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Keeping track of time: Daily time management, participation, and time-related interventions for children, adolescents, and young adults with neurodevelopmental disorders
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten.
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The overall aim of this thesis was to investigate daily time management (DTM) and time-related interventions aiming to enhance participation in everyday activities among school-age children and young adults with neurodevelopmental disorders.

In study I, experiences of participation when using time assistive devices (TADs) in daily activities were investigated from the perspective of young adults (aged 17–37) with intellectual disabilities (ID) (n = 9), using semi structured interviews. In studies II and IV, a new multimodal time-related intervention consisting of psychoeducation, compensation with TADs and time-skills training, was investigated in children aged 9–15 with attention-deficit/hyperactivity disorder (ADHD). Study II was a randomized controlled trial (RCT) with an intervention group (n = 19) and a control group (n = 19). The aim of study III was to describe DTM, time processing ability (TPA) and self-rated autonomy in children aged 9–15 with ADHD (n = 47), compared to children with ID (n = 47) and typically developing (TD) children (n = 47). In study IV, occupational performance and satisfaction were evaluated (n = 27). In studies II, III and IV, a source for data collection included assessment, proxy report and self-reports.

Using TADs (study I) increased participation in activities in all areas of daily life: self-care, activities at work or school and leisure time activities. A feeling of having more control led to health benefits. Participants described participation restrictions related to attitudes from their social network towards participation and attitudes towards the use of TADs from the individuals themselves. Study II showed that the children in the intervention group increased their TPA significantly more compared to the control group, mostly in terms of time orientation. The parents in the intervention group rated their children’s DTM as significantly more improved compared to the parents of the children in the control group. However, according to the children themselves, there was no statistically significant improvement in their DTM. The psychoeducation for parents and school staff did not increase children’s TPA and DTM on its own. The majority of parents and children (study IV) rated the children’s occupational performance and satisfaction significantly higher at follow-up than at baseline. In general, children rated their occupational performance and satisfaction higher than their parents did. Most goals decided by the children and their parents involved daily routines and time orientation. Study III showed that children with ADHD and children with ID had significantly lower TPA, DTM and autonomy compared to TD children. Children with ADHD showed higher levels of self-rated autonomy compared to children with ID, but the reverse was found in DTM. However, there was significant diversity among children with ADHD and children with ID, which was not explained by age. Some children had difficulties at every level of TPA, while others were skilled at every level. The level of self-rated autonomy followed the level of TPA.

In conclusion, this thesis revealed that children with ADHD and ID have the same overall pattern of TPA but may have a delayed TPA, which affects their DTM and autonomy, and thereby also influences their participation in daily activities. The results show that a multimodal time-related intervention using TADs and time-skills training could increase TPA and DTM in children with ADHD aged 9–15 years with time deficits. Experiences from young adults with ID also show increased participation in daily activities and health benefits using TADs. It is recommended that TPA and DTM should be measured to identify difficulties in TPA and DTM in children with ADHD and to offer tailored time-related interventions in addition to medication.

Ort, förlag, år, upplaga, sidor
Linköping: Linköping University Electronic Press, 2019. , s. 69
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1717
Nyckelord [en]
ADHD, autonomy, ID, daily time management, intervention, occupational therapy, participation, time assistive devices, time processing ability
Nationell ämneskategori
Arbetsterapi
Identifikatorer
URN: urn:nbn:se:liu:diva-162113DOI: 10.3384/diss.diva-162113ISBN: 9789179299552 (tryckt)OAI: oai:DiVA.org:liu-162113DiVA, id: diva2:1371347
Disputation
2019-12-13, Granitsalen, Campus US, Linköping, 13:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2019-11-19 Skapad: 2019-11-19 Senast uppdaterad: 2019-12-12Bibliografiskt granskad
Delarbeten
1. Participation when using cognitive assistive devices - from the perspective of people with intellectual disabilities
Öppna denna publikation i ny flik eller fönster >>Participation when using cognitive assistive devices - from the perspective of people with intellectual disabilities
2010 (Engelska)Ingår i: Occupational Therapy International, ISSN 1557-0703, Vol. 17, nr 4, s. 168-176Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The aim of the study was to describe how people with intellectual disabilities experienced their participation in everyday activities when using cognitive assistive devices. The purpose of cognitive assistive devices is to compensate for cognitive problems, to enhance independence when performing activities and to support decision making in daily life. Nine persons, 17–37 years old, with mild intellectual disability were selected by purposive sampling. Data collection was conducted by semi-structured interviews. The results showed that participation in everyday activities increased when using cognitive assistive devices. The persons experienced having more control and health benefits using cognitive assistive devices in daily activities. There were participation restrictions related to attitudes from the social network towards participation, and attitudes towards the use of cognitive assistive devices from the persons themselves and from the social network. Occupational therapists should be aware of the social factors that may influence a client's participation in everyday activities when using cognitive assistive devices. There is a need for more research with clients with intellectual disabilities and further research concerning long-time use of cognitive assistive devices.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons. Ltd., 2010
Nyckelord
Cognitive assistive devices, intellectual disabilities
Nationell ämneskategori
Arbetsterapi
Identifikatorer
urn:nbn:se:liu:diva-59025 (URN)10.1002/oti.296 (DOI)000289428900002 ()
Tillgänglig från: 2010-09-07 Skapad: 2010-09-07 Senast uppdaterad: 2019-11-19
2. Effectiveness of time-related interventions in children with ADHD aged 9-15 years: a randomized contolled study
Öppna denna publikation i ny flik eller fönster >>Effectiveness of time-related interventions in children with ADHD aged 9-15 years: a randomized contolled study
2018 (Engelska)Ingår i: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 27, nr 3, s. 329-342Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Specific problems with time and timing that affect daily routines, homework, school work, and social relations have been recognized in children with ADHD. The primary treatments for children with ADHD do not specifically focus on time-related difficulties. The aim of this randomized controlled study (RCT) was to investigate how multimodal interventions, consisting of training in time-processing ability (TPA) and compensation with time-assistive devices (TAD), affect TPA and daily time management (DTM) in children with ADHD and time difficulties, compared with only educational intervention. Thirty-eight children on stable medication for ADHD in the 9–15-year age range were randomly allocated to an intervention or a control group. The children’s TPA was measured with a structured assessment (KaTid), and the children’s DTM was rated by a parent questionnaire (Time-Parent scale) and by children’s self-reporting (Time-Self-rating). The intervention consisted of time-skill training and compensation with TAD. Data were analysed for differences in TPA and in DTM between the control and intervention groups in the 24-week follow-up. Children in the intervention group increased their TPA significantly (p = 0.019) more compared to the control group. The largest increase was in orientation to time. In addition, the parents in the intervention group rated their children’s DTM as significantly (p = 0.01) improved compared with the parents in the control group. According to the children, their DTM was not significantly changed. In conclusion, a multimodal intervention consisting of time-skill training and TAD improved TPA and DTM in children with ADHD aged 9–15 years.

Ort, förlag, år, upplaga, sidor
Springer, 2018
Nyckelord
Children, ADHD, Time perception, Time-assistive devices, Intervention
Nationell ämneskategori
Arbetsterapi
Identifikatorer
urn:nbn:se:liu:diva-142298 (URN)10.1007/s00787-017-1052-5 (DOI)000427592600009 ()2-s2.0-85030099032 (Scopus ID)
Anmärkning

Funding agencies: Stiftelsen Sunnerdahls Handikappfond; Medical Research Council of Southeast Sweden Stiftelsen Probilia [FORSS-305331, FORSS-565411]; Habilitering Halsa, SLSO; Riksforbundet for Rorelsehindrade Barn och Ungdomar (RBU); Vardalstiftelsen Ideprovningsprojekt 

Tillgänglig från: 2017-10-25 Skapad: 2017-10-25 Senast uppdaterad: 2019-11-19Bibliografiskt granskad

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