1.  What is the impact of wellbeing on the physical activities of occupational therapy for a child with dyspraxia?
Laura Power
Masters by research in physical education and physical activity- Canterbury Christ Church University
Introduction
Results
Discussion
Structured and supervised physical activities that are engaged with during a child’s schooling career are included under the domain of PE (Bailey, 2005). Therefore, the investigation of occupational therapy (OT) within school was deemed an interesting approach to research the implementation of physical activities of OT. Also, as wellbeing is a key focus within schools at this present day, it was interested to seek what the impact of wellbeing on physical activities of OT would determine.
The researcher implements (OT) physical activity exercises with a child (Sue) with dyspraxia in school, during morning break times. The setting is a boarding school that the child attends. The purpose of the research was to develop further the researcher’s OT knowledge and to support further working with the child, everyday (Monday to Friday) on a one to one basis.
This research has been based on an occupational therapy assessment, implemented and followed using the initial dyspraxia assessment report, completed by an occupational therapist. There were many dyspraxic difficulties being presented. These included: poor co-ordination; poor body awareness; lack of focus; poor organisation skills,. The assessment highlighted the specific activities implemented in the exercise programme were for the inhibition of reflexes (rolling, resisted crawl, cat and head turning activities).
It was thought that the research conducted would fill a gap in OT and physical activity due to closely regarding the importance of a child’s parental attachment, friendships, physical wellbeing, personal feelings and needs and how this impacts the physical aspects of OT development within school; current research does not consider these particulars.
Term 1- If the resisted crawl and cat were examined at the highest and lowest point of the wellbeing then it would appear that there was no impact from wellbeing on these physical activity movements. However it is important to note that Sue was not able to complete the resisted crawl and the cat successfully throughout the whole term (please ask for further detail for resisted crawl and cat results). Nor did her wellbeing go in just one positive direction, there were both positive and negative trends.
Term 2- If the resisted crawl and cat were examined at the highest point of wellbeing then it would appear that there is no impact from wellbeing on these physical activity movements. Yet, at the lowest point of wellbeing Sue was successful in all of the body movements for resisted crawl, but was unsuccessful with the body for cat (arching of the back was not supporting posture of the body nor muscle flexibility), whilst being successful for the rest of the body movements (see table 1). Unlike term 1, when at the lowest point, the cat was successful. However, it is important to note that the child was not able to complete the resisted crawl and the cat successfully throughout the whole term , but her wellbeing did go in one positive direction .
Term 3- If the resisted crawl was examined at the highest points of wellbeing then it would appear that there is no impact from wellbeing on these physical activity movements, however Sue was unsuccessful for cat with all of the head movements and aspects of leg/feet (see table 2). Yet, at the lowest point of wellbeing Sue was successful in all of the body movements for cat (see table 3), but was unsuccessful with the aspects of the head for resisted crawl (eyes maintain on focal point), whilst being successful for the rest of the body movements . However, it is important to note that Sue was not able to complete the resisted crawl and the cat successfully throughout the whole term, but her wellbeing did go in one positive direction.
Figure 1- illustrates Sue’s overall average wellbeing for all three terms that data was collected in and ran from 4th November to 17th March.
Term 1 is the first term of data collection and ran from 4th November 2016 until 9th December 2016.The graph illustrates that there is a positive trend in Sue’s wellbeing, from 4th November to 11th November with an increase of 8%. This is the highest point recorded of her overall wellbeing. This was followed by a negative trend where Sue’s wellbeing dropped by 8% from 11th November to 18th November. There was no change in Sue’s wellbeing between 18th November and 25th November. From the 25th November to the 2nd December there was a positive trend with 6% increase. From here, there was the most dramatic negative trend, within the term, with a decrease of 14% from 2nd December until 9th December, where Sue reached her lowest point on her overall wellbeing.
This was followed with a 4 week holiday period from 9th December to 20th January, which shows a negative trend where Sue’s wellbeing dropped by 4% by the start of term 2 on 20th January. This is the lowest point recorded of her overall wellbeing.
This was followed by the start of term 2, which is the second term of data collection and ran from 20th January 2017 until 10th February The graph illustrates that there is a positive trend in Sue’s wellbeing, from 20th January to 10th February 2017 with an increase of 12%. The greatest increase was by 7% and this occurred between 27th January to 3rd February.
This was followed with a 2 week holiday period from 10th February to 24th February, which shows a negative trend where Sue’s wellbeing dropped by 8% by the start of term 3 on 24th February.
This was followed by the start of term 3 which is the 3rd term of data collection and ran from 24th February until 17th March. The graph illustrates that there is a positive trend in Sue’s wellbeing, from 24th February to 17th March with an increase of 10%. The greatest increase was by 6% and this occurred between 24th February to 3rd March.
Methodology
A case study design was used to support Sue’s engagement with OT. Jupp, (2006) reports that this was important because it gave the researcher an opportunity to collect multidimensional data through observations, wellbeing questionnaires and questioning through natural conversations, which provided a very detailed picture of Sue.
A structured format, using a tick list method to observe the physical movements of the OT activities was used. Additionally, a semi-structured format, was applied to observe and comment about the emotional state of Sue. Finally, an unstructured observation method was implemented to observe and comment freely at Friday lunch breaks to see if there were any benefits to Sue’s self-esteem and confidence following the impact from OT at the end of the school week.
Data analysis was sought through coding quotes and categories, which were transferred to descriptive tables. Trend analysis was used to show the positive and negative trends of wellbeing that Sue displayed to show impact of wellbeing on the physical aspects of OT.
Successful
Unsuccessful
head-
drop head smoothly,
look down between knees,
keep head down whilst maintain stillness for five seconds,
head back up to look forwards,
Legs/feet-
keep feet still.
Arms/hands:
arms straight,
hands flat,
thumbs out,
Body:-
ensure arching of the back supports posture of the body,
four square position needed to support core stability,
Legs/feet
keep knees still.
Successful
Unsuccessful
Head:
drop heads smoothly,
looks down between knees,
keep head down whilst maintain stillness for five seconds,
head back up to look forwards,
Body
arching of the back was not supporting posture of the body nor muscle flexibility.
Arms/hands-
arms straight,
hands flat,
thumbs out.
Body:
four square position to support core stability.
Legs/feet
keep knees still,
keep feet still.
Successful
Unsuccessful
Arms/hands:
arms straight,
hands flat,
thumbs out,
Head:
drop head smoothly,
look down between knees,
keep head down whilst maintain stillness for five seconds,
head back up to look forwards.
Body:
ensure arching of the back supports posture of the body,
four square position needed to support core stability,
Legs/feet-
keep knees still,
keep feet still.
Conclusion
There has been a strong parental influence, particularly with reference to Sue’s mother, however important to state, not the father, that has impacted wellbeing on the participation of the resisted crawl and cat activities.
When Sue was approaching exams, in particular in term 1, her wellbeing went in a negative direction, which created feelings of anxiety and stress, heightening the need for her mother. Yet, when exams were over, Sue was able to look forward to family events and being part of her family unit.
As this research has been conducted throughout the three school terms and has shown that Sue has started each term followed from a negative trend of wellbeing from each of the previous terms, it would be recommended to continue OT activities throughout the school holiday periods.
Table 2- At the highest wellbeing points on 10th March and 17th March Sue was successful in all of the body movements for resisted crawl whilst for cat on 10th March (see table 2) and 17th March (see table 3) she was successful and unsuccessful in the following ways .
 Table 1- At the lowest wellbeing point on 20th January 2017 Sue was successful and unsuccessful in the following body movements for the cat movements.
Table 3 >>>>>