A perceptual-motor intervention programme for grade 1-learners with developmental coordination disorder

[摘要] English: BackgroundDevelopmental coordination disorder (DCD) is recognised as one of the most common developmental dysfunctions during childhood. Developmental coordination disorder is diagnosed in children who experience significant difficulties in motor learning and in the performance of functional motor tasks that are critical for success in their daily lives. However, one of the major concerns regarding children with DCD is that they are often not formally diagnosed, but rather described by their parents and teachers as lazy or awkward. In an attempt to identify children with DCD, several research tools, such as questionnaires for screening purposes and norm-referenced tests to measure the degree of movement difficulties, can be used. Even though children will not outgrow this disorder as previously believed, children can be helped by means of various interventions.AimsThe first aim of this study was to determine the prevalence of DCD among Grade 1 children in Bloemfontein. The second aim was to establish the ability of parents to identify Grade 1 children with DCD at home; in addition the third aim was to establish the ability of teachers in identifying Grade 1 children with DCD in the classroom. The fourth aim was to explore the influence of DCD on learning related skills. Aim five and six was to determine if the application of a perceptual-motor intervention as well as a sport stacking intervention will significantly improve the motor proficiency status of Grade 1 children identified with DCD independently.MethodParticipantsFor the purpose of aim 1, 559 participants' between the ages of 5 and 8 years took part in this study. There were n=321 girls and n=238 boys. Aim 2 include 410 participants and consisted of n=226 girls and n=184 boys, whilst aim 3 had 506 participants and there were n=289 girls and n=217 boys. Furthermore, aim 4 had 347 participants including n=190 girls and n=157 boys. Aim 5 and 6, which relates to the two interventions used in this study was as follows. Seventy six (76) participants took part in the perceptual-motor intervention. The group consisted of girls (n=34) and boys (n=42) classified with DCD. The intervention had a pre-test/post-test experimental design (n=36) with a control group (n=40). With reference to the sport stacking intervention, 18 children between the ages of 6 and 7 years took part in this study. The group consisted of girls (n=6) and boys (n=12) classified with DCD. This intervention also had a pre-test/post-test experimental design (n=10) with a control group (n=8).Measuring instrumentsThe instrument used to assess the participants motor proficiency levels and to identify symptoms of DCD was the Movement Assessment Battery for Children-2 (MABC-2 Test). This test includes manual dexterity, balance as well as aiming and catching, in addition the three sub-tests constitute a total test score. In order to determine if parents possess the ability to identify symptoms of DCD at home the Developmental Coordination Disorder Questionnaire '07 (DCDQ'07) was used. With the purpose of determining if teachers possess the ability to identify DCD in the classroom the Movement Assessment Battery for Children-2 Checklist (MABC-C) was used. It is designed to identify primary school children likely to have movement difficulties.The Aptitude Test for School Beginners (ASB) was administered by qualified teachers to all participating children in the first two months of the school year. A requirement of the ASB is that it must be presented and completed in a child's mother tongue. The ASB is a norm-based instrument and consists of eight sub-items, which include perception, spatial skills, reasoning, numerical skills, gestalt, coordination, memory and verbal comprehension. Each sub-item is evaluated by means of a standard score out of five. An evaluation score of 1 is regarded as below average and an evaluation score of 5 as above average. The aim of the ASB is to obtain a differentiated picture of certain aptitudes of grade 1 children.Data analysisAnalysis of the data was done by a biostatistician using Statistical Analysis Software Version 9.1.3. Descriptive statistics, namely frequencies and percentages, were calculated for categorical data. Medians and percentiles were calculated for numerical data. Median differences were tested by calculating p-values using the signed-rank test. The Chi-square statistics were used to test for proportion differences. This was used to determine the prevalence of DCD (article 1), as well as for learning related skills and DCD (article 4) and for the sport stacking intervention (article 6). Furthermore, data analysis was performed using the Statistical Package for the Social Sciences (SPSS) for Windows (SPSS version 16.0), in order to determine if parents and teachers possess the ability to identify children with DCD. The convergent validity of the classification of motor problems (no motor difficulties or motor difficulties) using the MABC-2 Test and the classification of motor difficulties (no motor difficulties or motor difficulties) by the parents of the participants using the DCDQ'07 and the teachers using the MABC-C, the kappa (k-) coefficient was used. Finally, the Mann-Whitney-U test was used to compare differences between the experimental- and control group with reference to the perceptual-motor intervention for children with DCD (article 5). Probability level of 0.05 or less was taken to indicate statistical significance.ResultsThe results of aim 1 revealed the prevalence of DCD amongst Grade 1 learners in Bloemfontein is estimated to be 15%. The results also indicate that boys have a significantly higher (p=0.050) prevalence of DCD although marginally when compared to their female counterparts. Aim 2 indicated a 15% convergent validity between the MABC-2 Test and the DCDQ'07, similar results were obtained for aim 3, indicating a 11% convergent validity between the MABC-2 Test and the MABC-C. Therefore, it can be argued that parents using the DCDQ'07 and teachers using the MABC-2 could not identify children with DCD at home or in the classroom. The results in aim 4 indicated the prevalence of DCD to be 12%. Additionally, DCD had a significant effect (p=0.050) on five of the eight learning-related subtypes, namely reasoning, numerical skills, gestalt, coordination and memory. Furthermore, the results of aim 5 indicated that a perceptual-motor intervention only improved balance as a sub-test of the MABC-2 Test. Interesting to note is that children taking part in Physical Education classes presented by the teachers also prove to be beneficial. In contrast, aim 6 (sport stacking intervention for DCD) showed that the intervention had a significant effect (p=0.050) on two of the three sub-tests, namely manual dexterity, balance, as well as the total test score. This suggests that sport stacking can be used as an effective intervention programme for children with DCD.ConclusionsThe results revealed that the school age children in the current study had a higher incidence of DCD (15%) compared to the findings reported in the literature (5-6%). This information is important, and indicates that appropriate screening tools should be used to identify children earlier. Unfortunately the reliability of the MABC-C and the DCDQ'07 completed by parents and teachers to identify children with DCD was found to be low. Therefore it is recommended that specific norms should be developed for South African children. Furthermore, the results revealed that children with DCD do struggle with learning related skills. This knowledge enables teachers to address the specific needs of children with DCD. It can be concluded that perceptual-motor interventions have more often than not positive effects on children with DCD; however it is recommended that a combination of the bottom-up approach and top-down approach should be used for optimal results.

[发布机构] University of the Free State