Critical Appraisal of Occupational Therapy Research

This assignment requires students to critically appraise a research study focusing on the effectiveness of occupational therapy in aiding children struggling in school. The appraisal should examine various aspects of the study including its aims, methodology, data collection, analysis, and implications for practice.

Running Head: OCCUPATIONAL THERAPY
Occupational therapy
Name of the Student
Name of the University
Author Note

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Introduction
For an adequate evidence based practice, it is necessary to have the skills of critical
appraisal. It is the systematic process of identifying the merits and demerits of the research
paper. This systematic process helps to determine the validity and the usefulness of the research
article (Gray et al. 2013). Research articles are appraised as one can obtain the sheer degree of
information. The benefit of critical appraisal is that it allows the person to identify the misleading
information and filter out the low quality of studies (Moralejo et al. 2017). The purpose of this
assignment is to critique the quantitative research article, titled “Using an innovative model of
service delivery to identify children who are struggling in school” by Missiuna et al. In order to
critique the quantitative paper the critiquing framework of Coughlan et al. is used in this paper.
In this critique, six areas are covered and each of the area is explained regrading a research
principle and concepts. The six areas include the aim/objective of the study, research
methodology, sampling, method of data collection, data analysis and results, and lastly ethical
considerations. The aim of the research article was to describe the children who are struggling in
school by performing classroom observation and dynamic performance analysis. Children
identified by traditional referral process are compared to those identified by occupational
therapist.
Aim/objective of the study
According to the critiquing framework of Coughlan et al. (2007), a research paper must
clearly state the aims and objectives of a study, along with research question. It will help form
the link between the initially stated purpose or the problem identified and the manner in which
the study will be undertaken. Further, the framework mentions that this area must be congruent

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with the literature review and indicate if any research hypothesis has been identified. In the
quantitative article by Missiuna et al. (2017), the aim of the paper is clearly stated in the abstract
as well as in the main body of the research paper. The objective of the paper is realised also from
the research question. The research question formulated in this context is- if the occupational
therapist working collaboratively with the educators in the P4C service delivery model is able to
identify the students who are struggling by classroom observation and dynamic performance
analysis. It is evident that the author of the quantitative paper had performed a thorough research
from the literature review, encompassing all the latest studies in this domain. The aim of the
study is well supported with the background, which aids in the construction of the research
question and methodology (LoBiondo-Wood and Haber 2017). In this context, the hypothesis
that is developed by the author that the children in same school who are not being indentified
may less likely to be presented with comorbid conditions, when compared to those referred to
occupational therapy services is appropriate. It can be said that this area or the component of the
paper states the concepts that the research is about to address as per Moralejo et al. (2017). This
section is in alignment with the description of the aims and objectives given by the Coughlan et
al. (2007) for a quantitative paper. Even the research hypothesis is well developed identifying the
population that is taken into consideration, variables to be manipulated, and the predicted
outcomes as also mentioned by Heyvaert et al. (2013). Overall, this section is the strength of the
study and meets the criteria mentioned by Coughlan et al. 2007.
Design Methodology
Research methodology design refers to the design for the collection of the data to address
the research question. In the quantitative paper, any number of instruments for data collecting
can be used including observational tools, questionnaires, attitude scales and the most common

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instrument is the questionnaire (Moralejo et al. 2017). According to Coughlan et al. (2007), the
research methodology of the paper should be well identified. It should be clear to the readers
with the instrument for data gathering well described. Further, this framework highlights that the
research paper must explain that how was the instrument developed while highlighting if the
reliability and the validity testing were undertaken. Lastly, this section must also mention that the
results must be disused and mention if pilot study was undertaken.
In the chosen paper for critique, the author has used quantitative research paradigm,
which deem appropriate for this type of research. The author had conducted a two years study in
which P4C model was delivered in 40 schools in two health care regions. The children in the
waitlist for the occupational therapy were transformed from the local health care service to the
practioners delivering P4C. Since the researcher is trying to describe the struggle of the
schoolchildren, the research design is appropriate and is the strength of the study. It will help
address the research question as well as hypothesises. The researcher has opted for survey of the
children who are enrolled in the two-year evaluative study (Missiuna et al. 2007). The research
methodology clearly states about the data-collecting instrument, and the population size. The
strength of the study is realised from the involvement of the parents, children and educators that
is well mentioned in abstract as well as in main body in detail. The hint of the data analysis is
given in the main body but would have been more convenient if mentioned in abstract as well
(Jelsness-Jørgensen 2015).
There was no clear section called research methodology. However, under the heading
called “procedure”, the author had explained the approach taken by researchers for proceeding
with the survey. It is the strength of the study as it gives insight into how classroom observation
is performed, health care consent was taken, followed by sampling and recruitment into study as

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well results obtained. The author had also described each component of the methodology under
separate section as measures (for individual data collection scales), data analysis and results.
This is the strength of the study as the readers get clear details on the overall research being
conduced and is flawless in terms of terminology used (LoBiondo-Wood et al. 2014).
Sample/subjects/participants
Sample and sample size is the decisive factor in the quantitative research as it determines
the adequacy of the study. The extent to which the population is reflected by the sample is
known as representativeness (Moralejo et al. 2017). According to Coughlan et al. (2007), a
probability sampling method is effective to consider the population that is likely to be
representive. This method will help identify the findings that are generalisable to the target
population. In quantitative studies, a large sample size decreases the sampling errors. This
section in any research article must mention the inclusion and exclusion criteria for the subjects
taken for research.
The quantitative paper contains no section called study sample. In abstract and in
procedure section the author had mentioned that the sample size is 246. Initially 392 parents
were approached that means 50% of the children are recruited ultimately based on informed
consent. The strength of the study is realised from the involvement of the parents, children and
educators. Since the percentage of the sample being participated in the quantitative study was
mentioned, it indicates the generalisability of the results adding to the strength of the study
Schneider and Whitehead (2013). It is the advantage of the study to consider the inclusion
criteria of measures, which captured the child’s perspective on their ability to participate fully.
The weakness of the study is realised from lack of proper details on the exclusion and inclusion

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criteria. At the end of the paper, under the heading “Notes”, the author motioned that the study
excluded children with the coordination difficulties with convincing justification. It stated that
children of 6 years age were include. This was impressive but could have been missed by the
readers.
Data collection methods
After deciding on the instrument that next step is to design of the data collection
instrument. According to Coughlan et al. (2007), it should be clear to the readers with the
instrument for data gathering well described. The reliability and the validity of the data should be
mentioned.
Missiuna et al. (2017) has described the research design clearly and in detail. The paper
outlined the research process in logical steps of the data collection. All the steps were easy to
follow and fully described and in separate headings. This constitutes the strength of the study.
Explaining the validity and reliability of the instruments under separate headings would have
been more convenient. It is the drawback of the study. Since the data, collection instrument
selected was previously designed, it was clearly established that the instrument was justified for
the study (Coughlan et al. 2007). This adds to the strength of the quantitative research. A little
more detail or outline of how the concepts are measured by the instrument would have been
better. Since, previously designed instruments are in the form of scales or standardised tests that
was designed for the purpose of determining the attitudes, range of perceptions, opinions, and
views, the research should have provided an evidence of the reliability and the validity of the
instrument (Moralejo et al. 2017). Overall, this area meets the criteria mentioned by the
Coughlan et al. (2007).

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Data analysis and results
According to Coughlan et al. (2007), this section of a quantitative research paper should
highlight about the type of data collected and if any kind of statistical analysis was performed.
Further, the research article must demonstrate the appropriateness of the statistical analysis along
with the significance of the findings. It will help eliminate the bias and chance of reducing the
research validity.
The author of the quantitative paper has very briefly detailed the data analysis. The paper
has only briefed that the data was obtained and managed using REDCap electronic data capture
tools. The paper mentioned that the statistical analysis of the data was completed using “IBM
SPSS Statistics Version 22.0”. It is the weakness of the study. It would be more convenient for
the readers to understand how the data was analysed using the software. This can be considered
the weakness of the study.
The researcher has comprehensively presented the data in tabulated forms under the
results sections. In separate tables, the author has illustrated the description of the children in the
study (both waitlist and occupational therapist). This adds to the merits of the paper as it
increased the presentation of the study and made it more convenient for the readers to understand
(Coughlan et al. 2007). The authors have made sincere efforts to depict the results of the
“Developmental Coordination Disorder Questionnaire (DCDQ) results”, and the “Movement
Assessment Battery for Children – 2 (MABC-2) results”. Other than that in the result section the
paper presented the clear description of the statistical significance of the demographic data,
DCDQ data, Strengths and difficulties questionnaire, School function assessment, and lastly
Movement assessment battery for children. Each of them was described separately, which is the
strength of the study. Since the mean values, standard deviations and the probability values were

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given for each study, it made it easy to understand that there is no significant statistical variation
in the demographics, questionnaires and the assessment scale (Coughlan et al. 2007). This is the
strength of the study as it makes the study reliable and can be used by other researchers for
interventions. As per the results, the occupational therapists identified children who faced
difficulties similar to those in the wait list, but were significantly younger and more likely to be
girls than those referred under the traditional model. Thus, the hypothesis was rejected. The
strength of the paper is realised from the research data that is addressing the research question
(Moralejo et al. 2017).
The limitations however cannot be avoided. It would have been more satisfactory if the
mean score of all the parameters were given with permissible level of standard deviation. In spite
of this, it can be said that the data was sufficiently analysed. The merit of the paper is that the
author had confessed the limitations of the study (Joanna Briggs Institute 2016). Further, the
weakness of the quantitative paper includes conclusions about the age differences between the
studies, which cannot be said with certainty. In comparison to the “occupational therapist
identified children”, the waitlist children’s data does not appear to be accurate and need more
validity (Missiuna et al. 2017). The other major weakness of this area of the quantitative paper is
the failure to conduct the pilot study. Pilot study is the indication that the proposed study is well
planned conceptually. Pilot study is the mini version of the main research study followed which
the researcher can later the definitions, research questions, sampling strategy or make changes to
the measuring instrument (Coughlan et al. 2007).

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Ethical considerations
According to Coughlan et al. (2007), this area in any quantitative paper should inform if
the participants of the research received complete information about the purpose and the nature
of the study. The researcher must have guaranteed the privacy, confidentiality and autonomy of
the subjects. The research paper demonstrated the ethics approval was obtained for the study and
the participants were protected from harm.
In the considered quantitative paper, having a clear heading as ethical consideration
would have reduced the burden of readers to search the paper for ethical issues. It adds to the
weakness of the study. The study by Missiuna et al. (2017), have obtained the ethics approval
from the “Hamilton Integrated Research Ethics Board”. Each of the school boards has also
approved the study, which is the strength of the study. Approval indicates the individual rights
have been adhered to. The researcher has obtained the parental consent before the survey was
conducted. However, there are some drawbacks identified, as the research article does not
demonstrate the moral principle of autonomy being considered in the study. The research also
does not demonstrate if the confidentiality and privacy of the participants were respected. It is
the drawback of the study as some more information related to it may have been convincing for
the readers. There should have been a justification of the considered ethical issues. However,
having no conflict of interest is the strength of the study (Moralejo et al. 2017).
Discussion and conclusion
Upon critically analysing the quantitative paper, it is evident that all the six areas have
more or less met the criteria mentioned by Coughlan et al. (2007). The aims of hypothesis were
clear and flawless. The research methodology described the entire research process succinctly.

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Further, the Sample/subjects/participants are and the data collection method was in alignment
with the chosen annotated framework. These two areas though considered some loopholes but it
was dominated by the strengths. The researcher has comprehensively presented the data in
tabulated forms under the results sections. Failure to conduct the pilot study was a major
drawback of the study. Overall, considering the six areas, it can concluded that the study has
wide implications for the occupational therapists and the school authorities. Occupational
therapist can identify children struggling in school without the need of the waitlists, formals, and
standardised assessment using the evidence generated from this quantitative research. It will be
easy for the therapists to collaborate with the educators to facilitate intervention for struggling
children. In conclusion, the critical appraisal has good benefit for evidence-based practice.

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Appendix
Annotated framework

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References
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model of service delivery to identify children who are struggling in school. British Journal of
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