Second Section - Class Notes Flashcards
PEO MODEL FOR SCHOOL
Students
-Strengths and needs
School Occupations
- -> may be impaired by their physical, sensory
- ->Performance components fine and gross motor
- -> if they have resources like an EA will impact
- Self care
- Productivity
- Leisure
- Social
Environments
- classroom
- Library
- Playground
- Field trips
- Bussing
Tier 1: Universal
Beneficial for All: Occupational therapists support classes, schools and board-wide initiatives that benefit ALL STUDENTS. Applying the principles of universal Design for Learning and Differentiated Instruction, occupational therapists and educators collaborate to support development of the skills and strategies necessary for student learning and access to curriculum
ADVOCATION
Tier 2: Targeted
Necessary for Some: Occupational therapists collaborate with educators and families to support students who require more targeted and specific differentiated interventions to support the development of the skills and strategies necessary for student learning and access to the curriculum. The student’s response to intervention is closely monitored, with strategies adjusted as needed. Through collaboration with educators and families, students are identified who require more intensive, individualized supports.
consultant to teachers, EA, Parents- Providing modification
Tier 3 Individualized
Essential for few: Occupational therapists provide specific assessments more intensive, individualized interventions to support the student’s participation and access to the curriculum. These interventions may be delivered 1:1 in groups, through mediator training, collaboration with educators, and/or parent coaching
hands on school develivery - working during school on routines
-sometimes one-to-one pull out
Types of handwriting grasps
Quadrupod Tripod Thumb wrap Thumb tuck 5 finger Tripod closed web space Adapted Tripod therapy fun zone
how you grasp does automatically affect handwriting
change it for: endurance, legibility, pain
hesitant to change grasp
under the age of 7 you can change their grasp
8, 9, 10 - harder to change their grasp
Grips
An industry unto itself
- Myriad types of grips to impact
- Position of fingers
- Location of fingers
grips don’t really work, unless they are holding the pencil reaaaaaaalllly hard
-lisa doesnt think its lasting
use co-op instead
Position of Pencil
- Many children try to hold pencils straight up.
- This simple trick can help them get the feel for a more efficient position (the string with the bead)
Pencil grip reminder care for position of pencil
-visual reminder card
Mountains
Pillow
-Sharpening Line
might use chalk or crayons first, tiny materials tiny hands, forces them to develop the pinch
What makes a pencil grasp functional
- Occupational therapists have traditionally recommended that dynamic tripod grasps are needed
- Actually no consensus about impact of pencil grasp on handwriting proficiency
Effect of Pencil grasp on the speed and legibility of handwriting in children
- 120 grade 4 typically developing students
- Students performed a writing task ona electronically inking and digitizing table
- No differences were found in speed or legibility among the 4 mature grasp patterns
What else does writing involve
Prewriting: planning before putting pencil to paper
- Interpreting task demands
- Understanding “white space”
- Brainstorming thoughts
- Sequencing thoughts
- Rules: grammar, spelling, syntax, punctuation, capitalization
- Vocabulary
- Motor control of writing tool -the “tip of the iceberg”
- letter formation or selection
- Spacing between words, margins, paragraphs
- Revision and editing
handwriting is so much more than motor school
-good to know the ministry curriculum expectations are
-30-60% requires fine motor - mostly handwriting
10-30%-handwriting problems
McMaster Handwriting Assessment Protocol
Classroom observation
Additional Pre-assessment tasks
Classroom observation
- -> classroom workstation and postural control
- ->Behavioural observation
- ->Workbook review
Additional Pre-assessment tasks
- Review of students record
- Conversation with teacher
really that pre-assessment talking to the teacher, looking at the report card
McMaster Handwriting Assessment Protocol
Assessment Tasks
- Writing from memory
- Near point copying
- Far point copying
- Dictation
- Composition
You look at
- Use of tools
- Use of material
- Speed
- Appearance
- Content
Evidence for intervention
bottom-up and top down
eclectic approach - to treat handwriting
Tracing first - tracing doesn’t do to much add in more intervention
Clock climbers- kite strings loops from other groups
- kinesthetic writing system
- teaches letters by grouping them based on a shared movement pattern
- for example a, d, g, q, c start with climb up to 1 oclock
- don’t find it as oriented to these kind of clock
- don’t often use it
Orient to sky, grass, ground,
- another intervention
- lots of different paper types with colours
- brown for the ground and grass on top
Printing like a pro
- free can download the worksheets
- modlily focuses on self talk
- simplified the language
- does not orient to four strokes
- group letters together
- it teaches lowercase first -surrounded by lowercase letter
- grade 2 older - benefit from cognitive approach - increase metacognition capacity
Lots of handwriting programs available
Handwriting Without Tears
-materials are not free
-add the self talk to form the letters
-starts with capitals, and starts with wooden pieces,
-all the letters use those 4 pencil strokes
-starts with letters that start in a happy face corner
-MULTISENSORY (children grade 1 and under benefit from a multisensory approach
-also use self-talk
-use helper hand to orient them
-whatever sticks with the child
-for children (younger) - pre K assessment tool, colouring, few letters, shapes
-do their capitals, lower case, how they orient the letters, placement, size, where they start, sequence, how they move through the letters, amount of control spacing
-extra training required
-she says it’s an ok tool,
a little finicky for marking
-disruptive or video tap instead
-wet dry try app - fun to use a little bit picky
ETCH
- Evaluation tool for children’s handwriting
- criterion-referenced test
- grade 1-6
- looks at cursive or print
- very similar to the mcmaster
Minnesota handwriting assessment
- norm-referenced
- quality and speed of manuscript writing near-point copying only
- how based on script types
three types of handwriting
- zaner bloser
- d’nealian
- handwriting without tears
DeCoste writing protocol/ test of written productivity
- formative assessment tool
- identify factors affecting an individual’s ability to procedure writing
- it compares their performance in handwriting to keyboarding tasks
- looks at spelling performance and writing skills
- inform you for instructional strategies and whether you should be introducing AT to meet their academic needs
LETTER SCHOOL APP
- choose the type of letter script
- requirements
- not as picky and interactive
- uses stuff that are fun
IEP - instructional (additional time, use of a calculator, dividing assignments into do-able tasks,using AT) , environmental (regular supervised body breaks) assessment accommodations (speak to text)
A systematic review of interventions to improve handwriting
-approaches to handwriting interventions have been
Three choices of what they are doing
- Provided directly to the child or in consultation with the teacher
- Focused on remediation of the potential causes of the handwriting problems
- Concentrated on the activity of handwriting
- In 2000, Canadian OT’s reported that they used an “electric” orientation including sensorimotor, biomechanical, and sensory integrative approaches
- ->a minority of those OT’s actually assessed the act fo handwriting but focused on the performance components though to contribute to the difficulty
Key findings for the systematic review studies
- Handwriting interventions that do not include practice of handwriting have not been shown to be effective
- Handwriting practice must occur at least twice a week for at least 20 total sessions to see an improvement in legibility
- improvement in speed require even more practice
- it is unclear if practice needs cognitive and/or sensorimotor components. Age may be a factor
Cramm and Egan (2015)
-To what extent are the findings of the systematic review congruent with existing practice patterns?
- OT’s see children an average of 9.6 sessions
- Formal assessments at baseline
- ->Visual Perceptual VP 81%, handwriting 77.3%, fine motor 73.8%
- Therapists rely on parents and teachers to implement their recommendations and practice suggestions
Cramm and Egan (2015)
Perceived continuing education needs:
- the need to understand and keep abreast of technology that could be used for written productivity: assessment, decision-making guidelines, efficacy of different tech products
- challenges in ensuring that strategies therapists recommend are being implemented consistently and across contexts
- for example handwriting without tears, not always sure its going the same way that we want it to go - Assessment and intervention for children with complex, multiple areas of difficulty; understanding how children learn to print or handwrite, the impact of attention/learning/language/sensory processing issues on written productivity
- Is not just motor, how do we take all issues into account
- might be a time issue
- curriculum barriers
Pfeiffer et al (2015). Developmental test of visual-motor Integration (VMI): an effective outcome measure to handwriting interventions for handwriting interventions for kindergarten, first-grade, and second-grade students?
- The purpose of this study was to provide more definitive information on whether a widely used ax of visual-motor skills, the VMI, is appropriate for use as an outcome measure for handwriting interventions
- Method: 2 group pretest-posttest design. Experimental group received the handwriting intervention for FORTY 20 min sessions over a period of 8 weeks.
- RESULTS: “the experimental and control groups hand similar VMI scores before the intervention, but even after the experimental group received the intervention, their VMI scores (and the over-time change in the VMI score) were not significantly different from the corresponding scores in the control group. All these findings hold for the entire sample and for each grade level separately.
Pfeiffer et al (2015). Developmental test of visual-motor Integration (VMI): an effective outcome measure to handwriting interventions for handwriting interventions for kindergarten, first-grade, and second-grade students?
Purpose, method, Results
- The purpose of this study was to provide more definitive information on whether a widely used ax of visual-motor skills, the VMI, is appropriate for use as an outcome measure for handwriting interventions
- Method: 2 group pretest-posttest design. Experimental group received the handwriting intervention for FORTY 20 min sessions over a period of 8 weeks.
-RESULTS: “the experimental and control groups hand similar VMI scores before the intervention, but even after the experimental group received the intervention, their VMI scores (and the over-time change in the VMI score) were not significantly different from the corresponding scores in the control group. All these findings hold for the entire sample and for each grade level separately.
feiffer et al (2015). Developmental test of visual-motor Integration (VMI): an effective outcome measure to handwriting interventions for handwriting interventions for kindergarten, first-grade, and second-grade students?
Discussion, conclusion
- Discussion: “the results of this study did not support the use of the VMI as an outcome measure for assessing changes after a handwriting intervention. These results are consistent with previous research using the VMI as an outcome measure after handwriting and related interventions… the VMI was not sensitive to measure changes in handwriting and related visual-motor integration skills after occupational therapy interventions
- If the VMI and handwriting are correlated, as the literature suggests, it is curious that handwriting outcome measures in this study and others, show consistent gains after interventions and VMI scores fo not…. the most obvious (reason) …is that the VMI measures a related but different construct from handwriting
feiffer et al (2015). Developmental test of visual-motor Integration (VMI): an effective outcome measure to handwriting interventions for handwriting interventions for kindergarten, first-grade, and second-grade students?
Implications
- Reinforces previous evidence that VMI may not be an effective outcome measure for handwriting interventions
- Use of handwriting measures need to be used to capture changes in handwriting (which the measures used in this study did demonstrate)
- Reinforces the lesson that the measurement tool used must be appropriate for and sensitive to the construct being measured!
- VMI was never intended to ax handwriting ability– Why is it used in that way so pervasively
- The extent of the correlation between handwriting and VMI remains unclear, so OT’s must be cautious wrt decisions for treatment plans/eligibility and progress
Wallenet al. (2013). Respecting the evidence: Responsible assessment and effective intervention for children with handwriting difficulties.
- given the inconsistency of the evidence regarding the relationship between performance components and handwriting abilities, occupational therapists’ continuing use of assessments of visual perception, visual-motor integration, fine motor ability, kinesthesia and aspects of biomechanics thought to be associated with handwriting requires revision
- do occupational therapists, in fact, use these assessment because they are readily available, easy to administer and score and generate “numbers” which we perceive that school system demands
- We are aware of no evidence that treating performance comments considered to underpin handwriting results in improved handwriting or output of written work. Quite the opposite in case.
- Lisa does a lot of observation, notebook review consultation with the parents and teacher and pick and choose what one of the specific handwriting assessments she will used based on her observations as well as other assessments
- for example if they are struggling copying from the board she will check if they have an updated vision assessment their reading abilities, read what they need to copy first, are there some perception issues (where are the underlying issues)
- Responsible assessment includes “assessment of the actual process and output of handwriting generated under differing conditions.
- Data gathering from multiple sources is also recommended including perceptions of the child, parent and teacher as to aspects of handwriting performance and related abilities such as motivation, attention, cognitive and learning capacities
Handwriting Mybusters: the take home message:
True
- Handwriting interventions must include handwriting practice
- Handwriting can improve with a minimum of twice per week, at least 20 sessions
- Handwriting issues do not resolve without intervention
Handwriting Mybusters: the take home message:
Busted
- Dynamic tripod grasp is necessary
- Targeting performance components improves handwriting
- Cursive writing is faster than printing - we may cursive for some kids DCD or dyslexia- more fluidity and flow you don’t lift your pencil as much , all letters start in the same place, there isn’t as much sizing or spacing issues, exposure children to cursive
- need to be expose in order to read it
- Cognition is routinely considered by OT’s assessing handwriting
- how to integrate it and its impact on printing abilities
Assistive Technology (AT)
- helps students explore, develop abilities, and engage in academic occupations
- Any item, piece of equipment, or product system, whether acquired or commercially off the shelf, modified or customized, that is used to increase, maintain or improve the functional capabilities of a child with a disability.
- Supports access, learning and success
- Bypasses area(s) of difficulty
Factors to consider in AT
- Learned helplessness
- Self determination
- Culture of systems where AT would be used
- Abandonment
What to ask about Assistive Technology
-Does this tool address the student’s specific needs and challenges?
-Does it use the student’s strengths?
-What are the student’s goals?
-Is there a simpler tool that would work as effectively?
-Does it meet the demands of the task and the environment?
-Is it portable?
-Is the student willing to use it?
-How easy is it to learn to use?
Will the student having training?
-Will the teachers have training?
Is the tool compatible with the existing technology the students use?
Criteria
- Effectiveness
- Affordability
- Reliability
- Portability
- Durability
- Securability
- Safety
- Learnability
- Comfort and acceptance
Categorization of Assistive Technology
Non Tech
-Mnemonics, checklists, one component of task at a time
Categorization of Assistive Technology
Low Tech
-Low cost, ease of use
Categorization of Assistive Technology
Mid Tech
-Requires a power source, some training
Categorization of Assistive Technology
High Tech
-Computer based, more expensive, more training required
Where you should start?
- Least intrusive
- Least stigmatizing
- Low tech
Academics and Assistive technology
- Universal design
- Reading
- Writing
- Organization
- Mathematics
What kind of issues could assistive technology target?
- Words you know but can’t write
- Knowing where to start
- Editing
- Writing as well as you can say it
- Seeing the sequence
- Keeping focussed
- Reading speed and comprehension
How can AT help?
-Mechanical burden mitigated
-lack of automatization accommodated for
-Discrete chunks of information more accessible in a clear sequence
-See how the pieces fit together, can alternate between big picture and little picture
-Inefficiencies supported through the use of study skills tools
-Organization supports provided
-Difficulty switching between tasks provided for
=reduces distractibility
-Support re-engagement in the learning process
Reading and AT
What can it help with
- Reading comprehension
- Decoding and word recognition
- reading fluency
- Revision-grammar
- Improved attitude toward reading
- Reduces dependence on others
Reading and AT
examples
- Google Chrom Extensions
- ->read and write - text to speech, simplify page, highlights, dictionaries,
- ->mercury reader
- ->Read Mode
- ->Diigo
- ->google keep
- Natural Reader
- Mac
- Ipad -Quizzlet, shakespeare in bits, Claro Scanpen, EasyReader
- Kurzweil 3000
- Ms word, One Note
- Wikipedia-simple english
- Rewordify.com
Reading and AT
examples
- Google Chrom Extensions
- ->read and write - text to speech, simplify page, highlights, dictionaries,
- ->mercury reader
- ->Read Mode
- ->Diigo
- ->google keep
- Natural Reader
- Mac
- Ipad -Quizzlet, shakespeare in bits, Claro Scanpen, EasyReader
- Kurzweil 3000
- Ms word, One Note
- Wikipedia-simple english
- Rewordify.com
- AERO, CELA, bookshare
Writing and AT
- Freed from tasks that are effortful by bypassing demand of typing or handwriting
- Provides opportunity to concentrate on developing ideas and planning their work
- Longer, more complex, fewer errors,
- Improved word recognition, spelling and reading comprehension
- Increased vocabulary
- Increased word fluency
- Reduces dependence on others
