Parents, educators and children: perceptions on dyspraxia

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Date
2013-02
Authors
Van Staden, Carli
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Publisher
University of the Free State
Abstract
English: Dyspraxia is a developmental condition in which the ability to ideate, plan and execute new and novel actions is impaired (Bundy, Lane & Murray, 2002:477- 478). The aim of this study was to investigate the child’s, parent’s and educator’s perceptions on dyspraxia, in order to identify comprehensive client-centred treatment goals. This study was carried out in order to further the understanding of the complexities surrounding a child with dyspraxia, as it pertain to the occupational performance areas of school, play and leisure, and self-care. A lack of literature on the use of a family-centred approach in assessment and treatment of children by South African occupational therapists and the growing emphasis on including the voice of the child in decision-making that affects them, gave relevance to this undertaking. A descriptive, cross-sectional study was done. The study population consisted of children aged 5 years 4 months to 8 years 2 months, living in Bloemfontein and surrounding areas, and diagnosed with dyspraxia as per the criteria of the Sensory Integration and Praxis Test (SIPT) (Ayres, 1989). The study sample further consisted of the parent(s) of the child who were involved in the occupational therapy process, as well as the educator of the child concerned. The PEGS (Missiuna, Pollock & Law, 2004) was used as the measuring instrument to obtain the perceptions regarding dyspraxia from the child, parent and educator. The PEGS’s assessment for children consists of 24 pairs of cards showing children participating in activities from the occupational performance areas of self-care, school/productivity and leisure/play. The child had to indicate if he is like the picture of the child who is “more competent” or “less competent” in the activity. During separate interviews with the parents and educators, the researcher asked the parent(s) and educators to rate the child’s competency on the same activities as those of the child’s cards of the PEGS. The child, parent and educator respectively also chose activities as goals to be addressed during occupational therapy intervention. Demographic information was also obtained from the parent(s) during a structured interview. The data analysis was done by Department Biostatistics, Faculty of Health Sciences, UFS. Findings indicated that dyspraxia reached across all functional spheres. Play and leisure was perceived by all to be the occupational performance area children with dyspraxia were the least competent in, with skipping with a rope perceived by all as the most troublesome activity. The perceptions of the parent, child and educator regarding the child’s competence in specific activities differed. Children were able to express their perceived efficacy and made themselves out to be both less and more competent in some items the adults did not agree with. A statistical significant difference was found between the child and educator’s summary score percentages of their perceptions of the child’s competence as it relates to the OPA of school/productivity. Parents, children and educators selected different combinations of items as goals, with almost half of the total number of goals selected by all participants related to the OPA of leisure. Printing, playing ball games that require hitting a ball, such as tennis and cricket, skipping with a rope and cutting with scissors were the specific goals selected by the greatest number of participants. In conclusion, recommendations towards child-centred practice were made. These included realising the extent of the influence of dyspraxia on all areas of the child’s functioning, considering all environments and all role-players in the child’s life when planning intervention and providing the child with an opportunity to express his perceptions of his abilities and goals for therapy. The limitations of the study were acknowledged and recommendations were made for future research.
Afrikaans: Dispraksie is ‘n toestand wat tydens die kinderjare geïdentifiseer word, waartydens die vermoë om nuwe motoriese aksies uit te dink, te beplan en uit te voer beperk is (Bundy, Lane & Murray, 2002:477-478). Die doel van hierdie studie was om die kind, ouer en opvoeder se persepsies oor dispraksie te ondersoek, ten einde omvattende, kliënt-gefokusde behandelings-doelwitte te kan identifiseer. Hierdie studie is uitgevoer om die probleme wat ‘n kind met dispraksie ervaar, soos dit verband hou met die aktiwiteitsverrigtingsareas van skool, spel/ontspanning en selfsorg, beter te verstaan. ‘n Gebrek aan literatuur wat handel oor die familie-gerigte benadering tot die evaluering en behandeling van kinders deur Suid- Afrikaanse arbeidsterapeute, en die toenemende klem op die insluiting van die kind in besluite wat hom raak, het toepaslikheid aan hierdie studie verleen. ‘n Beskrywende, dwarssnit-navorsingsontwerp is gevolg. Die studiepopulasie het uit kinders tussen die ouderdomme 5 jaar 4 maande en 8 jaar 2 maande, woonagtig in Bloemfontein en omgewing, en gediagnoseer met dispraksie volgens die kriteria van die Sensory Integration and Praxis Test (SIPT) (Ayres, 1989), bestaan. Die studiepopulasie het verder die ouer(s) van die kind, asook die kind se opvoeder, ingesluit. Die Perceived Efficacy and Goal Setting System (PEGS) (Missiuna, Pollock & Law, 2004) is as meetinstrument gebruik om die kind, ouer en onderwyser se persepsies van dispraksie te bepaal. Die PEGS assessering vir kinders bestaan uit 24 pare kaarte met prente van kinders wat deelneem aan aktiwiteite wat deel vorm van die aktiwiteitsverrigtingsareas selfsorg, skool en ontspanning/spel. Die kind moet aandui of hy soos die kind op die “meer bekwame” of “minder bekwame” prentjie is wanneer hy daardie aktiwiteit uitvoer. Tydens afsonderlike onderhoude moes die kind se ouer(s) en opvoeder die kind se bekwaamheid in soortgelyke aktiwiteite beoordeel. Elk van die kind, ouer en opvoeder het dan ook aktiwiteite as doelwitte vir arbeidsterapie-intervensie gekies. Demografiese inligting is van die ouer(s) verkry tydens gestruktureerde onderhoude. Die data-analise is deur Departement Biostatistiek, Fakulteit Gesondheidswetenskappe aan die UV gedoen. Resultate het getoon dat die invloed van dispraksie oor al die funksionele sfere strek. Almal het die persepsie gedeel dat die aktiwiteitsverrigtingsarea waarin kinders met dispraksie die minste bekwaam is, spel en ontspanning was, met touspring as die aktiwiteit wat deur almal as die grootste uitdaging vir die kind met dispraksie beskou is. Die kind, ouer en opvoeder se persepsies oor die bekwaamheid van die kind in die uitvoer van die verskillende aktiwiteite, het verskil. Kinders was in staat om persepsies rondom hul vermoëns uit te druk en het in sommige aktiwiteite aangedui dat hulle hulself as meer bekwaam ag as die volwassenes se mening, maar in ander gevalle het hul ‘n persepsie van onbekwaamheid aangedui wat die volwassesnes nie van bewus was nie. ‘n Statisties beduidende verskil is gevind tussen die kind en opvoeder se persentasies van hul persepsies oor die kind se bekwaamheid in skool-aktiwiteite. Ouers, kinders en opvoeders het verskillende kombinasies van aktiwiteite as doelwitte gekies, met bykans die helfte van alle doelwitte wat deel vorm van die aktiwiteitsverrigtingsarea spel/ontspanning. Handskrif, balspele waartydens ‘n bal geslaan word soos tennis en krieket, touspring en knip met ‘n skêr was spesifieke doelwitte wat die meeste deur deelnemers gekies is. Ter afsluiting is voorstelle omtrent kind-gerigte arbeidsterapie gemaak. Begrip vir die omvang van die invloed van dispraksie op alle fasette van die kind se lewe, inagneming van alle aktiwiteitsverrigtingsareas en rolspelers in die kind se lewe wanneer terapie beplan word, en die bied van ‘n geleentheid aan die kind om sy persepsie van sy vermoëns, asook sy doelwitte, uit te druk, is beklemtoon. Beperkinge van die studie is aangedui en voorstelle vir toekomstige navorsing is gemaak.
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Keywords
Dissertation (M. Occupational Therapy (Occupational Therapy))--University of the Free State, 2013, Apraxia -- Treatment, Occupational therapy for children, Child-centred practice, Occupational performance area (OPA), Goal setting, Children, Parent, Educator, Perception, Dyspraxia
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