The performance of five-year-old children from Mangaung Metro on ten subtests of J. Ayres based clinical observations

[摘要] English: Introduction: South African (SAn) occupational therapists (OTs) are increasingly confronted with children experiencing sensory integration (SI) difficulties. A wide variety of SI assessment measures are available from which Clinical Observations (COs), originally developed by Ayres, are used widely amongst SAn OTs to support their reasoning on possible dysfunction/s in SI. The COs assist the therapist in distinguishing typical from possible atypical performance. The COs are a cost and time effective measuring instrument, widely used amongst SAn OTs. In addition, in under-resourced communities, the COs are often relied on for assessment as funding is not available for the use of standardised tests. Limited research has, however, been done on the use of the COs on SAn children, describing age-related performance.Purpose: The purpose of the study was to investigate the performance of five-year-old children from Mangaung Metro on ten subtests of J. Ayres based Clinical Observations. This allowed the researcher to gain descriptive observations to assist the therapist in distinguishing typical from atypical performance more clearly.Methodology: A descriptive observational study design along with a cross-sectional study design was used. One hundred and twenty (120) participants from both genders, aged between five years six months and five years eleven months, adhering to specific inclusion criteria, and from diverse socio-economic status, were assessed at eight public pre-schools located in Bloemfontein. An adapted COs measuring instrument was used. The measuring instrument comprised of measurable characteristics that included quantitative data (e.g. overall grade score and number of repetitions in a movement pattern), and observable characteristics. The observable characteristics were grouped according to performance thought to be desirable, i.e. 'should have' (SH) parameters, and performance thought to be undesirable in the performance of the COs items, i.e. 'should not have' (SNH) parameters.The participants were assessed individually and video recorded to allow for detailed analysis. The participants were firstly scored in vivo, whereafter the researcher re-assessed each video recording to compare the findings with the initial assessment. The results were analysed by the Department of Biostatistics at the University of the Free State.Findings: The five-year-old children in this study performed similarly to the currently used norms on most of the items. These items can, therefore, be used in assessment to identify areas of possible difficulty. However, a high incidence of possible un-integrated primitive postural reflexes was found in the study population. The results for the observable characteristics (SH and SNH parameters) were categorised according to prevalence criteria. The results showed several COs' SH parameters were not always present and several SNH parameters were present in the execution of the COs items. In terms of comparing socio-economic groups, performance was similar in both groups across most test items. Two subtests did, however, have clinically significant differences on the measurable characteristics. Isolated differences on the observable characteristics were evident in most of the COs items, with clinically significant differences found in six of the COs items.Conclusion: The study revealed typical age expected performance of a group of five-year-old children in South Africa on ten selected COs items. It is a reasonable expectation that typically developing children from this age group, would be able to adequately perform most of the items and the inability to do so might be suggestive of possible difficulty. The data will allow OTs to interpret an observed performance on ten items of the COs more accurately, as in-depth observations became evident through this study.

[发布机构] University of the Free State