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Background This article presents findings from the development and evaluation of The KIT: Keeping It Together ™ for Y outh (the ' Youth KIT'). The Youth KIT is a resource intended to assist youth with disabilities during their teenage years and during the transition to adulthood to give information to others about themselves, get from others about themselves, and organize their own information to the best of their ability. Methods Thirty-six youth between the ages of 12 and 25 with physical and developmental disabilities were active participants in the development of the Youth KIT and partnered with a multidisciplinary team to conduct the qualitative evaluation. Focus groups and individual interviews were used in three phases of evaluation. Results The results of qualitative content analysis found the Youth KIT to be useful for a variety of youth in different contexts. The themes that emerged about the utility and impact of the Youth KIT were: (1) self-discovery for youth; and (2) the importance of the 'fit' between youth and mentors to support youth as they started to use the Youth KIT. Conclusion Clinical implications for healthcare providers working with youth during the transition to adulthood include recognition that discussions about adult goals should be a continuous dialogue throughout adolescence rather than a 'special' conversation occurring at the time of discharge from paediatric services. [ABSTRACT FROM AUTHOR]

Purpose Affecting 5-6% of children, Developmental Coordination Disorder (DCD) is a prevalent chronic condition. The nature of the disorder - impaired motor coordination - makes avoidance of physical activity (PA) common. The purpose of this study was to examine the effect of barrier and task self-efficacy on PA behavior in children with DCD and a group of typically developing (TD) children. Methods Children were compared on their perceived ability to complete different intensities and duration of PA (task efficacy) and their confidence in completing PA when faced with everyday barriers (barrier efficacy). An accelerometer was used to record their activity over the subsequent week. Results Children with DCD were found to have significantly lower task efficacy and barrier efficacy. They also spent significantly less time in moderate to vigorous physical activity (MVPA). Multivariate analyses revealed that gender modified the relationship for both groups. Separate multivariate regressions, were therefore conducted by gender. A direct effect of DCD on PA was observed for boys, but not for girls. Further analyses showed that neither task efficacy nor barrier efficacy influenced the relationship between DCD and PA. Conclusion Results from this study confirm that children with DCD have lower task and barrier self-efficacy than TD children and that males have lower PA levels than their TD peers; however neither task or barrier self-efficacy mediated the relationship between DCD and PA. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore parent perspectives regarding the early experiences of their children with Developmental Coordination Disorder (DCD). METHODS: A phenomenological approach was used to explore the meaning of developmental experiences for children with DCD and their families. Parents of 13 children with DCD, aged 6-14, were recruited through purposeful sampling. Parents completed two in-depth interviews, and a set of questionnaires. Transcripts and questionnaires were systematically coded to identify emergent themes. RESULTS: There was an evolution over time in the differences that parents noticed and the concerns that they had for their child. There seemed to be a progression from motor and play concerns in the early years, to self-care, academic and peer problems in middle childhood, to significant challenges with self-esteem and emotional health in later childhood. CONCLUSIONS: Defining the developmental trajectory of children with DCD highlights the importance of understanding the impact of this disorder as it relates to developmental age and environmental expectations. Implications for early screening and increased awareness of health care professionals are discussed. [ABSTRACT FROM AUTHOR]

Background Provision and use of information about their children is a major concern to families who have a child with a disability. Strategies or systems to influence parents’ abilities to receive, give and use information in a way that is satisfying to them have not been well validated. Methods This paper reports on the development and evaluation of a Parent Information KIT (‘Keeping It Together’) information management system and child advocacy tool. The KIT was designed to assist parents in giving, getting and organizing information in an effective way. The KIT was evaluated by a sample of 440 parents, with outcomes of use, utility, impact and perceptions of family-centred care measured at baseline, and after 6 months, and 15 months. Results Parents’ perceptions of their ability, confidence and satisfaction when using information improved significantly after using the KIT. Parents’ perceptions of care, as measured with the Measure of Processes of Care, also improved significantly in the areas of ‘Enabling/Partnership’ and ‘Providing General Information’. Parents’ ratings of the use and utility of the KIT were associated with increased impact and, in turn, predicted improved perceptions of care. Conclusion Parents who received and actively used the Parent Information KIT experienced significant increases in their perception of their ability and self-confidence in getting, giving and using information to assist their child with a disability. Strategies for improving the use of the KIT among parents are discussed. [ABSTRACT FROM AUTHOR]

PURPOSE: We reviewed current practice for children with Developmental Coordination Disorder (DCD) using research evidence and the International Classification of Functioning, Disability and Health (ICF). Characteristics of children with DCD can be described at the levels of body function (impairments), whole body movements (activities) and involvement in life situations (participation). SUMMARY OF KEY POINTS: Descriptive instruments measuring the extent of motor impairments or activity limitations can be used to: (1) identify children who might benefit from intervention; and (2) determine the optimal type of intervention and model of service delivery. Evaluative tools that measure activities or participation, but not primary impairments, should be used to determine change over time. Commonly used measures for describing children with DCD and evaluating outcomes are reviewed and discussed in the context of the ICF framework. Intervention approaches are then outlined for children with DCD that are targeted to the levels of activity, participation, and prevention of secondary impairments. CONCLUSIONS: Outcomes of children with DCD will be optimized with the use of current research evidence and the appropriate ICF level guiding both assessment and intervention. [ABSTRACT FROM AUTHOR]

Background. Children with Developmental Coordination Disorder (DCD) represent 5 to 6% of the school-aged population and are often seen by occupational therapists in the school system. Although a family-centred approach has been identified as best practice in pediatric care, the perspective of parents is often overlooked both in research and in practice. Purpose and Method. In this study, a qualitative, phenomenological approach was adopted to explore the insights and experiences of 13 parents of children with DCD. Each parent participated in two in-depth interviews and completed a set of questionnaires. Results. Analysis of the study findings led to three primary themes that captured the experience of parents as they attempted to understand and get help for their child. The theme of unravelling the mystery highlights parents' impressions of their child's difficulties. The second theme of negotiating the maze refers to the many pathways followed by families as they sought to affirm their perceptions and obtain services for their child and the final theme of parenting dilemmas underscores some of the common challenges faced by parents in trying to deal with their child's limitations. Practice Implications. For occupational therapists, the study findings illustrate the importance of focusing on occupational performance issues for children with DCD, facilitating the understanding of parents, and the need for early intervention. [ABSTRACT FROM AUTHOR]

Parts I and II of this series introduced the Cognitive Orientation to daily Occupational Performance (CO-OP), a new approach to intervention that is based on the premise that cognition plays an important role in the acquisition of occupational skills and the development of occupational competency. Developed for use with children who have occupational performance deficits, CO-OP is an individualized, client-centred approach focused on strategy-based skill acquisition. This third paper in this series presents a brief description of the actual CO-OP protocol including its objectives, prerequisites and key features. [ABSTRACT FROM AUTHOR]

Recently, researchers in occupational therapy have investigated the use of a cognitive or 'top down' approach to improving the occupational performance of children with developmental coordination disorder. A cognitive approach is multifaceted in nature and one essential component of such an approach is the use of cognitive strategies. Although strategy use has a long history within the education and psychology literature, little discussion within the pediatric therapy literature has occurred. This paper reports the results of an in-depth videotape analysis of therapists using cognitive strategies during occupational therapy intervention. Eight domain specific strategies were identified and elucidated. This research will be beneficial to therapists who wish to incorporate a cognitive approach into their clinical practice. [ABSTRACT FROM AUTHOR]

This paper is the first in a series of three papers that present the systematic development and evaluation of Cognitive Orientation to daily Occupational Performance (CO-OP). CO-OP is a cognitively based, child-centred intervention that enables children to achieve their functional goals. In Part I, the breadth of literature that provides the theoretical underpinnings for the approach is reviewed. Parts II and III provide a description of the approach and present the evidence to support its use with children with developmental coordination disorder. [ABSTRACT FROM AUTHOR]

One of the central tenets of client-centred occupational therapy is to enable clients to select goals to work on in therapy (Law, 1998). The process of identifying and prioritizing goals is fairly abstract, therefore occupational therapy goals for children are often prescribed by the therapist or by parents and teachers. The purpose of this study was to pilot test a measure and a process that would provide young children with the opportunity to assess their performance on daily tasks and to establish goals for occupational therapy intervention. Parents and children completed the Perceived Efficacy and Goal Setting System (PEGS), a measure of children's perception of their competence performing fine and gross motor tasks. Children 5-9 years of age were able to discriminate among tasks and to rate whether or not they were able to perform each task competently. They were also able to use this information to select and prioritize goals for intervention. While parents often rated the child's competence lower than the child did, there was a high level of agreement regarding which tasks were difficult for the child. Parents and children often did not agree about the specific selection or priority of these tasks for intervention, however, which highlights the need for further research. [ABSTRACT FROM AUTHOR]

This study examined the motor proficiency and physical activity levels of young children with low levels of perceived self-efficacy regarding their participation in physical activities. This group (n=48) was compared with 400 of their peers in Grades 4-8 attending the same schools and also with a group (n=44) who reported high levels of perceived self-efficacy. Although none of the students with poor self-efficacy had been identified by their schools as having a learning or behavioural disorder, these children were found to have characteristics which are typical of children with developmental coordination disorder (DCD). These findings suggest that an instrument which asks children about their confidence when participating in physical leisure activities, and their enjoyment of those same activities may have potential as a possible screening tool for DCD. [ABSTRACT FROM AUTHOR]

Pediatric therapists are strongly encouraged to use well-developed, standardized tests in order to assess children and to determine eligibility for clinical interventions. In this paper, the subject selection process of a clinical research study is used to illustrate some of the problems that were encountered when using one widely-used assessment, the Developmental Test of Visual Motor Integration (Beery, 1982), to identify children with developmental coordination disorder. Specific recommendations are outlined regarding the clinical observations which should accompany the use of this, or any similar, standardized assessment. The argument is made that qualitative observations and reports of functional performance must continue to receive attention in the comprehensive assessment of children. [ABSTRACT FROM AUTHOR]

An abstract of the study "Tracking Waist Girth and BMI in Children: The Contribution of Motor Proficiency to Overweight and Obesity," by J. Hay, J. Cairney, S. Veldhuizen, C. Missiuna and B. Faught is presented.

An abstract of the article "Motor Proficiency, Aging and Participation in Physical Activities: Is There An Activity-Deficit Over Time?" by J. Cairney, S. Veldhuizen, J. Hay, C. Missiuna and B. Faught is presented.

Abstract Background Developmental Coordination Disorder (DCD) is a chronic neurodevelopmental condition that affects 5–6% of children. When not recognized and properly managed during the child's development, DCD can lead to academic failure, mental health problems and poor physical fitness. Physicians, working in collaboration with rehabilitation professionals, are in an excellent position to recognize and manage DCD. This study was designed to determine the feasibility and impact of an educational outreach and collaborative care model to improve chronic disease management of children with DCD. Methods The intervention included educational outreach and collaborative care for children with suspected DCD. Physicians were educated by and worked with rehabilitation professionals from February 2005 to April 2006. Mixed methods evaluation approach documented the process and impact of the intervention. Results Physicians: 750 primary care physicians from one major urban area and outlying regions were invited to participate; 147 physicians enrolled in the project. Children: 125 children were identified and referred with suspected DCD. The main outcome was improvement in knowledge and perceived skill of physicians concerning their ability to screen, diagnose and manage DCD. At baseline 91.1% of physicians were unaware of the diagnosis of DCD, and only 1.6% could diagnose condition. Post-intervention, 91% of participating physicians reported greater knowledge about DCD and 29.2% were able to diagnose DCD compared to 0.5% of non-participating physicians. 100% of physicians who participated in collaborative care indicated they would continue to use the project materials and resources and 59.4% reported they would recommend or share the materials with medical colleagues. In addition, 17.6% of physicians not formally enrolled in the project reported an increase in knowledge of DCD. Conclusion Physicians receiving educational outreach visits significantly improved their knowledge about DCD and their ability to identify and diagnose children with this condition. Physicians who collaborated with occupational therapists in providing care reported more confidence in diagnosing children with DCD and were more likely to continue to use screening measures and to provide educational materials to families.

OBJECTIVES: Children with developmental coordination disorder (DCD) struggle to learn new motor skills, demonstrating more variable performance than typically developing (TD) children. The purpose of this study was to determine whether patterns of brain activity differed between children with and without DCD while performing a motor task. METHODS: Using functional MRI, we measured brain activation patterns in 7 children with DCD and 7 age-matched peers (aged 8-12 years) during a fine-motor, trail-tracing task. RESULTS: Despite similar levels of behavioral motor performance, different patterns of brain activity were noted between the 2 groups. The group with DCD showed significantly more activation than control subjects in left inferior parietal lobule, right middle frontal gyrus, right supramarginal gyrus, right lingual gyrus, right parahippocampal gyrus, right posterior cingulate gyrus, right precentral gyrus, right superior temporal gyrus, and right cerebellar lobule VI. These results suggest that the group with DCD relied on visuospatial processing to complete the task. The TD group demonstrated significantly more activation than the group with DCD in left precuneus, left superior frontal gyrus, right superior temporal gyrus/insula, left inferior frontal gyrus, and left postcentral gyrus; these regions have been associated with spatial processing, motor control and learning, and error processing. CONCLUSIONS: Children with DCD activate different brain regions from typical children when performing the same trail-tracing task. Despite the small sample size, our results contribute to a growing body of literature suggesting that children with DCD exhibit differences in neural networks and patterns of brain activation relative to same-age peers. [ABSTRACT FROM AUTHOR]

Background: Developmental Coordination Disorder (DCD) is a chronic neurodevelopmental condition that affects 5-6% of children. When not recognized and properly managed during the child's development, DCD can lead to academic failure, mental health problems and poor physical fitness. Physicians, working in collaboration with rehabilitation professionals, are in an excellent position to recognize and manage DCD. This study was designed to determine the feasibility and impact of an educational outreach and collaborative care model to improve chronic disease management of children with DCD.Methods: The intervention included educational outreach and collaborative care for children with suspected DCD. Physicians were educated by and worked with rehabilitation professionals from February 2005 to April 2006. Mixed methods evaluation approach documented the process and impact of the intervention.Results: Physicians: 750 primary care physicians from one major urban area and outlying regions were invited to participate; 147 physicians enrolled in the project. Children: 125 children were identified and referred with suspected DCD. The main outcome was improvement in knowledge and perceived skill of physicians concerning their ability to screen, diagnose and manage DCD. At baseline 91.1% of physicians were unaware of the diagnosis of DCD, and only 1.6% could diagnose condition. Post-intervention, 91% of participating physicians reported greater knowledge about DCD and 29.2% were able to diagnose DCD compared to 0.5% of non-participating physicians. 100% of physicians who participated in collaborative care indicated they would continue to use the project materials and resources and 59.4% reported they would recommend or share the materials with medical colleagues. In addition, 17.6% of physicians not formally enrolled in the project reported an increase in knowledge of DCD.Conclusion: Physicians receiving educational outreach visits significantly improved their knowledge about DCD and their ability to identify and diagnose children with this condition. Physicians who collaborated with occupational therapists in providing care reported more confidence in diagnosing children with DCD and were more likely to continue to use screening measures and to provide educational materials to families. [ABSTRACT FROM AUTHOR]

Introduction: Partnering for Change (P4C) is an innovative practice model for school-based occupational therapy developed in Canada and informed by a program of research spanning nearly two decades. National and international interest in P4C necessitated development of an explanatory theory to guide implementation in varied contexts. The purpose of this study is to document the process of theory development and to provide an overview of the initial P4C explanatory theory., Methods: Realist evaluation was used to construct an initial explanatory theory of P4C drawing on P4C developers' conceptualisations of the model, document analysis, and analysis of transcripts from interviews and focus groups., Consumer and Community Involvement: No consumers were involved in the study design or analysis., Findings: Four sets of premises expressed as context-mechanism-outcome configurations (CMOCs) comprise the initial explanatory theory of P4C. An abstracted summary of these four sets along with contexts, mechanisms, and outcomes central to the P4C initial explanatory theory is presented. An exemplar CMOC is shared to illustrate how theoretical premises are developed and expressed using realist evaluation., Conclusion: This study advances knowledge regarding the hypothesised core elements of P4C and provides an example of using realist evaluation to advance knowledge in occupational therapy. Preliminary implications for clinical practice are discussed., Plain Language Summary: Partnering for Change (P4C) is a way of providing occupational therapy services in schools that helps all children to learn and participate successfully. P4C was created in Ontario, Canada, and has been researched for almost 20 years. People in different parts of Canada and other countries are interested in trying P4C. As the researchers who created P4C, we think there is a need to explain how it works so it can be used in different places. This study explains how we created a theory to describe P4C. To develop this theory, we used a method called realist evaluation that would help us explain how, why, and in what situations P4C works best. To do this, we analysed documents and transcripts of interviews and focus groups. Our findings are organised into four main ideas, each explained in terms of contexts (the situations), mechanisms (how and why P4C works), and outcomes (the impacts of P4C). One detailed example is given to show how these ideas were formed and work together. In conclusion, our study helps us understand the key parts of P4C and shows how realist evaluation can be used to improve knowledge in occupational therapy. The study also suggests some early ideas on how P4C can be used in practice., (© 2024 The Author(s). Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Purpose: The Facilitating Integration of Rehabilitation Services Through Training (FIRST) Course provides online professional development on tiered service delivery models for rehabilitation professionals working in education settings. Created by content and e-learning experts, this study describes our use of the Analysis, Design, Development, Implementation, Evaluation (ADDIE) instructional design model and the Successive Approximation Model (SAM) to develop, implement, and evaluate the FIRST Course , and reports the findings of an initial program evaluation., Method: Rehabilitation professionals who completed the FIRST Course were invited to complete a cross-sectional survey to evaluate its utility., Results: Between May 1, 2020, and August 11, 2023, 314 occupational therapists, 54 physiotherapists, and 170 speech-language pathologists completed the online course and survey. Respondents perceived the FIRST Course content to be relevant to their practice and to meet their learning needs regarding tiered services in education settings. Most respondents viewed the course positively and would recommend it to colleagues. More experienced respondents suggested a need for training on tiered service delivery models beyond an introductory level., Conclusions: The ADDIE and SAM instructional design models were successfully applied to develop, implement, and evaluate online professional development for school-based rehabilitation professionals who wish to learn about tiered service delivery models.

The United Nations champions inclusive education as a moral obligation, requiring equitable learning environments that meet all individuals' diverse learning needs and abilities, including children and youth. Yet the practice of inclusive education is variable and implementation challenges persist. A participatory action research framework was used to develop a solution, Partnering for Change (P4C), which is a tiered service delivery model that bridges health and education by re-envisioning occupational therapy services and transforming the role of the occupational therapist from a service provider for individual children to a collaborative partner supporting the whole school community. This perspective article will describe the P4C model and its evolution, and will outline how it has been implemented in Canadian and international contexts to facilitate children's inclusion and participation in educational settings., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Campbell, Missiuna, Dix and Whalen.)