Using Occupational Performance Coaching to target teachers' perception of their own performance ...

259 Pages·2014·7.38 MB·English

Using Occupational Performance Coaching to target teachers’ perception of their
own performance, satisfaction, and self-efficacy in supporting the
self-regulation of their students: A pilot study

Caroline Hui
School of Physical and Occupational Therapy
Faculty of Medicine, McGill University, Montreal, Quebec
December, 2013

A thesis submitted to McGill University in partial fulfillment of the requirements of the degree
of Master’s of Science.

©Caroline Hui, 2013
Abstract

The policy of inclusive education has changed the makeup of the Canadian classroom.
Today’s elementary school teacher is faced with the challenge of meeting the myriad classroom
needs of their students, many of whom demonstrate disruptive classroom behaviours due to
different underlying diagnoses. It is known that these behaviours have a large impact on a
teachers’ stress level. This increased stress can lead to reduced performance, dissatisfaction in
performance, and lower self-efficacy. Only 13% of surveyed Canadian teachers felt they could
manage the challenge of these behaviours. Preliminary studies of the Alert Program®, an
innovative program which promotes the use of sensorimotor strategies to enable students to
attain and maintain an appropriate level of arousal and self-regulation for learning, have shown
effectiveness. Occupational Performance Coaching (OPC), an occupation and client centred
approach, has been shown to be successful in helping adults meet their occupational goals.
The primary objective of this master’s thesis was to estimate the extent to which elementary
school teachers’ perceived performance, satisfaction of performance, and self-efficacy changed
following participation in a one day training and weekly OPC on the use of tools for self-
regulation of their students. This study used a multiple case replication study design. A cohort
of regular classroom elementary school teachers (n=11) were recruited from the Quebec
Eastern Townships School Board. Intervention took place over a period of 11.3 weeks. The
intervention included a one day workshop, based on the Alert Program®, entitled Tools to
Improve Attention and Self-regulation for Students in the Classroom and was followed by eight
individual sessions of OPC with the teachers. The key outcome measures were the Canadian
Occupational Performance Measure (COPM), used to assess the teachers’ perceived
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performance and satisfaction performance in supporting self-regulation of their students, and
Goal Attainment Scaling (GAS) to evaluate functional goal attainment. The Teachers’ Self-
Efficacy Scale-Classroom Management (TSES-CM) was used to measure teacher’s self-efficacy in
classroom behaviour management. Open ended questions were used in semi-structured
interviews and a daily log was filled out by the teachers to collect data on the sensorimotor
strategies implemented in their classroom.
The results of this pilot study suggest that the use of a workshop and OPC sessions with
teachers improved their perceived perception, satisfaction and self-efficacy when working with
students with self-regulation issues. Perceived performance improved in 82% of participants,
perceived satisfaction improved in 91% and self-efficacy improved in 73% of participants.
Overall results on outcome measures indicated clinically significant change with a probability of
response at 0.77 (CI=0.58, 0.85). The results of GAS indicate that progress was noted in
teachers as well as students. Preliminary results suggest that the use of OPC as a school-based
OT intervention with teachers can be beneficial.

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Résumé
La politique de l’éducation inclusive a modifié le portrait de la salle de classe canadienne.
Aujourd’hui, les enseignants au niveau du primaire font face au défi de répondre aux
innombrables besoins de leurs étudiants dans la classe, plusieurs de ces derniers adoptant un
comportement inadéquat en raison de troubles sous-jacents. On sait que ces comportements
ont un important impact sur le niveau de stress des enseignants. Ce stress accru peut entrainer
une diminution de la performance, un mécontentement quant au rendement occupationnel et
une plus faible auto-efficacité. Seulement 13 % des enseignants canadiens sondés sentent être
en mesure de gérer les comportements perturbateurs dans la classe. Les études préliminaires
sur le « Alert Program® », un programme innovateur qui enseigne comment utiliser des
stratégies sensorimotrices pour atteindre et conserver le niveau adéquat d’éveil pour
l’apprentissage chez les étudiants, a démontré son efficacité à permettre aux enseignants de
soutenir leurs étudiants dans leur autorégulation. « Occupational Performance Coaching »
(OPC), une approche centrée sur le client et l’occupation, a démontré du succès avec les adultes
afin de réaliser leurs buts.
L’objectif général de cette thèse était de estimer jusqu’à quel point la perception du
rendement des professeurs, leur satisfaction quant à leur rendement et leur auto-efficacité ont
changées à la suite de leur participation à une formation d’une journée suivie de sessions
régulières de OPC visant à les aider à soutenir l’autorégulation de leurs étudiants. La devise de
l’étude était une étude de cas multiple avec réplication. Des enseignants (n=11) au niveau du
primaire ont été recrutés à la Commission scolaire Eastern Township, au Québec et
l’intervention s’est déroulée sur une période de 11,3 semaines. Elle prévoyait une journée
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d’atelier, basé sur le « Alert Program® », intitulé Outils pour améliorer l’attention et
l’autorégulation des étudiants dans la salle de classe. L’atelier était suivi par huit sessions
individuelles de l’OPC avec les enseignants. Les outils d’évaluations utilisées étaient la Mesure
canadienne du rendement occupationnel (MCRO) pour évaluer comment les enseignants du
primaire perçoivent leur rendement et leur satisfaction quant à leur rendement lorsqu’ils
soutiennent l’autorégulation de leurs étudiants. Le « Goal Attainment Scale » (GAS) a aussi été
utilisé. Le « Teachers' Self-Efficacy Scale - Classroom Management » (TSES-CM) a été utilisé
pour mesurer l’auto-efficacité des professeurs dans la gestion du comportement en classe. Des
questions ouvertes ont été utilisées lors d’entrevues semi-structurées et les enseignants on
remplit un journal quotidiennement afin de recueillir des renseignements sur les stratégies
sensorimotrices mises en œuvre dans la salle de classe.
Les résultats de cette étude pilot suggèrent que l’utilisation de l’OPC avec des enseignantes a
amélioré leur perception de leur participation et satisfaction ainsi que l’auto-efficacité pour
travailler avec des élèves qui ont des difficultés d’auto-régulation. La perception de
performance c’est amélioré dans 82% des participants, la satisfaction c’est amélioré pour 91%
des participants, et l’auto-efficacité c’est amélioré pour 73% de participant. Les résultats
globaux dans les tests MCRO, GAS et TSES-CM indiquent des changements significatifs, avec
une probabilité de réponse de 0,77 (Intervalle de confiance=0,58, 0,85). Les résultats du GAS
indiquent que du progrès a été mesuré au niveau des enseignants ainsi qu’au niveau des élèves.
Des résultats préliminaires suggèrent que l’OPC est une intervention ergothérapique bénéfique
qui pourrait être utilisé dans les écoles.

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Contribution of Authors
Caroline Hui BSc OT
I, the candidate, am the author of this thesis. I performed the literature review, recruited
participants, collected the pre-intervention measures, provided the intervention, and collected
the post-intervention and follow-up measures. I completed the data interpretation and
discussion.

Laurie Snider PhD
Dr. Snider provided guidance throughout the study. She reviewed the thesis and provided
expertise on methodology, measurement outcomes, content and structure.

Ingrid Sladeczek PhD
Dr. Sladeczek reviewed the thesis and provided expertise on content and structure as well as
guidance for statistical interpretation.

Mélanie M. Couture PhD
Dr. Couture reviewed the thesis and provided expertise on content and structure. She also
provided numerous helpful insights regarding methodology.

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Statement of Authorship

I certify that I am the primary author of this thesis. I claim full responsibility for content and
style of the text included herein.
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Acknowledgements

Returning to school after more than twenty years of clinical work has been a challenge that I
could not have done by myself. It has been a journey, one of discovery and sometimes pain, but
definitely a journey of growth. Although I spent many hours in isolation with my laptop and
piles of papers working on this degree, I was not alone. I felt supported in many ways.
Dr. Laurie Snider, my supervisor, provided encouraging words and valuable insight
throughout this process. She always knew what to say to keep me going and her attention to
detail was a great contribution to the evolution of this thesis. Her dedication to pediatric
research is inspiring. I would also like to thank Dr. Fiona Graham for her never ending support
with Occupational Performance Coaching. Regardless of the New Zealand and Quebec time
differences, she was always there when I needed.
I would also like to extend my gratitude to my supervisory committee Dr. Mélanie M.
Couture from Université de Sherbrooke and Dr. Ingrid Sladeczek from McGill University. Their
advice and research experience were always helpful. In addition, thank you to Dr. Nancy Mayo
and Dr. Susan Scott from McGill University for their patience with my questions on statistics.
Their help was valuable.
I appreciated the financial support of the Richard and Edith Strauss Foundation of Canada
and the Judith Kornbluth Gelfand Pediatric Fellowship. Their financial support was very much
appreciated.
It is the teachers who participated in this study who made it happen. Without them, I’d still
be waiting and recruiting. Thank you. Thank you for opening up your classrooms to me and for
sharing your hardships and successes. Your dedication to your profession and to your students
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is an inspiration to me. ETSB is privileged to have you and I was privileged to get the
opportunity to work with you. Thank you.
Finally, I want to thank my friends and family. Sophie and Lyette, thank you for answering
my phone calls and encouraging me every time. They believed in me. Of course, without the
support of my husband, Louis and my children, Amélia and Tristan, I would never have begun
this personal project. Thank you to my mother for her belief that I can do anything I set my
mind to doing. And to Pop, my guardian angel, I cannot thank you enough.
You all have been supportive and encouraging throughout this process. I truly appreciate
your patience and thank you for helping me realize my dream! I dedicate this thesis to my
children. There is nothing that you cannot do if you really want: follow your dreams.

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Table of Contents
ABSTRACT………………………………………………………………………………………………….………… i
RESUMÉ……………………………………………………………………………………………………………….. iii
CONTRIBUTION OF AUTHORS………………………………………………………………………………. v
STATEMENT OF AUTHORSHIP………………………………………………………………………………. vi
ACKNOWLEDGEMENTS……………………………………………………………………………..…………. vii
TABLE OF CONTENTS…………………………………………………………..……………………………….. ix
LIST OF FIGURES…………………………………………………………………..………………………………. xi
LIST OF TABLES………………………………………………………………………………………….…………. xii
LIST OF APPENDICES…………………………………………………………….………………………………. xiii
LIST OF ABBREVIATIONS…………………………………………………………………………….………… xiv
GLOSSARY OF TERMS…………………………………………………………….……………………………. xv
PREFACE……………………………………………………………………………………………..…….…………. xvii

1. GENERAL INTRODUCTION……………………………………………………………………..…………. 1

2. BACKGROUND……………………………………………………………..……………..……………………5
Heterogeneity of students in regular classrooms………………………….. …………. 5
Identifying the problem…………………………………………………………………………….. 7
Teacher workload………………………………………………………………….…………………. 7
Teacher stress……………..……………………………………..……………………..…………… 8
Self-efficacy of teachers……………………..…………………………….…..…………………. 10
Solution/Action Process…………………………………………………………………………….. 10
Occupational therapy …………………………………..…….……………………………………. 11
Collaboration between occupational therapists and teachers………..………… 12
Occupational Performance Coaching …………………….….…………………..………… 14
Sensory processing…………………………………………………………………………………… 18
Impact of sensory processing on student behaviour…………………………………. 20
Sensory processing impacts self-regulation………………………………………………. 23
Self-regulation and demands on the teacher………………………………………….. 25
The Alert Program®………………………………………...……………………………………….. 25
Sensorimotor strategies: Five methods of the Alert Program®……………….. 29
(1) Put something in your mouth…………………………………..………….…………. 30
(2) Move …………………………………..…….………………………………………..………… 32
(3) Listen…………………………………..…….…………………………………………………… 35
(4) Look…………………………………..…….…………………………………………..………… 36
(5) Touch…………………………………..…….………………………………………..…………. 36
Knowledge Translation…………………………………………………………………………… 39
Rationale………………………………………………………………………………………………….. 42

3. OBJECTIVES………………………………………………………………………………………………………. 44

4. METHODS……………………………………………………………………………..……………….………… 45
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