Orit Bart

Effect of Focus of Attention and Age on Motor Acquisition, Retention, and Transfer: A Randomized Trial

Background and Purpose: Adult participants benefit more from external focus than internal focus when learning a new motor skill. Because learners from different age groups use different learning strategies, the purpose of this study was to investigate whether the effect of attention focus varies among children and adults. Subjects and Methods: Thirty-four children and 32 adults were randomly assigned to internal or external focus-of-attention practice groups. Throwing darts toward a static target, participants performed 50 acquisition trials, 20 retention trials, and 20 transfer trials. Results: The results indicate that focus of attention varies between children and adults in accuracy and variability in the acquisition phase and in accuracy in the transfer phase. No interactions were found in the retention phase. Discussion and Conclusion: The findings suggest that external focus is more effective than internal focus in adults; therefore, physical therapists should instruct adult clients to focus their attention externally to facilitate motor learning. Physical therapists working with children should perhaps direct the clients attention internally; however, further study is needed.

Participation patterns of school-aged children with and without DCD

UNLABELLED Participation is recognized as a key to ones health and well-being and is considered to be a vital part of the development of children and youth. The purpose of this study was to examine the participation patterns of children with and without Developmental Coordination Disorder (DCD) in their out-of-school-time (OST) activities, and to see whether there is a relationship between the childrens motor abilities and their choices and participation. METHODS 50 children (5-7 years old), 25 who met diagnostic criteria of DCD and 25 without DCD, completed the Children Assessment of Participation and Enjoyment (CAPE) and were administered the Motor Assessment Battery for Children (MABC) and the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI). RESULTS A relationship was found between participation patterns and motor ability. Children with DCD had limited participation diversity in which they participated less frequently, and chose activities that were quieter and more socially isolated compared to children without DCD; there were no differences in their levels of enjoyment. CONCLUSIONS The present study emphasizes the importance of looking at the childrens participation from a broad perspective, and the many difficulties children with DCD experience in OST participation. Future studies might consider other factors (e.g., environment) while examining participation among children with DCD.

Development and initial validation of the Children Participation Questionnaire (CPQ)

Purpose. To develop and test the psychometric properties of a parent-reported questionnaire measuring participation of preschool children (Children Participation Questionnaire; CPQ) aged 4–6 years in their everyday activities. Methods. Reliability was tested by Cronbachs α and by test–retest. Construct validity was computed by known group differences analysis. Convergent and divergent validities were calculated by correlation with the Vineland Adaptive Behaviour Scale (VABS). Two hundred thirty-one children with mild to moderate developmental disabilities (mean age 5.16 ± 0.66 years old) were compared to 249 children without disability (mean age 5.13 ± 0.72 years old). Results. The CPQ has good internal reliability. Cronbachs α for the participation measures ranged between 0.79 and 0.90, indicating good homogeneity. The temporal stability of the CPQ was supported with intra-class correlations ranging from 0.71 to 1.00. Significant differences were found between children with and without disabilities in all the CPQ measures. The CPQ could also differentiate between age groups and groups of varying socio-economic status. Convergent and divergent validity were supported. Conclusions. The CPQ has demonstrated good psychometric properties and can be used as a reliable and valid measure to assess childrens participation at the age of 4–6 years.

Childhood Participation in After-School Activities: What is to be Expected?

Participation is recognised as a key to health and wellbeing and is considered to be a vital part of the development of children and youth. The purpose of this study was to examine the participation patterns of children and adolescents in their time outside formal school. More specifically, the influence of age and gender on after-school participation patterns was explored. Method: Three hundred and thirty-two children and adolescents (5 to 18 years old) were divided into five age groups and completed the Childrens Assessment of Participation and Enjoyment (CAPE). To test the interaction effect of gender and age on participation measures, ANOVAs were conducted. Results: The results indicated differences with moderate to high effect size in participation patterns across age, where a decline in participation was detected as children made the transition to adolescence. Differences with negligible effect size in participation were found between boys and girls in some of the activity types. No interaction effect between age and gender was observed. Conclusion: Participation patterns change with age, particularly as children make the transition to adolescence; however, this change does not depend on gender. Intervention strategies might take into account these inherent changes. Future studies might consider additional factors (for example, environment) while examining participation throughout age.

Personal and environmental pathways to participation in young children with and without mild motor disabilities

OBJECTIVE Participation in everyday activities has a positive influence upon health and well-being and is considered as an outcome measure. According to recent models child participation is the product of the dynamic interaction between health states and both individual and environmental factors. Children with mild developmental disabilities often present decreased participation in everyday activities. The purpose of this study was to explore the extent to which individual and environmental factors explain the participation of young children, with and without mild motor disabilities. METHODS The study population included 58 kindergarten children together with their parents (29 children with mild motor disabilities who were referred to occupational therapy and 29 children without motor disabilities). Both groups of children were matched for: age; gender; age of parents; and socio-economic status (SES). We assessed participation using the Child Participation Questionnaire (intensity, diversity, independence, child enjoyment and parental satisfaction) and we assessed childrens self-efficacy and motor abilities for individual factors. Parental self-efficacy and SES were collected by questionnaires. RESULTS Participation diversity (number of activities) was predicted by child and mother self-efficacy and by SES. Child independence and enjoyment as well as parental satisfaction were predicted by child motor ability but mainly by maternal self-efficacy. Results suggest that the total explained variance is more than double when the environmental variables (parental self-efficacy and SES) are inserted to the participation model. CONCLUSIONS Maternal self-efficacy and SES serve as facilitators to increased participation and well-being of children with mild motor disabilities.

Balance treatment ameliorates anxiety and increases self-esteem in children with comorbid anxiety and balance disorder.

Comorbidity between balance and anxiety disorders in adult population is a well-studied clinical entity. Children might be particularly prone to develop balance-anxiety comorbidity, but surprisingly they are practically neglected in this field of research. The consequence is that children are treated for what seems to be the primary disorder without noticing possible effects on the other disorder. In Study 1, children with balance dysfunction were compared to normally balanced controls on anxiety and self-esteem. In study 2, children with balance dysfunction were assigned to either balance training or a waiting-list control. Training consisted of 12 weekly sessions of balance treatment. Anxiety and self-esteem were tested before and after treatment/waiting. Study 1 confirmed significantly higher anxiety and lower self-esteem in the balance dysfunction group compared to the control group. Study 2 showed that treatment improved balance performance, reduced anxiety, and increased self-esteem relative to the control waiting list group. Taken together, the present findings are in accord with the observations of comorbidity between balance and anxiety disorders in adults and confirm their validity in children younger than 7 years of age. This profile of comorbidity between balance dysfunction and anxiety also include lower self-esteem.

The profile of performance skills and emotional factors in the context of participation among young children with Developmental Coordination Disorder

Participation is a persons involvement in daily activities in a variety of environments, roles and life situations. Children with Developmental Coordination Disorder (DCD) experience difficulties in gaining academic achievements or in their engagement in activity of daily living. Motor difficulties have a negative effect on the ability to participate, as well as on various affective components. Senses of coherence, effort and hope have not yet been assessed, within the context of participation, in children with DCD. The purpose of the present study is to look into the relations between participation and senses of coherence, effort and hope among children with DCD, in comparison to typically developed children. Fifty subjects aged 5-6 years participated in the study, 25 of whom are children diagnosed with DCD, the other 25 being typical children. The DCD diagnosis was established according to the DSM-IV criteria and the M-ABC test. All children completed the coherence questionnaire for children as well as the childrens questionnaire on effort and hope. Parents completed the Children Participation Questionnaire (CPQ), and the Performance Skills Questionnaire (PSQ). Children with DCD had lower performance skills, lower sense of coherence, hope, and effort than their peers. They less enjoy their participation and their parents are less satisfied in comparison to control group. Significant correlations were found between sense of coherence and hope to participation. Process skills were found to be the main predictor for explaining childs participation. While treating children with DCD we have to consider also socio-psychological aspects that may be weakened.

Effects of prone and supine positions on sleep state and stress responses in preterm infants

AIM The purpose of the study is to assess the influence of prone or supine position on sleep states and on withdrawal and approach reactions of preterm infants. METHODS Thirty-two preterm infants from Meir Medical Center, Israel, mean post menstrual age 30.37±2.57, mean birth weight 1250g±313.86, participated in the study. Infants were studied during 48h. Positions (prone and supine) were alternated every 3-4h after feedings. Sleep states were assessed by Actigraph measurement and by two daily 30-min Naturalistic Observations of Newborn Behavior (NONB) to confirm sleep states and for recording the behavioral reactions (approach and withdrawal). RESULTS In the prone position there were more approach reactions as compared to withdrawal reactions (p<.001) while in the supine position, the approach and withdrawal reactions were comparable. In the prone position more sleep patterns (deep sleep, light sleep, drowsy) were observed as opposed to more awake patterns (quiet awake, active awake and agitated fussy) that were seen in the supine position. CONCLUSIONS Clinical implications encourage placing the preterm infant in the prone position while in the NICU. This enables important achievements such as longer periods of quality sleep, and production of adaptive self-regulatory reactions.

Perceived environmental restrictions for the participation of children with mild developmental disabilities

AIM In light of the International Classification of Functioning, and Health (ICF) model, to assess whether parents of children with mild developmental disabilities perceived various environmental factors as barriers to their childs participation, and whether these factors have a unique contribution to the total explained variance of participation, beyond personal factors. METHODS Seventy-nine kindergarten children (mean age 5.20 ± 0.52 years old) with mild developmental disabilities and their parents participated in the study. Three questionnaires measuring the childs participation, performance skills and environmental factors were completed by the parents. RESULTS Parents perceived environmental factors as slightly restricting to their childs participation. Associations were found between home and education factors and the dimensions of child participation - independence, enjoyment and parental satisfaction. Although parents perceived human environmental factors as more restricting than physical factors at home, regression analysis revealed that the latter was found to affect the child participation dimension of independence beyond the contribution of personal factors. INTERPRETATION These findings are the first, to our knowledge, to support the contribution of environmental factors to the participation of young children with mild developmental disabilities. The results show that environmental factors have significant slight contribution to childs independence in participation beyond other predictors (i.e. personal factors). Therefore, it is recommended to include environmental restrictions measurement in the child evaluation process to facilitate effective intervention programs.

Can personal and environmental factors explain dimensions of child participation

OBJECTIVE One of the main goals of paediatric occupational therapists and other health professionals is to enhance child participation in age-related activities within their communities. According to theoretical models, the act of participation has numerous dimensions, affected by personal and environmental factors. However, there have been relatively few studies undertaken to validate this theory. The purpose of this study was to explore the extent to which personal and environmental factors explain each of five distinct dimensions of child participation, which are: diversity, intensity, independence, enjoyment and subsequent parental satisfaction. METHOD A convenient sample of 70 kindergarten children without developmental disabilities together with their parents participated in the study. Data were collected using standardized assessments for personal factors and questionnaires for environmental factors. RESULTS The findings confirmed our hypothesis and revealed that with typical children, motor and cognitive abilities affect participation diversity. Moreover, performance skills and self-perceptions of competence affect their independence levels, while environmental factors contribute to frequency of participation and parental satisfaction. However, these factors on their own do not fully explain the degree of enjoyment experienced by children. CONCLUSIONS The findings highlight the importance of measuring the full range of participation dimensions, and provide empirical evidence about the nature of child participation. Further studies are warranted to validate this approach for children with developmental difficulties.