VALORACIÓN DE LA ACTIVIDAD

The individual constraints (Figure 3.1) makes the person unique and are predominantly physical and structural (weight, height, etcetera), but can also be functional (motivation, attention, etcetera). The environment as a constraint (Figure 3.1) is considered as everything externally influencing the person (indoor, outdoors, etcetera). It is important to note that the environment can also be referred to as social (peer and parent attitudes and support). When looking into the task as a

Spontaneous movement Individual

-CAS

Environment Task

-Intervention

constraint, this includes everything that has an influence on the task such as:

movement goals; direction of movement; as well as equipment (Colombo-Gougovito, 2017:142).

Both the paired groups and the small group’s gross motor intervention programmes for the current study were based on the Dynamic Systems Theory (DST). The DST was selected due to the understanding that children with apraxia struggle with motor planning (Murray et al., 2014:486). In this case the DST allows the child to select their own motor plan to execute a movement by referring to the task, their environment and their individual constraint.

When integrating the current study into the DST, the neuro-developmental delay, in this case the (CAS), is an individual constraint influencing the child’s movement. As the 3 constraints influence each other, the other 2 constraints could be manipulated to create an appropriate motor movement. Therefore, the activities (tasks constraints) in the intervention were broken down to very simple movement patterns in order to compensate for the individual constraint. The difficulty of the activities (tasks constraints) gradually progressed.

The integrated method of intervention was used in this study in both intervention groups. The reason being that the children will gain from both the process- and the product-oriented approaches. By using the integrated approach, the underlying systems will be stimulated and the focus will not only be on the end-product, namely the gross motor skills.

Process-oriented method selected:

The process-oriented method mainly focuses on the intervention of the underlying sensory systems, such as the kinaesthetic system.

The kinaesthetic intervention method (using the perception of one’s body parts, movement and weight to learn a new skill), uses the 5 principles of the proprioceptive system (Cheatum & Hammond, 2000:188):

A. contraction and stretching of muscles;

B. compression and pulling on joints;

C. tonic contraction of muscles around the joints;

D. increasing the weight on the muscles during execution; and E. increasing the duration of in which the movement is executed.

Product-oriented methods selected:

The product-oriented method mainly focus on problem-solving skills.

According to the cognitive-motor intervention method there is a clear interaction between the children’s understanding of the movement and the execution of the movement. This type of problem solving can be divided into 3 components (Miller et al., 2001:186; Barnhart et al., 2003:727):

A. planning the motor movement;

B. executing the motor movement; and C. evaluating the motor movement.

For example, the researcher showed the children a picture of a movement. The children had to plan how they were going to imitate the movement and correctly execute the movement. After they had done it once, they had to think about how they executed the movement and try to improve the movement the second time around.

The task-specific intervention method include learning processes that focus on specific gross motor skills. This intervention method focus on the repetition of a specific gross motor skill that enhance motor learning sequences, such as (Barnhart et al., 2003:727; Pienaar, 2014:225):

A. locomotor skills;

B. object control skills;

C. manual dexterity skills;

D. aiming and catching skills; and E. balancing skills

Hypothesis statement

If the integrated intervention method is used, then the gross motor capabilities of children pre-identified with CAS will improve because the process-oriented method focus on stimulating the underlying sensory systems and the product-oriented method focus on the problem solving skills.

Programme outline

The programmes were created each week according to the outline in Table 3.7. One programme for the pairs and one programme for the small group. The same programme were presented for 45 minutes, twice a week.

The programme consisted of more or less the same warm-up and cool-down throughout the intervention. This ensured that the participants followed a routine and that they knew where the beginning and the end of the programme was. As the participants were very young, this also helped with the discipline and organisation of the participants. The warm-up consisted of a lot of aerobic activities to prepare the participants’ bodies for the activities that were to follow. The cool-down consisted of passive movements to gradually calm the participants down.

Four activities were created with a main focus but also underlying focusses. Each activity had a progression. The participants were allowed to progress according to the discretion of the main researcher after receiving feedback from the researchers implementing the intervention programme. After each week, the main researcher reflected on the programme. If the participants, as a group, mastered the activity, a new activity was created. If the participants, as a group, did not master the activity, the activity was repeated the following week. The difficulty of the programmes progressed during the intervention period.

Table 3.7 explains the outline of the 12-week gross motor intervention and the types of activities that were selected to be part of the intervention.