known about implementation in real-life clinical settings. This study aimed to understand experiences of clinicians implementing PREP in a UK clinical context, with a focus on implementation processes and key factors for successful implementation. Methods: A qualitative single-site 8-week knowledge translation intervention study, guided by an action research framework, explored clinicians' experiences of implementation. Six occupational therapists (OTs) working in a neurorehabilitation setting participated. The therapists provided two intervention sessions per week, over four weeks for one child on their caseload. Planning, implementation and evaluation were explored through two focus groups. Thematic analysis was used to analyse data. Results: Two themes, "key ingredients before you start" and "PREP guides the journey", were identified before introducing PREP to practice. Four additional themes were related to PREP implementation: "shifting to a participation perspective", "participation moves beyond the OT", "environmental challengers and remedies" and "whole family readiness". A participation ripple effect was observed by building capacity across the multi-disciplinary team and families. The involvement of peers, social opportunities and acknowledging family readiness were key factors for successful implementation. Conclusions: The findings illustrate practical guidance to facilitate the uptake of participation-based evidence in clinical practice. Further research is required to understand aspects of knowledge translation when implementing participation interventions in other UK clinical settings.
... parental self-efficacy, are suggested and four categories represent potential intervention processes and outcomes: parenting and parent behaviour; parent health; child behaviour and peer and social support. The wider evidence base for interventions to support children with neurodisability more broadly supports the potential for factors such as parental self-efficacy to be a plausible mechanism for change (Armitage et al. 2016) within group-based parent training interventions. By drawing on this wider research field, some of the exploratory findings from our review such as intervention ingredients (e.g. ...
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Parents of children with autism spectrum disorders should have access to interventions to help them understand and support their child. This literature review examines the existing evidence for group-based parent training interventions that support parents of children with autism. From the literature, core intervention processes and outcomes are identified and include parenting and parent behaviour, parent health, child behaviour and peer and social support. Results show a positive trend for intervention effectiveness, but findings are limited by low-quality studies and heterogeneity of intervention content, outcomes and outcome measurement. Future research should focus on specifying effective intervention ingredients and modes of delivery, consistent and reliable outcome measurement, and improving methodological rigour to build a more robust evidence base.
... Understanding the nature of pediatric rehabilitation programs requires an examination of the active ingredients thought to mobilize processes of client change. 5,6 Pediatric rehabilitation interventions are typically complex, 7 producing outcomes through the synergistic interaction of contextual factors and multiple components or ingredients. 2,3,8 Without knowing how an intervention works and its active ingredients, it is difficult to optimize therapeutic change or develop intervention manuals. ...
Article
Objective: To examine intervention strategy use in residential immersive life skills (RILS) programs. Methods: The Service Provider Strategies-Checklist was used to record the strategies used in 100 activity settings across two summers at three RILS program sites. Activity settings were categorized by activity type and session format. Relative occurrence of the strategies was examined using percentages. Results: Socially mediated strategies (listening, engaging youth) and teaching/learning techniques (verbal cues, verbal instruction) were used in over 75% of the settings. Strategy use was highly contextualized, with different strategy patterns observed for different types of activity settings. Conclusion: The findings suggest that RILS programs be characterized by their use of socially mediated strategies and teaching/learning techniques, with socially mediated and non-intrusive strategies appearing to be program hallmarks. Strategy use was aligned with the types of sessions offered, providing evidence of program fidelity and indicating that RILS programs are complex in their formats, activities, and strategy use.
... Codes that represented a similar concept were subsequently assembled into conceptual categories [22] with the assistance of the memos. Coding was performed iteratively within and between interview transcripts, using the technique of constant comparative analysis [23]. ...
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In the United Kingdom, following the emergence of Seoul hantavirus in pet rat owners in 2012, public health authorities tried to communicate the risk of this zoonotic disease, but had limited success. To explore this lack of engagement with health advice, we conducted in-depth, semi-structured interviews with pet rat owners and analysed them using a grounded theory approach. The findings from these interviews suggest that rat owners construct their pets as different from wild rats, and by elevating the rat to the status of a pet, the powerful associations that rats have with dirt and disease are removed. Removing the rat from the contaminated outside world moves their pet rat from being ‘out of place’ to ‘in place’. A concept of ‘bounded purity’ keeps the rat protected within the home, allowing owners to interact with their pet, safe in the knowledge that it is clean and disease-free. Additionally, owners constructed a ‘hierarchy of purity’ for their pets, and it is on this structure of disease and risk that owners base their behaviour, not conventional biomedical models of disease.
... -7-11 yaþ arasý uyum sorunu yaþayan 7 çocukla ve bakýmverenleri ile yapýlan bir çalýþmada, performans aktiviteleri, baþarý, bakýmverene destek, bakýmverenin çocuða desteði ve iþaretleme olarak 5 adet giriþim belirlemiþ ve ergoterapi süreci sonunda anlamlý düzeyde geliþme kaydedildiði gösterilmiþtir (29). ...
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'Ergo’ word which means ‘work’ has an origin of Greek language. It is a method which practises in individuals who have pyhsical or mental disabilities. Ergotherapy, on the other meaning occupational therapy, includes activities like art, music, painting, handiwork, physical activities, motor functioning therapy, auditory perception exercises, ligering on exercises. Although it seems as a new healthcare field, the history of ergotherapy is quite old. It has been used in the century of 4th anno domini in Asklepios Temple as a rehabilitation method for disabled people. Nowadays, there are ever increasing articles about the efficieny of ergotherapy. It already took 17th place inside the list of best healthcare jobs and 23th place inside the best entire jobs in United States of America. At the present time, although there are many ergotherapists all over the World, unfortunately in our country there is few. In this sense, ergotherapy seems to be an important job field in the near future in Turkey. Keywords: Ergotherapy, occupational therapy, rehabilitation
Article
Introduction Children and young people with developmental coordination disorder experience multiple occupational performance and participation challenges across environments. Research to date has not fully explored occupational therapy practice with children with developmental coordination disorder and their families. This study aims to describe current occupational therapy practice with children with developmental coordination disorder. Method This study used a cross-sectional, online qualitative vignette survey methodology. International occupational therapists who were working with or had worked with children with developmental coordination disorder within the previous 5 years were invited to participate. Following a case vignette, clinicians were asked questions prompting them to describe their practice based upon the vignette. The data were analysed thematically. The Consolidated Criteria for Reporting Qualitative Research and Checklist for Reporting Results of Internet E-Surveys reporting guidelines were adhered to. Findings Fifty-three valid responses were analysed. Analysis identified three themes describing occupational therapy practice with children with developmental coordination disorder: (a) a collaborative approach to establish occupation-focused goals; (b) occupation-focused assessment to guide therapy and diagnose developmental coordination disorder; and (c) the use of occupation-based interventions incorporating multiple strategies to enhance occupational engagement. Conclusion This study suggests that current occupational therapy practice with children with developmental coordination disorder is collaborative, occupation-focused, and multi-component. Findings highlight a gap between the complexity of practice and the nature of interventions evaluated in research to date.
Article
Aim: Client engagement is assumed to affect therapy outcomes. This study examined service providers' perceptions of youth engagement in solution-focused coaching sessions focusing on participation-oriented goals for youth with cerebral palsy. Method: Service providers completed the Pediatric Rehabilitation Intervention Measure of Engagement-Service Provider version (PRIME-SP) at the end of each session of the brief solution-focused coaching intervention (3-5 sessions) for 10 youth. Results: Youth engagement was high yet fluctuated over the sessions. Service providers noted a range of components of engagement/disengagement (affective, cognitive, and behavioral) and related factors, including client states, components of behavior change (success or nonsuccess between therapy sessions, and pleasure with success), and service provider strategies. Four preliminary patterns involving engagement, client-reported success, and goal difficulty (personally achievable or dependent on others) appeared to be meaningfully related to quantitative measures of youth outcomes. Conclusions: The study provides insights into the highly engaging nature of solution-focused coaching and the relational, co-constructed nature of the therapeutic interaction. The study indicates the utility of the PRIME-SP as a tool for recording observations of components of engagement and related factors that may be useful for clinical decisions about the use of engagement strategies and for general reflections on practice.
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Occupational therapy theory, practice and research has increasingly emphasized the transactional relationship between person, environment and occupation. Occupational performance results from the dynamic relationship between people, their occupations and roles, and the environments in which they live, work and play. There have, however, been few models of practice in the occupational therapy literature which discuss the theoretical and clinical applications of person-environment interaction. This paper proposes a Person-Environment-Occupation Model of occupational performance which builds on concepts from the Occupational Therapy Guidelines for Client Centered Practice and from environment-behaviour theories. The model describes interactions between person, occupation and environment, outlines major concepts and assumptions, and is applied to a practice situation.
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The International Classification of Functioning Disability and Health (ICF) offers an agreed language on which a scientific model of functional outcomes can be built. The ICF defines functional outcomes as activity and activity limitations (AL) and defines both in behavioural terms. The ICF, therefore, appears to invite explanations of AL as behaviours. Studies of AL find that psychological variables, especially perceptions of control, add to biomedical variables in predicting AL. Therefore, two improved models are proposed, which integrate the ICF with two psychological theories, the theory of planned behaviour (TPB) and social cognitive theory (SCT). These models have a sound evidence base as good predictors of behaviour, include perceived control constructs and are compatible with existing evidence about AL. When directly tested in studies of community and clinic-based populations, both integrated models (ICF/TPB and ICF/SCT) outperform each of the three basic models (ICF, TPB and SCT). However, when predicting activity rather than AL, the biomedical model of the ICF does not improve prediction of activity by TPB and SCT on their own. It is concluded that these models offer a better explanation of functional outcomes than the ICF alone and could form the basis for the development of improved models.
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This article first appeared in May 1996 in The Psychologist, Volume 9, Number 5, Pages 205–210. Permission to reproduce the article in Physiotherapy Theory and Practice has been granted by the author and the publisher of The Psychologist, the British Psychological Society. The article is based on the author' 1995 Presidents' Award Lecture at the British Psychological Society' Annual Conference held at the University of Warwick in April 1995.
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Aim: The aim of this study was to review systematically evidence about the efficacy of motor interventions for children with developmental coordination disorder (DCD), and to quantify treatment effects using meta-analysis. Method: Included were all studies published between 1995 and 2011 that described a systematic review, (randomized) clinical trial, or crossover design about the effect of motor intervention in children with DCD. Studies were compared on four components: design, methodological quality, intervention components, and efficacy. Twenty-six studies met the inclusion criteria for the review. Interventions were coded under four types: (1) task-oriented intervention, (2) traditional physical therapy and occupational therapy, (3) process-oriented therapies, and (4) chemical supplements. For the meta-analysis, effect sizes were available for 20 studies and their magnitude (weighted Cohen's d [d(w) ]) was compared across training types. Results: The overall effect size across all intervention studies was d(w) =0.56. A comparison between classes of intervention showed strong effects for task-oriented intervention (d(w) =0.89) and physical and occupational therapies (d(w) =0.83), whereas that for process-oriented intervention was weak (d(w) =0.12). Of the chemical supplements, treatment with methylphenidate was researched in three studies (d(w) =0.79) and supplementation of fatty acids plus vitamin E in one study (no effect). The post hoc comparison between treatment types showed that the effect size of the task-oriented approach was significantly higher than the process-oriented intervention (p=0.01) and comparison (p=0.006). No significant difference in the magnitude of effect size between traditional physical and occupational therapy approaches and any of the other interventions emerged. Interpretation: In general, intervention is shown to produce benefit for the motor performance of children with DCD, over and above no intervention. However, approaches from a task-oriented perspective yield stronger effects. Process-oriented approaches are not recommended for improving motor performance in DCD, whereas the evidence for chemical supplements for children with DCD is currently insufficient for a recommendation.
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Disability following stroke is highly prevalent and is predicted by psychological variables such as control cognitions and emotions, in addition to clinical variables. This study evaluated the effectiveness of a workbook-based intervention, designed to change cognitions about control, in improving outcomes for patients and their carers. At discharge, stroke patients were randomly allocated (with their carers) to a 5-week intervention (n = 103) or control (normal care: n = 100). The main outcome (at 6 months) was recovery from disability using a performance measure, with distress and satisfaction as additional outcomes. The intervention group showed significantly better disability recovery, allowing for initial levels of disability, than those in the control group, F(1,201) = 5.61, p = 0.019. Groups did not differ in distress or satisfaction with care for patients or carers. The only psychological process variable improved by the intervention was Confidence in Recovery but this did not mediate the effects on recovery. A large proportion of intervention participants did not complete the workbook tasks. This was perhaps associated with the fairly low level of personal contact with workbook providers. The modest success of this intervention suggests that it may be possible to develop effective behavioural interventions to enhance recovery from disability in stroke patients.
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Participation in physical play/leisure ('PPP') is an important therapy goal of children with motor impairments. Evidence for PPP interventions for these children is scarce. The first step is to identify modifiable, clinically meaningful predictors of PPP for targeting by interventions. To identify body function and structure, activity, environment, and personal factors related to PPP in children with motor impairments and modifiable by therapists. A mixed methods, intervention-development study using the WHO framework International Classification of Functioning, Health and Disability. Participants: children (6-8yrs) with motor impairments, mobilizing independently with/without equipment, and seen by physical or occupational therapists in six regions in the United Kingdom; and their parents. Self-reported PPP was assessed by Children's Assessment of Participation and Enjoyment (CAPE). Modifiable-factor data were collected by therapists' observations, parent questionnaires, and child-friendly interviews. CAPE, therapist, and parent data were analysed using descriptive statistics and linear regression. Interview data were analysed for emerging themes. Children's (n=195) PPP [mean 18 times/week (IQR=11-25)] was mainly 'recreational' (e.g., pretend play, playing with pets) rather than 'active physical' (e.g. riding a bike/scooter). Parents (n=152) reported positive beliefs about children's PPP but varying levels of family PPP. Therapists reported 23 unique impairments (e.g., muscle tone), 16 activity limitations (e.g., walking), and 3 personal factors (e.g., child's PPP confidence). Children interviewed (n=17) reported strong preference for active play, but indicated that adults regulated their PPP. Family PPP and impairment in the child's movement-related body structures explained 18% of variation in PPP. Family PPP explained most variation. Results converge with wider literature about the child's social context as a PPP intervention target. Results question therapists' observations in explaining PPP. © 2015 American Physical Therapy Association. To access the full text, please do to: http://physther.org/content/early/2015/05/14/ptj.20140404?cited-by=yes&legid=ptjournal;ptj.20140404v1
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Children with developmental coordination disorder (DCD) have a motor impairment that affects their ability to perform everyday tasks. Although severity of motor impairment can be measured, methods for assessing the perceived impact of DCD on daily activities have not been established. The purpose of this study was to use a child-focused approach to understand children's views of the impact of DCD on the activities that they perform daily. Children aged 5–10 years, referred with coordination difficulties to occupational therapists, were assessed using the Movement Assessment Battery for Children: children who received scores below the 15th percentile were included. The Perceived Efficacy and Goal Setting System (PEGS), a pictorial scale validated as a method for engaging children with disabilities, was administered to examine the children's perceptions of their competence in performing everyday activities and to identify goals for therapy. Parent and teacher concerns were collected by a questionnaire. The children, parents and teachers shared many concerns about the impact of DCD on physical tasks and on academic activities such as handwriting. The children expressed additional concerns, however, about their ability to perform daily self-care tasks and leisure activities, which were rarely recognised by the adults. Children require specialised methods to enable them to express their views and the PEGS appears to be suitable for this purpose.
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The present experiment was designed to test the theory that psychological procedures achieve changes in behavior by altering the level and strength of self-efficacy. In this formulation, perceived self-efficacy. In this formulation, perceived self-efficacy influences level of performance by enhancing intensity and persistence of effort. Adult phobics were administered treatments based upon either performance mastery experiences, vicarious experiences., or they received no treatment. Their efficacy expectations and approach behavior toward threats differing on a similarity dimension were measured before and after treatment. In accord with our prediction, the mastery-based treatment produced higher, stronger, and more generalized expectations of personal efficacy than did the treatment relying solely upon vicarious experiences. Results of a microanalysis further confirm the hypothesized relationship between self-efficacy and behavioral change. Self-efficacy was a uniformly accurate predictor of performance on tasks of varying difficulty with different threats regardless of whether the changes in self-efficacy were produced through enactive mastery or by vicarious experience alone.
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This paper is the first in a series of three papers that present the systematic development and evaluation of Cognitive Orientation to daily Occupational Performance (CO-OP). CO-OP is a cognitively based, child-centred intervention that enables children to achieve their functional goals. In Part I, the breadth of literature that provides the theoretical underpinnings for the approach is reviewed. Parts II and III provide a description of the approach and present the evidence to support its use with children with developmental coordination disorder.
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Parts I and II of this series introduced the Cognitive Orientation to daily Occupational Performance (CO-OP), a new approach to intervention that is based on the premise that cognition plays an important role in the acquisition of occupational skills and the development of occupational competency. Developed for use with children who have occupational performance deficits, CO-OP is an individualized, client-centred approach focused on strategy-based skill acquisition. This third paper in this series presents a brief description of the actual CO-OP protocol including its objectives, prerequisites and key features.
Developing and evaluating complex interventions: new guidance
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MRC. Developing and evaluating complex interventions: new guidance; 2008 [Internet]; [cited 2015 Oct 13]. Available from: www.mrc.ac.uk/complexinterven tionsguidance.
Activity and participation interventions for children with movement problems: a systematic review to generate a Rehabilitation Intervention Technique Classification v1
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Kolehmainen N, McAnuff J, Tissen-Budde A. Activity and participation interventions for children with movement problems: a systematic review to generate a Rehabilitation Intervention Technique Classification v1. Dev Med Child Neurol.; Forthcoming 2016.