Another assignment I have been asked to share. This was originally a powerpoint presentation with notes.
As a special school, there are very few interventions that we do not already carry out. In order to ensure that progress could potentially be shown, it was important to choose an intervention that was easy to manage and that was not being carried out elsewhere, as that could have affected the results.
Analysis of need
There are a number of students in the school for whom fine motor skills developments appear to be a problem. Referring to the Occupational Therapist results in a link to a website and parents are expected to carry out their own interventions. Although only one student was chosen to be worked with for this intervention, her class teacher quickly picked these up and now the whole class spend ten minutes a day on fine motor skills practice, with some positive results already.
- Student S was identified by teacher as having significant difficulties with handwriting
- As you can see, letter formation in the name is poor and number formation, although consistent, is equally awkward.
- It was felt that some dedicated time practicing fine motor skills on a daily basis was required
Identification of targets
Fine motor skills are more important than just handwriting, as it leads to students being able to carry out a much wider range of self help skills and tasks. There was not much in the way of research available on the effects of developing fine motor skills.
- From the previous slide, it is clear to see that the target should be to improve handwriting.
- However, from reading that I have done on this subject, it is more important to develop the wider fine motor skills of the student, and then an improvement in handwriting should follow
- Thus, the target is ‘to show improvement in a range of activities designed to develop fine motor skills’
Each intervention was carried out three times in the six week period. Each is stored in its own box, similar to a takeaway box, which itself provides a further challenging in removing and replacing the lid during the session. It was important to swap hands halfway through the session, in order to ensure both hands were exercised and improved
- The planned intervention is to follow some of the activities in the ‘Clever Hands’ leaflets provided in discussion with the Occupational Therapist linked to the school
- The activities include:
Rolling playdough Building lego towers Stacking and turning over coins Jigsaws Colouring in and cutting out shapes Threading screws Putting pegs onto the lid of the box Putting paperclips onto card Doing up shirt buttons Threading beads
- It is important to encourage the use of both hands
I was coincidentally reading Jordan while preparing for this task, having been recommended it by our Educational Psychologist in order to better support some students with behavioural difficulties and it had some good suggestions about working with students with ASD/SLD that I had not really thought about previously.
Both websites, as previously mentioned, provide a range of activities that can be done to develop fine motor skills. The OT that I spoke to about this felt that a range of activities was best, rather than the same one every day for six weeks, as that would make sure you worked as much of the hands as possible.
As you can see, the journal articles that were available are based on developing fine motor skills in younger students. Memisevic and Hadzic noted that ‘Fine motor skills are prerequisite for many everyday activities and they are a good predictor of a child’s later academic outcome… Furthermore, the results indicated that there are possible sensitive periods at preschool age in which the development of fine motor skills is accelerated. Early intervention specialists should make a thorough evaluations of fine motor skills in preschool children and make motor (re)habilitation programs for children at risk of fine motor delays’
Huffman and Fortenberry report on the importance of young children participating in a variety of developmentally appropriate activities intentionally designed to promote fine motor control. It states fine motor skills depend on muscular control, patience, judgement and brain coordination.
- Huffman, J. & Fortenberry, C. (Sep2011, Vol. 66 Issue 5). Developing Fine Motor Skills. YC: Young Children, p100-102
- Jordan, D. R. (2013). Autism with severe learning difficulties. London: Souvenir Press.
- Memisevic, H., & Hadzic, S. (2013, vol 14 issue 1/2). Development of fine motor coordination and visual-motor integration in preschool children. Journal of Special Education & Rehabilitation, pp. 45-53
- http://www.ekhuft.nhs.uk/patients-and-visitors/information-for-patients/patient-information-leaflets/fizzy-leaflets/ link to the ‘Clever Hands’ leaflets (20/3/15)
- http://www.covkidsot.co.uk/pages/motor-skills-advice-for-schools-2.html link to the Coventry OT website (20/3/15)
Recording the intervention
I could not find an academic measuring tool for fine motor skills, apart from highly specialised ones that are not available for me to use.
Instead, I took a baseline at the start of handwriting, and then took note of how hard each task was each time we did it. The majority of the tasks seemed to get easier as time progressed.
Measuring the effectiveness of the intervention
As you can see, the cutting has significantly improved. The colouring still needs to be done with verbal prompts to stay within the lines. I found that by giving the shapes to cut as the only shape on the piece of paper made the cutting much neater.
I kept comments on the progress seen each day, and structured the sessions as suggested by Jordan, not assuming that S (who has ASD as well as a severe learning disability) knew what was expected but giving full verbal prompts in every session. Particularly when completing the jigsaw puzzle it was noted that asking where pieces with matching colours were meant that she was more easily able to complete the task – although fitting the pieces together was still a challenge.
Commentary on intervention, critical reflection and learning points
- Although this was short time of intervention, it can be seen that the formation of numbers has improved
- It was noted that S was using the opposite hand to write with that the initial assessment, so was asked to write again using the other hand
- This has been fed back to class staff to ensure consistency when improving writing
- I felt that the intervention worked well, and with sustained practice would be shown to make more of a positive impact on both writing and everyday self help skills.
- The most interesting thing I learned was not to assume the student knew what was meant from them in the task, but to use lots of verbal prompts, keeping them on track to complete the task, and also reminding and encouraging them to use the non dominant hand as well
- I will be looking to set up this programme for more than just one class to help our students to develop their skills.