Persistence on Task, Executive Functions, and the Perceived Meaning of Occupations Among Children

Importance: Persistence on task-the voluntary continuation of a goal-directed action despite difficulties-is described as a behavioral component of involvement in an occupation; however, it has not yet been extensively studied in the context of pediatric occupational therapy. Objective: To describe persistent children, compared with their less persistent peers, in terms of age, sex, executive functions (EF), and perceived meaning of occupations and to assess whether intrapersonal factors, EF, and the perceived meaning of occupations can predict persistence. Design: Cross-sectional. Setting: A community in Israel. Participants: Typically developing healthy children (N = 180) ages 6.0 to 12.5 yr and their parents. Outcomes and Measures: The Tower of Hanoi task (TOH; seven discs) was used to assess persistence on task. EF were assessed with the TOH (three discs) and the Verbal Working Memory test. Occupational meaning - challenge, value, sense of time, and autonomy-was assessed with the Perceived Meaning of Occupation Questionnaire. Results: Twenty-six children (14%) completed the task. They were older than their peers, performed better on most of the EF tests, and perceived more autonomy in their everyday activities (Mann-Whitney U = 1,185.0, p < .001). However, only the perceived autonomy of occupations was found to be a statistically significant factor that predicted persistence on task (B = -0.12, SE = 0.05, Wald = 7.60, p = .01). Conclusions and Relevance: Perceived autonomy in everyday activities is crucial for persistence on task. Occupational therapy practitioners can promote children's involvement and persistence in cognitive tasks by supporting a sense of autonomy in everyday activities, although further study is needed. What This Article Adds: This article highlights the contribution of perceived autonomy in everyday activities to children's involvement and persistence on task by providing empirical data on children's persistence on task with regard to their EF and perceived meaning of occupations. Children who persisted longer and completed tasks differed from their less persistent peers in terms of age and EF. However, perceived autonomy in everyday activities was the only predictor of task completion.