Saturday, 19 November 2011

Saturday's class: Writing analysis, OT videos and profiles on misunderstood minds LD

Occupational therapy video: Sharpening up on pencil skills by Joanna Buttfield -An occupational therapy perspective.

This video addresses the child’s ability or inability to produce acceptable handwriting.  It is discussed that an occupational therapist supports learning and addresses fine motor skills that are associated with handwriting.  Typical development for a child is explained using a pyramid model where sensory input is at the bottom followed by an understanding of the body, purposeful use of body and cognition at the top.  It is noted that handwriting requires so many skills put together and that many children can do each skill individually but putting the skills together can be difficult for some children - it is explained that a child needs to recognize what its body is telling it so that they can’ use their body better’.  The phrase ‘the quick brown fox jumps over the lazy dog’ was said to be used by OT’s and educational psychologists as well for children ages three plus to assess handwriting skills as this phrase contains all the letters of the alphabet . The OT presenter in this video goes on to explain the intricacies of handwriting which very much depend on two key factors:  core trunk muscles and finger strength.

It is described that children lacking in stability have several coping mechanisms in the classroom at a school desk (or table) and tend to:  1. extend two arms out over the table and slump their body over it ‘like a puddle’, 2. lean on one elbow, 3. position their body so as to tuck their tummy against the table, or 4. twist their leagues around the bottoms of chairs.  Students using these positions are attempting to correct for their lack of core trunk muscles.  It is noted that occupational therapists look under the desk as well as on top of the desk for clues to positioning which indicate poor core strength.

Equally as important is finger positioning and strength.  The video discusses pencil skills as a significant indicator of future handwriting outcomes noting that not only is it important to pay attention to children who produce illegible handwriting at an early age, it is equally as important to observe how a child holds a pencil as a child who produces legible handwriting now but holds the pencil incorrectly may eventually turn into a poor writer as the demands of speed and quantity increase.  The ‘How do I do it?’ becomes as important as the ‘outcome ‘of legible handwriting.  The video spends its last few minutes in an interesting demonstration by the occupational therapist showing how finger strength is crucial for developing proper handwriting technique.  The proper way to hold a pencil is shown – the grip requires a rounded web space when holding a pencil which visually forms the letter C.  If a pencil is not held correctly it’s often an indicator of weak fingers: pencil Olympics (attempting to move quickly from the bottom to the top of the pencil while using your fingers) is an exercise that will give clues to finger strength.  The baton twirl with a pencil will also indicate finger strength and dexterity; also mentioned is looking at how the thumb holds the pencil -holding a pencil using the thumb joint as opposed to the thumb tip (the correct way) will indicate weak thumb and finger strength.

 I found this video to be extremely informative as I didn’t realize body positioning and finger strength, of all things, played such an important role in producing accurate and legible handwriting.  I imagine it can be awkward for some children to hold a pencil properly as it is for some adults to master the skill of holding chopsticks in order to eat a meal.  As an adult, one can always give up and get a fork instead but, early on, children are not usually offered an alternative option for writing in school.  There is no ‘fork’ until many struggles and poor outcomes occur.

Low Tech Handwriting Aids: Tech tips from INDATA at the Assistive Tech Lab at Easter Seals Crossroads.

The following video is very informative as it shows "how you can use all kinds of different things to make handling a pen or a pencil more independent": many 'low tech' assistive accomodations for students  are demonstrated by Carol. Some such featured accomodations include a slip on writing guide, a pencil inserted into a wider "cork-like" object, grips, fingertip pens and a 'writing bird' that functions somewhat like a 'mouse'. I really liked the practicality of this video as it shows how to help one's own students with less money when school budgets are an issue. Of note is the writing grips, my children and myself love to use them as a 'comfort' feature with the added bonus of 'gripability'.

In addition to the preceding two videos, we also watched a couple of videos about two children, Nathan and Lauren.

In Nathan's case, he appeared to be a very bright young child who loved books and who presented as highly functional entering school . Once he started school, problems with text and reading occured to the extent that he needed  to repeat 1st grade. After testing, it was discovered that he camoflaged his inability to cope with print by memorizing books in his early years and thus could not cope with the demands of school and new material. Even a tutor hired by the mother for Nathan prior to entering second grade did not 'solve' Nathan's inability to properly decode and understand print. Nathan ended up in a separate resource room for supsequent grades for specialized, tailored instruction, much to the initial disappointment of his mother.  However, with continued resource support, Nathan was able to slowly learn sound - letter relationships and make gains with decoding print. Using his strengths such as memory and attention to detail, plus a scribe for oral responses, Nathan was able to excel at end-of- year 5th grade promotion testing and get a perfect 4.0 score. Nathan and his mother understand his differences and are pleased with the progress. Additionally,Dr. Levine indicates that testing for dyslexia is not enough to understand a child like Nathan and complex neurological testing is needed.

In the second profile on Lauren, her parents sensed something was amiss as she often lost her train of thought at home and her parents indicated her mind wandered when she was actively involved in a task. Sadly, it became apparent that Lauren had great difficulty with social skills and did not have any friends. Additionally, her lack of other skill sets that are important contributors to success in school such as such as attention to task and organization, contributed to a situation where Lauren could not cope with the academic demands of school at all. Upon testing it was found that although Lauren was described as fanciful and creative she needed assistance medically with Ritilin to help her concentrate as well as assistance from a coach for social skills and organizational skills - Lauren did not have the ability to distinguish between quality school work and garbage papers in her backpack. Lauren's father did not want to 'drug' his daughter and initially dismissed the recommendation of Ritalin and instead changed his daughter's school which only worked for a few weeks until the newness of the situation wore off and his daughter once again performed horribly with the demands of school life. The end of the video showed Lauren's parents accepting that their daughter's brain neurologically needs medical compensation to help her cope with school. Lauren seemed resigned to her situation and happier that she was receiving assistance to co-exist in a school system that for most of her years was a puzzle to understand.

This Saturday’s class also looked at writing task analysis much in the same vein as the task of reading was analyzed. We looked at the Writing task analysis chart developed by Barb which indicated that writing was a very complex task indeed, to no one’s surprise.
Barbara Welsford's Writing Task Analysis Chart

Although the individual details are difficult to distinguish, the above picture by Barb Welsford shows the scope of the processes that need to work together to produce written work. In class we brainstormed and discussed some of what is involved in the writing process: attention to task  first, followed by visualization of ideas, planning, filtering and attending to body position, proprioception, and pencil grasp, language issues, knowing the word, vocabulary, conventions of writing, processing memory, mechanical skills, prior knowledge, spelling, speed, self-regulation involving executive brain functions.