Ingrid C. King

MSc OT

www.myfantasticfingers.com

Fantastic Fingers®: Addressing young students’ fine motor needs through a collaborative modelling teacher training intervention

© Ingrid C. King 2014

Intro. Why address fine motor skills?

Fine motor skills predict future academic success (Dinehart & Manfra, 2013)

Use fine motor skills in order to learn how to learn

(Adolf, 2008)

30–60% of class time spent on fine motor tasks (Marr et al., 2003; McHale & Cermak, 1992)

10–30% of students have handwriting difficulties (Feder & Majnemer, 2000)12–17% have impaired manual dexterity (Ratcliffe, 2011)

Low self-esteem, academic & behavioural issues

What do teachers report?

Australian teachers reported:Lack of support for students with fine

motor difficultiesStudents not eligible for funding for fine motor issues aloneHalf had little experience with OT & that OTs can help students with fine motor difficulties(Jackman & Stagnitti, 2007) © Ingrid C. King 2014

Current OT service delivery issues

Internationally, direct intervention and consultation are used in the provision of school based OT services

Limitations of the OT consultation model:Implementation challenges (Bayona et al., 2006)At-risk students seldom addressed

Long wait lists for therapy service – need to explore additional models of service delivery(Campbell et al., 2012; Hutton, 2009)

Other models of OT service delivery?

Whole class OT service delivery:Supplementing a preschool curriculum with OT

fine motor program results in significant gains (Lust & Donica, 2011)

Fine motor & visual-motor interventions for whole classes of 5 year olds leads to significant gains

(Ohl et al., 2013)

Coteaching: OT & teachers jointly conducting handwriting & writing program for whole classes of grade one diverse learners beneficial for all students; collaboration leads to new skills (Case-Smith et al., 2012)

What type of training do teachers want?

Studies show that teachers value:Fine motor workshops that are practical

and interactive(Chiu et al., 2008)Demonstrations and modelling of OT programs within the classroom(Fairbairn & Davidson, 1993)

© Ingrid C. King 2011

Purpose of this study & design

Purpose of this two phase study was to:Examine the effectiveness of a fine motor

collaborative modelling teacher training intervention on the fine motor task performance of five yr. old students = quantitative research methods with one group pre-test post-test design

ANDExplore whether the collaborative modelling

teacher training intervention was effective from the teacher’s perspective = qualitative research methods with five year follow-up interview

Phase 1: study participants

Phase 1: whole class evaluated beginning of 2007Senior new entrant teacher from low socio-

economic, decile 3 primary school in New Zealand

Average age of students five years10 boys and 9 girlsNone of students had a diagnosisNone were receiving OTAll 19 students from the class evaluated by OT on six fine motor tasks

© Ingrid C. King 2014

Fine motor task evaluation

The six fine motor tasks were:sequential finger touching; channel drawing task; in-hand manipulation task; copying pre-writing pattern; colouring-in and cutting out a circleEach task was scored according to set criteriaPerformance was rated as good (3 points), fair (2 points), poor (1 point)Pre-writing task scored on 3 criteriaMaximum score of 25

© Ingrid C. King 2014© Ingrid C. King 2014

Fine motor program with whole class

Phase 1 whole class participates in:8 week fine motor program, 40 minutes, 3x weekAction songs and graded activities integrated with early literacy and numeracy objectives 1st session of each week run by OT modelling

activities with teacher observing and assistingWritten guidelines provided for activities Teacher repeated session twice more in weekFollowing week OT modified/upgraded activitiesTeacher carried out modified activities twice moreNew activities presented each fortnight

Fine motor program now with group

Phase 1 small group identified:Six students with low fine motor task performance

scores made slower progress so teacher assistant assigned to run this group with OT & class teacher training & supporting, followed same scheduleThese six repeated the 8 week program over 10 weeks plus 2 weeks of new activities = 20 weeksThis group re-evaluated on six fine motor tasks by OT© Ingrid C. King 2014

Phase 2: follow-up interview & analysis

Telephonic interview with class teacher: Conducted over five years later in 2013Active interviewing techniques utilised e.g. collaborative with mutual disclosure (Holstein & Gubrium, 1998)Lose parameters provided were: classroom practice; students’ fine motor skills; teacher’s perception on training process; intervention content; nature of relationshipRecorded and transcribed verbatimThematic approach used to analyze the

data (Braun & Clark, 2006)

Class pre-test:mean 16.53

std. dev. 2.82

Group pre-test:mean 14.33std. dev. 1.86

Group post-testmean 18.67

std. dev. 1.51

Paired samples t-test t (5) = 8.77, p < . 001, d = 3. 58

02468

101214161820

Change in Fine Motor Task

Performance Mean

Class n=19Group n=6

Phase 1 results: large effect size

Phase 2 results: follow-up interview

Four main themes emerged from interview with teacher five years on:1. Fine motor need then and nowAfter the training workshop, teacher identified a big need for fine motor development in her class, extending to other year levels and ongoingPrincipal also saw the need and supported herShe believed that she needed to do something

for her low achieving learners: The need for schools is big… I’ve got lots of children who can’t write their name… priority learners… are the low achieving… what are you doing to teach that kid?

Phase 2 results: follow-up interview

2. Collaboration for successTeacher indicated that the collaboration between

herself and the therapist was enormous and building up of the relationship was essential;

(The OT) became a friend as wellHer classroom was de-privatized and openBeing flexible was important when collaborating

incl. data collection process which wasn’t onerous

and scheduling of sessionsCollaboration with the principal was also

important, provided funding for teacher assistant

Phase 2 results: follow-up interview

3. Program content for successTeacher liked the fact that the activities

complimented what she was doing already: like the Caterpillar Song… you made up a tune and the actions. It wasn’t an extra thing. It was taking something (a handwriting program) that I was interested in in any case but adding music to it… I still sing that all the time… music is important for all children

Program was perceived to be really nice and simple to do and fun for the children and teacher. It contained lots of variety with inside activities, outside activities, things to do together

Phase 2 results: follow-up interview

4. Training for successTeacher thought the practical workshop activities

and illustrated handouts were excellentWith reference to the therapist returning each

week to demonstrate activities, the teacher said: That was really good because for teachers you do need to have somebody coming back to model it… I would say ‘when Johnny does this with his fingers, what are they really meant to be doing?’

It was hands-on … it wasn’t a theory thing. It was practice. Modelling is a very important thing to do.

The fine motor program did not discontinue like some of the other class programs

Conclusion

Teacher reported positive benefits from the training for herself professionally & for her students

After five years she continues to use the acquired knowledge & activities from the fine motor program

This model of therapy service appears justified given

the enduring outcomes2/3 of group sessions were conducted exclusively by teaching staff yet a significant difference & large effect size were obtained

© Ingrid C. King 2014© Ingrid C. King 2014

For more info: www.myfantasticfingers.com

Clinical implicationsAccording to the statistics we can expect to find between 12% to 30% of students with fine motor difficulties. Address this need through:Practical fine motor workshops for teachers – can lead to further training interventionsCollaboration – build relationship include school

management, set joint goals, flexible data collection & scheduling, use a relevant fine motor program – fun, easy to do, related to curriculum

Train teaching staff by modelling in the classroom – hands-on, weekly, provide written info., evaluate progress, apply intervention to groups of students