Executive Functioning Skills Deficits in university students

with Developmental Co-ordination Disorder (DCD)

Kirby, A., Thomas, M. & Williams, N.

Background to the study

• What is Executive Function (EF)?

• EF in relation to DCD

What is Executive Function (EF)?

• Term used to describe a complex cognitive construct which allows us to act as efficiently as possible.

• Components include:o Planning o Problem-solvingo Working memoryo Sustained attentiono Impulse controlo Decision-making

EF processes can be split into actions that require:

• conscious control (e.g. learning a new skill)• those that are automatic (e.g. memory recall) –or

• a combination of both (e.g. riding a bicycle).

Executive Function (EF)EF processes are associated with the prefrontal cortex (PFC) and other areas….

EF is not a unitary conceptDifferent constructs have been made each

with adifferent focus (Alloway, 2007; Gathercole

et al.2008).

Different approaches to assessment of EF –Brown review (2009). He suggests clinical interviews and rating scales may be valid assessments.

Impact of Executive Function Deficits

Impairments or deficits in the system will impact greatly on a person’s ability to conduct day to day tasks and maintain social relationships (Goel et al., 1997; Green et al., 2000).

EF is a predictor of future social competence (Nigg et al,1999; Clark et al., 2002).

ADHD and poor EF- affect academic achievement (Biederman et al., 2004).

EFDs have been identified in a number of Developmental

Disorders

• ADHD (Barkley, 1997; Biederman et al., 2007; Brown, 2009; Parker & Boutelle, 2009)

• ASD (Verté et al., 2005)

• Dyslexia (Reiter et al., 2005; Gooch et al., 2011)

EF & DCD• Alloway (2007), Alloway & Temple (2007) –

significant deficits in working memory in children with DCD.

• Kirby et al. (2008) – self reported executive functioning deficits in students with DCD (and to a greater extent than those with dyslexia).

• Kirby et al. (2011) – a high proportion of parents of emerging adults with DCD report problems with organisation, time & money management.

1) Students arrive with/without diagnosis of

DCD or an inaccurate diagnosis e.g. Dyslexia.

However, support is often variable and determined by a “label” (Kirby et al., 2008).

2) DCD is a heterogeneous condition.

Severity is on a continuum and will vary.

3) To understand support needs in relationship to EF it is useful to map out the profile of symptoms and signs.

Rationale for the exploratory study

Study Aims1. To investigate and compare patterns of self reported executive function skills in:

a) students with DCD. b) students who do not have a diagnosis but

reported difficulties. c) TD students.

2. Develop a functional tool to be used to assist planning and delivery of support.

Method• Developed a 77-item questionnaire including

different aspects of EF in the context of university, home and work life.

• Paper and electronic version of questionnaire.

• Each item scored on a 5 point Likert scaleranging from “Not at all like me” to “Very much like me”.

6 componentsPlanning - “I always write essay plans before starting an

assignment”Organisation - “I am good at organising lecture notes”Inhibition/impulse control - “I am easily distracted by

other people or noise around me when writing assignments”

Working memory - “When writing an assignment I often lose my flow of thought”

Metacognition - “I find it hard to use feedback/ comments from previous assignments to improve

work”Time management - “I am good at estimating how long it

will take to complete different assignments”

Recruitment Students currently attending university

The study was advertisedo Posters/bulletins around the universities/

student services o Social networking siteso The Dyscovery Centre website and databaseo DANDA members

DataGender No Diagnosis

(TD)DCD No diagnosis

but difficulties

Total

Male 122 12 12 146

Female 81 19 42 142

Total 205 31 54 290

Age range 18-64 years.

Mean 26.78 (9.51) years

Approach to analysis• TD group scores for each of the 6 components of EF

were used as the comparison group.

Examined how many of:a) the DCD groupb) “no diagnosis but difficulties group”

fell below the cut offs for the bottom 15th, 10th and 5th percentile based on the TD group.

Planning

Organisation

Inhibition/Impulse

Control

Working M

emory

Metacognition

Time M

anagement0

102030405060708090

100

15% or below10% or below5% or below

%

Number of students with DCD who fell into the lower percentile cut off ranges based on the

typically developing scores

No diagnosis but difficulties – a sub threshold group?

Planning

Organisation

Inhibition/Impulse

Control

Working M

emory

Metacognition

Time M

anagement0

10

20

30

40

50

60

70

80

90

100

15% or below10% or below5% or below

%

Conclusions

1. Significant self-reported EF difficulties in those with DCD

2. ALSO those who do not have a diagnosis BUT say they have difficulties DO have greater EF difficulties than TD’s.

Conclusions• Sub-threshold students at

risk of failure and not being able to access same supports – due to not having a diagnosis.

• Differential support system-with a bias for those with Dyslexia (Kirby et al., 2008)

Implications for universities support services

• Screening/check list could oDelineate patterns where support

could be offeredoProvide tailored supporto Identify the sub threshold student

Future work

• Further development of questionnaireo Refine questionnaireo Collect more datao Validate against other measures

Executive Functioning Skills Deficits in university students with Developmental Co-ordination Disorder (DCD)

Natalie Williams

For further information please contact:

Email: dyscoverycentre @newport.ac.uk

Tel: 01633 432330