Date Presented 4/1/2017
In a quasi-experimental study, 20 typically developing first and second graders with poor handwriting significantly improved and retained growth as measured by the Minnesota Handwriting Assessment, establishing the potential effectiveness of mental practice coupled with repetitive task practice in remediating motor control in children.
Primary Author and Speaker: Ghazala Saleem
PURPOSE: Handwriting dysfunction is one of the major reasons for referring children to occupational therapy. Despite its increased occurrence and relevance to a child’s self-esteem and educational outcome, there is a paucity of empirically based handwriting interventions. Most elementary schools use repetitive task practice (RTP) to remediate handwriting; however, this approach seems to overlook motor planning, a critical underlying mechanism of handwriting especially associated with handwriting rate, alignment, and size. Mental practice (MP) is linked to increasing motor planning abilities. The purpose of this research was to examine the potential effectiveness of MP in conjunction with RTP for the rehabilitation of handwriting dysfunction in typically developing school-age children. The long-term objective of this research was to establish a therapeutic intervention that efficiently improves impaired handwriting in school-age children. The research question guiding this quantitative study was, Is MP combined with RTP an even more effective intervention than the usual and customary RTP alone in rehabilitating handwriting dysfunction in typically developing school-age children?
DESIGN: This study used a quasi-experimental, nonrandomized, repeated-measures design across four time points. Participants with impaired handwriting were recruited from a private school. Twenty typically developing children ranging in age from 6.5 to 7.5 yr (first and second graders) with decreased scores in three or more variables of the Minnesota Handwriting Assessment (MHA) participated in the study.
METHOD: In addition to visual and descriptive analysis, a one-way repeated-measures analysis of variance was used to analyze data. Participants were tested on four occasions using the MHA. The baseline (Time Point 1) was followed by the usual and customary RTP-only training that lasted 4 wk. After the RTP-only training, participants took the MHA (Time Point 2) and then engaged in the MP combined with RTP experimental intervention for the same duration as RTP-only training. At the conclusion of the experimental MP coupled with RTP intervention, participants took the MHA again (Time Point 3). The final MHA assessment (Time Point 4) was given 1 wk after the withdrawal of both RTP-only and the experimental intervention. Semipartial correlation was computed to assess the relationship between participants’ imaging responsiveness as measured by the Kids Imaging Ability Questionnaire (KIAQ) and final residual scores on the MHA. The KIAQ was used as part of the demographics.
RESULTS: After the MP and RTP experimental intervention (Time Point 3), the children significantly improved on all dependent variables of handwriting, with significantly higher gains occurring in handwriting rate, alignment, and size. These handwriting improvements were sustained at 1-wk follow-up testing (Time Point 4). After usual and customary RTP-only training (Time Point 2), no significant effects were observed in the dependent variables except for significant improvement in handwriting form. Additionally, a semipartial correlation revealed a significant positive correlation between final residual rate and size scores and KIAQ scores.
CONCLUSION: MP as an additive to RTP appears to be a viable intervention that can readily fit into school curricula and advance the occupational therapy clinical domain to improve handwriting dysfunction in elementary schoolchildren.
IMPACT STATEMENT: This proposal established the potential effectiveness of MP coupled with RTP in improving handwriting dysfunction in typically developing children. A broader implication may be seen in using this intervention to improve occupational performance in children with motor planning deficits.
References
Barclay-Goddard, R., Stevenson, T., Poluha, W., & Thalman, L. (2011). Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke. Cochrane Database of Systematic Reviews, 2011, CD005950. https://doi.org/10.1002/14651858.CD005950.pub4
Case-Smith, J., Frolek, G. J., & Schlabach, T. L. (2013). Systematic review of interventions used in occupational therapy to promote motor performance for children ages birth–5 years. American Journal of Occupational Therapy, 67, 413–424. https://doi.org/10.5014/ajot.2013.005959
Graham, S., Berninger, V. W., Abbott, R. D., Abbott, S. P., & Whitaker, D. (1997). Role of mechanics in composing of elementary school students: A new methodological approach. Journal of Educational Psychology, 89, 170–182. https://doi.org/10.1037/0022-0663.89.1.170
