Describing the performance of five-year-old children on 11 subtests of the revised clinical observations by the South African Institute for Sensory Integration
Janse van Rensburg, Elana
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Introduction: The Clinical Observations (COs) are a battery of 30 observations developed according to the constructs of Ayres Sensory Integration® (ASI®). The observations measure how children can do different body movements and see whether these movements are completed appropriately for their age. The COs are often used together with standardised assessments, to help occupational therapists determine whether or not children present with Sensory Integration Dysfunction (SID). The COs were developed more than a decade ago, and remain popular due to its time efficiency and being inexpensive. It is a nonstandardised assessment, and often the only assessment instrument at the disposal of occupational therapists working in resource-constrained settings. Purpose: In the current version of the COs interpretation is done by comparing performance to norms from the United States of America (USA). Some efforts have been made to describe performance of South African (SAn) children on certain subtests of the COs, however, not all the subtests have been investigated. The South African Institute for Sensory Integration (SAISI) is aware of the significance of the COs in South Africa (SA) for the identification of SID. They are also aware of the limitations of the assessment and the need for it to remain relevant. In 2016, SAISI set out to revise the COs so that they could maintain its clinical relevance. The Revision of the Clinical Observations (RCOs) is still under development and to the researcher’s knowledge none of the newly added subtests have been piloted. It is necessary to describe the performance of SAn children on subtests of the COs, not already investigated, in order to establish what the performance of typically developing South African children on these subtests look like. The purpose of the study was to describe the performance of five-year-old children from the Buffalo City Metro on 11 subtests of the RCOs by SAISI. Methodology: This is a quantitative, descriptive and analytical, cross sectional study. The participants consisted of 104, five-year-old children in the Buffalo City Metro, situated in the Eastern Cape, South Africa. Participants were selected in proportion with the gender and socioeconomic background of the area. Data was collected by means of data collection form based on the RCOs by SAISI (2016). The data collection form was used to record the performance of participants in 11 subtests of the RCOs. Performance characteristics were divided into measurable and observable characteristics. Measurable characteristics referred to observations which were quantifiable such as grade scoring and time taken to perform a task. Observable characteristics were structured observations determined before the data collection period and were divided into Should Have (SH) parameters and Should Not Have (SNH) parameters. SH parameters are characteristics which are favourable and indicate that a participant is performing well. SNH parameters are unfavourable characteristics and indicate that a participant experiences difficulty. The results were analysed by the Department of Biostatistics at the University of the Free State (UFS). Results: Results demonstrate that for most subtests’ children performed in accordance to available development norms. Children did however perform below the expected norms in some of the subtests. Few gender differences were identified in the performance of the investigated subtests. This indicates that boys and girls perform similarly in most of these subtests. Conclusion: The performance of SAn children in 11 subtests of the RCOs has been investigated. More research should however be completed to determine how SAn children perform in the remainder of the subtests. A collective picture of how SAn children perform in all the subtests of the RCOs will better equip therapists to test children more accurately with this tool.