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Back to School II - 52981

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Transcript of Back to School II - 52981

you passed!
Literature Review
Size Matters
A Quasi-experimental Study
in the
The Skill of Handwriting
Theoretical Framework
Study Design
Developed between ages 3 & 5
Lack of proficiency generates many referrals to OT for pediatrics
Up to 60% of a child's school day is spent using handwriting (McHale & Cermak, 1992).
Prerequisite skill to higher-level cognitive processes
Poor handwriting often results in poor academic success and in general may become a "barrier to learning" (Jones, 1998).
What is Size Matters Handwriting?
Developed by Beverly Moskowitz, DOT, MSOTR/L, FAOTA
Fun and interactive!
Practice-based approach to teach children in K-2nd grade writing skills
Focused on readability in relation to letter size, shape, and spacing
Frame of Reference for the Development of Handwriting Skills
Used in OT to improve handwriting methods for children
Comprised of three theories
Theory of Multiple Intelligence
Theory of Discrete Motor Learning
Theory of Optimal Challenge Point
(Kramer & Hinojosa, 2010)
The Evaluation Tool of Children's Handwriting- Manuscript (ETCH-M) vs. Other evaluations
Minnesota Handwriting Assessment
Test of Handwriting Skills
Children's Handwriting Evaluation Scale for Manuscript Writing
The ETCH-M was found to be most appropriate related to all aspects of our study
Log Handwriting Program
Handwriting Without Tears ®
Research revealed a need for a more effective and encompassing handwriting tool
Purpose &
Purpose: To investigate the use of the Size Matters Handwriting Program ™ to improve the handwriting skills of neurologically impaired children
Does the Size Matters Handwriting Program™ have an impact on the handwriting skills of neurologically impaired children when implemented in the therapeutic milieu?
We hypothesized that this intervention would improve children's handwriting skills and performance after the implementation of Size Matters Handwriting™
Quantitative quasi-experimental pre/post test design
ETCH-M serves as the pre and post test measure for both our control period and experimental period
Individuals between 4 & 18 years of age
Currently receiving intervention at Niagara Therapy, LLC
Neurological impairments including but not limited to:
Sensory Processing Disorder
Attention Deficit-Hyperactivity Disorder
Autism Spectrum Disorders
Developmental Coordination Disorder
Basic prewriting skills
English language
Participation in all sessions
9 total participants
ETCH-M was our chosen measure
Standardized, criterion-referenced tool
Used for 1st-6th graders to measure letter, word, and numeral legibilty and speed
Includes seven writing tasks
Size Matters Handwriting Program™ implemented during the four week experimental period
Fidelity manual was used to regulate intervention of participants ages 7 and up
Age appropriate workbooks used for children ages 5-6 y/o
Data Analysis
Paired t-test to compare the means of two non-independent samples
i.e. measures of same individual before and after treatment
Utilized data analysis tools on Microsoft Excel
Results grouped into three sub-sections for both experimental and control data
pre and post letter legibility
pre and post word legibility
pre and post numeral legibility
This tool provided participants with
visual stimuli
positive feedback
guided practice
self-monitoring skills
Individual improvements were noted by researchers although no statistical significance was reached
Further research is necessary to validate the tool
Researchers believe this tool has the potential to be an effective intervention
Small sample size
Length of the study & time alotted for each session
Wide age range of participants
Inability for participants to be seen more than once per week
Scheduling conflicts
Use of same participants for both control and experimental periods
Researchers were not blinded to participants
Suggestions for Further Research
Separate participants used for control and experimental periods
Increased amount of time for implementation and length of study
Larger sample size
Consideration of use of double-blind study
Include components in research question such as:
a more diverse population
use of intervention across varied settings
direct comparison of age groups
Special Thank You
Lynne Oberle, PhD, OTR/L
Beverly Moskowitz, DOT, FAOTA
Michelle Mioduszewski, OTR/L Niagara Therapy, LLC
Jeffery Boss, OTR/L
Julia Hawkins, OTD
Ryan Leonard, PhD
& all of you!
Explain Handwriting Significance
Size Matters Handwriting
Theoretical Framework
Literature Review
Purpose & Hypothesis
Researchers: Kailey DaLonzo, Torie Gradizzi, Sarah Grassucci, Danielle Jaworski, & Allyn Overfield

Interpretation of Results
Lack of statistical significance in three tested areas
word legibility
letter legibility
numeral legibility
-Brossard-Racine, M., Mazer, B., Julien, M., & Majnemer, A. (2012). Validating the use of the Evaluation Tool of Children’s Handwriting-Manuscript to identify handwriting difficulties and detect change in school-age children. American Journal of Occupational Therapy, 66, 414-421. http://dx.doi.org/10.5014/ajot.2012.003558.
-Case-Smith, J., & O’Brien, J. (2010). Occupational therapy for children (6th ed.). Maryland Heights, MO: Mosby Elsevier.
-Denton, P. L., Cope, S., & Moser, C. (2006). The effects of sensorimotor-based interventions versus therapeutic practice on improving handwriting performance in 6 to 11-year-old children. American Journal of Occupational Therapy, 60, 16-27.
-Diekema, S. M., Deitz, J., & Amundson, S. J. (1998). Test-retest reliability of the Evaluation Tool of Children’s Handwriting-Manuscript. American Journal of Occupational Therapy, 52, 248-255.
-Dinehart, L.H. (2015) Handwriting in early childhood education: Current research and future implications. Journal of Early Childhood Literacy. 15(1) pp. 97-118. doi: 10.1177/1468798414522825
-Feder, K. P., Majnemer, A., Bourbonnais, D., Blayney, M., & Morin, I. (2007). Handwriting performance on the ETCH-M of students in a grade one regular education program. Physical & Occupational Therapy in Pediatrics, 27, 43-62. doi:10.1300/J006v27n02_04.
-Howe, T., Roston, K. L, Sheu, C., & Hinojosa, J. (2013). Assessing handwriting intervention effectiveness in elementary school students: A two- group controlled study. The American Journal of Occupational Therapy, 67(1), 19-26. doi: 10.5014/ajot.2013.005470.
-Kramer, P., & Hinojosa, J. (2010). Frame of references for pediatric occupational therapy (3rd ed.). Baltimore, Maryland: Lippincott Williams & Wilkins.
-Lust, C. A., & Donica, D.K. (2011). Effectiveness of a handwriting readiness program in head start: A two-group controlled trial. American Journal of Occupational Therapy, 65(5), 560-568. doi: 10.5014/ajot.2011.000612.
-Mackay, N., McCluskey, A., & Mayes, R. (2010). The Log Handwriting Program improved children’s writing legibility: A pretest-posttest study. American Journal of Occupational Therapy, 64, 30-36.
-Morris, C., McLaughlin, T.F., Derby, K. M., & McKensie, M. (2012). The differential effects of using Handwriting Without Tears® and Mat Man™ materials to teach seven preschoolers prewriting skills using the draw a person with sixteen specific body parts. Academic Research International, 2(1), 590-598.
-Moskowitz, B. (2011). The Size Matters Handwriting Program™ Instruction Manual. Newtown, PA: Real OT Press.
-Palsbo, S. E. & Hood-Szivek, P. (2012). Effect of robotic-assisted three-dimensional
repetitive motion to improve hand motor function and control in children with handwriting deficits: A nonrandomized phase 2 device trial. American Journal of Occupational Therapy, 66(6), 682-690.
-Pfeiffer, B., Murray, T., Rai, G., & Brusilovskiy, E. (2015). Effectiveness of the Size Matters handwriting program. OTJR: Occupation, Participation and Health, 35, 110-119. doi:10.1177/1539449215573004.
-Rosenblum, S., Weiss, P. L., & Parush, S. (2003). Product and process evaluation of handwriting difficulties. Educational Psychology Review, 15(1), 41-81. doi:http://dx.doi.org/10.1023/A:1021371425220.
-Worthington, C. L. (2011). Handwriting proficiency: A critical foundation for middle-school success (Order No. 3438872). Available from ProQuest Central. (848922366). Retrieved from http://ezproxy.gannon.edu/docview/848922366?accountid=36086.
-Zwicker, J. (2011). Cognitive versus multisensory approaches for handwriting: Current state of evidence. Dyspraxia Foundation Professional Journal, 3-11. Retrieved from http://www.childdevelopment.ca/Libraries/Printing_Like_A_Pro/Cognitive_versus_Multisensory_Approaches_for_Handwriting.sflb.ashx.
-Zwicker, J., & Hadwin, A. (2009). Cognitive versus multisensory approaches to handwriting intervention: A randomized controlled trial. OTJR: Occupation, Participation & Health, 29(1), 40-48. Retrieved from CINHAL.

Implementation Procedures
Control period
Experimental period
Administration of ETCH-M
Four consecutive weeks of general handwriting practice
30 minute sessions
1:1 ratio of researcher to participant
Re-administration of ETCH-M
Four consecutive weeks of Size Matters Handwriting Program™
30 minute sessions
1:1 ratio of researcher to participant
Final administration of ETCH-M
Full transcript