The evaluation of the Conductive Education program and the Cognitive Stimulation program in a home for children with developmental disabilities in a rural area of South Africa

Abstract

Introduction: This research evaluated the effectiveness of two developmental programs given in the Sizanani Children’s Home for disabled children in Bronkhorstspruit, South Africa. The Conductive Education (CE) program focuses on motor functional skills to create more independency in daily life activities. This follow-up study measured the development of those skills in the children and young adults at Sizanani Children’s Home in the period from April 2008 to November 2009. Next to this, it was measured whether this development is moderated by the level of gross motor functioning in April 2008. The Cognitive Stimulation (CS) program was an 8-week program focusing on stimulating the cognitive abilities. Methods: The CE program is evaluated in a longitudinal research (N = 39), in which the functional skills were assessed with the Functional Motor Assessment Scale (FMAS), the Level of intervention Observation Instrument (LOI) and the Pediatric Evaluation of Disability Inventory (PEDI). The CS program consists of an experimental group (N = 12), in which the participants received two times a week cognitive stimulation by play intervention in a social context, and a control group (N = 9), in which the participants received no play intervention. The possible cognitive effect of this program has been assessed with the Play Observation Scale (POS; Vos & Van Westrhenen, 2009) through the observation of play performance. This instrument is based upon Piaget’s (1962) classification of successive stages of play and was, in the current study, adjusted to make it more sensitive. Furthermore, the CS program has been optimized to enlarge learning opportunities by introducing a guideline of encouragement in play. Results: A significant improvement was found between April 2008 and November 2009 in functional skills according to the FMAS and the dressing subscale of the LOI, but not according to the PEDI and the feeding subscale of the LOI. Also, no further improvement was shown from April to November 2009. In addition, the level of gross motor functioning in April 2008 was not a moderator for the effect of the CE program. The results after the 8-week CS program showed a significant improvement in the level of cognitive play performance, as well as a significant interaction effect between time and condition. Conclusion: The effect of the CE program on the development of the motor functional skills was only proved partly in the current study and the level of gross motor functioning of April 2008 was not a moderator for this effect. The CS program proved to be effective, with a significantly more improved cognitive play performance for the group that received play intervention than for the group that did not.