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Mastery motivation as a predictor of occupational performance following upper limb intervention for school‐aged children with congenital hemiplegia
Author(s) -
Miller Laura,
Ziviani Jenny,
Ware Robert S,
Boyd Roslyn N
Publication year - 2014
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12471
Subject(s) - intervention (counseling) , psychology , occupational therapy , persistence (discontinuity) , physical therapy , cerebral palsy , international classification of functioning, disability and health , physical medicine and rehabilitation , clinical psychology , medicine , rehabilitation , psychiatry , geotechnical engineering , engineering
Aim To determine the extent to which children's mastery motivation predicts occupational performance outcomes following upper limb intervention ( ULI ). Method In this cohort study, participants received 45 hours of ULI , either in an intensive group‐based or distributed individualized model. The Dimensions of Mastery Questionnaire ( DMQ ) measured mastery motivation at baseline. Occupational performance outcomes were assessed at baseline and 13 weeks’ post‐intervention using the Canadian Occupational Performance Measure ( COPM ). Multivariable models determined the contribution of mastery motivation to COPM outcome irrespective of group membership. Results Forty‐two children with congenital hemiplegia (29 males, 13 females; mean age 7y 8mo [ SD 2y 2mo]; range 5y 1mo–12y 8mo; Manual Ability Classification System [ MACS ] I=20 and II=22; predominant motor type unilateral spastic n =41) participated in the study. Significant gains were seen in COPM performance and satisfaction scores ( p <0.001) post‐intervention with no between group differences. Children who had greater persistence with object‐oriented tasks ( p =0.02) and better manual ability ( p =0.03) achieved higher COPM performance scores at 13 weeks. Children's persistence on object‐oriented tasks was the strongest predictor of COPM satisfaction ( p =0.01). Interpretation Children's persistence with object‐oriented tasks as well as manual abilities needs to be considered when undertaking ULI . Predetermining children's motivational predispositions can assist clinicians to tailor therapy sessions individually based on children's strengths, contributing to effective engagement in ULI .