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Executive Functioning Skills Deficits in university students
with Developmental Co-ordination Disorder (DCD)
Kirby, A., Thomas, M. & Williams, N.
Background to the study
• What is Executive Function (EF)?
• EF in relation to DCD
What is Executive Function (EF)?
• Term used to describe a complex cognitive construct which allows us to act as efficiently as possible.
• Components include:o Planning o Problem-solvingo Working memoryo Sustained attentiono Impulse controlo Decision-making
EF processes can be split into actions that require:
• conscious control (e.g. learning a new skill)• those that are automatic (e.g. memory recall) –or
• a combination of both (e.g. riding a bicycle).
Executive Function (EF)EF processes are associated with the prefrontal cortex (PFC) and other areas….
EF is not a unitary conceptDifferent constructs have been made each
with adifferent focus (Alloway, 2007; Gathercole
et al.2008).
Different approaches to assessment of EF –Brown review (2009). He suggests clinical interviews and rating scales may be valid assessments.
Impact of Executive Function Deficits
Impairments or deficits in the system will impact greatly on a person’s ability to conduct day to day tasks and maintain social relationships (Goel et al., 1997; Green et al., 2000).
EF is a predictor of future social competence (Nigg et al,1999; Clark et al., 2002).
ADHD and poor EF- affect academic achievement (Biederman et al., 2004).
EFDs have been identified in a number of Developmental
Disorders
• ADHD (Barkley, 1997; Biederman et al., 2007; Brown, 2009; Parker & Boutelle, 2009)
• ASD (Verté et al., 2005)
• Dyslexia (Reiter et al., 2005; Gooch et al., 2011)
EF & DCD• Alloway (2007), Alloway & Temple (2007) –
significant deficits in working memory in children with DCD.
• Kirby et al. (2008) – self reported executive functioning deficits in students with DCD (and to a greater extent than those with dyslexia).
• Kirby et al. (2011) – a high proportion of parents of emerging adults with DCD report problems with organisation, time & money management.
1) Students arrive with/without diagnosis of
DCD or an inaccurate diagnosis e.g. Dyslexia.
However, support is often variable and determined by a “label” (Kirby et al., 2008).
2) DCD is a heterogeneous condition.
Severity is on a continuum and will vary.
3) To understand support needs in relationship to EF it is useful to map out the profile of symptoms and signs.
Rationale for the exploratory study
Study Aims1. To investigate and compare patterns of self reported executive function skills in:
a) students with DCD. b) students who do not have a diagnosis but
reported difficulties. c) TD students.
2. Develop a functional tool to be used to assist planning and delivery of support.
Method• Developed a 77-item questionnaire including
different aspects of EF in the context of university, home and work life.
• Paper and electronic version of questionnaire.
• Each item scored on a 5 point Likert scaleranging from “Not at all like me” to “Very much like me”.
6 componentsPlanning - “I always write essay plans before starting an
assignment”Organisation - “I am good at organising lecture notes”Inhibition/impulse control - “I am easily distracted by
other people or noise around me when writing assignments”
Working memory - “When writing an assignment I often lose my flow of thought”
Metacognition - “I find it hard to use feedback/ comments from previous assignments to improve
work”Time management - “I am good at estimating how long it
will take to complete different assignments”
Recruitment Students currently attending university
The study was advertisedo Posters/bulletins around the universities/
student services o Social networking siteso The Dyscovery Centre website and databaseo DANDA members
DataGender No Diagnosis
(TD)DCD No diagnosis
but difficulties
Total
Male 122 12 12 146
Female 81 19 42 142
Total 205 31 54 290
Age range 18-64 years.
Mean 26.78 (9.51) years
Approach to analysis• TD group scores for each of the 6 components of EF
were used as the comparison group.
Examined how many of:a) the DCD groupb) “no diagnosis but difficulties group”
fell below the cut offs for the bottom 15th, 10th and 5th percentile based on the TD group.
Planning
Organisation
Inhibition/Impulse
Control
Working M
emory
Metacognition
Time M
anagement0
102030405060708090
100
15% or below10% or below5% or below
%
Number of students with DCD who fell into the lower percentile cut off ranges based on the
typically developing scores
No diagnosis but difficulties – a sub threshold group?
Planning
Organisation
Inhibition/Impulse
Control
Working M
emory
Metacognition
Time M
anagement0
10
20
30
40
50
60
70
80
90
100
15% or below10% or below5% or below
%
Conclusions
1. Significant self-reported EF difficulties in those with DCD
2. ALSO those who do not have a diagnosis BUT say they have difficulties DO have greater EF difficulties than TD’s.
Conclusions• Sub-threshold students at
risk of failure and not being able to access same supports – due to not having a diagnosis.
• Differential support system-with a bias for those with Dyslexia (Kirby et al., 2008)
Implications for universities support services
• Screening/check list could oDelineate patterns where support
could be offeredoProvide tailored supporto Identify the sub threshold student
Future work
• Further development of questionnaireo Refine questionnaireo Collect more datao Validate against other measures
Executive Functioning Skills Deficits in university students with Developmental Co-ordination Disorder (DCD)
Natalie Williams
For further information please contact:
Email: dyscoverycentre @newport.ac.uk
Tel: 01633 432330