Date Presented 04/05/19
Primary Author and Speaker: Fern Silverman
Contributing Authors: Carrie Knight
PURPOSE: Typically developing children learn to zip with little formal instruction; the ability to pull up the zipper with the shank already connected emerges around 3 years of age, with independence achieved by five years (CHOC, 2014). Using these milestones as benchmarks, this pilot project aimed to test of the value of a specially designed zippering teaching vest presented with targeted vocabulary and storytelling relating to the vest’s additional visual cues. The research question is: Does zippering instruction using a specially designed zippering teaching vest accompanied by stories with targeted vocabulary improve the zippering skills of typically developing 3 and 4 year olds who cannot zipper?
DESIGN:This quantitative pilot study has an experimental pre-post-test design. After receiving IRB approval, participants were recruited at a local preschool; researchers sought typically developing 3 and 4-year-old children who could not zipper independently by parent report. Once informed consent was procured, eligibility was confirmed using the Developmental Assessment of Young Children (DAYC) to determine if each participant’s language and fine motor skills were within normal limits. Inability to zipper independently was also verified during the eligibility screening; three attempts were permitted.
METHODS: Each eligible child received 3 intervention sessions during which the skill of zippering was taught by OT and SLP faculty and graduate student assistants, using the modified teaching vest and story. The vest had a plant shoot’s image on it along the zipper’s length, with leaves at the top, roots at the bottom, and a leaf-shaped zipper pull. The related story reinforced the idea of holding down the root and pulling up the shoot to achieve a bilateral oppositional pulling action needed to zipper. During each session, each child was taught targeted vocabulary, read the story, and given 3 trials to attempt to engage and pull up the vest’s zipper. The treatment protocol was administered over no more than three weeks per child to minimize the impact of normal development.
ANALYSIS: Each individual session was video recorded. Videos were reviewed by two researchers who independently analyzed the data, and then compared and aligned their findings. Data was coded using a binary measure of 1 or 0, examining each child’s ability to complete the steps of a six-part sequence of the task of zippering. A paired sample T-test was used to compare the difference between the initial assessment and the third treatment protocol.
RESULTS: 20 children were recruited for the study; due to either delays on the DAYC or school absences, 14 children participated. Preliminary results revealed a significant difference between the initial assessment of zippering skills and treatment three (t
13 = 4.616, p< 0.001). On average, treatment three achieved a 1.429 gain to a higher level in zippering skills than the initial assessment (95% CI [.760, 2.10]).
CONCLUSION:This pilot study suggests that by using a carefully designed vest and related story with targeted vocabulary, zippering skills can be effectively taught. This builds on earlier research showing the benefit of physical and verbal prompts when teaching this task (Iscan, Nurcin, & Fazlioglu, 2016). Given the current pilot study’s absence of a control group, however, it is unknown how the modified vest and targeted language protocol would compare to other interventions. Future studies should compare different treatment methods. Zippering is a frequent IEP goal for children receiving OT. This research has the potential to improve zippering instruction and instructional materials for those with cognitive, motor, and/or language delays as well as for typical children from a universal design perspective.
References
Children’s Hospital of Orange County (2014). Developmental Milestones: Dressing Skills [PDF file]. Retrieved from https://www.choc.org/wp/wp-content/uploads/2014/11/Rehab-Developmental-dressing-skills.pdf
Iscan, G., Nurcin, E. & Fazlioglu, Y. (2016). Effect of most-to-least prompting procedure on dressing skill of students with Autism. Educational Research and Reviews. Vol. 11(18), pp. 1766-1774.
