Efficacy of a Manualized Intervention to Enhance Manual Dexterity for Children Ages 5–7 Yr

RESEARCH QUESTION: Is the manualized occupational therapy intervention Pencil Gymnastics effective in improving manual dexterity and fine motor skills in young school-age children?

RATIONALE: Current literature shows that although many elementary school-age children receive intervention for manual dexterity and fine motor deficits, there is little evidence available to support or refute any single intervention for these deficits (Smits-Engelsman et al., 2013). Children with manual dexterity and fine motor deficits may struggle with successful engagement in everyday school activities (Chien, Brown, McDonald, & Yu, 2014). The profession of occupational therapy is focused on providing research and evidence-based interventions as part of the 2017 Centennial Vision and efficacy of interventions need to be investigated.

DESIGN: This pilot investigation used a quantitative, quasi-experimental pretest–posttest design to examine the efficacy of a manualized intervention, Pencil Gymnastics, with young school-age children. The intervention sessions were 30 min twice a week for 6 wk and focused on in-hand manipulation skills.

PARTICIPANTS: A convenience sample of 12 children, enrolled in kindergarten and first grade, were referred by their teacher for deficiencies in fine motor skills. All children spent the majority of the school day in a regular education classroom setting. Children were invited to participate in the program if they scored below average or well below average on the Fine Manual Control and Manual Coordination sections of the Bruininks-Oseretsky Test of Motor Proficiency–2nd ed. (BOT–2). Parental consent and child assent were obtained before the beginning of the program.

METHOD: The BOT–2 Fine Manual Control and Manual Coordination sections were administered as the pretest–posttest measures of fine motor control and manual dexterity.

ANALYSIS: Using SPSS, a Wilcoxon signed-rank test was run on the pretest–posttest raw scores of each BOT–2 subtest to detect potential improvement in performance following the 6 wk of intervention.

RESULTS: The Wilcoxon signed-rank test showed a statistically significant improvement in manual dexterity (Z = –2.320, p = .020), fine motor integration (Z = –2.556, p = .011), and upper-limb coordination (Z = –2.805, p = .005) in all children. There was no statistically significant change in fine motor precision (Z= –.551, p = .582) after the intervention period.

DISCUSSION: This pilot investigation found the manualized intervention, Pencil Gymnastics, effective in improving fine motor skills in children between the ages of 5 and 7 within a 6-wk time frame. At present, Pencil Gymnastics is the only known manualized intervention targeting manual dexterity in children that is supported by evidence.

IMPACT STATEMENT: This pilot study contributes to the professional body of evidence supporting occupational therapy interventions that improve fine motor skills in young school-age children.

References

Chien, C. W., Brown, T., McDonald, R., & Yu, M. L. (2014). The contributing role of real-life hand skill performance in self-care function of children with and without disabilities. Child: Care, Health and Development, 40, 134–144. http://dx.doiorg/10.1111/j.1365-2214.2012.01429.x

Smits-Engelsman, B. C., Blank, R., van der Kaay, A., Mosterd-van der Meijs, R., Vlugt-van den Brand, E., Polatajko, H. J., & Wilson, P. H. (2013). Efficacy of interventions to improve motor performance in children with developmental coordination disorder: A combined systematic review and meta-analysis. Developmental Medicine and Child Neurology, 53, 229–237. http://dx.doi.org/10.1111/dmcn.12008