[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
Re: [OTlist] Evidence?
I really appreciate your input. I have found a few articles about the effectiveness of the consultation model as well as 'clinic' vs. natural environment. I think the biggest challenge seems to be educating parents on educational model vs. medical model of therapy services. Thanks so much for your input : ) -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Carolyn Sent: Friday, February 19, 2010 2:52 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Evidence? Hello, As the mother of a learning disabled child, although I do not have evidence in writing to support this, I agree with your approach based on my personal experience. My child strongly resents having to leave his classroom to go to the resource room. He has been receiving special ed services since preschool. They miss out on activities in the classroom when pulled out and feel different. I strongly feel the less time they are singled out and pulled out of the class the better off they are. As they get older they don't want to be pulled out even more. What his resource room teacher does (although she is not an OT but I think this method would work) is "push in" to the classroom to help him and any student that might be struggling. She even helps students who do not have an IEP. Lastly, his speech teacher gives him homework for articulation exercises along with a calendar to check off each day he does it. When he brings it in she gives him rewards. I feel it is a great way for him to take responsibility for his exercises and making him independent. As a parent that is my goal, to make him independent and to be responsible for his work. He will begin middle school next year and the demands for him to be independent and responsible for his work will only increase. Care --- On Fri, 2/19/10, Renee Lowrey wrote: From: Renee Lowrey Subject: [OTlist] Evidence? To: otlist@otnow.com Date: Friday, February 19, 2010, 7:18 AM 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 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Hand strengthening
Beverly, The acc/mods in place are effective and he is able to keep up with his work at school without difficulty. Mom reports he struggles at home to complete writing activities though. I wonder how much is physical and how much is psychological?! Although I have tried to educate mom on educational vs. medical model of services, she wants us to 'fix the problem' rather than provide the support we are providing for him to be successful. Unfortunately, mom is an SLP in the same district, so I'm not quite sure why she doesn't understand we are trying to help her son : ( Thanks so much for your input : ) -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Beverly Elkins Sent: Friday, February 19, 2010 5:26 PM To: otlist@otnow.com Subject: [OTlist] Hand strengthening Renee, The child may benefit from some hand strengthening through functional task (play). I haven't worked with peds for some time now. Given this child's age would strengthening be appropriate? It sounds as though positioning for postural support/stability would be the most appropriate/effective in this case. How is handwriting during your sessions with the child utilizing your accommodations/modifications? If it is effective, what better "outcome study" could a parent hope for? Also, how is the child's attention to task during handwriting activity and in general overall? Another thought, how is his vision? I'm interested in what you determine. Beverly Elkins, OTR/L CONFIDENTIAL COMMUNICATION This electronic transmission may contain PRIVILEGED and CONFIDENTIAL information and is intended only for the specific individual(s) to which it is addressed. If you are not the intended recipient of this electronic transmission, you are hereby notified that any unauthorized use, dissemination or copying of this electronic transmission or information contained in it or attached to it is strictly prohibited. IF YOU HAVE RECEIVED THIS ELECTRONIC TRANSMISSION IN ERROR, PLEASE NOTIFY THE SENDER NAMED ABOVE THEN DESTROY IT. Thank you. -- 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?
Chris, Thanks for the info. I found those in my original search, but was hoping there was something out there I hadn't seen yet. Thanks for taking the time!! -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of cmnahrw...@aol.com Sent: Friday, February 19, 2010 6:04 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Evidence? 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 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 t
Re: [OTlist] Evidence?
eived 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 > 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
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?
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] 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
