Students with learning difficulties comprise one of the main groups of
children referred for assessment to Australian occupational therapists. Teachers and
parents typically express concern regarding difficulty with participation during school
occupations. In particular, teachers and parents describe the cognitive aspects of
participation as being a challenge. While much research has focused on the concept
of participation for students with physical disabilities, little is known about the
impact of cognitive dimensions of a learning difficulty on school participation. There
are few ecological assessments which document difficulties with the cognitive
aspects of school participation relative to the expectations of task performance.
Specifically, there is a lack of standardised assessments which utilise the perspectives
of teachers and parents.
The initial purpose of this study was to explore the concept of participation
and how students with learning difficulties used cognitive strategies to participate
successfully in school occupations. The second purpose of the study was to develop a
teacher and parent questionnaire that might assist in the occupational therapy
assessment of the cognitive aspects of a student’s school participation.
A review of the literature was motivated by the need to better understand the
construct of participation and to determine how best to measure cognitive strategy
use as a component of school participation. The subsequent research was then carried
out in three phases. Phase One explored difficulties in school participation using a
longitudinal retrospective case study of one student with a learning difficulty over 13
years. In addition, 50 teachers and 44 parents were surveyed regarding participation.
Data collected from this phase formed the basis of Phase Two in which a teacher and
parent questionnaire was constructed following principles of questionnaire
construction. An instrument, PRPP@SCHOOL-Version 1(Teacher Questionnaire and
Parent Questionnaire), was developed which reflected theoretical and empirical
descriptions of cognitive strategies and descriptors used in an existing instrument, the
Perceive, Recall, Plan, and Perform (PRPP) System of Task Analysis. These
questionnaires, designed to form a companion instrument to the PRPP System of
Task Analysis, were trialled on 355 children, referred to a private occupational
therapy clinic in Greater Western Sydney. Data were analysed to determine
measurement viability. Phase Three of the study comprised reliability and validity
testing on the PRPP@SCHOOL-1(TQ & PQ). Intraclass correlations indicated
excellent test-retest reliability with a high level of agreement for the PQ. Content
validity was determined through consumer review, peer review, and an expert panel
review. Discriminant validity testing confirmed that the PRPP@SCHOOL-1(TQ &
PQ) was able to differentiate between typically developing students and students with
learning difficulties. Construct validity was assessed. Five factors emerged from the
analysis which also demonstrated that the PRPP@SCHOOL-1(TQ & PQ) was
functioning as a multidimensional measure.
Findings indicated that for children in this study, participation in school
occupations was undermined by challenges with inefficient cognitive strategy use.
Teachers and parents were able to observe and clearly identify these difficulties using
the PRPP@SCHOOL-1(TQ & PQ). This research adds a companion instrument to
the PRPP System of Task Analysis in the form of teacher and parent questionnaires
to be used with students who experience school participation difficulties. In so doing,
the research contributes to the expansion of occupation-focused, criterion-referenced
ecological instruments recommended by the profession as best practice assessment.