Parental perspectives on the changes in their child’s participation in physical activities after a highly intensive functional balance training for Developmental coordination disorder: A sequential multimethod qualitative study

Abstract

Background Children with Developmental coordination disorder (DCD) experience challenges that extend beyond the motor domain, impacting their mental health and participation but also their parents and families. Currently, little is known about how motor intervention affects participation in physical activities in children with DCD. Methods This sequential multimethod qualitative study explored parental perspectives on their child’s participation following a highly intensive one-week (40-hour) group intervention focusing on balance performance in school-aged children with DCD. In Phase 1, post-intervention changes in participation in physical activities were examined using open-ended questionnaires in a first cohort of parents. In Phase 2, focus groups with a second cohort of parents further explored the changes of Phase 1 and investigated how these were interrelated. Thematic analysis was applied in both phases. Results Parents (Phase 1: 22; Phase 2: 14) reported improvements in their child’s participation, family dynamics and social interactions. Key themes included increased child empowerment, increased participation involvement through self-initiated actions, parent-centered support, and the fact that the empowerment of both parents and child potentially induced sustained changes in their child’s participation in physical activities after three months. Specific interventional features (individual therapist, accessible environment, and high amount of therapy time) empowered the child, initiating greater participation involvement through self-initiated actions. These changes were sustained through enhanced parental understanding of DCD and improved communication with their child and members of their environment (e.g., teachers), leading to shifts in parental behavior and sustained changes in daily routines. Conclusion This highly intensive group-based functional balance training resulted in sustained improvements in child participation in physical activities after three months potentially due to empowering both the child and their parents. These findings highlight the importance of addressing not only motor performances of the child with DCD but also involve caregivers in therapeutic processes to attain sustained changes.