Development of in-hand manipulation and relationship with activities. - Semantic Scholar
and Relationship tion between in-hand manipulation skills and activities could nor be used to models of human development and a better understand-. Small but significant relationships between in-hand manipulation skill and performance in selected activities were found when the effects of age were controlled. In-Hand Manipulation skills—translation, shift, and rotation—are important fine motor skills for a child's development. IHM skills have been.
In rotation, an object is moved around one or more of its axes. All of these skills can be performed in isolation and while holding one or more objects within the palm.
The latter skill is termed "with stabilization. Moreover, shift and rotation can be further classified into simple and complex. Many authors have proposed methods to assess IHMS. These include two tests and two assessment protocol. IHMS has been unequivocally been established as a prerequisite to academic and leisure activities.
Delay or deficiencies in IHMS can be one of the reasons for poor academic performance and apparent clumsiness in children. Therefore, there is a need to have sensitive, easily available tool to assess this function.
There are two tests and three assessment protocols described in literature to assess IHMS. Difference in testing methods, scoring criteria, incomplete evaluation of IHMS and lack of psychometrics leads to inconclusive evidence on which tool to use as an outcome measurement for IHMS and a need to develop a standardized tool to assess IHMS.
Tool development can be broadly classified into tools developed according to the classical response theory and those developed according to item response theory. The classical response theory recognizes that a test must have content validity, test-retest stability, inter-rater reliability and be sensitive enough to pick up change with intervention also known as responsiveness, the item response theory seeks to establish robustness of the tool within itself and as related to the person.
These characteristics include hierarchy of items, difficulty level of items, the function of equal separation between scores, and ability to the test discriminate between levels of functioning. These functions are undertaken by Rasch analysis. The objectives undertaken for this process are as follows: Methods Ethical approval was obtained from the Institutional Ethical Board, and the study was conducted in two phase: Phase I was tool development and Phase II was evaluation of responsiveness.
Tool development Construct Based on literature review, the construct was identified and defined. The construct was identified as IHMS. It was defined as adjustment of an object in the hand after grasp. Exner's classification of IHMS was followed to identify the subcategories. These were finger to palm translation, palm to finger translation, shift, simple rotation, and complex rotation each with and without stabilization.
Hence, it was hypothesized that IHMS is a multidimensional construct and the dimensions identified were translation, shift, and rotation. Item pool generation Items were pooled on the basis of literature and experts opinion. The number of items for the test was decided on the basis of the table of specification for IMT-Q section. The test constructed in an activity format, and common activities were included. This was ensured by interviewing a group of parents 10 of children between 3 and 9 years of age to assess if the items chosen were familiar to their children.
Only those items that were unanimously considered familiar and easily available to the target group were retained. Instructions to administer the test were formulated. Specifications of number of items in each subscale Scale design Type of measurement The tool is meant to be a discriminative performance based tool. It was expected to help in identifying children with IHMS dysfunction when their performance was compared with age-matched norms.
The tool is also expected to identify hand skill maturation in children.
Activities to Develop In-Hand Manipulation Skills in Children | WeHaveKids
The quality of skill was considered in determining the child's score. Scaling Based on the qualitative nature of the construct, a 4-point ordinal scale was formulated for scoring [Appendix 1].
Target population IHMS is seen as early as months of age, but the lower age limit of 3 years 6 months was decided for this study to ensure that the child was able to follow instructions. All components of IHMS develop by the age of years, but speed and skill improve until 12 years of age.
Children were recruited from local schools. Afterwards, the video footage of each child was scored separately by two researchers who were not part of the child's assessment process and inter-rater reliability was established. The coding of each checklist was cross-checked. Data analysis Descriptive statistics, namely frequencies and percentages for categorical data and medians and percentiles for continuous data, were calculated.In-Hand manipulation exercises for fine motor coordination
To ensure ethical conduct, written consents were received from the Department of Basic Education Free State Provincial Department, principals and teachers of the eight participating schools. Written consent was received from parents of the participants to include video footage, and assent was given by each of the participating children prior to the study.
With regard to hand preference, 49 An efficient pencil grasp was observed in 57 For the purpose of this study an efficient pencil grasp was defined as a grasp where an open web space was present and included a tripod, quadruped and adapted grip, as described by Benbow Translation - assess finger-to-palm and palm-to-finger translation tasks Table II Table II indicates that all the participants in both age groups were able to pick up one dowel at a time and hold more than one dowel in the palm during finger-to-palm translation task 2.
Seventy Two percent of the six-year-olds used a number of compensatory methods including the most common compensatory method used by the seven-year-olds which was to stabilise against body and surface The median completion time taken from task two to five was 80 seconds range seconds for the six-year-olds and 65 seconds range seconds for the seven-year-olds.
Rotation Simple rotation task 7: The task required constant contact between the coin and fingers. When the coin fell, or when the coin was moved to the palm, contact with the fingertips did not take place. Both the six-year-olds Complex rotation task I see Table IV The child removes five dowels from the holes in the peg board, one at a time.
Development of in-hand manipulation and relationship with activities.
Complex rotation with stabilisation and shift components task 8: Shift Shift with stabilisation task 6: The most common compensatory method used by the six-year-olds None of the children dropped coins during this task. Table VII shows a summary of all the individual aspects of FSU IHM that were completed successfully by the six- and seven-year-old children with or without making use of compensation.
Translation According to Visser et al. This finding corresponds with Exner's3 allusion that palm-to-finger translation is more complex than finger-to-palm translation. The seven-year-olds completed the translation tasks in a shorter time period than the six-year-olds, which was similar to research by Exner3 that indicated that between the ages of three and six, mastering of skills leads to a decrease in time needed to complete the tasks as the child gets older.
During the completion of the translation tasks, the six-year-olds used more compensatory methods than the seven-year-olds. This may be due to the fact that the biomechanical structures of the hand and other related motor skills are more developed in seven-year-olds. This finding correlates with those of Exner3 who indicated that IHM continues to develop until the age of twelve years.
The most common compensatory method used during translation was stabilisation against the body and a surface, which occurred in both age groups, although more frequently in the seven-year-olds. Using more than one compensatory method was more common among the six-year-olds however.
The fact that the six-year-olds used other compensatory methods may explain why fewer children in this age group used stabilisation against the body and a surface and dropped less dowels during the completion of this task. Rotation According to Case Smith8, simple rotation should be developed in children between three-and-a-half and five-and-a-half years. This is congruent with the observation that the majority of the six- and seven-year-olds was able to perform simple and complex rotation with or without compensation.
In simple rotation the most common compensatory method used was rotation of the wrist in both age groups while fixation of the arm was more common during complex rotation.
The use of more than one compensatory method occurred more amongst the seven-year-olds, possibly resulting in the seven-year-olds dropping less dowels during simple and complex rotation. Thirteen children in each age group Therefore complex rotation with stabilisation was the most difficult IHM component for both age groups, in accordance with Case-Smith8, indicating that complex rotation with stabilisation is present but not yet refined in six- and seven-year-old children.
The seven-year-olds used more stabilisation against the body and the surface in complex rotation with stabilisation and therefore dropped fewer dowels. This may also be ascribed to the fact that seven-year-olds rely more on cognitive abilities such as planning, and can comprehend that compensation can contribute to a higher quality of task execution.
Shift with stabilisation Only two of the six-year-olds 3. Most of the participants used their thumb, index finger and middle finger in isolation to place the coins in the slot, which contributed to a higher quality of control when performing this task. In the previous study on four- and five-year-old children6, however, it was found that younger children who were not using the thumb and index finger in isolation had poor shift movements and perhaps not adequately developed "intrinsic hand muscles in isolation from extrinsic hand muscles"3: Overall, the majority of the participants did not use compensatory methods to complete tasks requiring shift.
The six-year-old participants who compensated used stabilisation against the body and surface, and fixation of the arm, while the seven-year-olds used rotation of the body and fixation of the arm. The seven-year-olds more frequently used compensatory methods possibly resulting in a smaller number of dowels dropping, resulting in a higher quality of task execution, and the researchers ascribe this to better cognitive planning in the older children.
Pencil grip Based on Benbow's19 definition of efficient pencil grip, 57 The occurrence of efficient pencil grasp observed in the majority of the six-year-olds and seven-year-olds could be related to the adequate IHM skills of these children, identified in this study.
This finding was in accordance with Feder20, who stated that IHM allows a child to assume an efficient grasp and control their pencil in handwriting tasks. It is crucial to take note that aspects such as finger-to-palm translation and complex rotation had been mastered by six-year-olds and seven-year-olds, and are therefore considered as the moderately difficult IHM components that are consolidated after five years of age.
Similar performance can thus be expected from other typically developed children in this age group. However, simple rotation and complex rotation with stabilisation appear to be the most difficult IHM aspects for the six-year-olds, and are not necessarily indicative of dysfunction or delays. Limitations of the study The limitations identified in this study were the poor response from schools and parents which limited the study population to children. However, the number of children compared well to the group of participants from the previous study6.
Although a multicultural group of children constituted the study population, only children with English as their primary language of education, regardless of their home language and culture, were included in the study. Consequently, the results of this study cannot be generalised to the South African population.
A factor that was not taken into consideration was the potential influence of recording video footage on the children's performance during the assessment procedures and how it could have affected the results. The lack of such instruments results in a lack of accurate assessment and interpretation of IHM according to age, which influences intervention planning for IHM in occupational therapy. The results of this study indicated that most children in both age groups could perform palm-to- finger translation, complex rotation and shift with stabilisation, with simple rotation and finger-to-palm translation improving from six year-olds to seven-year-olds.
It appears that children use fewer compensatory methods in IHM tasks, as they get older. Complex rotation with stabilisation appeared to be the most difficult task for all age groups and is not consolidated by seven years of age. These IHM standards make a unique contribution to the current state of knowledge in the profession, and the collective results from the two studies on IHM can be used as a base-line for IHM in clinical decisions for four-year-old to seven-year-old children.
It provides a practical interim solution through a comprehensive Checklist for use with children that is inexpensive, easily reproducible and quick to administer. This checklist can be used to inform evidence-based practice in occupational therapy. However, further recommendations on amendments to the IHM Observation Checklist following this study include: For future research, it is recommended that a standardised measurement tool, with 6 month intervals and not just year intervals and using a broader spectrum of ages and populations, be developed for the South African population.
Fine motor outcomes in pre-primary children who receive occupational therapy services. American Journal of Occupational Therapy, ; Case-Smith J, Pehoski C. Development of Hand Skills in the Child. American Occupational Therapy Association, Inc; Case-smith J, Pehoski C.
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