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A Framework of Uniform Motor Terminology for Occupational A FRAMEWORK OF UNIFORM MOTOR TERMINOLOGY FOR SOUTH AFRICAN OCCUPATIONAL THERAPISTS WORKING WITH DEVELOPMENTAL MOTOR DELAY Paula Monique Barnard A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science in Occupational Therapy FEBRUARY 2009 Ethical Clearance: M01-06-04 DECLARATION I, Paula Monique Barnard, declare that this dissertation is my own work. It is being submitted for the degree of Master of Science in Occupational Therapy at the University of the Witwatersrand, Johannesburg. It has not been submitted before for any degree or examination at this or any other university. Paula Monique Barnard ___________________ day of _______________ 2009 i To my parents, Beau and Gill, for always believing in me; To my daughter, Morgan, for loving me unconditionally; To my husband, Marc, for standing by me. ii PUBLICATIONS AND PRESENTATIONS PUBLICATIONS 1. Barnard P, Franzsen D. Motor terminology clarification survey. South African Journal of Occupational Therapy. 2004;34(2):13-7. (APPENDIX A) 2. Barnard P, Franzsen D. Towards A Uniform Taxonomy Of Motor Terminology: Stage 2. South African Journal of Occupational Therapy. Accepted for publication June 2008 PRESENTATIONS South African Institute for Sensory Integration (SAISI) Congress Cape Town 2003 paper presentation: “Motor Terminology Clarification Survey”. iii ABSTRACT A uniform taxonomy within occupational therapy has become a recent focus of discussion and concern in the literature. This study investigated inconsistency in the literature and how South African occupational therapists use and understand terms related to motor performance in children with developmental motor delay. A three stage Delphi Technique was used to gain consensus on the association of characteristics of movement to six motor component terms. The results yielded both quantitative and qualitative data, which revealed that while there was strong consensus among the occupational therapists on some aspects of motor terminology, there is still ambiguity and overlap of understanding. This is reflected in a worrying inconsistency of the description of these terms in the literature and how occupational therapists use the terms in clinical practice. A Framework of Uniform Motor Terminology was developed based on the results of the Delphi Technique. iv ACKNOWLEDGEMENTS I would like to thank the following people for their support and contribution towards the completion of this dissertation: My Supervisor: Denise Franzsen (Faculty of Health Sciences, Department of Occupational Therapy) My Research Mentor: Rosemary Crouch (School of Therapeutic Sciences, Research Mentor) Especially for the opportunity to be included in the 2007 Writing Retreat. My Research Support Group: Ingrid Ratcliff (Occupational Therapist) Nonceba Mbambo (Physiotherapist) Hellen Myezwa (Physiotherapist) The Department of Occupational Therapy, University of the Witwatersrand: My colleagues: for allowing the fluctuation in my workload. Other: My friends and family Corina Botha, Ray-Anne Cook, Sonja Berry, Lyn Zeervogel and Ingrid Khón (for hosting me on the road trip) v TABLE OF CONTENTS DECLARATION ------------------------------------------------------------------------------------------------------------ i PUBLICATIONS AND PRESENTATIONS ----------------------------------------------------------------------- iii ABSTRACT --------------------------------------------------------------------------------------------------------------- iv ACKNOWLEDGEMENTS ---------------------------------------------------------------------------------------------- v TABLE OF CONTENTS ----------------------------------------------------------------------------------------------- vi LIST OF FIGURES ------------------------------------------------------------------------------------------------------- x LIST OF TABLES ------------------------------------------------------------------------------------------------------- xi OPERATIONAL DEFINITIONS ------------------------------------------------------------------------------------- xii ABBREVIATIONS ----------------------------------------------------------------------------------------------------- xiv CHAPTER 1: INTRODUCTION --------------------------------------------------------------------------------------- 1 1.1 STATEMENT OF THE PROBLEM ----------------------------------------------------------------------------- 2 1.2 PURPOSE OF THE STUDY ------------------------------------------------------------------------------------- 3 1.3 AIM OF THE STUDY ------------------------------------------------------------------------------------------------ 3 1.3.1 Study objectives---------------------------------------------------------------------------------- 3 1.4 JUSTIFICATION ------------------------------------------------------------------------------------------------------ 4 1.5 OVERVIEW OF THE STUDY ------------------------------------------------------------------------------------ 4 1.6 DELIMITATIONS OF THE STUDY (SCOPE) ------------------------------------------------------------- 5 CHAPTER 2: REVIEW OF CURRENT LITERATURE ---------------------------------------------------------- 6 2.1 INTRODUCTION ------------------------------------------------------------------------------------------------------ 6 2.2 MOTOR THEORIES ------------------------------------------------------------------------------------------------- 7 2.2.1 Motor Control Theory --------------------------------------------------------------------------- 7 2.2.2 Motor Learning Theory ------------------------------------------------------------------------- 8 2.2.3 Motor Development Theory ------------------------------------------------------------------- 9 2.2.4 Occupational Therapy Frames of Reference ------------------------------------------- 10 2.3 EXISTING TAXONOMIES --------------------------------------------------------------------------------------- 11 2.3.1 Medical Taxonomies -------------------------------------------------------------------------- 11 2.3.2 Occupational Therapy Taxonomies ------------------------------------------------------- 12 2.3.3 Motor Development Related Taxonomies ----------------------------------------------- 15 2.4 CONFUSION IN THE PROMINENT TEXTS -------------------------------------------------------------- 16 2.5 THE NEED FOR UNIFORM TERMINOLOGY ----------------------------------------------------------- 17 2.6 CONCLUSION -------------------------------------------------------------------------------------------------------- 19 CHAPTER 3 – RESEARCH METHOD OVERVIEW ----------------------------------------------------------- 20 3.1 INTRODUCTION ----------------------------------------------------------------------------------------------------- 20 3.1.1 Ethical Considerations ------------------------------------------------------------------------ 21 3.2 STAGES OF THE STUDY --------------------------------------------------------------------------------------- 22 3.2.1 Stage 1: Definitional Audit of the Literature --------------------------------------------- 22 3.2.2 Stage 2: Delphi Technique A: Term Clarification Survey ---------------------------- 22 3.2.3 Stage 3: Delphi Technique B: Expert Survey ------------------------------------------ 23 3.2.4 Stage 4: Delphi Technique C: Expert Open Card Sort ------------------------------ 24 3.2.5 Stage 5: Development of a Motor Taxonomy Outline --------------------------------- 25 3.3 RATIONAL FOR SELECTION OF RESEARCH METHOD ----------------------------------------- 25 3.4 VALIDITY OF THE STUDY -------------------------------------------------------------------------------------- 26 3.4.1 Audit Trail ---------------------------------------------------------------------------------------- 26 vi 3.4.2 Triangulation ------------------------------------------------------------------------------------ 27 3.4.3 Validity of the measuring tool --------------------------------------------------------------- 27 3.4.4 Member checking ------------------------------------------------------------------------------ 28 3.5 RELIABILITY AND RESEARCHER BIAS ------------------------------------------------------------------ 28 3.6 CONCLUSION -------------------------------------------------------------------------------------------------------- 28 CHAPTER 4 – STAGE 1: DEFINITIONAL AUDIT ------------------------------------------------------------- 29 4.1 INTRODUCTION ----------------------------------------------------------------------------------------------------- 29 4.2 METHODOLOGY ---------------------------------------------------------------------------------------------------- 29 4.2.1 Research Design ------------------------------------------------------------------------------ 29 4.2.2 Data collection ---------------------------------------------------------------------------------- 29 4.2.3 Data Analysis ----------------------------------------------------------------------------------- 30 4.3 RESULTS --------------------------------------------------------------------------------------------------------------- 31 4.3.1 Literature accessed for definitional audit ------------------------------------------------- 31 4.3.2 Audit of the Literature ------------------------------------------------------------------------- 31 4.3.2.1 Audit of Definitional Precision Error ---------------------------------------------- 32 4.3.2.2 Audit of Definitional Parsimony
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