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Fine Motor Activities in Elementary School: Preliminary Findings and

Provisional Implications for Children With Fine Motor Problems

Article  in  The American journal of occupational therapy.: official publication of the American Occupational Therapy Association · November 1992
DOI: 10.5014/ajot.46.10.898 · Source: PubMed

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 Fine Motor Activities in
Elementary School:
Preliminary Findings
and Provisional
Implications for
Children With Fine
Motor Problems
Kathleen McHale, Sharon A. Cermak
Key Words: apraxia. coordination function.
in~truction. A third child whc. writes vel)' slowly may not
handwriting. learning disorders.
be able to complete many math problems on the annual
occupational therapy treatment
timed test that determines math group placement. He
This study was designed to obtain a detailed picture of
the fine motor requirements in regular elementary
school classrooms. This knowledge is cn·tical for occu­
pationaltberapisJs in working u'itb children with fine
motor and handwn'ting problems who are main­
streamed into regular classes. The allocation of lime
to fine motor activities and the ~l'pes offine motor
tasks children are expected to perform in elementary
school U'e7l? int'estigated through the obsen1ation ofsix
elementa,,' school classrooms. A un'tlen minute·hr·
minute record of one u'hole day's actil'ities in each
classroom showed that 30% to 60% of the day u'as allo­
cated to fine motor actiL'ities, u'ith un'ling tasks pre­
dominating over other manipulatil'e tasks. Implica­
tiolls for children U!ith fine motor difficulties include
t/.7t' need for modifications to l'ollime of u'ork, ~rpes of
tasks. and rnaten'als.
K.Ilhlt:t:n McHalt:..\ttl! is a consultant and founder of the: As­
soc:i:ltion for Children With Fine Motor Difficulties. PO Box
!l29. :'\eedham, MA 02194.
Sharon A. Cermak. F~II), OTR L. is Associate Professor of Occupa·
Ilona! Ther:lp~' and Co-Director, I'eurobcha\'ioral Rehahilit;j­
tllm Research Center, Boston L'niversil\', Sargent Collt:gt:.
Boston. Massachusens.
Tbi.< Qrticl~ u'as QI:Cl'p/~dfor puhlicalion .'Im· /5. /w.!
898
ine rl1owr:,kills mJy h<.:con-,ide.:n:d e.:nahling bella\'·
F ioni and may affect the child in school 10 se.:ver:ll
waF;. They may influence the quality and quantity
of the.: child'~ learn;;lg ,wd achievement in the da~~room.
the validity of a~se~smcnt~ for in~tructi()nal planning.
educational placement and eligibility for service~, and the.:
development of the child'" ,;::Jf-esteem and motivation
(Cermak & H-::'lderson, 1990; Levine, 1987).
For example, ~!..her; r, child with fine motor probl<.:ms
must copy math problems o"t of a textbook before even
beginning to solve them, she m~y not physically be able to
do enough probleiBs to get~he necessary practice, thus
her achievement in math may be affected. Another child
may not be able to demonstrate that he know~ how to do
long division if he cannot write legibly enough to read
oock to himself correctly Lhe numbers he has written.
This situation may lead the teacher to assume that the
child does not know how to do long division, thus iHu~­
trating the effect of fine motor skills on assessment for
may then be placed in an inappropriate math group.
Ustly, if a child with fine mo~or problems is graded in
handWriting by the same standards as children without
fine motor problems, the child's self-esteem may suffer.
The incidence of fine motor difficulties among chil­
dren i~ not readily available because fine motor difficulties
is not one of the standard reporting categories for federal,
state, or local rccords. Howcver, available research shows
that betw<.:en 90% (Tarnopol & Tarnopol, 19-:--) and 98%
(Clement~. 1966) of children with learning disabilities or
minimal brain damage demonstrate either fine motor dif­
ficultie~ or poor, slow, and labored handwriting. Al­
though the federal goverT'mel"t repons that about S% of
the school-aged population receives sef\;ces for learning
disahilities (l'.S. DepJr1.ment of Education, 198'). in pr:lC­
tice. the.: number of <:hiidren rccei\'ing such ~ef\'ices is
often considerably higher. Forexampk:, in .~!a~sachusetts
in 19H8. 16,"/% of the school·aged population receiwd
~e.:f\·il·<':s for Ie.:Jrning disabilitie~ (~1a~sachusetts Depan·
ment of Education. personal communication. February
10. 1989), In fact, e~timates of the number of children
wi~:1 iearning disabi1itie~ have ranged as high a~ 3090 of
the ::1t,dent population (Cermak & Henderson. 1990). On
,h=:.>::;i~ of Tarnopol and Tarnopol's (19~-:') finding that
90";'; ()f :;hildre.:n with learning disabilities han: fine motor
or handwriting difficulties as .....ell. one may estimJte thJt
at least 4.5'?u of school·aged children (90<?o of th<.: Depan­
mcni of Educatjon'~ S90 figure cited aoon:) will have seri­
ous fine motor problem~ in connection with their learn·
ing di~abiliti<.:s. Fine motor difficu)tie.:s greatly affect
childn:n'~ performance in the.: classroom, Younc:s.
Rusner, and Webb (1983) repone.:d that of th<.: 199 chil­
dren with learning disabililie~ th<.:y studied. "/7% were
Initially rc.:fc:rr<.:d for handwriting problt:ms.
exloht-r 19?2, \'olu",/! ..j {). Numlwr 10
 ·\taIlY Ilt/H.-r studl.'nls may ha\'l.' finl.' mowr prohlems
I'
th;.It arc due primarily ttl a physic:l1 uisahility, such as
cl'rl.'hral paby, mU:Kular uyslroph~', juwnile anhrilis, Ilr
0' spin:1 hifiua. Andrl.'ws :mu Elkins (.I 91'l.l) rl'poned thl: re­
sults of a SUf\'L'y in Auslralia of rq,~ul;lr dassroom teachers
of children Wilh spina bifk!a anu hydrocephalus, Thirty­
nine percent of the students were perc.:cived as experience
ing some degn:e of difficulty with fine motor tasks, includ­
ing writing, urawing, using an eraser, ruling lines,
sleadying papers, laking books from the desk, turning
pages, using scissors, and doing craft activities,
Children who have attention deficit disorders with or
without learning disabilities may also have difficulty with
fine motor tasks (Denckla, Rudel, Chapman, & Krieger,
1985). Lastly, Gubbay (1985) found that 5% of children
without learning disabilities nevenheless have major
problems because of clumsiness.
It seems that, at a minimum, nearly 10% of elemen·
tary school-aged children may experience major difficulty
With fine motor tasks. We derived this figure by combin­
ing the estimate<! minimum of 4,5% of children who have
both learning disabilities and fine motor difficulties (Tar­
nopol & Tarnopol, 19n; C.S. Department of Education,
1987) and the finding of 5% of children without learning
disabilities who have major problems with fine motor
tasks (Gubbay, 1985), Figures on lhe incidence of fine
motor difficullies among all children with physical disabil­
ities and attention deficits were not available, but would
probably increase this figure even after overlap between
categories is taken into consideration. In a typical class­
room, then, the average te:Jcher will probably have at
leasl two students each year whose fine mOlor difficulties
;In: serious enough to require special education or other
sef\'ices.
Although it is unifomlly recognizeu that elementary
school work reqUires fine motor tasks. there is little docu­
mentation about either the percentage of time spent on
.such t:Jsk.s or lhL' spl'cific types of tasks with fine mOlor
requiremL'nts that childn:n are expected to perform. This
knowledgl.' i:- crilicil for occupatilln:J1 therapists hecause
most referrals for Occup;ltional lher..lpy for children in
schools involw problems in handwriting and fine motor
skills (Cermak. 1991), Toohtain a detailed pictureofthl:
fint: motor requirements of work in regular elementary
school dassnx>ms, the first author conducted day-long
observation~ in sLx dassrooms across the different years
of elementary sch(x>!. The method and findings from this
study (~1c:Hak', 1987 ) art: presented, followed by a discus­
~ion of somt: of lhe implications for children with fine
InUlor problems who are in regular classrooms.
Method
Subjects
Six classes from two middle·incomt: suburban public
school dislrins in New England served as observation
'1"" American .loun/al oj Occupaliollol Tberapr
siles for Ihis slud~'. The six cla.sses consisled of 1\\'0 Classl's
each from Gratll:s 2, oi, and 6. Two of the six rbsses
oh.~l.'rvL'd were .~plit gr:Jdes. onl' a split first and sl.'cond
gr;llle, the other a split fiflh and sixth grade. \X'here a
schoul system offered a choice of c.:Iasst:s within a grade
level and the classes had been groupt:d hy ahjlit~" I ill'
c:Iass representing a middle academic group was selel'led
for ohsef\ation, Where mort: than two such c:Iasses at :J
grade level were available for observation, the panicip:Jl­
ing class was chosen randomly. The inclusion of splil­
grade classrooms was not pan of the design of the study.
but rather reflects the frequency with which one of lhe
school distril1s uses split-grade classrooms.
Procedure Ii·
d,
A written record of activities on a minute-by-minute h:Jsis I!!
"
~U
was made for one whole academic <.Jay in each of thl' six
i!
dassrooms. The major indicators of fine motor requirl'­ :,1
ments were allocation of time to fine mOlor lasks and the !j!
I..
types of tasks children were eXJ1Ccted to perform. All q,
.c:Iassroom uhsef\'ations and coding were done hy the first II'
III
"}
author.
During observations, the time at which a panil'ular
task or acti\;ty began was recorded un an ohsef\';ltion
~i:1l'
data sheet, and that task was described. 'X'hen the task or
activity changed, the time of the change and the nature ()f
the new activiry were recorded, All obsef\'ations began or
ended at the time that a school administrator had ideIHi­
fled as the beginning or ending of the school day. LUllch­
lime, which was -I; min. was not inc:luded in thL' ObSl'I,\,;I­
tions or cakulatjons. Thus each class was ohsef\'ed for 'i
hr 1-; min.
In one of the second'W:lde and one of lhe founh·
grade classes, soml' of lhe students changed re:ll hers fill'
particular suhjel'ts. For example. in onl.' fourth·gr:ll!L·
class, 9 students lefl to rl'ceh'e their m:Hh in.struniol1 in ;1
uif/\:rent cl:Jssroom. Because some stU(ll.'ntsslayed in the
original cbssrool11. the ohsl:f\'atioll l'l>l1tilll1e<l in the
original c:Iassroom. Howc\'er. in onl' six[h-,~ralk' cLi's. :111
Ilfthl.' students I11m'ed as a group 10 diffl.'n,..nr ll'adll.'rs (, Ir
math and sodal studies. In th:Jt l':JSl'. rhe oh'l'!'Yarions
took place in three differl'nt c1assrollms as till' Slll<!cJlI­ I'
mO\'L'd from teacher to leacher. \x'hen instrlll'tillll:tI i;
/'.
groups wilhin a class panicipated in separate al-tl\·itics.
time allocations and tasks Wl'rL' recorded sep;lr:ltl'h' f( Ir
each grou r,
l.;
I'I
After each observation was completed. all tasks \\l'rl' I
assigned to one of four cltegoriL's: fine I11otor lasks. illtl'­
grated fine motor tasks. other academic lasks. ;lOll III ll1­
academic activities. Fine motor t(lsks were tho:-l' fllr
which pcrform:Jnce required :1 I11ajor USl.' of OIll.'·S halld,.
such as writing Wilh :I pencil. usi'ng .sci.s:-ors. :lnd usill).! .1
computer kc:~ho:lrd. IlIIeRraled.!il1C! motor tasJ..'s indud,
ed activities in which fine l110wr and mhl'r ;lC:I(k'mi.' t;lsk,
occurred simult:lnl'ously_ For exampk'. sonll:lillll'S :1
 lc:acher instructed orally while children complcl<.:d work Table 1
shel'ts. The category of other academic tasks included Time Allocated to Tasks In Regular Classrooms
tasks for which performance did not require frequent use TOlal Time
AJI()(JleU (0
of one's hands. such as reading or group discussion. Non·
Fonc ~Olor
academic ac/il'i/ies included those activities that seemed
Time
_____ __ on _
Tasb
__ (min) anu
_ _ _ _ _ Intcgrated
to be dther functional (e.g., the collecting of lunch mono
ey) or transitional (e.g., moving from one classroom to Fine Integr:lleu Other Non· Fine Motor
Graue MolOr' Fine MOlllr' AcadL'Tllic" 3c3demicd Tasks (%)"
another) rather than instructional.
Interrater reliability within these six classrooms was 2 128 1S 119 113 oj;

2 (Splil) 166 6 Il6 57 5S

not calculated; however, at a later date, four }-hr class­ oj 70 28 145 72 31

room observations were videotaped and independently 4 80 17 147 71 31

sl"Ored by both the first author and another trained rater. 6 90 14 137 74 33

6 (Split) 180 9 65 61 60

Results indicated interrater agreement of more than 95%

on the cooing of both fine motor and integrated fine
motor activities for time allocation and type of task.
The key factor in selecting a category for the activi·
ties dUring a particular span of time was always the teach­
er's instructions to the class or group as a whole, rather
than the activities of particular children within the group.
For example. if the teacher assigned the task of writing
sentences from vocabulary words, the task was catego­
rized as a fine motor task from the time the teacher
indicatl..'l! that students should begin work until the teach­
er gave instructions for all students to begin some other
type of actiVity. In some classes, children who had fin­
ished a particular academic task were allowed to deter·
mine how they would use their remaining free time.
Thus, in one class, children who finished writing their
spelling words might listen to tapes, whereas in another
class, children who finished a small group discussion
might do their math homework. In this study, however,
all activities were categorized according to the teacher's
instructions and the time the teacher allowed for task
l"Ompletion. not according to how particular children
used the time.
All tasks thaI met the definition offine motor, that is,
th:1t required mJjor use of one's hands, were identified
and described in detail on the observation data sheets.
The academic subjel"l, the precise task, and the materials
u..ed were reconJcd. For example, rather than just de­
. .crihing a task as /l'ri/ing, the firsl author described it as
l"llpving .sentences from a texth<xlk onto paper with a
pencil.
After the obscC"ations were completed, the duration
(If time: spent on each of the four categories of tasks was
calculated with the data from the obseC"ation data sheets.
The percentages of time allocated to fine motor and inte­
grated fine motor tasks wcre thcn calculated. A list of all
tasks assigned was then developed. and tasks were
grouped together for reporting purposes.
Results
Findings regarding actual time and the percentJge of the
day spent on fine motor ta:.ks and integrated fine motor
tasks are shown in Table 1. Where classes contained sepa-
',W = 119.50 = oi2. h.u = 1;,SD = ~. '){ = 112.SD = 33. u.\I = 70.50
'" 9. ~M '" 43. 50 = 12.
rate instructional groups, the results reflect an average of
the time allocations for the different groups. However, in
split-grade classes, only the results for the grade actually
being observed are reported.
The types of fine motor tasks that occurred in the
classrooms are shown below. Only tasks actually ob­
served in the six classrooms were induded. For reporting
purposes, tasks were grouped under two major headings:
paper·and·pencil tasks and manipulative tasks. The cate­
gory of paper·and-pencil tasks, which included all tasks
requiring the use of pencil, pen, crayon, or marker on
paper, contained tht: following:
• Cop~ing from text or the board
• Doing rcpetitive writing
• Writing headings on paper
• Writing from dictation
• Taking notes
• Complcting commerdJI work shcets. workbooks,
or tests
• Correcting work rapidly
• Answering questions from text
• Doing creative writing
• DraWing.
The category of maniplllatj\·l' t;lsk,. which indude:s
tasks that require manil1ulatin~ objl'n~ rathl'r than writ­
ing with an implement, contained the follOWing:
• Folding paper to make margins and dividing lines
• Cutting or pasting or Doth
• Using a computer
• Manipulating objects such as seclls or plam,.
For all fine motor acti\'ities for the sLx d;l.... ruom~.
8;% of the time was spent on paper-and-pt'ncil tasks and
15% was spent on manipulative tasks. Subheadings under
each major category of task also rdlcL"! groupings of simi­
lar tasks. For exampic, in the catcgory of paper-and-pen.
cil tasks, the subheading of repetitive: writing includes the
specific tasks of the repetitive writing of spelling words,

900 Octobe,. /991. Vulum.. -16. .\'lImbe,. 10

 handwriting practice:. and the: r<.:pe:titivc: writing of vo­
cabulary L1dinilions.
Discussion
Allucation of Time
There was a considerable range in the length of time and
percentage of the day allocated to all types of fine motor
tasks in the classrooms obsen'ed (see Table 1). The range
i extended from 31 % to 60% of the academic day. This
ft finding indicates that different classrooms may have dif­
ferent levels of fine motor demands. The variations may
result from factors such as teacher style, classroom and
school organization. and curriculum decisions. Results
from the small sample of six classrooms did not indicate a
relation betwee:n increasing grade level and increasing
percentage of time allocated to tasks with fine motor
demands. Rathe:r, it seemed that in some elementary
school classrooms. the primary learning modality was fine
motor activity. whereas in other classrooms, fine motor
activity played less of a role in learning because group
discussion or oral instruction predominated.
Equally imponant. however, is the finding that in all
the classrooms observed, a substantial pan of the day was
spent on fine motor tasks. Thus. it seems that regardless
of the differences between classrooms in the degree of
emphasis on fine motor tasks, all the classrooms ob­
served had a high level of fine motor demands. It should
be emphasized that these observations were made in only
one day in each of the six classrooms. Therefore, broad
conclusions ahout c1emental'\' school classrooms in gen­
eral would not be: warranted.
A third finding rdates to the time allocated to inte­
~r3ted fine motor tasks. Integrated tasks may present
increased difficuftics for the child who must concentrate
on thc physical aet of writing or using hands while also
focusin~ on the content of the oral instruction being pre·
~e:nte:d. Fine motor activities were classified as integrated
t:Jsks only whe:n fine: motor and other academic tasks
Ill.:currcd simultaneously. If the tc:acher's instructions to
:he clas:'> cre:ated a houndJl'\' betwee:n types of tasks. the
t:Jsks we:re: not con"ide:red to be occurring simultaneous·
ly, for example:. if the te:acher said, "I want you to put
your pencib down and liste:n for a minute," that statement
cre::lte:d a clear demarcation between time spent on fine
motor tasks and time spent attending to oral instruction.
In general. the: classes obsen'ed did not seem to
spe:nd large percentages of the day engaged in integrated
t:l~k.'i. \X'ith the exception of onc founh·grade class, no
':ISS spent more than 5% of the day on integrated tasks.
I the founh-grade class in which 990 of the day was spent
,
. III inte:grated tasks. most of the integrated time occurred
f while the children were preparing a science project. As
they worked on a plant hooklet. the teacher continued
oral instru<:tion ahout their plants. It may be that high
allocations of time to integrated tasks are not evident
Til,. Amt'rican foun/al of Occupatiol/al Tberapy
until junior high sch~xli or high school whe:n there b
more: emphasis on such task~ as taking notes during oral
instruction.
An interesting finding e:merged whe:n data from the:
classrooms were examined. Although only two split-grade
classrooms were observed, the two highest per<:l:ntage~
oftime allocated to fine motor tasks were in these classes.
In the two split grades observed. teachers organized the
students into many separate small instructional groups.
In the first- and second-grade classroom there were four
separate groups, two for reading and two for math. In the
fifth· and sixth-grade classroom there were five separate
groups, three for reading and two for math. The high
percentages of time on fine motor tasks resulted from the
need to keep students in some groups involved in seat
work while the teacher conducted oral instruction with
other groups.
7)pes of Tasks
Paper-and-pencil tasks are listed according to the degree
of student control over the volume and content of task
perfonnance as detennined by task analysis done by the
authors. The list begins with tasks that offer little student
control in these areas. such as copying from a textbook or
Writing spelling words repeatedly. Creative writing and
drawing, tasks with the highest degree of student defini­
tion of the task, are listed near the end of paper-and­
pencil tasks. The manipulative tasks listed require high
fine motor skills but do not involve the use of a v.Titing
implement on paper. They focus on working with materi­
als or tools. For example. in one founh-grade class. the
students prepared a science project that involved cutting
a seed in half, gluing it to a piece of paper, and cO\'ering
the seed with a piece of adhesive-backed transparent
plastic.
Several patterns related to types of fine motor activi­
ties were identified during the observations. ~iost time
spent on fine motor tasks involved some kind of writing
with paper and pencil rather than manipulating Othe:r
types·of materials or tools or using markers or crayons.
Two t\'pes of fine motor activities occurred in e:vel'\' n:gu­
lar classroom observed. First. children were instnKte:d to
fold paper to make margins or diViding lines heron: d( ling
their work. Second. reading workhooks or work sheeh
were used in all classes, The fine mo[Or demands of thl'
reading workbooks could be de:scrihcd as minimal. Ex­
cept for comprehension questions. the: [asks in the reJd­
ing workbooks involved either circling numhe:rs for
multiple-choice questions or writing sjn~de letters or
words,
In five out of six classrooms. children were expected
to copy from textbooks and do repetitive writing for such
tasks as copying spelling words or vocabulal'\' definition."
Cre:ative writing and answering questions in se:ntences.
tasks in which the child does have a great degre:e of
901
 l'IlOtrol ovcr the: volume and conte.:nt of writing. o\.Turre:d
in fpur out of ~ix c1a~srooms,
Implications for Children With Fine MOlor
Difficulties
The:: findings re::garding the:: amount of time:: allocate.:d to
fine motor tasks and the types of tasks that children an:
expected to perform raise important issues about provid·
ing appropriate education for children with fine motor
difficulties in the regular classroom. In all classrooms ob­
served, at least one third of the day was allocated to fine
motor activity. and in two out of six of the classrooms
observed. at 'least 55% of the day was allocated to fine
motor tasks, thus it seems that fine motor tasks are an
integral part 'of elementary school education. Providing
an appropriate education for a child with known fine
motor problems in regular classes may therefore reqUire
a teacher to make needed modifications, proVide alterna·
tive modes of response and learning, or reduce the vol·
ume of written work while ensuring that adequate prac·
tice fOF learning new tasks has been proVided. Careful
monitoring of the chikl's work and learning is required to
ensure that an appropriate match between fine motor
demands, environmental adaptations, and the child's
ability is occurring,
Given that a range in fine motor requirements wa<;
observed within the same grade level, placing the child in
a class in which the requirements lie at the lower end of
the rang<.: may be the prt:ferred coursl' of action when a
choice of <:lasses <.:xists. However, in the present study we
<.:xamine.:d only time allocated to fine motor tasks and did
not conside.:r the volume of work to be done in the time
allocated, In making decisions about a child's education,
we would also n<.:ed to consider thiS factor,
Ao;, mentioned earlier. a substantial amount of time
allocate.:d to integrated tasks can present a prohlem for
the child who has difficulty thinking while Writing, How·
ever. the:se: six ohsl'l'\'ations do not indicate that ;J suh·
stantial amount of time: is ;Jllocate:d to integratt'u tasks in
elementary school. It should hl' note.:d that our opc:ration·
al definition of inte.:gr;Jtcd fine motor tasks influl'nceu
these findings. 'X'c defin<.:u inleRraledjine mOlor !clsks as
simultaneous occurrcnce of fin<.: motor activities and oral
instruction by the tcach<.:r. Many of the acti\'ities that we
uefin<.:d as fin\.' motor activities, such as writing sentences
with wKahulary words. also demanded thinking whil<.:
writing,
Split-grade class<.:s are often viewed as ad\'antageous
for the child with special nl"Cds because a greater spread
of ahility is present to enahle the child's needs to Ix: mer.
However, this type of daso;, mi~ht not be an optimal
choil'l.: for a child with fine mo ,r prohlems because of
th<.: high p<.:rcentag<.: of time Spl'nt on fine motor anivi·
til'S. Th<.: organization of dassroom activities in a split­
wadI..' da~~room must he <.:x;Jmined car<.:fully before a
902
l'hild with hill' IlH !lor prol>k'll1" I," plJll'<! III t hat cia",." The
dfel't Oil line 1I11J!llr (k'm:lIHI.., of so many in.,tnll'tion;J1
group:- l'an be.: rl'dul'l'll. For e.:xJmple.:, in rhl' fll'.,t- and
s<':l"lllld·grJlIl" dassrlllllll (JiJslTv<.:d for this study, an :Jiue.:
took 9 studl'nts inlo ;J separate.: room for computl'r in·
strunion whill' anothe.:r group was instructl'd in math in
the dassroom hy the.: tl';Jc!K'r, Thus, th<.: fin<.: motor aeth'·
ity of thos<.: 9 childrl.."n w:ts of a diffe.:rent intl'nsity than it
would h~I\,(: hc<.:n if th<.:y had bee.:n assi~n<.:d the.: more.:
USU;J\ type of s<.:at work while: the other group was re.:ce.:i\'­
ing dirl'Ct instrul'tion.
Th<.: typ<.:s of ta~ks assigned affe.:ct thl.." child with finl.."
motor difficulties, h<.:c;Juse tasks th<.:mse.:\v<.:s ma\' prl.."s<.:nt
differ<.:nt r<.:tjuirements rt'latin~ to the amount. size. I<.:g·
ihility, and spacing of writing or to the comple.:xity and
difficulry of work with particular materials, For example. a
math ditto with answer spaces designed for a child with
handwriting uf avera~t' size may not offer enough work
space for a child whose handWriting is larger than aver·
agL', Different tasks also may offer the child differl'nt b'­
ds of contrul over the volume and content of writing, For
example. assignin~ ;J child the task of writing a stOl'\' with
sre::lling words allows fJr more latitude in volume of writ­
ing than dues assigning the task of copying fiv<.: para­
graphs from a soci;JI stuui<.:s text. Thus, the tyre:: of t;Jsks
assi~ned may increase or decrl'3St: th.e nee.:d for n1odifka­
tion~ to work.
A panicular issue is the frequency with which repet·
itiw writing tasks we.:re assigned to childr<.:n, The t'duca­
til lilaI \'alm: of such tasks for children who haw difficu!!\'
thinking whil<.: f(X,'using on handwriting must be c;Jrefully
l'onsidl.."r<.:d. Spelling prete:sts or oral vocabulary pretL'sts
could e.:liminate.: the ne.:ed to have students copy entire.:
spelling oF\'lll'ahubr\' lists O\'l'r al--\ OVl'r, In math, rcquir­
ing stuuL'nts to copy a numhl'rof cumple.:x math problcm~
onto another pi<':l'e: of pape:r hefore.: they h<.:gin to soh'e
thl' prohlems ,'oulll he.: l'lirninate.:u through the.: usc of 3
photol,'(lpying enlarging m:ll'hine.:, A..o;, an ;Jltl'Fn;Jtiw, thl"
SllJdl'l1t l"l luld use: thl' workhook version of thl' tl'xtbook u'
that is JV:lilahlL',
Th<.: pr:1l'till' I If ha\'mg l'hildn:n fold pJlx'r tll l1lakl'
margins and <hiding linl's on their papl'r:-., whkh Ul.'.
l'llrn:d in l'\'<':~' l"la,.,..,rool11, is a frequ<.:ntly rl'l'(lmml'ntk'd
modific;Jtion '!(lr childr<.:n with handwriting pr()bk:rn~,
Th<.: lI"l' of re.:ading workbooks with mil1lmal fine m()[or
<k'mands i,,, also h<.:lpful fDr thl' integratiun of L'hi/th':")
with fine 1111 III lr pn lhll"ms into rl'gular c1a:-:-rnoms,
Simpk' llHldifil·:1tiDns fm handling more: Il'ngtl1\' J"
signml'nts in reading workhooks could induuL' allowing
tilt' child to r<.:mm'l' the pa~l' from th<.: workhook and to
use.: a typt'\\Tit<.:r t, It\')1<': answers directly onto the PJgl'. In
onl" sixth·gradl" cl:l.,sroom ()h~el'\'ed. a typewrit<.:r wa"
uSl'd f(lr this pUrp(l:-l' hy se.:\'l"rJI stude.:nts. nont' uf whom
had known finl' l11otor diftkulties,
In suml11JI\', tl1l' rl"sult~ of this study 3re exdting but
l11u:-t hI.' \'il'\wd a." prl'lil11in:l~'. Mowl<.:ug<.: of the: hl'a\~'
t
i
finc motor demands of regular dassroo01s should assist
1 Ol'(upational therapists working in the schools in rrl>vid­
ing more appmrrialt: consu!'ation. HoweVl..·r, Ihios study is
based on limited ohservations. The sample was sm:1I1­
only six different c1assruoms and only two split-grade
classrooms were observed. Mureover, each class was oh·
served for only one day. AlthouRh we a[lcmpted 10 select
typica: days, with such a shan observation an atypical day
wuuld have skewed the results. In additiun, the issue of
interrater reliability of coding was nOl fully addressed in
this study in that on-site imerrater reliability was not cal­
I. educalion of cbildrell u:i/b spina hifida and hydrocephalus
culated. It is possible that rating from a videotape results
in higher (or lower) imerrater reliability of coding com­
pared with rating from on-site observation. This study
should be replicated With a larger sample with Wider
geographic representation and over a longer period of
time, and on-site reliability must be examined.
Direct observation of the classroom provides helpful
information about classroom organization, the use of
time for academic activities, and the tasks that children
will be expected to perfonn. Classroom observation pro­
vides invaluable infonnation to the therapist consulting
with the teacher and can help to identify potential prob·
lem areas for a child With fine motor problems, Appropri­
ate modifications and personalized instruction can then
be anticipated. Necessary plans can be implemented be­
fore or during the performance of academic tasks, rather
than after the child has experienced failure at a panicular
task. "''hen comhined with careful monitori.lg of the
child's work and learning. knowledge and antlciratiun
of fX.>tential problem areas will help ensure that the
child receives an appropriate ellul'ation in the regular
classroom...
Acknowledgments
\\'e thank the Special Education Dl'panment at Rhode Island
College, Providence. Rhode !slant!. espeCially A. Anthony An·
The I\.meriam jUUM/(l1 uJ Occupatiunal Th"mpl'
View publication stats
losh, "10'>, and Ihl' btl' Eli.sa Bonaventura. Phil. Th,s srudv \\,;b
l'ompil'tl'd as pan of [he requiremcnts for the first author's
dq{ree of master of l'du<.:ation, Rhode Island College.
This paper \\'a- written under the auspiccs of the :"eurolx:·
ha\,j()ral Rl'hahilital1lm Research Center. Boston, Massachu·
selts, a center for scholarship and research in oc<.:upational
therapy at Boston L'niversity funded by lhe American Occup:!­
tiona) Therapy foundation and the American Occupational
Therapy A~sociati()n.
References
Andrl"Ws. R., & Elkins. J. (1981). The mana.cwm!!nt (lnd
Canherra, Australia: Australian Education Research and Devel­
opment Commillt:e. (ERIC Document Reproduction Service
r\o. ED 242 162)
Cemlak. S. (1991) Somatodyspraxia. In A. Fisher, E. Mur­
ray. & A. Bundy (Eels.), Sensory- integration: Theory- and prac­
tice (pr. 13&-170). Philadelphia: F. A. Davis. .
Cermak, S., & Henderson, A. (1990). Learning disabilities.
In D, l:mphrcd (Ed.)J...· eurological rehahilitation (2nd ed., pp.
2R3-331). SI. Louis: Mosby.
Clements. S. D. (1966),.t1inimal brain dysfunction in chil·
dren: TenninolO1{1' alld identlficatioll (NI!':DB Monograph l'o.
3). WashinglOn, DC: L'.S. Departmenl of Health. Education and
\X'elfare,
Den<.:kla, M., Rudel, R., Chapman. c.. & Krieger, J. (1985).
~ll>l()r proficienC"!' in dyslexic children with and without allen·
tiol1al disorders. Archil'es of Neurology, 42, 228-231.
Guhha~', S. S. (1985). Clumsiness In P. Vinken, G. Bru~'n. &
H, Klawans (Eds.), Handbook ofclinical neurology (Vol. 2. pp.
159-167), New York: Elsevier.
l.evine. M, D. (19IP). DeI'elopmentall'oriatloll ond I!!am·
11I,I!. di.~or("·rs. Camhridge. /l.1A: Educ3lOrs Puhlishini! Service.
~1rllalc. K. (19~-), Intf!grat;'lf?, children Il'llh jin!! motor
dijli'cultif!s 11110 rl!J.(ular classrooms. Cnpublished master's tht'­
sis, Rhode Island Colle~t:. Pru\'idence. Rhode Island.
Tarnopol. 1.., & Tamopol. M. (1977). Brain/unction a1l(1
'""lIding di>;(lhilitif!s. Baltimore: L'niversily Park Press.
[·.S. Dl'partmcnt of Education. (198-). ft.'imh amllwl n'·
/X)rt to CunRr!!ss. \\·:JshlOglOn. DC.
Younes, R.. Rosner. B.. & \\'ebh, G. (1983). :"euroimmatur·
it\ of Il':Jrning-disahled ('hildren: A controlled ~tudy. Dl'l'IdofJ­
IIIl'/I/(I1 .I/I'dicille a/lll C/)ild Nf!urolol-..'1'. .15. 5~-l-';-9.
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