Date Presented 04/20/2023

Preparations for a single-subject design study to examine the impact of Ayres Sensory ntegration on motor coordination and self-confidence are described. Outcome measures that are objective, are sensitive to change, and control for a practice effect were developed.

Primary Author and Speaker: Stacey E. Szklut

Contributing Authors: Kerry Burokas, Barry James

Poor motor coordination can impact participation in age-appropriate occupations and affect self-confidence in children (Grajo, Guzman, Szklut & Philibert, 2020). Parents seeking occupational therapy intervention identify self-confidence as one of the most important treatment outcomes (Cohn, Kramer, Schub, & May-Benson, 2014). Further evidence is warranted to ensure intervention effectively addresses this parent priority. To examine the impact of Ayres Sensory Integration Intervention on motor coordination and self-confidence, researchers developed specific outcome measures in preparation for completing a multiple baseline single subject design study. In single-subject design studies, recurring tasks (probes) should be conducted throughout a study to continuously measure predicted outcomes, while ensuring that a practice effect would not increase performance over time. Researchers must also consider how to measure data objectively and reliably, as well as the sensitivity of a probe to change (Orsmond & Cohn, 2015). To measure improvements in coordination, investigators developed a variety of hopscotch sequences. The order of the sequence is changed each administration to prevent a practice effect. Sequences were designed to be of equal difficulty. This was verified through assessing two 7-year-old children with typical motor development, who completed all sequences equally well. To create an objective measure of motor coordination, investigators developed a rating form, which measures errors based on specific definitions. Two researchers established 92% reliability with this form by separately coding videos. To assess changes in self-confidence, researchers developed a Parent Perception of Child’s Self-Confidence form utilizing a visual analog scale. By preventing a practice effect, measuring data objectively and reliably, and developing probes which are sensitive to change, researchers can develop high-quality progress measures for treatment outcom


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