1. What is the Relationship between Self-efficacy and Occupational Performance in Children with DCD?
Elisa Agnoletto
Christine Charlebois
Amanda Garnett
Iris Lazaro
Behdin Nowrouzi
Colleen Ross
Eugenia Wong

2. Outline of Presentation
Introduction to DCD & self-efficacy
Research process & Model 1
Critical appraisal
Limitations and gaps in research
Model 2
Future research
Take home points
Discussion

3. Developmental Coordination Disorder
Diagnostic Features
Impairment in motor coordination.
Interferes with academic achievement & ADLs.
Prevalence
Estimated to be as high as 6 % for children between the ages of 5-11 years.
(American Psychiatric Association, 2000)

4. Developmental Coordination Disorder
Manifestations of this disorder vary with age and development:
younger children: clumsiness and delays in walking, crawling, sitting, tying shoelaces, buttoning shirts, zipping pants
older children: difficulties with motor aspects of assembling puzzles, building models, playing ball, printing or writing
(American Psychiatric Association, 2000)

5. Self-efficacy
Belief in one’s ability to carry out specific actions that produce desired outcomes
These beliefs determine how people feel, think, motivate themselves and behave
(Bandura,1986; Bandura,1994)

6. Self-efficacy Self-efficacy beliefs are based on:
Performance experiences
Observational learning
Verbal persuasion
Emotional arousal
(Bandura, 1997)

7. How did we come to frame our question?
Interest in DCD from personal experience (had some background knowledge)  ↓
We each did an initial quick reference search, scratching the surface of the topic. ↓
 After reading a few articles, we asked the broad question “Are there psychosocial factors involved which affect occupational performance in children with DCD?
This question was then refined to ask more specifically “What is the relationship between self-efficacy and occupational performance in children with DCD?”

8. Model #1 DCD  Occupational Performance  Psychosocial  Self-efficacy
Development
 Self-efficacy

9. Outline for Finding Research Articles
Keywords used:
DCD, clumsy children, dyspraxia, motor difficulties, participation, performance, activities, physical activities, occupational performance self competence/esteem/efficacy, perceived competence

10. Outline for Finding Research Articles
Databases:
EMBASE, ERIC, CINAHL, Cochrane, PsychInfo, Proquest, PubMed, Taylor & Francis
Additional Articles:
References of journal articles, library for hard copy, contact Professors for additional articles

11. Methods Purpose Quantitative, Level II study
Motor Proficiency in Children Reporting Low Levels of Participation in Physical Activity Hay & Missiuna, 1998
Purpose
Assessed whether the Children’s Self-Perceptions of Adequacy in and Predilection for Physical Activity Scale (CSAPPA) could be used as a screening tool for DCD
Methods
Quantitative, Level II study
492 students from grade 4-8 with mean age 12.4 years

12. Hay & Missiuna, 1998
Results
students with the lowest 5% CSAPPA scores had significantly lower Participant Questionnaire scores
reported by teachers to be significantly less likely to perform physical activities well and to show less enjoyment of physical activities
- had significantly lower scores in BOTOM (motor proficiency) than students with highest CSAPPA

13. Hay & Missiuna, 1998 How this relates to our research question?
Poor self-efficacy in physical activities 
less likely to be physically active and participate 
occupational performance in physical activities is decreased

14. Hay & Missiuna, 1998 Limitations
does not directly study DCD population, even though they want to use the CSAPPA as a screening tool for DCD
only measures self-efficacy in terms of motor competence
Concern for the validity and reliability of the instruments used

15. Rites of Passage: Understanding participation of children with DCD Mandich, Polatajko & Rodger, 2003
Purpose
– explore the effect of DCD on children and the
importance of participation in occupations
Methods
Qualitative, interviewed parents
10 children age 7-12 years, dx’d with DCD
CO-OP intervention
Results
Poor occupational performance had negative effects on children
With CO-OP, children able to participate in occupations   self-esteem and QOL

16. Mandich, Polatajko & Rodger, 2003
How this relates to our research question?
Study does not look directly at self-efficacy and occupational performance
difficulty mastering various occupations  sense of failure
Bandura (1997)
Past performance has strongest impact on self-efficacy
Infer that poor occupational performance   self-efficacy

17. Mandich, Polatajko & Rodger, 2003
Positive Aspects (Trustworthiness )
Negative Aspects (Applicability)
Credibility: semi-structured interview, member check, informal member check, triangulation, prolonged engagement
The sample size (10 families) is too small
Transferability: detailed participant records
Most of the DCD children were boys
Confirmability: extensive field notes, transcripts audited by 2 experienced researcher, informal member check (family)
The children are receiving the COOP treatment
Dependability: field notes, coding of 2 researchers
Only have middle class families

18. Mandich, Polatajko & Rodger, 2003
Limitations
The low variability in the sample decreases the applicability of findings to other individuals with DCD
Since they did not directly interview the children with DCD, they may have lost some confirmability in their findings (i.e. parental bias)

19. – Examination of psychosocial variables on children
Psychosocial implications of poor motor coordination in children and adolescents Skinner & Piek, 2001
Purpose
– Examination of psychosocial variables on children
and adolescents with and without DCD
Methods
Quantitative data & research design
8-10 year children & adolescents with DCD
Results
DCD groups perceived themselves as less competent in several psychosocial domains & and had lower levels of self-worth

20. Skinner & Piek, 2001 How this relates to our research question?
The study finds that poor motor skills may have adverse social and emotional implications
Difficulties can affect how children/adolescents view themselves physically, socially and scholastically

21. Skinner & Piek, 2001 Limitations
Validity: “Harter’s measures has not been adequately tested.”
Reliability: Studies have mixed findings
- “Most researchers have failed to find a significant difference in global self-worth between children with poor motor skills and those who are coordinated”
Definitions: Self-worth, self-concept, self-efficacy, perceived competence, etc.

22. Model #2 ? DCD Anxiety Occupational Performance Perceived
Social
Support
 Self-efficacy

23. Research Approaches for OS
Further research be conducted on directly investigating the relationship between DCD, self-efficacy, and occupational performance
Examine whether DCD children generalize their self-efficacy in one occupation to other occupations
Further research on affective and cognitive components that affect self-efficacy and occupational performance

24. Research Approaches for OT
Investigate effectiveness of increasing self-efficacy through enabling children with DCD to participate in meaningful occupations
Evaluate effectiveness of family involvement in interventions of children with DCD
Evaluate whether or not interventions are effective in natural environments of children with DCD
To what extent do these interventions increase social participation

25. Take Home Points
Self-efficacy is a significant factor in enabling occupation in children with DCD
More research required to explore mechanism between self-efficacy and occupational performance
DCD is relevant to occupational science and therapy

26. Discussion Case Study B
(Losse, Henderson, Elliman, Hall, Knight, & Jongmans , 1991)
“B.” was a bright child with severe motor problems. Both his parents and teachers were concerned about him in school due to the fact that although highly motivated to learn new motor skills, he found it difficult to do so. At school he had no social difficulties and had a verbal IQ of 129.
When interviewed in adolescence he did not present himself as depressed by his difficulties. He had not done well academically and chose to leave school and was working as a postman, which he greatly enjoyed. He rated himself on the Harter scale as “sure of himself” and “happy the way he was”. He had many friends and seemed to be a “clumsy” but well-adjusted teenager.
Question: This actual case study shows that not all children with DCD will experience decreased self- efficacy through the cycle described in our proposed model. Can anyone suggest any factors that may come into play in such cases?

27. Model #2 ? DCD Anxiety Occupational Performance Perceived
Social
Support
 Self-efficacy

28. Discussion
What can occupational therapists do to enhance occupational performance and self-efficacy in children with DCD?