Therapists’ Use of Instructions and Feedback in Motor Learning Interventions in Children with Developmental Coordination Disorder: A Video Observation Study

Abstract

Aim

This qualitative study explored therapists’ use of instructions and feedback when teaching motor tasks to children with developmental coordination disorder (DCD) as a first step in developing practical recommendations.

Methods

A conventional content analysis approach was used to analyze videotaped treatment sessions of physical therapists using a newly developed analysis plan. Inductive coding was used to code purposively selected video segments. The codes were sorted into categories to identify key themes. Analyses were performed independently by two researchers until data saturation was reached.

Results

Ten video-taped sessions were analyzed and 61 segments were coded. Three key themes were identified: (1) therapists’ intention with the instructions and feedback was to motivate or to provide information; (2) the preferred therapists’ teaching style was either direct or indirect; and (3) parameters to shape specific instructions and feedback were the focus of attention, modality, information content, timing and frequency.

Conclusion

Therapists used numerous instructions and feedback with different information content, often shaped by multiple focuses and/or modalities to motivate children or to provide specific information about task performance. Although therapists adapted instructions and feedback to child and task, future research should explore how characteristics of child and task can guide therapists’ clinical decision-making.

Keywords:

• Children
• developmental coordination disorder
• feedback
• instruction
• motor learning
• motor skills disorder
• video observations

Acknowledgements

The authors are grateful to the therapists, parents and children that participated in this study. Furthermore, we acknowledge Les Hearn ([email protected]) for proofreading and editing this article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data Availability statement

The dataset generated and analyzed during this study are not publicly available due to them containing information that could compromise research participants’ privacy/consent.

Additional information

Funding

This work received no funding.

Notes on contributors

Ingrid P. A. van der Veer

Ingrid P. A. van der Veer, PPT, Drs is a clinical epidemiologist, master pediatric physiotherapist, and PhD candidate at University Hasselt, Belgium. She is pursuing a PhD on the use of motor learning strategies in children with developmental coordination disorder (DCD). She has a special interest in bridging the gap between research and clinical practice. Her research focuses on the use of instructions and feedback in clinical practice for children with DCD.

Caroline H. G. Bastiaenen

Caroline H. G. Bastiaenen, PT, PhD, is a clinical epidemiologist, physiotherapist, and associate professor at the Department of Epidemiology, Maastricht University, the Netherlands. Her expertise is in the field of health measures within the ICF framework.

Mieke Goetschalckx

Mieke Goetschalckx, PT, Drs, is a physiotherapist, and PhD candidate at University Hasselt, Belgium. She is pursuing a PhD on locomotor coordination and sensorimotor synchronization ability in children with DCD and typically developing children.

Nathalie N. F. van der Wielen-Heezius

Nathalie N. F. van der Wielen-Heezius, PPT, MSc, is a master pediatric physiotherapist at a primary health care facility in the Netherlands. She works, mostly, with primary school children with motor disabilities and has a strong interest in motor learning approaches.

Eugene A. A. Rameckers

Eugene A. A. Rameckers, PPT, PhD is associate professor in Rehabilitation Sciences at University Hasselt, Belgium, senior researcher in Rehabilitation at University Maastricht, and at Adelante Rehabilitation Centre, the Netherlands. His research focuses on the development of tests in the functional therapy, and functional strength training of upper and lower limb in children with disabilities and especially cerebral palsy (CP). He is the co-developer of the neuromotor task training in children with DCD and developer of innovative treatment modalities in the rehabilitation as Hand in hand Survival Camp for adolescents with CP and Functional Intensive treatment camps for children severe disabilities, with focus on self-care, sitting and standing balance problems (FiTCare4U).

Katrijn Klingels

Katrijn Klingels, PT, PhD is associate professor in Rehabilitation Sciences at University Hasselt and guest professor at KU Leuven, Belgium, specialized in pediatric rehabilitation. Her expertise lies in studying assessment and intensive treatment models of sensorimotor function from a clinical, biomechanical and neurological approach in pediatric populations. Current research projects focus on assessment and intensive intervention of upper limb function and postural balance, and motor learning paradigms in children with diverse disabilities.