Re: [OTlist] Evidence?
Joan, In the context of his school environment he is able to successfully manipulate all materials. When I completed the assessment (about 45 min of writing activities), he did not appear to fatigue and I even asked him if his hands were tired, to which he responded they were not. He is able to keep up with taking notes in class, and other than some issues with spacing between words, his writing is 100% legible. With these things in mind, I provided the recommendations of modified paper and keyboarding. My job is to assist him in meeting his needs to promote success in his educational setting through acc/mods, not provide 'treatment' to address decreased strength. I also work in a pediatric clinic and often have difficulty separating the two models. The challenge is to provide the appropriate services in each individual setting per regulations and scope of practice. I think sometimes it's hard for parents to understand the difference between the two models. It doesn't help that not all districts provide services in the same way, making it more difficult for parents to understand. Thanks so much for your input!! -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Joan Riches Sent: Friday, February 19, 2010 1:38 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Evidence? Renee What did you suss out regarding the reason that he grips his pen or pencil so hard that his hand gets tired?-or was that your conclusion? In my experience and this is not research evidence or even particularly large handwriting problems can go back to atypical development of the shoulder girdle in infancy so that the child was unable to hold up his hands to explore the movements of his fingers. This can be a result of treatment for congenitally dislocated hips among other things - anything that prevents pushing up from the prone position. By the time the shoulder girdle strengthens there are more interesting things to do than be fascinated with fingers so they remain undifferentiated. I'm sure your recommendations are designed to remedy this. It might help the mother to understand if she thinks back and realizes that this developmental step was skipped for one reason or another and that meaningful activities will be more effective than exercises. How does he do with activities that require him to manipulate very small pieces - Lego model building etc? Joan Riches B.Sc.O.T., OT(C) Specialist in Cognitive Disability High River, Alberta, Canada -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Renee Lowrey Sent: February 19, 2010 5:19 AM To: otlist@otnow.com 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 doesnt get tired when he writes (Hes 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 doesnt 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 No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.435 / Virus Database: 271.1.1/2691 - Release Date: 02/19/10 07:34:00 No virus found in this outgoing message. Checked by AVG - www.avg.com Version: 8.5.435 / Virus Database: 271.1.1/2691 - Release Date: 02/19/10 07:34:00 -- 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
Re: [OTlist] Evidence?
Sue, Thanks, I will! -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Sue Doyle Sent: Friday, February 19, 2010 7:37 PM To: otlist@otnow.com Subject: Re: [OTlist] Evidence? I would recommend directing this question to Dianne Long at dl...@ithaca.edu. She did an extensive look at consultation programs etc. Sue D > From: renee.low...@mmsean.com > To: otlist@otnow.com > Date: Fri, 19 Feb 2010 06:18:46 -0600 > 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 doesnt get tired when he writes (Hes 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 doesnt 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 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] functional assessment for youngsters with severe mental retardation
I like the School Function Assessment (SFA) and the Sensory Profile (SP). The SFA is very comprehensive and promotes a team approach. The SP is easy to do and assists with ideas in developing interventions. I also found the Pediatric Evaluation of Disability Inventory (PEDI). I have not used it and it only goes up to a functional level of 7 years old. Hope this helps. Renée L. Austin, TX -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Katia Cohen Sent: Saturday, February 20, 2010 2:59 PM To: otlist@otnow.com Subject: [OTlist] functional assessment for youngsters with severe mental retardation Hello I work in a special education day school. The students enter the school at age 6 years and leave at the age of 21 years. The school's mandate is to cater for children with mental retardation from the moderate level to severe and profound levels. I am looking for a good functional assessment battery to cover fine and gross motor skills, social and communication skills, behavioral skills, ADL, cognitive skills, tactile, smell, sight, hearing, taste abilities..Until now we have used parts of many batteries and we now want to become more uniform and standardized. Ideas? Thanks from Katia -- 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
Re: [OTlist] Evidence?
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 pe
