Davis, Actually, keyboarding was one of the accommodations I recommended! Since the student has legible writing and mom was complaining of fatigue, I recommended keyboarding for longer, more intense writing activities. Unfortunately, mom sees accommodations as a way out of her son doing what the other students are doing, which will result in him depending on them. I tried explaining the difference in the educational vs. medical model, but she is determined we provide 'treatment' to address her concerns about hand strengthening. She has requested an outside OT eval, which the district will have to pay for. The principal of the school explained that even if the 'clinic' OT recommends strengthening exercise, does not mean we are obligated to provide them. I guess we'll see what happens.
Thanks for your input! -----Original Message----- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of David Harraway Sent: Friday, February 19, 2010 7:47 PM To: OTlist@otnow.com Subject: Re: [OTlist] Evidence? Hi, just coming at this from another angle - interested in learning from those therapists who work with school aged population when they might consider it appropriate to recommend to move from a handwriting based means of text production towards primarily keyboard generated text for class and homework? If it's just plain hard slog for a kid to get through the demands of class and school work using pen and pencil; and so much so that their capacity to keep up with peers in terms of literacy and language development; and given that the broader culture is jumping across to work with digital media and the potential efficiency gains to be had by doing so (not needing to double handle hard crafted sentences and paragraphs)....it seems that recommending that the student be working smarter might be preferred in setting them up for life/work. Can appreciate that there are potentially all kinds of cultural and logistical constraints in this kind of recommendation; but in my experience when a kid can use a keyboard to produce text at 30 wpm neatly and only12wpm with pencil/ paper, the choice about which way to go is fairly apparent. As always though, it's a lot about the types and blend of tasks the student is doing; and for sure work on handwriting for signatures etc; but for the grunt work, if a keyboard is an possible accommdation; and allows the focus to be redirected away from what is physically demanding to what is really important - learning and language acquisition and the social experiences gained from being with peers, then I say go for it. David Harraway OT working in AT ComTEC cmnahrw...@aol.com wrote: > Some conflicing evidence, but from my brief lit review it looks like > practice is the major factor. In the second study the intervention > was only to meet with the student twice a week for 30 minutes lasting > 10 weeks. The intervention consisted of biomechanical, sensorimotor, > and teaching learning strategies (practice and feedback?). In the > first study provided it states that they compared sensorimotor > (strength, coordination, sensory training?) versus practice and the > practice intervention was more effective, in fact the sensorimotor > group declined in their ability. > > 1) The effects of sensorimotor-based intervention versus therapeutic > practice on improving handwriting performance in 6- to 11-year-old > children > P. L. Denton, S. Cope and C. Moser (2006) > > Journal Title: American Journal of Occupational Therapy > Volume 60; Issue 1; Pages 16-27 > > Abstract > OBJECTIVE: The aim of this study was to investigate the effects of two > interventions (sensorimotor and therapeutic practice) on handwriting > and selected sensorimotor components in elementary-age children. > METHOD: Thirty-eight children 6 to 11 years of age with handwriting > dysfunction but no identified educational need were randomly assigned > to one of the two intervention groups or a control group. Intervention > groups met four times per week over 5 weeks. Handwriting was measured > pre- and postintervention using the Test of Handwriting Skills. Visual > perception (motor-reduced), visual-motor integration, proprioception, > and in-hand manipulation were also measured. RESULTS: Children > receiving therapeutic practice moderately improved handwriting whereas > children receiving sensorimotor intervention declined in handwriting > performance. The control group did not change significantly. > Sensorimotor impairment was noted at pretest in three or four > components and selected sensorimotor component function improved with > intervention. CONCLUSION: Therapeutic practice was more effective than > sensorimotor-based intervention at improving handwriting performance. > Children who received sensorimotor intervention improved in some > sensorimotor components but also experienced a clinically meaningful > decline in handwriting performance. > > 2) Effect of an occupational intervention on printing in children with > economic disadvantages > C. Q. Peterson and D. L. Nelson (2003) > > Journal Title: American Journal of Occupational Therapy > Volume 57; Issue 2; Pages 152-60 > > Abstract > OBJECTIVE: The purpose of this study was to evaluate whether an > occupational therapy intervention improved an academic outcome > (D'Nealian printing) in a school setting. The study specifically > examined improvement in printing skills in economically disadvantaged > first graders who were at risk academically and socially. The > intervention was based on an occupational framework including > biomechanical, sensorimotor, and teaching-learning strategies. METHOD: > The final sample consisted of 59 first-grade children from a low > socioeconomic urban elementary school-based health center who were > randomly assigned to an occupational therapy intervention or a control > condition. In addition to regular academic instruction, the > intervention group received 10 weeks of training twice a week for > 30-minute sessions. The control group received only regular academic > instruction. Subjects were pretested and posttested on the Minnesota > Handwriting Test, which assesses legibility, space, line, si ze, and > form (the main variables in this study) as well as speed. RESULTS: > Multivariate analysis of variance confirmed that the gain scores in > the occupational therapy intervention group were significantly greater > than those in the control group. The Hotelling-Lawley Trace value was > 0.606, with F(5, 53) = 6.43, p < .0001). The estimated effect size > (eta2) was .378, with an observed power of .994. Largest gains for the > intervention group were in the areas of space, line, and size. > CONCLUSION: The intervention group demonstrated a significant increase > in scores on the posttest of the Minnesota Handwriting Test when > compared to the scores of the control group. Occupational intervention > was effective in improving the academic outcome of printing in > children who are economically disadvantaged > > Chris Nahrwold > > -----Original Message----- > From: Renee Lowrey <renee.low...@mmsean.com> > To: otlist@otnow.com > Sent: Fri, Feb 19, 2010 7:18 am > Subject: [OTlist] Evidence? > > I am working in a school district where we provide ‘hands-on’ > consultation. > I work with a student to see which intervention strategies > (accommodations/modifications) will work best and then education > teachers on > how to use and follow through with the recommendations. I recently > completed an eval on a student for handwriting legibility (per mom). I > recommended acc/mods for home & school and provided some strengthening > activities that could be incorporated into the natural context of his > school > day. Unfortunately, but mom was not satisfied with these > recommendations. > She wants us to work on hand strengthening (like in the a clinic) > setting so > his hand doesn’t get tired when he writes (He’s in 3rd grade now). No > matter how I explain how services are better provided in the context > of the > classroom and how the acc/mods will allow him to participate in his > education, she is not satisfied. She doesn’t want him to depend on the > acc/mods, which she thinks will result in decreased hand strength and > therefore illegible handwriting. Does anyone know of any research > regarding > the efficacy, or lack thereof, of hand strengthening exercises and > improved > hand writing; or of the benefits of a consultation model rather than an > direct, pull-out model in school systems? Any info will be most > appreciated. > > > > Thanks, > > > > Renée L., OTR/L > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com > > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com > > > __________ NOD32 4881 (20100219) Information __________ > > This message was checked by NOD32 antivirus system. > http://www.eset.com > > > -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
