Canadian Association of Occupational Therapists National Conference 2009, Engaging in Healthy Occupation: Partners for Change Effects of a MULTI-SENSORY Handwriting Program with Grade One Students Alanna Derkach, Gwen Roberts, Melissa Myers, Jodi Siever Objectives background information research study results closing remarks Importance of Handwriting Prevalence of Handwriting Problems meaningful and purposeful occupation spend 30 to 60% of their day McHale and Cermak (1992), demonstrate knowledge (Case-Smith, 2002). 5-44% of school-age children tool of communication (Olsen, 2008; Amundson, 1992). prerequisite for academic achievement (Graham, Berninger, Abbot, Abbot, & Whitaker, 1997; Graham & Harris, 2000). Negative Outcomes of Handwriting Difficulties Handwriting Instruction 2007Derkach, Roberts & Myers 2007 97% teach printing 2009 2009Derkach & Roberts 2009 94% teach printing 1
Prevalence of Handwriting Problems for OT Referrals major reason up to 98% (Amundson & Weil 1996; Chandler, 1994; Clark-Wentx, 1997; Tait, 1998; Vreeland, 1999) sufficient, age appropriate performance components Handwriting Without Tears Jan Olsen Occupational Therapist developmentally-based curriculum materials & training multi-sensory approach groups letters by difficulty simple, vertical line continuous stroke Efficacy of HWT Our Primary Objective Pontello (1999) overall printing skills, alignment on baseline, & size. Owens (2004) size and spacing 1. Determine if Handwriting Without Tears is an effective tool for improving the printing quality and speed in grade one students. Our Secondary Objectives Methods 1. Determine if students who use Handwriting Without Tears will perceive gains in their printing skills. 2. Determine the impact of Handwriting Without Tears on the bottom 25% of the poor printers quasi-experimental study crossover design repeated measures 2
Participants Instrumentation grade one students 5-5yrs 7-6yrs 2 classes from 2 elementary schools public school board, Calgary, Alberta 1. The Minnesota Handwriting Assessment (MHA) Reisman, 1999 2. The Canadian Occupational Performance Measure (COPM)*. Fourth Edition Law, Baptiste, Carswell, McColl, Polatajko, & Pollock, 2005 * modified version The Minnesota Handwriting Assessment MHA RATE MHA Legibility MHA Form 3
MHA Alignment MHA Size MHA Spacing MHA Total Test Score** Legibility Alignment Form Size Spacing TOTAL TEST SCORE (TTS) The Canadian Occupational Performance Measure (COPM) Student COPM Modified version 1. student COPM 1. teacher COPM 4
Teacher COPM Procedure October-January 2 classes receive HWT instruction Group A while 2 classes receive typical instruction Group B Switch: February-May Intervention Resources printing instruction: readiness activities capital letters lowercase letters investigator taught initial letters teachers taught remaining letters Procedural Reliability 1. in-service 2. consultation 3. HWT Kindergarten Teacher s Guide 4. lesson plans 5. log books 6. classroom observations Data Collection & Scoring 3 time points: Test 1 Baseline Test 2 Middle Test 3 End One research assistant administered MHA & COPM Another research assistant scored the MHA 5
Results N= 72 Total Students Recruited Group A & Group B same at baseline demographic characteristics printing skills & perceptionsp N=36 Students Participated Group A N= 32 Students Participated Group B received equivalent HWT intervention Primary Outcomes Within Groups comparisons between Group A & Group B at each testing point no SS difference between groups at each time point. (P> 0.05) October-January Group A (HWT) SS improvements: rate form space Group B (No HWT) SS improvements: rate size (P< 0.01) Secondary Outcomes Secondary Outcomes 1. no SS gains in perceived printing skills regardless of intervention ti type 2. bottom 25% in both Group A & Group B: SS improvement October-January more quality categories with SS improvement in Group A (HWT) 6
Other Interesting Findings Teacher COPM Test 1- Test 3 Importance H W T boys TTS lower than girls TTS younger TTS lower than older TTS Performance H W T but all groups are improving Satisfaction H W T Reisman s (1999) MHA Manual States: MHA Performance Levels: Performing Like Peers Performing Somewhat Below Peers Performing Well Below Peers Reisman s (1999) MHA Manual States: high priority for evaluation & remediation Performing Well Below Peers Legibility and Form Jan-April no significant changes in any quality category Other Interesting Findings Limitations Comparison Over Time of Students Performing Well Below Peers in Form & Legibility small sample size orming Well & Legibility Students Perfo Below in Form 100 90 80 70 60 50 40 30 20 10 0 Test 2 Test 3 Group A Group B prescribed program taught in control group student COPM rating scale home instruction & practice Time 7
CONCLUSIONS Calgary students, from Oct-Jan HWT illustrated SS improvements in: rate form space Calgary teachers reported improved: importance performance satisfaction Future Direction replication study 2009-2010 2 schools- 4 classes Special Thanks Contact Details Please feel free to contact me: Alanna Derkach, BSc.O.T.(c) 403 944 7925 1 1 alanna.derkach@albertahealthservices.ca 8