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

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dc.contributor.advisorPlastow, Nicolaen_ZA
dc.contributor.advisorUnger, Marianneen_ZA
dc.contributor.authorVan der Walt, Jankeen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Occupational Therapy.en_ZA
dc.date.accessioned2022-02-08T19:18:50Z
dc.date.accessioned2022-04-29T09:37:05Z
dc.date.available2022-02-08T19:18:50Z
dc.date.available2022-04-29T09:37:05Z
dc.date.issued2022-04
dc.descriptionThesis (PhD)--Stellenbosch University, 2022.en_ZA
dc.description.abstractENGLISH 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.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Daar is 'n hoë voorkoms van motoriese vaardigheidsinperkings in lae sosio-ekonomiese gebiede. Motoriese vaardigheidsinperkings onder voorskoolse kinders beïnvloed hul funksionele ontwikkeling, insluitend spel, sosiale ontwikkeling en akademiese vaardighede en vordering. Hierdie kinders het terapeutiese insette nodig; terapiehulpbronne is egter dikwels nie toeganklik nie en motoriese inperkings kan ongediagnoseerd en onbehandeld bly. Die doel van hierdie studie is om 'n toeganklike bewysgebaseerde motoriese vaardigheidsintervensie te ontwikkel vir graad R-kinders in 'n landelike, lae sosio-ekonomiese gebied van Suid-Afrika naamlik die Weskus. Die vyf-fase studie het 'n opeenvolgende ontwerp van gemengde metodes gebruik, asook die teoretiese model van komplekse intervensie-ontwikkeling. Eerstens, in die afwesigheid van prevalensiedata vir motoriese vaardigheidsinperking in Suid-Afrika, is 'n prevalensiestudie gedoen met behulp van 'n deursnee-beskrywende studie-ontwerp en 'n meerfasige steekproefneming. Die studie het 'n hoë voorkoms van motoriese vaardigheidsinperkings getoon met 14.5%. Belangrike faktore wat geïdentifiseer is, was geslag (manlik), gebrek aan speelgrondtoerusting, lae gewig en lengte en lae sosio-ekonomiese status van 'n gebied. Vervolgens is 'n bestekopname-ondersoek gedoen om die sleutelelemente van motoriese vaardigheidsintervensies vir voorskoolse kinders te ondersoek. Die PRIMA-SCR-ontwerp is gebruik om 45 studies te identifiseer deur gestruktureerde databasis-soektogte, gevolg deur titel- en abstrakte sifting volgens insluiting- en uitsluitingskriteria. Die geïdentifiseerde sleutelelemente is saamgevat in 'n voorgestelde raamwerk vir intervensiebeplanning. ‘n Drie-rondte Delphi-studie wat uitgevoer is met kundiges op die gebied van motoriese vaardigheidsintervensie, het gevolg op die bestekopname. Die doel was om vas te stel wat die komponente van 'n haalbare, koste-effektiewe motoriese vaardigheidsintervensie vir voorskoolse kinders in die plattelandse lae-sosio-ekonomiese Weskusgebied sou wees. Konsensus is bereik op 75% of gemiddeld > 4. 'n Skoolgebaseerde, klein-groepintervensie, wat deur onderwysers onder leiding en toesig van terapeute gefasiliteer word, is voorgestel. Die Hopscotch-intervensieprogram vir motoriese vaardighede is vervolgens ontwikkel na aanleiding van die bestekopname-ondersoek en Delphi-studie resultate. Die resultaat is 'n koste-effektiewe, skoolgebaseerde, twaalf weke intervensie. 'n Taakverskuiwende benadering is gevolg waar onderwysers die program onder toesig van terapeute fasiliteer. Die studie word afgesluit met 'n protokol vir 'n loodsstudie om die voorlopige effek van die Hopscotch-program te bepaal. 'n Gerandomiseerde stap-wigproef-ontwerp word voorgestel om twee gerandomiseerde skoolgroepe die geleentheid te bied om moontlike voordeel uit die program te trek. Die vooruitsig is dat verdere ondersoek om die intervensie te evalueer, die loodsstudie sal volg. Die Hopscotch-motoriese vaardigheidsintervensieprogram kan 'n haalbare oplossing wees om kinders in landelike lae-sosio-ekonomiese gebiede broodnodige koste-effektiewe, dog hoë gehalte intervensie te bied. Die ontwikkeling van hierdie komplekse intervensie is 'n vloeiende, deurlopende proses en die voorlopige effek daarvan moet nog bepaal word. Die uitkomste van hierdie studie dui op verdere navorsing op die gebied van kultuursensitiewe-siftingsinstrumente, inklusiwiteit van intervensiegroepe en uitvoerbaarheid van implementering in ander gebiede.af_ZA
dc.description.versionDoctoral
dc.format.extentxvii, 234 pages : illustrations, includes annexures
dc.identifier.urihttp://hdl.handle.net/10019.1/124855
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University
dc.rights.holderStellenbosch University
dc.subjectHopscotch (Computer program language) -- South Africa -- West Coasten_ZA
dc.subjectMotor ability in children -- South Africa -- West Coasten_ZA
dc.subjectPhysical therapy for children -- South Africa -- West Coasten_ZA
dc.subjectChild development -- Study and teaching -- South Africa -- West Coasten_ZA
dc.subjectMotor skill learning -- Study and teaching -- South Africa -- West Coasten_ZA
dc.subjectToddlers -- Development -- South Africa -- West Coasten_ZA
dc.subjectUCTD
dc.titleThe development of Hopscotch : an early intervention programme to improve motor skills and academic performance of grade R children in the West Coast of South Africaen_ZA
dc.typeThesisen_ZA
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Doctoral Degrees (Occupational Therapy)