Personal Projects of Boys With

Developmental Coordination Disorder

Anne A. Poulsen, Fiona M. Barker, Jenny Ziviani
key words: participation, physical activity, client-centered practice

ABSTRACT

Understanding the leisure perspectives of preadolescent boys with developmental coordination

disorder (DCD) requires more than documenting time-use patterns. This study explored the
use of the Personal Projects Analysis for Children (PPA-C) to improve depth of understanding
about personally meaningful leisure participation for this population. Sixty boys with DCD
and 113 boys without DCD completed the PPA-C. Boys with DCD reported significantly
fewer personal projects involving physical activities; fewer friends with whom to complete per-
sonal projects; more solitary leisure projects; and fewer personally meaningful personal projects
in total than the comparison group. The PPA-C findings provided ecologically sensitive and
personally salient information about leisure time participation from the perspectives of boys
with and without DCD. The low frequency of self-reported social and physical activity personal
projects for boys with DCD has not been previously detailed in this way. Occupational thera-
pists are challenged to be vigilant regarding restricted leisure portfolios and expectations about
activity participation in boys with DCD, with further research and advocacy for balanced
portfolios of personally meaningful leisure.

P
roxy diaries (Poulsen, Ziviani, & Cuskelly,
2008) and observational studies of playground
behavior (Smyth & Anderson, 2001) describe
low levels of social-physical activity participation
(e.g., team sports) for boys with developmental coor-
dination disorder (DCD) compared with boys with-
out DCD. Parental interviews confirm activity partici-
pation differences and note the links between motor
performance difficulties, perceived activity restric-
tions, low peer acceptance, and uncertainty about
trying new activities (Mandich, Polatajko, & Rodger,
2003). Understanding the perspective of boys with
DCD about their leisure experiences and companions
and the places they choose to play and plan to spend
more time during the out-of-school hours is poorly
understood. It is therefore the purpose of this study
to improve depth of understanding about personally
meaningful leisure participation for this population
from the childs point of view.
To meet this aim, we intend to explore the use of
personal projects methodology to describe and com-
pare meaningful leisure-time pursuits of boys with
and without DCD, aged 10 to 12 years 11 months.
Boys with DCD, defined as having poor motor coordi-
nation relative to age and cognitive level, are referred
for therapy services at a four times higher rate than
girls with DCD (American Psychiatric Association,
2000). A United Kingdom population study explor-
ing the prevalence of DCD at 7 years of age identified
a smaller gender ratio of 1.7:1 male:female (Lingam,
Hunt, Golding, Jongmans, & Emond, 2009). The in-
creased prevalence of DCD in boys, and the greater

Anne A. Poulsen, PhD, BOccThy (Hons), is Senior Research Officer, Fiona M. Barker, BOccThy (Hons), is Occupational
Therapist, and Jenny Ziviani, PhD, MEd, BAppSc (OccThy), is Associate Professor, The University of Queensland, Division of
Occupational Therapy, School of Health and Rehabilitation Sciences, St. Lucia, Queensland, Australia.
Originally submitted February 1, 2010. Accepted for publication May 15, 2010. Posted online July 27, 2010.
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Anne Poulsen at a.poulsen@uq.edu.au.
doi: 10.3928/15394492-20100722-02

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numbers of boys requiring therapeutic intervention,
in part justifies the focus on them in this study.
Personal Projects Analysis (PPA) is a tool that
taps into each persons unique perspectives on ev-
eryday projects, goals, and pursuits that are upper-
most in his or her mind at any point in time. As such,
PPA methodology can elicit rich information about
meaningful engagement in both current and future
leisure-time pursuits (Christiansen, Little, & Back-
man, 1998). Although PPA has typically been used
for adult populations, we believe that this approach
can be adapted for children to further understanding
about meaningful activity participation. This goes
beyond examining time-use patterns or describing
what children are currently engaged in doing, and
looks at the relative value they ascribe to these ac-
tivities or ideas for future time use.
PPA is an idiographic and nomothetic tool designed
to elicit personally salient and contextually sensitive
information about leisure-time projects, activities, and
goals (Little, 1983). Personal project systems refer to the
individuals selection of goal-directed pursuits (Chris-
tiansen et al., 1998) and may be defined as the kinds of
activities and concerns that people have over the course
of their lives (Little, 1983, p.1). There are two guiding
principles underlying PPA: (1) projects are carriers of
personal meaning and (2) they provide information
about the social and physical context of each project.
For these reasons, the client-generated nature of tradi-
tional PPA is described as aligning remarkably well
with the philosophy of occupational therapy (Brooke,
Desmarais, & Forwell, 2007, p. 284).
The PPA was modified for children by adapting
the first module of the adult PPA version. In Module
One, adults typically list 15 personal projects using
a Project Elicitation List after having read 14 ex-
amples of projects related to any aspect of their life
(Little, 1983). Individuals then rate these projects on
a series of dimensions (e.g., enjoyment, stress) in
Module Two. In the adult version of PPA, there are
three further modules using cross-impact matrices
and project nesting with laddering techniques to ex-
plore project networks.
In our modification of the PPA for children, called
PPA-C, children are provided with simplified in-
structions and illustrated examples of leisure proj-
ects to reduce response burden. Children list where
and with whom the projects typically take place.
Additional details spontaneously provided by the
child are recorded to provide a richer understand-
ing of the childs leisure world. Children can offer
extra information about their relationship to other
people/social supports (e.g., coach, uncle, or fam-
ily pet), or simply provide a number count of social
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companions. Similarly, the physical environmental
details that the child provides can be listed quickly
and contained to the minimal requirement of de-
scribing the project as an inside (I) or outside (O)
activity. This information may act as a trigger for the
child to reflect and elaborate on the physical context
(e.g., in the park, in my bedroom with the door shut,
or on the back deck) in which the project took place.
If children require assistance in recording their re-
sponses, verbatim transcripts are made.
To the best of our knowledge, there has only been
one previous modification of the PPA for children. In
a study of children with diabetes, Module Two was
used to evaluate a list of 21 diabetes-related activi-
ties from which to select 10 current personal projects
(Karoly & Bay, 1990). Our modification of the PPA
for children retains one of the key components of
Littles (1983) approach by asking children to elicit
an open-ended list of projects rather than providing
children with a prescribed list of goals. Additionally,
in our study we asked children to list things they
like to do in their spare time because of the focus
on leisure. Our study aimed to (1) explore the dif-
ferences in number and context (social and environ-
mental) of leisure-time personal projects reported
by boys with and without DCD and (2) describe the
types of personal projects elicited by boys with DCD
using PPA.
Method
Participants
Sixty boys with DCD and 113 boys without DCD
aged 10 to 12 years 11 months were group-matched
for chronological age, school year level, and socio-
economic status (Table 1). Boys with DCD had mean
percentile scores (mean = 6.05, standard deviation
[SD] = 4.64) on the Movement Assessment Battery
for Children (M-ABC) (Henderson & Sugden, 1992)
that were significantly different (t (171) = 16.44, p <
.001) from the mean percentile scores of boys with-
out DCD (mean = 64.95, SD = 25.5). Boys who par-
ticipated in the study lived in the Brisbane metro-
politan area of Queensland, Australia.
For boys in the DCD group, inclusion criteria
were: (1) scores below the 15th percentile on the
M-ABC (Henderson & Sugden, 1992), (2) age be-
tween 10 and 13 years, and (3) parent-identified
difficulties with daily living skills as assessed using
parent questionnaires and interviews. Exclusion
criteria for this group were: (1) evidence of intellec-
tual impairment (< 70) on the Slosson Intelligence
Test-Revised (SIT-R3) (Slosson, Nicholson, & Hibp-
shman, 1990), (2) previously diagnosed neurologi-
cal or motor disorder, (3) presence of any emotional
109
 Table 1
Demographic Characteristics
Characteristic Boys With DCD (n = 60) Boys Without DCD (n = 113) F
Mean age 11 years 10 months (SD = 10 months) 11 years 9 months (SD = 9 months) 0.47
M-ABCa 60 (34.7%) 113 (65.3%)
Intelligenceb 117 (SD = 18) No intellectual impairment
Total family size 4.45 (SD = 1.1) 4.54 (SD = 1.0) 0.31
Proportion of one-child families 0.05 (3.0%) 0.10 (6.0%) 1.18
Parents occupational groupingc 1.02
Higher status 5 (85.0%) 89 (78.8%)
Middle status 8 (13.3%) 22 (19.5%)
Lower status 1 (1.7%) 2 (1.8%)
School characteristics 32.39*
Independent boys only 39 (65.0%) 110 (97.3%)
Independent - coeducational 4 (6.6%) 0 (0%)
State funded - coeducational 17 (28.3%) 3 (2.6%)
DCD = developmental coordination disorder; SD = standard deviation.
a
Motor performance was measured using the Movement Assessment Battery for Children (M-ABC) (Henderson & Sugden, 1992).
b
Intelligence was measured in the DCD group using the Slosson Intelligence Test-Revised (Slosson, Nicholson, & Hibpshman, 1990). For the non-DCD
group, parent and teacher reports indicated no intellectual impairment.
c
Parents occupational groupings were based on the Australian Standard Classification of Occupations (Australian Bureau of Statistics, 1990), collapsed into
three categories by Najman and Bampton (1991).
*p < .001.

problems or environmental issues impacting on de-
velopment (e.g., psychiatric disorder) as identified
by parent or teacher report, and (4) participation in
an occupational therapy intervention program dur-
ing the past 3 months that may have impacted on
leisure-time participation patterns.
For boys in the non-DCD group, inclusion crite-
ria were: (1) scores in the 15th percentile or great-
er on the M-ABC (Henderson & Sugden, 1992), (2)
age between 10 and 12 years 11 months, and (3) no
evidence of parent- or teacher-reported intellectual
impairment or academic difficulties. Exclusion cri-
teria were the same as those described for boys with
DCD. A standardized assessment of intelligence was
not completed by boys without DCD.
Procedure
This study was part of a larger study exploring
leisure-time participation of boys with and without
DCD. The study protocol has been reported in other
articles where between-group differences were ex-
amined using proxy diary data about out-of-school
time use and standardized questionnaires about
psychosocial cognitions (Poulsen et al., 2008), as
well as provided by the boys themselves (Poulsen,
Ziviani, Cuskelly, & Smith, 2007). Ethical clearance
was obtained from The University of Queenslands
Behavioural and Social Sciences Ethics Review Com-
mittee. Boys with DCD were recruited through prac-
titioner referrals from therapy clinics, parent refer-
rals from media releases, and snowball recruitment.
A school screening program was conducted at two
private boys schools, with 89% and 75% of children
in the respective schools participating in the screen-
ing. Children identified as having DCD (n = 29) in
these schools represented 48.3% of our total sample
of boys with DCD.
Boys with DCD were assessed using the M-ABC
(Henderson & Sugden, 1992), Personal Projects
Analysis for Children (PPA-C), and the SIT-R3 (Slos-
son et al., 1990). Boys without DCD completed the
M-ABC (Henderson & Sugden, 1992) and PPA-C
and a standardized test of intelligence was not per-
formed. Parent and teacher reports of satisfactory
academic progress against benchmarking standards
for the school year level were used to provide evi-
dence about intellectual ability. All assessments
were performed by experienced occupational thera-
pists trained in the use of the M-ABC and PPA-C at
schools or occupational therapy clinics.
Instruments
The M-ABC (Henderson & Sugden, 1992) is a
standardized motor assessment used to identify chil-

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 Table 2
Personal Projects Descriptor
Category Description
Physical Activity Personal projects involving body movements produced by skeletal muscles resulting in energy
expenditure
MVPA Physical activity resulting in body movements of upper and lower limbs sufficient to raise breathing
and heart rate above baseline level
Structured PA Physical activities that are timetabled, structured, and adult organized
Structured Non-PA Non-physical activities that are timetabled, structured, and adult organized (e.g., future problem solving)
Team Sport A sport that involves participation between teams of players who have shared goals and objectives
Popular Sports Australian Football League, athletics, basketball, cricket, martial arts, rugby league, rugby union,
soccer, swimming, or tennis
Social Activity Personal projects in which the engagement with other people, or lack thereof, is considered
Total Friends Total number of friends identified by participant across all of their nominated personal projects
Solitary All activities completed alone
Small Group Activities completed with 1 or 2 other children/people/pets
Other Personal projects that are not otherwise covered by, or limited to, the Physical Activity and Social
Categories
MVPA = Moderate to Vigorous Physical Activity; Structured PA = Structured Physical Activity; Structured Non-PA = Structured Non-Physical Activity.

dren aged 4 to 12 years with DCD. It consists of three
tests of manual dexterity, two tests of ball skills, and
three tests of static and dynamic balance. Raw scores
on items are summed and converted to a percentile
rank. The M-ABC (Henderson & Sugden, 1992) has
acceptable reliability and validity (Crawford, Wil-
son, & Dewey, 2001).
The SIT-R3 (Slosson et al., 1990) is a brief screen-
ing measure of verbal intelligence. It was used to de-
termine whether boys with DCD met the exclusion
criteria of intellectual impairment. Children with
measured intelligence less than 70 are excluded from
DCD diagnosis (Leeds Consensus Statement [LCS],
2006). Validity and reliability for the SIT-R3 are ac-
ceptable (Slosson et al., 1990).
The PPA-C, based on Littles (1983) Module One
of the Project Elicitation List for adult PPA, was used
for this study. Children were encouraged to write
down six projects as a minimum after perusal of il-
lustrated project examples and the following intro-
ductory explanation:
We are looking at the kinds of activities and concerns
children have in their lives. We call these personal
projects. Think about how you spend your time out of
school. What will you do today, tomorrow, this week
or next? What sorts of things did you do last week? All
of us have a number of personal projects that we think
about, plan for, carry out, and sometimes (though not
always) complete. They can be activities you want to
do, or they might be things you have to do.
Children listed projects in a table where: (1) proj-
ect descriptions were recorded in the first column; (2)
number of social companions was listed in the sec-
ond column; and (3) project location, Away (A) or At
Home (AH), was placed in the third column. Sponta-
neous comments about projects were also recorded by
the therapist on the form, with the childs approval.
Children were allowed time to reflect on projects and
to provide further clarifying details about the project
as they filled in these columns. Interactive language
with minimal encouragers (e.g., mmm, I see,
and really) and invitations to talk (yes, please tell
me about that) was used to facilitate more detailed
descriptions. Respectful information checking and
attentive silence were also used when recording the
interest-sparked comments from children.
Analyses
In the first instance, classification criteria for per-
sonal projects using theoretical and empirical evidence
about leisure participation of boys with and without
DCD were established. The team who developed the
classification criteria comprised two of the authors,
an educational psychologist, and a research method-
ologist with a professional background in DCD re-
search and ipsative methodologies (e.g., Ahern, 2002).
Twenty projects were independently rated by each
expert using these predetermined criteria and 98%
agreement was achieved. Definitions of categories are
presented in Table 2 and for the purpose of analyses

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 Table 3
Physical Activity Personal Projects
No. of Participants (%)
Variable DCD Group (n = 60) Non-DCD Group (n = 113) Chi-square* df
a
MPVA 54.7 3
<2 32 (74.4) 11 (26.6)
3 to 4 22 (41.5) 31 (58.5)
5 3 (10.3) 26 (89.7)
>6 3 (6.3) 15 (93.8)
Structured PA 54.4a 2
0 to 1 41 (71.9) 16 (28.1)
2 13 (28.3) 33 (71.7)
>3 6 (8.6) 64 (91.4)
Team Sports 65.7a 3
0 35 (81.4) 8 (18.6)
1 19 (45.2) 23 (54.8)
2 4 (7.1) 62 (92.9)
>3 2 (6.3) 30 (93.8)
Popular Sports 66.9b 1
0 or 1 51 (68.9) 23 (31.1)
>2 9 (9.1) 90 (90.9)
MVPA = Moderate to Vigorous Physical Activity; Structured PA = Structured Physical Activity.
a
Linear-by-linear association.
b
Pearson chi-square.
*p < .001.

these were further collapsed into three broad catego-
ries: physical, social, and other personal projects.
SPSS for Windows, version 15.0 (SPSS, Inc., Chica-
go, IL) was used for data analyses. For variables that
were not normally distributed, chi-square analyses
of count data were used to determine differences be-
tween the DCD and comparison groups.
Results
Physical Activity Personal Projects
Statistically significant between-group differ-
ences were found for all physical activity variables
(Table 3). Boys with DCD identified fewer moder-
ate to vigorous physical activities (MVPA), team
sports, popular sports, and structured physical ac-
tivity (Structured PA) personal projects than boys
without DCD. Of particular interest, boys with
DCD accounted for 81.4% of boys involved in no
team sports (chi-square (3, N = 173) = 65.68, p <
.001) and 74.4% of boys who participated in two or
fewer MVPA (chi-square (3, N = 173) = 54.86, p <
.001). Many of the physical activity personal proj-
ects reported by boys with DCD were completed
individually or in the home environment, often in
the company of a family member or pet dog as the
person with whom they were completed.
A common team sport personal project reported
by the non-DCD group involved an ambition to
represent their country (Table 4). This type of goal
was much less prevalent in the DCD group, many of
whom nominated skill improvement.
Social Personal Projects
Statistically significant between-group differences
were found for two of the social variables (Table 5).
Boys with DCD identified having fewer total friends
across all of their projects, with total number ranging
from 0 to 76, 85.7% with 10 or fewer friends (chi-square
(4, N = 173) = 60.32, p < .001) and more than half with 20
or fewer friends. Comparatively, the non-DCD group
reported total number of friends ranging from 7 to 160,
with more than half nominating more than 40 friends.
Boys with DCD reported higher participation
rates in solitary personal projects, accounting for
72.7% of boys participating in six or more solitary
personal projects (chi-square (3, N = 173) = 27.669,

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 Table 4
Physical Activity Personal Project Examples as Described by Participants
Variable Boys With DCD Boys Without DCD
MVPA To do 10 laps of the pool and try and get fit Plan on representing Australia for swimming
instead of being last
Play outsideplay tiggy Athleticsrun 100 meters in 8 seconds drug-free
Bike riding with Dad Bike ridingdo it for fun and for fitness
Structured PA Tenniswork on my tennis shots Tennisnext year I want to win the competition
Kayakbuild up strength and muscles so Kayakingmake it to Nationals again
dont look so runty
Golfwant to learn, Mom has been giving us Golfwant to become a pro
lessons
Team Sports AFLhope to reach my 50th game AFLbe an AFL player when I grow up
Play backit ball (sic)every day & try to get 11 Basketballstay in team & get in As next year
baskets in a row & beat mom
Popular Sports Rugbyto get into a better team than the Cs, Rugbyplay for school and country
far away goal at the moment
To score a 50 in cricket Play cricket for Australia
MVPA = Moderate to Vigorous Physical Activity; Structured PA = Structured Physical Activity; AFL = Australian Football League.

Table 5
Social Personal Projects
No. of Participants (%)
Variable DCD Group (n = 60) Non-DCD Group (n = 113) Chi-square df
a
Solitary 27.67 * 3
0 to 1 6 (11.5) 46 (88.5)
2 to 3 17 (31.5) 37 (68.5)
4 to 5 21 (46.7) 24 (53.3)
>6 16 (72.7) 6 (27.3)
Small Group 0.94b* 1
<2 37 (37.8) 61 (62.2)
>3 23 (30.7) 52 (69.3)
Total Friends 60.33a* 4
< 10 24 (85.7) 4 (14.3)
11 to 20 15 (75.0) 5 (25.0)
21 to 40 9 (24.3) 28 (75.7)
41 to 65 10 (17.2) 48 (82.8)
> 66 2 (6.7) 28 (93.3)
DCD = developmental coordination disorder.
a
Linear-by-linear association.
b
Pearson chi-square.
*p < .001.

p < .001). The majority of boys across both groups
reported engaging in two or more solitary personal
projects. Common solitary activities included play-
ing with pets, homework, reading, and various me-
dia-related personal projects (Table 6).
Other Personal Projects
Statistically significant between-group differ-
ences were found for all other variables (Table 7).
Boys with DCD identified fewer away-from-home
activities than their peers, accounting for 82.4% of

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 Table 6
Social Category Personal Project Examples as Described by Participants
No. of Participants (%)
Variable Boys With DCD Boys Without DCD
Solitary Clarinetbe at one with clarinet Clarinetplay
MeccanoI like to shut the door and do this on LegoBUILD CREATION
my own
Reading as much as Mom13 books a week Readfinally finish second Lord of the Rings
book
TVwatch more, all night TVwtach (sic) for fun
invening (sicinventing)
Small Group Visitinggo to Grandfathers place with Dad and Help Dad with drag-racing and building cars
brother
Play in the cubby house (with friends) Take 2 dogs for walking with neighbor
Play with friendsclimb trees, would like to Walk the dogits a boxer, big, powerful, so Mum
swing on vines comes too
Future Projects Youth groupwant to meet friends Go to my friends houses for more sleepovers
DCD = developmental coordination disorder.
Small group = activities completed with one or two other children/people/pets.

Table 7
Other Personal Projects
No. of Participants (%)
Variable DCD Group (n = 60) Non-DCD Group (n = 113) Chi-square df
a
Away from home 40.72 3
<2 28 (82.4) 6 (17.6)
3 to 4 17 (32.7) 35 (67.3)
5 to 6 12 (20.3) 47 (79.7)
>7 3 (10.7) 25 (89.3)
Structured Non-PA 15.11b 1
0 35 (26.7) 96 (73.3)
1 to 2 25 (59.5) 17 (40.5)
Total Projects 9.52a 2
6 to 7 21 (51.2) 20 (48.8)
8 to 9 21 (38.2) 34 (61.8)
> 10 18 (23.4) 59 (76.6)
DCD = developmental coordination disorder; Structured Non-PA = Structured Non-Physical Activity.
a
Linear-by-linear association.
b
Pearson chi-square.

boys participating in two or fewer away-from-home
personal projects (chi-square (3, N = 173) = 40.72, p
< .001). Boys with DCD were more likely to partici-
pate in structured non-physical activity (Structured
Non-PA) projects, accounting for 59.5% of boys iden-
tifying one or more Structured Non-PA personal
projects (chi-square (1, N = 173) = 15.11, p < .001). Al-
though boys in the non-DCD group were less likely
to identify Structured Non-PA personal projects, the
content of the projects was similar to that of the DCD
group (Table 8).
Significant between-group differences were found
for total number of personal projects (chi-square [2,
N = 173] = 9.52, p = .002). The total number of proj-

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 Table 8
Other Category Personal Project Examples as Described by Participants
Variable Boys With DCD
Away from home Go window shoppingtry not to get kicked out
of mall
Play at neighborsplay hide and seek at night
Go to the beach
Play with neighbors dog if he doesnt have fleas
Structured Non-PA Scoutsget more cords to get Scout Medal
Chior (sic)go and dont fall over
Art classtake pictures home and hope they
dont get eaten by moths
DCD = developmental coordination disorder; Structured Non-PA = Structured Non-Physical Activity.
ects reported by both groups ranged from 6 to 15.
Boys without DCD were found to be more likely to
nominate 10 or more total projects, accounting for
76.6% of that subgroup. It should be noted that the
two groups had similar percentages in the lower
band (six to seven projects) of total projects (DCD =
51.2%; non-DCD = 48.8%).
Discussion
This study found significant differences between
the self-reported personal projects of boys with and
without DCD. Boys with DCD reported participat-
ing in fewer current and future physical and away-
from-home activities, recorded having fewer friends
associated with their projects, and identified signifi-
cantly fewer personal projects overall compared with
boys without DCD. These results are consistent with
research using data from parents proxy reports of
their childs current time use that showed how boys
with DCD participated in fewer social and physical
activities and had fewer friends than their non-DCD
peers (Poulsen et al., 2007). However, in this study
both current and inspirational projects were identi-
fied from the perspective of the boys. It is the latter
information that offers a uniquely different view of
the world of each childs leisure through his eyes,
rather than being revealed in studies reporting time
use differences. Although both approaches are im-
portant, the use of PPA-C has the potential to detect
differences at another level, and this has additional
benefits in clinical practice as a means of enriching
intervention planning using child self-report of per-
sonally meaningful leisure-time projects.
PPA-C findings contributed a wealth of eco-
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Boys Without DCD
Go shopping at the mall
Play in park and build secret base camp
Have fun at the beach, swimming and body
boarding
Fishingtake boat out and put it in the water
Attend writers campI want to be an author
when I grow up
Acting talent agencyauditiones (sic) for movie
Tromboneget into Brisbane Orchestra
logically sensitive information about the social and
physical context of the leisure worlds of boys with
DCD. Particularly noteworthy is that this is from the
boys perspectives, thereby enhancing knowledge
about the personal meaning of each current and/or
projected personal project. Through self-report, chil-
dren are provided with a means for communicating
their own unique perspectives about their out-of-
school interests and plans with their occupational
therapist, allowing them to be collaborators in iden-
tifying meaningful goals for intervention (Dunford,
Missiuna, Street, & Sibert, 2005), a core concept of
client-centered practice.
It was interesting to note that completing the PPA-
C activity was accompanied by spontaneous com-
ments, such as this is fun or Id never thought
about this before, by many children. Although the
PPA-C is a relatively simple, straightforward in-
strument, it was effective in promoting a consider-
able amount of dialogue from the boys engaging
in the activity. Even boys who nominated only the
minimal number of six projects engaged enthusias-
tically with the PPA-C and the researchers. A pro-
posed reason for this response is the client-gener-
ated nature of the PPA. It appears that the boys had
a high level of intrinsic motivation to engage in the
PPA-C because it allowed them to express and de-
scribe self-selected activities that were personally
meaningful. There were also no restrictions placed
on the content and feasibility of the personal proj-
ects during the PPA-C activity. This methodology
can thus be used in occupational therapy sessions
as a means of eliciting information-rich responses
from children to assist goal setting and to measure
the progress of these goals.
115
Clinical Implications
Children with DCD are commonly referred to oc-
cupational therapy services (Dunford et al., 2005).
Although academic-related issues are often of con-
cern to parents and teachers, the impact of DCD
on participation in personally meaningful pursuits
during out-of-school hours cannot be overlooked.
Missiuna and Pollock (2000) reported that children
who were provided with the opportunity to assess
their performance on daily tasks and to establish
goals for intervention selected different goals than
those identified by their parents. Not surprisingly,
children were more motivated to work on tasks that
involved leisure pursuits, whereas parents were typ-
ically more focused on achieving academic-related
goals. Therapists are able to advocate for a childs
full participation in a balanced portfolio of occupa-
tions. Supporting parents in their understanding
of the relationship between participation in leisure
activities and long-term mental and physical health
remains an important occupational therapy goal.
To practice in a client-centered manner, it is rec-
ommended that pediatric occupational therapists
work collaboratively with children and their fami-
lies to develop individualized leisure goals that are
shaped by the childs personal needs and aspirations.
Mandich et al. (2003) suggested that when childrens
occupational therapy sessions were focused on self-
identified activity goals, there were greater benefits
than skill acquisition alone. Importantly, many of
these self-identified leisure-related goals provided a
means for building self-efficacy and social networks.
In this context, PPA-C can be used to facilitate goal
identification and support mastery of personally im-
portant projects.
Another source of social support identified in
projects was pets. Using the PPA-C, several boys
with DCD identified their pet dog as one of their
primary friends (or their only friend). Previous re-
search exploring friendship networks of children
with disabilities has also highlighted the value of
pet companionship for children with limited social
networks (Morrison & Burgman, 2009). Interest-
ingly, dog-walking was identified by some boys as
their only form of physical activity. These findings
provide directions for practitioners working with
children with DCD not only in terms of the physi-
cal, but also social and mental health benefits of pet
ownership.
To ensure children are having positive leisure expe-
riences, occupational therapists can help the children
explore their personal interests and choices for leisure
activities, as well as personal and environmental bar-
riers and supports to participation. It is proposed that
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the PPA-C would be an effective means of eliciting
this information. This knowledge allows for the for-
mulation of interventions that include leisure coun-
seling to direct children toward activities that offer
them a sense of competence and autonomy and are
self-motivating for boys with DCD.
Although the participants completed the PPA-C
during one initial data gathering session, there is a pos-
sibility that the PPA-C could be used to obtain infor-
mation and personal insights about changes in projects
during the course of a therapeutic encounter, or follow-
ing specific intervention strategies. Affective responses
and cognitions associated with completion or antici-
pated completion of personal projects could also be
tapped with an expanded version of the PPA-C where
Module Two is also included. In the adult version of
the PPA, Module Two is used for project rating on a
series of dimensions, such as enjoyment, importance,
or stress. It is proposed that work to develop further
modules of the PPA-C and to examine reliability and
validity of dimensional analysis is undertaken.
In the current study, although the researchers
endeavored to make participants as comfortable as
possible and assured them about the confidentiality
of the information they shared, data were collected
during one single session, thereby limiting the de-
velopment of trust that could occur in lengthier
encounters. Some boys may have felt constrained
about revealing their innermost personal projects.
Although several boys focused on future-oriented
projects or goals (e.g., get better at X-Box games or
become a better chess player), others focused on
current projects (e.g., have fun clowning around).
It is possible that boys may have exaggerated their
personal projects in an attempt to impress the re-
searchers. For example, one boy reported that he
would like to Do more choresdust, do my own
ironing, make my own lunch each day as a person-
al project. Although social desirability is a consider-
ation, further knowledge of the individual child and
his environment circumstances is required.
Conclusion
This study compared self-identified meaning-
ful leisure pursuits of boys with and without DCD
using the PPA-C. Significant between-group differ-
ences were found. Boys with DCD were less likely
to participate in all physical activities and had lower
social participation than the non-DCD group. Boys
with DCD described more solitary leisure personal
projects than boys without DCD and fewer total
friends with whom they undertook or were likely to
undertake current and future leisure activities.
Copyright American Occupational Therapy Foundation
 Participation in typical childhood leisure activi-
ties has numerous benefits for children. The low fre-
quency of self-reported social and physical activity
personal projects for boys with DCD is concerning.
Restricted social and physical activity participation
was evident in future and current projects. Occupa-
tional therapists have the challenge of being alert to
restricted leisure activities and expectations in chil-
dren with DCD, and of working with them and their
families to facilitate broader participation in a bal-
anced portfolio of leisure activities.
Acknowledgments
The authors thank the families and schools who took part
in the study; Judy Jones, who assisted with data collection;
Kathy Ahern and Monica Cuskelly for their contribution
to data coding; and Asad Khan for statistical advice.
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