what is the relationship between self-efficacy and occupational performance in children with dcd?...

What is the Relationship between Self-efficacy and

Occupational Performance in Children with DCD?

Elisa AgnolettoChristine Charlebois

Amanda GarnettIris Lazaro

Behdin NowrouziColleen Ross

Eugenia Wong

Outline of Presentation

• Introduction to DCD & self-efficacy• Research process & Model 1• Critical appraisal• Limitations and gaps in research • Model 2• Future research • Take home points• Discussion

Developmental Coordination Disorder

Diagnostic Features• Impairment in motor coordination.• Interferes with academic achievement & ADLs.

Prevalence• Estimated to be as high as 6 % for children

between the ages of 5-11 years.

(American Psychiatric Association, 2000)

Developmental Coordination Disorder

Manifestations of this disorder vary with age and development:

• younger children: clumsiness and delays in walking, crawling, sitting, tying shoelaces, buttoning shirts, zipping pants

• older children: difficulties with motor aspects of assembling puzzles, building models, playing ball, printing or writing

(American Psychiatric Association, 2000)

Self-efficacy

• Belief in one’s ability to carry out specific actions that produce desired outcomes

• These beliefs determine how people feel, think, motivate themselves and behave

(Bandura,1986; Bandura,1994)

Self-efficacy

Self-efficacy beliefs are based on:

• Performance experiences

• Observational learning

• Verbal persuasion

• Emotional arousal

(Bandura, 1997)

How did we come to frame our question?

Interest in DCD from personal experience (had some background knowledge)

↓

We each did an initial quick reference search, scratching the surface of the topic.

↓

After reading a few articles, we asked the broad question “Are there psychosocial factors involved which affect

occupational performance in children with DCD?

↓

This question was then refined to ask more specifically “What is the relationship between self-efficacy and occupational performance in children with DCD?”

Model #1

DCD

OccupationalPerformance

Self-efficacy PsychosocialDevelopment

Outline for Finding Research Articles

Keywords used:

• DCD, clumsy children, dyspraxia, motor difficulties, participation, performance, activities, physical activities, occupational performance self competence/esteem/efficacy, perceived competence

Outline for Finding Research Articles

Databases:

• EMBASE, ERIC, CINAHL, Cochrane, PsychInfo, Proquest, PubMed, Taylor & Francis

Additional Articles:

• References of journal articles, library for hard copy, contact Professors for additional articles

Motor Proficiency in Children Reporting Low Levels of Participation in Physical Activity

Hay & Missiuna, 1998

• Purpose– Assessed whether the Children’s Self-

Perceptions of Adequacy in and Predilection for Physical Activity Scale (CSAPPA) could be used as a screening tool for DCD

• Methods– Quantitative, Level II study– 492 students from grade 4-8 with mean age

12.4 years


• Results - students with the lowest 5% CSAPPA scores had

significantly lower Participant Questionnaire scores

- reported by teachers to be significantly less likely to perform physical activities well and to show less enjoyment of physical activities

- had significantly lower scores in BOTOM (motor proficiency) than students with highest CSAPPA


How this relates to our research question?

Poor self-efficacy in physical activities

less likely to be physically active and participate

occupational performance in physical activities is decreased


Limitations

• does not directly study DCD population, even though they want to use the CSAPPA as a screening tool for DCD

• only measures self-efficacy in terms of motor competence

• Concern for the validity and reliability of the instruments used

Rites of Passage: Understanding participation of children with DCD

Mandich, Polatajko & Rodger, 2003

• Purpose – explore the effect of DCD on children and the

importance of participation in occupations • Methods

– Qualitative, interviewed parents– 10 children age 7-12 years, dx’d with DCD– CO-OP intervention

• Results– Poor occupational performance had negative effects on children– With CO-OP, children able to participate in occupations

self-esteem and QOL


How this relates to our research question?- Study does not look directly at self-efficacy and

occupational performance- difficulty mastering various occupations sense

of failureBandura (1997)

– Past performance has strongest impact on self-efficacy

- Infer that poor occupational performance self-efficacy


Positive Aspects (Trustworthiness ) Negative Aspects (Applicability)

Credibility: semi-structured interview, member check, informal member check, triangulation, prolonged engagement

The sample size (10 families) is too

small

Transferability: detailed participant records

Most of the DCD children were boys

Confirmability: extensive field notes, transcripts audited by 2 experienced researcher, informal member check (family)

The children are receiving the COOP treatment

Dependability: field notes, coding of 2 researchers

Only have middle class families


• Limitations- The low variability in the sample decreases the

applicability of findings to other individuals with DCD

- Since they did not directly interview the children with DCD, they may have lost some confirmability in their findings (i.e. parental bias)

Psychosocial implications of poor motor coordination in children and adolescents

Skinner & Piek, 2001

• Purpose – Examination of psychosocial variables on children and adolescents with and without DCD• Methods

– Quantitative data & research design– 8-10 year children & 12-14 adolescents with DCD

• Results– DCD groups perceived themselves as less competent in

several psychosocial domains & and had lower levels of self-worth


How this relates to our research question?

• The study finds that poor motor skills may have adverse social and emotional implications

• Difficulties can affect how children/adolescents view themselves physically, socially and scholastically


• Limitations- Validity: “Harter’s measures has not been

adequately tested.”- Reliability: Studies have mixed findings - “Most researchers have failed to find a significant

difference in global self-worth between children with poor motor skills and those who are coordinated”

- Definitions: Self-worth, self-concept, self-efficacy, perceived competence, etc.

Model #2

DCD


Self-efficacy

?Anxiety

Perceived Social

Support

Research Approaches for OS

• Further research be conducted on directly investigating the relationship between DCD, self-efficacy, and occupational performance

• Examine whether DCD children generalize their self-efficacy in one occupation to other occupations

• Further research on affective and cognitive components that affect self-efficacy and occupational performance

Research Approaches for OT

• Investigate effectiveness of increasing self-efficacy through enabling children with DCD to participate in meaningful occupations

• Evaluate effectiveness of family involvement in interventions of children with DCD

• Evaluate whether or not interventions are effective in natural environments of children with DCD

• To what extent do these interventions increase social participation

Take Home Points

• Self-efficacy is a significant factor in enabling occupation in children with DCD

• More research required to explore mechanism between self-efficacy and occupational performance

• DCD is relevant to occupational science and therapy

Discussion• Case Study B

(Losse, Henderson, Elliman, Hall, Knight, & Jongmans , 1991)

• “B.” was a bright child with severe motor problems. Both his parents and teachers were concerned about him in school due to the fact that although highly motivated to learn new motor skills, he found it difficult to do so. At school he had no social difficulties and had a verbal IQ of 129.

• When interviewed in adolescence he did not present himself as depressed by his difficulties. He had not done well academically and chose to leave school and was working as a postman, which he greatly enjoyed. He rated himself on the Harter scale as “sure of himself” and “happy the way he was”. He had many friends and seemed to be a “clumsy” but well-adjusted teenager.

• Question: This actual case study shows that not all children with DCD will experience decreased self- efficacy through the cycle described in our proposed model. Can anyone suggest any factors that may come into play in such cases?

Model #2

DCD


Self-efficacy

?Anxiety

Perceived Social

Support

Discussion

• What can occupational therapists do to enhance occupational performance and self-efficacy in children with DCD?

what is the relationship between self-efficacy and occupational performance in children with dcd?...

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