"It feels as though I need to exert more effort than others": the experience of daily participation of young adults with developmental coordination disorder (DCD) - a qualitative study.

PURPOSE: Participation difficulties among adults with developmental coordination disorder (DCD) have been documented. However, little attention has been given to the subjective aspects of participation, also called occupational experience, including feeling during engagement in activities and their meaning. This study aimed to explore the occupational experience of young adults with DCD. MATERIALS AND METHODS: Informed by the phenomenological approach, we conducted semi-structured interviews with 10 young adults with DCD. FINDINGS: Three themes emerged: (1) Complexity of occupational experience; describes the motives for participation, with variations in experience across activities and individuals. Participants engage in activities that provide them with pleasure and fulfillment, while other activities require constant effort and cause stress and shame; (2) The role of internal factors; illustrates the influence of poor motor and organizational/planning skills, self-acceptance; and utilizing strategies on the participants' occupational experience; and (3) The role of the social environment; reveals the participants' dual perception of their environment - as a source of criticism as well as a source of support. CONCLUSIONS: Individuals with DCD may benefit from intervention during young adulthood to enhance their well-being. The interventions should target their subjective occupational experiences in addition to their objective performance difficulties, by enhancing their psycho-social resources.

Occupational experience, the subjective experience of participation in daily activities, is vital for well-being.The occupational experience of young adults with developmental coordination disorder (DCD) varies across activities, including daily struggles with household tasks and work.Rehabilitation clinicians and researchers are encouraged to relate to the subjective occupational experience of young adults with DCD in addition to objective performance difficulties.Well-being may be enhanced by altering the occupational experience of young adults with DCD, by fostering self-acceptance and support developing adaptive strategies and social resources.

"The clumsiness is always present": Parents perspectives of their adolescents with pDCD.

AIM: This study elicited the perspectives of parents of adolescents with probable Developmental Coordination Disorder (pDCD) of the implications of DCD on their adolescents' daily-life and the parents' coping strategies and future concerns. METHODS: Using a phenomenological approach and thematic analysis, we conducted a focus group including 7 parents of adolescents with pDCD aged 12-18 yrs. FINDINGS: Three major themes emerged from the data: (a) Manifestation and implications of DCD; Parents described the performance challenges and strengths of their adolescents; (b) Discrepancy in perceptions of DCD: Parents described a gap between them and their children's, and between the parents themselves, in their views of the child's difficulties; (c) Diagnosis of DCD and strategies for overcoming its implications: Parents' expressed the pros and cons of labeling and described strategies they used to assist their children. CONCLUSIONS: It appears that adolescents with pDCD continue to experience performance limitations in daily-life activities, and psychosocial difficulties. Yet, parents and their adolescents do not always view these limitations in a similar manner. Therefore, it is important that clinicians obtain information from both parents and their adolescents'. These results may assist in developing a client-centered intervention protocol for parents and adolescents.

Underlying functions associated with keyboarding performance of elementary-school students.

BACKGROUND: Keyboarding (Typing) is a major writing mode in educational settings in addition to, or as an alternative to, handwriting. Therefore, it is important that occupational therapists become experts on this activity, to support students' performance. Yet, the knowledge of keyboarding performance of elementary-school students, and the underlying functions it entails, is limited. AIM: To compare keyboarding performance (speed and accuracy) of 4th-grade students in copying and dictation keyboarding tasks, and to examine the role of underlying functions in predicting keyboarding performance. MATERIAL AND METHODS: The sample consisted of 57 4th-grade students, recruited from 2 elementary schools. Students were tested for reading speed, attention shifting, fine-motor skills, kinaesthetic awareness, and keyboarding performance. RESULTS: Keyboarding performance differed in the copying and dictation tasks. Reading speed was the major underlying function predicting keyboarding performance in both tasks. Additionally, kinaesthetic awareness had a low, negative correlation with dictation accuracy. CONCLUSIONS: When occupational therapists assess students' keyboarding performance, they should use various tasks. Additionally, therapists should consider students' reading speed and kinaesthetic awareness, as they may explain keyboarding performance. This knowledge may also support decision-making when considering keyboarding as an alternative writing mode for students with handwriting difficulties.

Leisure Participation Opportunities for Adults With Intellectual Disability With Moderate Levels of Impairment Residing in Community Apartments.

The purpose of this study was to examine the leisure and recreation opportunities available in community apartments for adults with intellectual disability (ID), and their association with leisure participation. The study included 38 adults with ID with moderate levels of impairment residing in 19 apartments. Apartment coordinators reported on apartment characteristics, as well as leisure and recreation schedule and opportunities. Findings revealed diverse leisure and recreation activities. We found correlation between the number of activities (rs = .392 , p = .015; rs = .433, p = .007, respectively) as well as a visible daily schedule (Z = 2.143, p = .035) and leisure participation. Findings suggest that diverse leisure activities and a visible schedule may be associated with improved leisure participation.

Correction: Can self-efficacy mediate between knowledge of policy, school support and teacher attitudes towards inclusive education?

[This corrects the article DOI: 10.1371/journal.pone.0257657.].

Can self-efficacy mediate between knowledge of policy, school support and teacher attitudes towards inclusive education?

BACKGROUND: While research has focused on understanding teachers' attitudes towards the inclusion of children with special educational needs into general education classrooms, there are lacunae that have yet to be addressed. This study examined the association between perceived self-efficacy and attitudes towards inclusion among elementary school teachers. The study also examined the role of teachers' self-efficacy as a mediating variable between knowledge of inclusion policy, perception of school support and teachers' attitudes towards inclusion. METHODS: Teachers (N = 352) working in general or special education schools completed questionnaires assessing attitudes towards inclusion, sense of self-efficacy, knowledge of current policy, and perception of support for inclusive practices. RESULTS: Higher perceived knowledge of inclusion policy and higher perceived school support of inclusion were both related to higher self-efficacy regarding inclusion, which, in turn, was related to more positive attitudes about inclusion. CONCLUSION: Our results suggest that point to being knowledgeable regarding local and national policy is important in order to increase feelings of self-efficacy regarding the implementation of effective educational practice. To enhance inclusion, local and national policy must be clearly communicated to teachers. Furthermore, leadership and a supportive school environment are conducive to successful inclusive education.

Validity and reliability of the 'Leisure Participation Observation' among adults with intellectual disabilities: A pilot study.

BACKGROUND: Individuals with intellectual disabilities have decreased leisure participation, affecting their health and well-being. Existing measures of leisure participation are primarily based on self- or proxy reports. This study describes the initial validity and reliability of Leisure Participation Observation (LPO), developed for individuals with ID. METHOD: Two judge panels (N = 10 each) completed a table of specifications for content validity. Reliability of the LPO was established on 38 individuals with moderate ID 25-45 years old. RESULTS: This study established the content validity of the LPO. Additionally, weighted kappa showed moderate-high statistically significant inter-rater reliability (.667-.859, p < .01) and low-moderate, significant test-retest reliability, based on intraclass correlations (.226-.474, p < .05). Finally, results yielded moderate-high internal consistency (α = .74). CONCLUSIONS: The LPO shows promise as an observation tool for assessing leisure participation in the moderate ID population that may serve as the basis for developing intervention programmes.

School quality of life: Cross-national comparison of students' perspectives.

BACKGROUND: Cross-national comparisons of students' school quality of life (QoL) can support our understanding of factors that may affect students' health and well-being at school. OBJECTIVE: To compare Canadian and Israeli students' perception of their school QoL. METHODS: The Quality of Life at School Questionnaire (QoLS) was administered to 1231 students in 4th to 6th grades from Canada (n = 629) and Israel (n = 602), measuring: Physical Environment, Positive Attitudes, Student-Teacher Relationship, and Psychosocial. RESULTS: The Canadian students scored significantly higher than the Israeli students on all domains. The two-way ANOVA did not show a statistically significant interaction between country and gender nor age. However, within each country, girls and 4th grade students reported higher overall QoLS. CONCLUSIONS: This study lends support for the universal aspects of perceived QoL at school. This information may serve clinicians and educators in setting goals and developing programs to enhance students' school QOL.

Reliability and Preliminary Outcomes of a Protocol for Selection of Test Accommodations for Higher Education Students With Dysgraphia: A Pilot Study.

IMPORTANCE: Students with dysgraphia often receive test accommodations to enhance their handwriting legibility or speed. However, these accommodations are seldom individualized to ensure that they actually improve the performance of a specific student. Therefore, a need exists for an evidence-based protocol (henceforth, the Protocol) for selecting individually tailored test accommodations for students with dysgraphia. OBJECTIVE: To establish the Protocol's content validity, interrater reliability, and preliminary outcomes through a pilot study. DESIGN: Descriptive and exploratory design. SETTING: Research laboratory at a large university in central Israel. PARTICIPANTS: The sample consisted of 25 students (mean age = 24.9 yr, standard deviation = 2.1), of whom 88.0% were male. Inclusion criteria included a previous diagnosis of a specific learning disability and handwriting difficulties. Exclusion criteria were a physical condition or medication intake that may have affected students' handwriting or typing ability. RESULTS: The Protocol was found to have face validity and high interrater reliability (κ = .80). Its initial use showed that the most suitable accommodations for students with dysgraphia varied and were not always intuitive (e.g., extended time was not always the best accommodation for students with slow handwriting). CONCLUSIONS AND RELEVANCE: The Protocol appears to be a promising tool to assist occupational therapists in selecting the most appropriate accommodations for students with dysgraphia in a systematic manner. However, additional studies are required to further support these results. WHAT THIS ARTICLE ADDS: This study indicates that the selection of the most appropriate accommodation for students with dysgraphia is not always intuitive. It describes a Protocol that enables occupational therapists to select accommodations that are tailored to students' writing abilities, following a systematic process, while considering the students' writing performance with and without accommodations.

The Psychometric Properties of the Structured Preschool Participation Observation (SPO).

AIMS: To evaluate the validity and reliability of the Structured Preschool Participation Observation (SPO), based on the COnsensus-based-Standards for the selection of health Measurement INstruments. The SPO development was based on biopsychosocial and ecological models to evaluate children's participation in play, learning and social occupational areas. METHODS: Following the establishment of content validity, construct validity using factor analysis and reliability were examined among 250 preschool children with typical development (TD). The known-groups procedure was used, comparing 88 children with developmental disabilities (DD), who attended special educational settings with the TD children. RESULTS: Three factors accounted for 68% of the variance. High internal consistency (alpha>.812) was found, as well as a significant moderate-to-high inter-rater reliability in most areas. Children with TD scored significantly higher than children with DD with small to large effect sizes. CONCLUSIONS: The SPO appears to be a suitable measure for assessing children's participation in preschool activities through structured observation. Further studies are needed to further establish its psychometric properties, along with using additional scales of enjoyment and/or involvement and self-care activities. The SPO may assist in generating intervention goals for children with limitations in participation and may complement information gathered from parents.

Motor functions of higher education students with dysgraphia.

This study examines the motor skills and motor-related daily functions of higher education students with and without dysgraphia, and their contribution in predicting handwriting performance. The sample included 82 higher education students aged 20-35 years old. Thirty-four were students without any known developmental disorder (NDD) and 48 students had dysgraphia. We individually administered a test battery evaluating handwriting performance, fine-motor skills, and visual-motor spatial-organization skills. Students also filled out a questionnaire relating to their fine- and gross-motor-related daily functions. Overall, the NDD students had significantly better motor skills and motor-related daily functions. Additionally, the motor skills and daily functions explained 62.9% of the variance in handwriting performance, and they correctly classified 90% of the students into the handwriting performance groups. Yet only visual-motor spatial organization and fine-motor-related daily functions significantly contributed to the fit of the model. These findings suggest that students with dysgraphia continue to encounter handwriting difficulties in higher education. These difficulties are linked to poor motor skills and motor-related daily functions. Therefore, higher education students with dysgraphia may require assistance and accommodations throughout their studies, not only with regard to their academic performance, but also in their motor-related daily functions.

The impact of monocular vision on motor function and quality of life in survivors of retinoblastoma.

BACKGROUND: Monocular vision has been found to have a negative effect on children's motion processing and motor functions. Yet, knowledge of motor function of survivors of retinoblastoma (RB) with monocular vision (due to enucleation, for example) is limited. This study examined motor function and its relationship to visual-related and health-related quality of life (HRQOL) in survivors of RB with monocular vision. PROCEDURE: Parents of 27 survivors of RB, who underwent an enucleation of one eye resulting in monocular vision, and of 21 typically developing children between the ages of 6 and 12, were administered questionnaires relating to their children's motor function (DCDQ), as well as vision-related function (CVFQ) and HRQOL (PedsQL). RESULTS: Of the 27 survivors of RB, 7 (25.6%) were found to have difficulties in motor functions, compared with 1 (4.8%) child in the control group. The difficulties were faced mainly in daily function requiring control during movement, including jumping, running, and ball playing. Additionally, significant correlations were found between motor functions and children's QOL. Finally, survivors of RB with monocular vision were found to have lower QOL, specifically physical- and school-related QOL. CONCLUSION: Survivors of RB who have monocular vision have a higher rate of decreased motor function and lower QOL. These results point to a need for ongoing assessment of survivors of RB to allow timely detection of motor deficits and to institute appropriate therapeutic interventions.

Effectiveness of the Co-PID for Students With Moderate Intellectual Disability.

OBJECTIVE: We aimed to corroborate the effectiveness of the Collaborative Consultation for Participation of Students With Intellectual Disability (Co-PID), intended for enhancing participation in classroom-related activities. METHOD: The study took place in two special education schools and included students with moderate intellectual and developmental disabilities ages 7-20 yr. The schools were randomly assigned to intervention (Co-PID; n = 28 students, n = 4 teachers) and control (In-Service [IS]; n = 32 students, n = 7 teachers) groups. Participation was evaluated at pre- and posttest of an 8-mo intervention. RESULTS: The Co-PID improved students' ability to choose among provided options. Additionally, the Co-PID group achieved more goals (measured by goal attainment scaling) than the IS group in all participation areas, and their enhanced participation transferred to other school environments (as measured by the School Function Assessment). CONCLUSION: The Co-PID was found to be an effective program for enhancing classroom and school participation.

Relationship between body functions and Arabic handwriting performance at different acquisition stages.

BACKGROUND.: The written languages and handwriting acquisition stages place different demands on the writer. Therefore, the relationship between body functions and handwriting performance may vary in different languages and acquisition stages; yet these demands have not been studied in the Arabic language. PURPOSE.: We examined the relationship between linguistic, visual-motor integration (VMI), and motor coordination (MC) functions and Arabic handwriting at two handwriting acquisition stages. METHOD.: This study used a cross-sectional and correlative design. Second- ( n = 54) and fourth-grade ( n = 59) students performed tasks examining reading, handwriting automaticity, VMI, MC, and copying a text. FINDINGS.: Handwriting automaticity significantly explained the variance in handwriting speed in both grades, in addition to the VMI in second grade and the MC in fourth grade. Enhanced performance in the VMI increased the likelihood of having good legibility in second but not in fourth grade. IMPLICATIONS.: Similar to other languages, the body functions related to Arabic handwriting vary at the different acquisition stages. Handwriting evaluation should be adjusted to students' acquisition stage.

Enhancing classroom participation of students with intellectual and developmental disabilities.

BACKGROUND: Students with intellectual and developmental disabilities (IDD) have been found to participate less in school-based activities. PURPOSE: This study aimed to examine the effectiveness of a combined in-service and collaborative consultation intervention model for enhancing classroom participation of students with IDD. METHOD: The Collaborative Consultation for Participation of Students With IDD (Co-PID) program involved a multidisciplinary team (an occupational therapist and 17 teachers) as well as 35 students and was compared to an in-service program (20 teachers and 34 students). Students were 8 to 20 years old. The programs aimed to enhance three classroom participation components: communicating, choosing, and initiating. FINDINGS: The Co-PID was found to significantly improve students' participation in all areas, whereas the participation of the students in the in-service group decreased. IMPLICATIONS: A school-based multidisciplinary intervention program for students with IDD, combining in-service and collaborative consultation (e.g., Co-PID), may assist in enhancing classroom participation among students with IDD.

Efficacy of a Crisis Intervention in Improving Mother-Child Interaction and Children's Play Functioning.

OBJECTIVE: We examined the efficacy of a crisis-based intervention in improving mother-child interaction and children's play functioning for families who had experienced domestic violence. METHOD: Using a pretest-posttest two-group control study design, we assigned the intervention group (n=20 mother-child dyads) to the Family Intervention for Improving Occupational Performance (FI-OP) program and the control group (n=17 dyads) to a playroom program. Both programs consisted of eight 30-min sessions. We videotaped dyads during free play and used standardized tools to assess interactions, play skills, and playfulness. RESULTS: After the intervention, mother-child interaction was significantly better in the FI-OP group than in the playroom group. The children in the FI-OP group also demonstrated significantly greater improvement in play skills, but not in playfulness. CONCLUSION: FI-OP is a promising program for improving aspects of mother-child interaction and children's play functioning among survivors of domestic violence.

Efficacy of an early intervention program for at-risk preschool boys: a two-group control study.

OBJECTIVE: We report the results of a preschool-based multidisciplinary intervention program. METHOD: This study took place in two educational settings and included 81 preschool boys from unique cultural backgrounds and of low social economic status (SES). The settings were randomly assigned to an intervention or control group. In the intervention group, boys identified as at risk for or with developmental delays received 8 mo. of intervention through a monitoring model. Additionally, a collaborative consultation model was used with all participants. Performance skills (visual-motor integration, motor, and cognitive) and performance and participation in preschool activities were evaluated at pretest and posttest. RESULTS: At termination of intervention, all children in the intervention group scored significantly better than control children on most performance skills and more fully participated in preschool activities. CONCLUSION: A multidisciplinary preschool early intervention program appears to assist children of low SES with improving their performance skills, and participation in preschool activities.

The influence of environmental factors on the development of ultra-orthodox preschool boys in Israel.

The study objectives were: (a) to compare the prevalence of children at risk and/or with developmental delay (at risk/delayed) among the Ultra-Orthodox community with the prevalence reported in the literature and (b) to compare the performance of Ultra-Orthodox children in kindergarten versus that of children in preschool. To this end, motor, visual-motor integration and cognitive performance of 203 Ultra-Orthodox boys from low socio-economic status were assessed. We found a higher percentage of children who were at risk/delayed in gross motor and motor-cognitive skills as compared with the percentage reported in the literature. However, as opposed to expected, the results did not show that there was a higher percent of at-risk/delayed children among the kindergarten group as compared with those among the preschool group. Our findings are consistent with the research literature suggesting that children's cultural background and economic constraints can affect their motor and cognitive development. Thus, occupational therapists and other health professionals should be more culturally competent and more aware of the specific values and practices of families of children with whom they work, which can impact their development. However, in this study, it is difficult to distinguish between the influence of the cultural factors and the influence of socio-economic factors. Therefore, it is recommended to repeat this study among children from either low socio-economic status or other cultural backgrounds.

Participation in daily activities and quality of life in survivors of retinoblastoma.

PURPOSE: To assess the participation and health-related quality of life (HRQOL) of survivors of childhood retinoblastoma (RB). PATIENTS AND METHODS: Parents of 46 survivors of childhood RB between the ages of 2-18 were administered questionnaires relating to their children's participation (CFFS) and HRQOL (CHQ and PedsQL) and children were administered the PedsQL. Results of the HRQOL were compared to population-based norms. RESULTS: The overall QOL of survivors of RB was similar to that of age norms. However, parents' rating of their children's general and emotional health was lower than that of age norms, and survivors reported lower QOL related to school. Survivors of bilateral RB participated less in daily activities and had lower emotional QOL compared to those with unilateral RB, and parents of children who had an eye enucleated reported that their children had lower self-esteem. The level of participation was related to the perceived QOL. CONCLUSION: Our results indicate that children who are survivors of RB have an overall QOL that is similar to their age-peers. However, subgroups of survivors appear to have unique difficulties that require continued follow-up and intervention. Focus should be placed on their participation in daily activities both in the community and at school.

Relationship between handwriting and keyboarding performance among fast and slow adult keyboarders.

OBJECTIVE: We examined the relationship between handwriting and keyboarding performance and between these writing modes and underlying performance skills. METHOD: Sixty-three young, healthy adults who used the computer daily were recruited for this study by means of a convenience sample (mean = 25.3, standard deviation = 3.0); 15 were slow keyboarders and 17 were fast keyboarders. Participants were administered handwriting and keyboarding assessments, as well as measures of finger function, kinesthetic processing, and eye movement. RESULTS: Although handwriting and keyboarding speed were moderately correlated, these activities did not share underlying performance skills. In addition, different correlation patterns between written communication modes and performance skills were found among slow and fast keyboarders. CONCLUSION: Results suggest that occupational therapists and educators should consider a variety of factors before recommending keyboarding as an alternative written communication method for people with handwriting difficulties. Moreover, different recommendations appear to be warranted for slow and fast keyboarders.