Doctoral Degrees (Occupational Therapy)

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Browsing Doctoral Degrees (Occupational Therapy) by Subject "Physical therapy for children -- South Africa -- West Coast"

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    The development of Hopscotch : an early intervention programme to improve motor skills and academic performance of grade R children in the West Coast of South Africa
    (Stellenbosch : Stellenbosch University, 2022-04) Van der Walt, Janke; Plastow, Nicola; Unger, Marianne; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY: There is a high incidence of motor skill impairment in low socio-economic areas. Motor skill impairment among pre-school children effects their functional development, including play, social development, and academic skills and progress. These children need therapeutic input; however, therapy resources are often not accessible and motor skill impairment may remain unrecognised and untreated. This study aims to develop an accessible evidence-based motor skill intervention for grade R children in a rural low socio-economic area of South Africa, namely the West Coast. It is a five-stage study with a sequential mixed-methods design and using the theoretical model of complex intervention development. Firstly, in the absence of prevalence data for motor skill impairment in South Africa, a prevalence study using a cross-sectional descriptive study design and multi-stage cluster sampling was conducted. The study showed a high prevalence of motor skill impairment at 14.5%. Significant influencing factors identified were gender (male), lack of playground equipment, low weight and height and low socio-economic status of an area. Next, a scoping review was conducted to investigate the key elements of motor skill interventions for pre-school children. The PRIMA-SCR design was used to identify 45 studies through structured data-base searches, followed by title and abstract screening according to inclusion and exclusion criteria. The identified key elements were summarised in a proposed framework for intervention planning. A three-round Delphi study conducted with experts in the field of motor skill intervention followed on from the scoping review. The aim was to determine what the components of a feasible, cost effective motor skill intervention for pre-school children in the rural low socio-economic West Coast area would be. Consensus was reached at 75% or mean >4. A school-based, small-group intervention, facilitated by teachers under guidance and supervision of therapists was proposed. The Hopscotch motor skill intervention programme was subsequently developed, following on from the informative reviews. The result is a cost effective, school-based, 12 week intervention. A task-shifting approach was adopted where teachers facilitate the programme under the supervision of therapists. The study concludes with a protocol paper for an exploratory randomised controlled trial to determine the preliminary effect of the Hopscotch programme. A cluster randomised stepped wedge trial design is proposed to provide two randomised clusters of schools the opportunity to potentially benefit from the programme. It is envisaged that further research to evaluate the intervention will follow the pilot study. The Hopscotch motor skill-intervention programme may be a feasible solution to provide children in rural low socio-economic areas with much needed cost-effective, yet high quality intervention. The development of this complex intervention is a fluid, ongoing process and its preliminary effect is yet to be determined. The outcomes of this study suggests further research in the areas of culturally sensitive screening tools, inclusivity of intervention groups and feasibility of roll-out to other areas.