Mei Hui Tseng

Relationship between motor proficiency, attention, impulse, and activity in children with ADHD

The aim of this study was to investigate the relationship between motor performance, attention deficit, impulsiveness, and hyperactivity in children with attention‐deficit–hyperactivity disorder (ADHD). Participants were 42 school‐aged children with ADHD (36 males, 6 females; mean age 8 years 2 months, SD1 year 2 months; range 6 years to 11 years), and 42 age‐ and sex‐matched children without ADHD (mean age 8 years 3 months, SD 1 year 1 month; range 6 years to 11 years). Motor abilities were assessed with the Bruininks‐Oseretsky Test of Motor Proficiency. Attention and impulse control were measured with the Gordon Diagnostic System, and assessment of activity level was based on two Activity Level Rating Scales that were completed by parents and teachers. Analysis by t‐test revealed a significant difference between children with and without ADHD in fine and gross motor skills, impulse control, and attention. Stepwise regression indicated that attention, impulse control, and parent ratings of activity level were the three best predictors of gross motor skills for children with ADHD, accounting for 55.9% of the variance. Attention and impulse control were the two best predictors of fine motor skills, accounting for 45.7% of the variance. Attention and impulse control were consistently found to be important predictors of both fine and gross motor skills in children with ADHD. However, the fact that activity level was a predictor for gross motor proficiency but not for fine motor tasks suggests that different behavioral processes are involved in fine and gross motor performance to different extents.

Functional performance of children with developmental coordination disorder at home and at school

This study investigated the functional performance of daily activities at home and at school in a population‐based sample of children with different degrees of motor coordination impairment and competence. Sixteen children (seven males, nine females; mean age 8y, SD 9mo) with developmental coordination disorder (DCD), 25 with suspected DCD ([sDCD] 17 males, eight females; mean age 7y 6mo, SD 8mo), and 63 children without motor problems (39 males, 24 females; mean age 7y 9mo, SD 7mo) were recruited from public schools (Grades 1–3, age 6y 4mo–9y 10mo) using the Chinese version of the Developmental Coordination Disorder Questionnaire, the Movement Assessment Battery for Children, and the Bruininks‐Oseretsky Test of Motor Proficiency. Functional performance was assessed using the Chinese versions of the Vineland Adaptive Behavior Scales and the School Function Assessment–Chinese version. The functional performance of children with DCD and sDCD was statistically significantly lower than those without DCD (p’s<0.05). χ2 and logistic regression analyses showed significant differences among all groups in the proportion of children scoring at the ‘inadequate’ adaptive level of home performance (p’s<0.05). There were also significant differences among the groups in the proportion of children scoring below the cut‐off in school performance (p’s<0.05). The findings show the pervasive impact of DCD on children’s functional performance in daily activities at home and at school.

Cooccurrence of problems in activity level, attention, psychosocial adjustment, reading and writing in children with developmental coordination disorder.

The purpose of this paper was to investigate the cooccurrence of problems in activity level, attention, reading, writing and psychosocial adjustment of children with developmental coordination disorder (DCD). A parent-report questionnaire, the Developmental Coordination Disorder Questionnaire – Chinese version (DCDQ-C), was used to screen first to third graders from 13 mainstream schools in Taipei. Two standardized motor tests were then administered to those who scored below 10% on the DCDQ-C. Tests of activity level, attention, reading, writing and psychosocial adjustment were then administered to this sample. Thirty-eight children identified as DCD, 32 as suspect for DCD and 82 as normal comparison were included in the final sample. Multivariate analysis of variance comparing the three groups (DCD, suspect DCD, and comparison) revealed that both children with DCD and suspect for DCD obtained significantly poorer scores on measures of attention and reading, and were more hyperactive than comparison children. Children with DCD and suspect for DCD were also reported to have more internalizing and social problems than children without motor problems. No significant differences, however, were noted between children with different degree of motor coordination problems (categorized as DCD and suspect for DCD) on any measure. Furthermore, a high percentage of children in both the DCD and suspect groups fell in the clinical range of attention, activity level and psychosocial adjustment problems. The results revealed a high risk for these problems in nonreferred children with motor coordination problems. The high percentage of clinical range behavioral problems warrants attention of clinicians who work with children with motor coordination difficulties to the need to promote early identification and referral.

Psychosocial adjustment and attention in children with developmental coordination disorder using different motor tests

This study examined the consistency between the findings of developmental coordination disorder (DCD) as identified by the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) and the Movement Assessment Battery for Children (MABC), and explored the psychosocial and attention characteristics of children with DCD identified by the two motor tests, respectively. Participants were 270 children (male: 161, female: 109; age 7.74+/-0.81 years). The association between DCD status identified by each of the motor tests and psychosocial problems measured by the Child Behavioral Checklist-Chinese version (CBCL-C) was examined using multiple logistic regressions. The results showed that DCD identified by the BOTMP was associated with high scores on the Withdrawn and Social Problems, with a higher proportion of females identified. DCD identified by the MABC was associated with high scores on the Withdrawn and Attention Problems and low score on the Aggressive Behavior. The results reaffirmed the lack of consistency between the motor tests and indicated that children identified by the two motor tests showed different profiles of attention and psychosocial adjustment.

Psychometric properties of a Chinese version of the Developmental Coordination Disorder Questionnaire in community-based children.

The aim of this study was to adapt and evaluate the Developmental Coordination Disorder Questionnaire (DCDQ) for use in Chinese-speaking countries. A total of 1082 parents completed the DCDQ and 35 parents repeated it after 2 weeks for test-retest reliability. Two items were deleted after examination of test consistency. Cronbachs alpha for the total score was 0.89 and test-retest reliability was 0.94. Exploratory and confirmatory factor analyses showed this version to be compatible with the original and two adaptations of the DCDQ. One-way ANOVA and the post hoc tests revealed that the non-DCD group scored significantly higher than the DCD group and the suspect DCD group, but the latter two did not differ significantly. Sensitivity and specificity of the DCDQ were 73% and 54%. The estimated area under the Receiver Operating Characteristic curve was 0.68. Compared to the dichotomized grouping in assessing sensitivity and specificity, which provides clinicians with all or none information about a childs probability of being DCD, the informative conditional effect plot could alert clinicians to the child with less conspicuous movement problems. This adaptation of the DCDQ could be used for identifying motor coordination problems in Chinese-speaking societies.

Impacts of Autistic Behaviors, Emotional and Behavioral Problems on Parenting Stress in Caregivers of Children with Autism

This study examined the effects of autistic behaviors and individual emotional and behavioral problems on parenting stress in caregivers of children with autism. Caregivers were interviewed with the Childhood Autism Rating Scale and completed the Strength and Difficulties Questionnaire and the Parenting Stress Index Short Form. Results revealed that caregivers of children with mild/moderate autistic behavior problems perceived lower parenting stress than did those of children with no or severe problems. In addition, prosocial behaviors and conduct problems respectively predicted stress in the parent–child relationship and child-related stress. The findings can provide guidance in evaluations and interventions with a focus on mitigating parenting stress in caregivers of children with autism.

Evidence-based practice and research utilisation: Perceived research knowledge, attitudes, practices and barriers among Australian paediatric occupational therapists

BACKGROUND/AIM Evidence-based practice (EBP) and research utilisation (RU) are promoted as ways for clients to receive the best level of care. However, limited research has evaluated the use of these approaches by occupational therapists. This study investigated the knowledge, attitudes, practices of and barriers to EBP and RU of a group of paediatric occupational therapists from Australia. METHODS Questionnaires were received from 138 participants (response rate 46%) who completed the Research Knowledge, Attitudes and Practices of Research Survey, the Edmonton Research Orientation Survey and the Barriers to Research Utilisation Scale. RESULTS The participants held positive attitudes towards research, and were willing to access new information to guide practice approaches. However, participants were less confident in their research knowledge and practices and implemented research findings into clinical practice. Multiple barriers to RU were perceived, particularly associated with the presentation and accessibility of research. Participants reported limited engagement in conducting research studies, although the majority of the participants reported implementing the findings of research into their clinical practice to some extent. CONCLUSION Additional research education and support within organisations would be beneficial to ensure that children and families are receiving occupational therapy services that are based on sound, high-quality research evidence. The findings of this study provide insight into the perceived research knowledge, attitudes, practices of and barriers to Australian paediatric occupational therapists, enabling specific strategies to be implemented to increase the use of EBP and RU within the profession.

RELIABILITY AND VALIDITY OF A CHINESE VERSION OF THE PEDIATRIC EVALUATION OF DISABILITY INVENTORY IN CHILDREN WITH CEREBRAL PALSY

OBJECTIVES To examine the reliability and validity of a Chinese version of the Pediatric Evaluation of Disability Inventory in children with cerebral palsy. DESIGN A prospective study. SUBJECTS Two samples: 58 children with cerebral palsy (mean age 65.4 (standard deviation 29.9) months) and 89 normally developing children (mean age 43.5 (standard deviation 20.6) months). METHODS The Pediatric Evaluation of Disability Inventory was translated and cross-culturally adapted into a Chinese version. The test-retest reliability, concurrent validity and discriminative validity were examined. RESULTS Internal consistency was high (Cronbachs alpha: 0.90-0.99). Test-retest reliability was excellent (intraclass correlation coefficient: 0.982-0.998). The concurrent validity was good, as evidenced by the high correlation between the Pediatric Evaluation of Disability Inventory and the Functional Independence Measure for Children (Spearmans rho: 0.92-0.99). Logistic regression analysis demonstrated that the Pediatric Evaluation of Disability Inventory factor scores estimated by confirmatory factor analysis differentiated the children with cerebral palsy from normally developing children. CONCLUSION This study demonstrated that the Chinese version of the Pediatric Evaluation of Disability Inventory has good reliability and validity and provides support for its use in Chinese-speaking children with cerebral palsy.

Pediatric Evaluation of Disability Inventory: A Cross-Cultural Comparison of Daily Function between Taiwanese and American Children.

The study described the psychometric properties of the Pediatric Evaluation of Disability Inventory (PEDI) when used in Taiwanese normally developing children and illustrated the ethnic differences in determining capacity and independence in daily function between Taiwanese and American children. The Chinese version of the PEDI (PEDI-C) was administered to Taiwanese parents of 494 normally developing children and 110 children with developmental disabilities (DD). The scores of Taiwanese population were compared with the American counterparts using independent samples t-test. The PEDI-C had demonstrated good psychometric properties when used in Chinese-speaking population. The results revealed that internal consistency and inter-rater reliability was high. The unidimensionality of each domain was supported by Mokken analysis. The standardized factor scores of the PEDI-C differentiated children with DD from normally developing children. Group differences existed in various areas of daily function between Taiwanese and American children. Taiwanese children were less capable and needed more assistance in self-care and social function of daily living, especially after 4 years of age. Taiwanese and American children had similar capacity and performance in mobility. The identified discrepancy could serve as a guide of child-rearing for parents and for clinicians working with clients from different cultural backgrounds in a culturally diverse society.

Development of Pencil Grip Position in Preschool Children

Pencil grip is an aspect of handwriting that has been addressed by occupational therapists who treat children with handwriting difficulties. However, there has been little research investigating the developmental progression of pencil grip in Taiwanese children. Without knowledge of normal development, therapists cannot justify a diagnosis of “unusual” or “bizarre” pencil grips. This study was designed to investigate the developmental progression in pencil grips in Taiwanese children. The subjects were 326 children aged 2.5 to 6.4 years. The type of grips each child used to perform a drawing task was videotaped. A developmental assessment of pencil grips compiled by Schneck and Henderson was used to rate childrens grip positions. A developmental pregression was noted and 14 grip patterns were identified. About half of the 3- to 3.4-year old children were able to employ a mature grip when drawing in a 7.89 cm x7 cm box. By the age of 4, about three fourths of the children were able to use mature grips to draw. For children aged 5 years and older, the percentage increased to more than 90%. Comparison of the results with those of Schneck and Henderson (1990) suggests that Taiwanese children 3.5 to 5.9 years of age are more advanced than American children of the same age. In addition, the percentage of Taiwanese children using the lateral tripod is much higher than that of American children. Possible reasons for these differences are proposed. Implications for occupational therapy and suggestions for future studies are discussed.