Determinants of activity performance and participation in preschool children with developmental delay

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Determinants of activity performance and participation in preschool children with developmental delay

 

Author: Leung, Po-kam
Title: Determinants of activity performance and participation in preschool children with developmental delay
Degree: D.H.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations
Developmentally disabled children -- Education (Preschool) -- China -- Hong Kong
Department: Dept. of Rehabilitation Sciences
Pages: xii, 276 leaves : ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2321670
URI: http://theses.lib.polyu.edu.hk/handle/200/5359
Abstract: Background Although integrated education programs have been operating in Hong Kong for many years, many preschool children with developmental delay (DD) still experience difficulty in integrating into school. According to the International Classification of Functioning, Disability and Health (ICF) model adopted by the World Health Organization (WHO, 2001), the activity and participation of an individual are highly influenced by not only different body functions and structures but also a variety of personal and environmental factors. One of the important roles of the occupational therapist in inclusive education is to enhance the adaptive performance and active participation of children with DD in home, school and community settings. This calls for a better understanding of the factors underlying the activity and participation of these children. Purpose This research study had two purposes. The first was to compare various aspects of body functions (i.e., sensory functions, motor proficiency and behavioral symptoms), activity performance and participation (communication, daily living skills, socialization and school functioning) among Hong Kong preschool children with global developmental delay (GDD), borderline developmental delay (BDD) and typical development. The second was to identify determinants of the activity and participation of Hong Kong preschool children with DD. Methodology A total of 108 Hong Kong Chinese preschool children (25 with GDD, 29 with BDD and 54 with typical development) aged from 5 years to 5 years 11 months, who were attending integrated kindergarten-cum-child care centers, were recruited using a two-stage cluster sampling method. Their activity and participation were measured using the Vineland Adaptive Behavior Scales - Classroom Edition (Chinese Version), and School Function Assessment: Part I: Participation - Chinese Version. The body functions and structures of each child were evaluated using the Kindergarten Sensory Integration Checklist, Bruininks-Oseretsky Test of Motor Proficiency: Long Form and Conners' Teacher Rating Scale - Revised: Long Form. Information on environmental adaptations and supports was obtained through the administration of a questionnaire. One-way analysis of variance (ANOVA) was used to compare the characteristics among the three groups of children. Multiple regression analyses were performed to identify the determinants of activity and participation among the children with DD (GDD or BDD).
Results The results showed that the children with DD (GDD or BDD) had significantly poorer adaptive functioning and a lower level of school participation than those with typical development (p < 0.05). In addition, the children with DD also had significantly more deficits in sensory integration, poorer motor proficiency and more severe behavioral symptoms (p < 0.05). However, no significant differences were found in any of the major characteristics between children with GDD and those with BDD (p > 0.05). Multiple regression analyses revealed that motor proficiency, social skills, ADHD-related symptoms (particularly inattention) and environmental factors (classroom design and motor training) were the best predictors of adaptive functioning. The most significant predictors of school participation among children with DD were the same as those of adaptive functioning except motor training. Conclusion In summary, the results indicate that skill deficits in motor, social and attention aspects together with environmental factors (classroom design and motor training) can account for adaptive problems in Hong Kong preschool children with DD. It is suggested that these components be considered in the development of intervention programs for this population. In addition, educational programs that are designed to enrich the knowledge and skills of preschool teachers in these areas could be important in facilitating the healthy development of Hong Kong children with DD.

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