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-solving
o Working memory
o Sustained attention
o Impulse control
o
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 concept
Different constructs have been made each with a
different 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.
Rationale for the exploratory
study
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.
Study Aims
1. 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 scale
ranging from “Not at all like me” to “Very
much like me”.
6 components
Planning - “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 advertised
o Posters/bulletins around the universities/
student services
o Social networking sites
o The Dyscovery Centre website and database
o DANDA members
Data
Gender
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 group
b) “no diagnosis but difficulties group”
fell below the cut offs for the bottom 15th, 10th
and 5th percentile based on the TD group.
%
Number of students with DCD who fell into the
lower percentile cut off ranges based on the
typically developing scores
100
90
80
70
60
50
40
30
20
10
0
15% or below
10% or below
5% or below
No diagnosis but difficulties – a sub
threshold group?
100
90
80
70
%
60
50
40
15% or below
30
10% or below
20
5% or below
10
0
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 systemwith a bias for those with
Dyslexia (Kirby et al., 2008)
Implications for universities
support services
• Screening/check list could
o Delineate patterns where support
could be offered
o Provide tailored support
o Identify the sub threshold student
Future work
• Further development of questionnaire
o Refine questionnaire
o Collect more data
o 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