Heidi Schwellnus

A Developmental Comparison of the Out‐of‐school Recreation and Leisure Activity Participation of Boys and Girls With and Without Physical Disabilities

Similarities and differences were examined in the out‐of‐school recreation and leisure activity participation of 422 children with physical disabilities and 354 children without disabilities. The roles of age (six to eight years, nine to 11 years, and 12–14 years), gender, and disability status were examined with respect to the diversity, intensity, location, companionship, and enjoyment of participation in five types of activities, controlling for family income. The findings indicate that dimensions and types of activity participation are differentially influenced by age, gender, and disability. Age cohort comparisons indicated that children without disabilities experienced a widening social world characterised by more intense social participation, greater participation with non‐family members, and stable levels of enjoyment across the age groups. In contrast, children with disabilities in the various age groups were similar in their intensity of social participation and the nature of their companionship, with 12–14 year olds reporting less enjoyment of social activities than those aged six to eight years or nine to 11 years. The findings support the utility of a developmental and contextual perspective in understanding children’s patterns of participation. The information can be used by service providers and managers interested in creating centre‐based or community‐based recreational opportunities, and in providing information to parents about how to encourage children’s recreation and leisure participation.

Changes in Kinetics and Kinematics of Handwriting during a Prolonged Writing Task in Children with and without Dysgraphia.

Handwriting difficulties or dysgraphia have a profound impact on childrens psychosocial development, and yet, 10-30% of school-aged children are reported to experience difficulties mastering this skill. Several studies have examined the nature and biomechanical underpinnings of handwriting difficulties in children with and without dysgraphia. While the majority of these studies have considered short handwriting activities involving a sentence or a paragraph, handwriting quality and speed are reported to vary with the length of the writing task. Further, it is suggested that the biomechanics of handwriting also evolve over extended writing periods, and that these changes may be distinct between children with and without dysgraphia. The nature and specificity of these biomechanical alterations remain unknown. To address this knowledge gap, we examined changes in writing speed, grip forces on the pen barrel, and normal forces on the writing surface, over the course of a 10-min writing task, in a large cohort of 4th grade children with and without dysgraphia. Horizontal stroke speed, grip force and normal force increased over time while vertical stroke speed decreased in all children. These biomechanical changes may be attributable to physical and psychological fatigue and the corresponding compensatory processes invoked by the motor system.

Peer-coaching with health care professionals: What is the current status of the literature and what are the key components necessary in peer-coaching? A scoping review

Background: Peer-coaching has been used within the education field to successfully transfer a high percentage of knowledge into practice. In recent years, within health care, it has been the subject of interest as a method of both student training and staff continuing education as well as a format for knowledge translation. Aims: To review the literature from health care training and education to determine the nature and use of peer-coaching. Method: Due to the status of the literature, a scoping review methodology was followed. From a total of 137 articles, 16 were found to fit the inclusion criteria and were further reviewed. Results: The review highlights the state of the literature concerning peer-coaching within health care and discusses key aspects of the peer-coaching relationship that are necessary for success. Conclusions: Most research is being conducted in the domains of nursing and medicine within North America. The number of studies has increased in frequency over the past 10 years. Interest in developing the potential of peer-coaching in both health care student education and continuing clinical education of health care professionals has grown. Future directions for research in this quickly developing area are included.

Effect of Pencil Grasp on the Speed and Legibility of Handwriting in Children

OBJECTIVE Pencil grasps other than the dynamic tripod may be functional for handwriting. This study examined the impact of grasp on handwriting speed and legibility. METHOD We videotaped 120 typically developing fourth-grade students while they performed a writing task. We categorized the grasps they used and evaluated their writing for speed and legibility using a handwriting assessment. Using linear regression analysis, we examined the relationship between grasp and handwriting. RESULTS We documented six categories of pencil grasp: four mature grasp patterns, one immature grasp pattern, and one alternating grasp pattern. Multiple linear regression results revealed no significant effect for mature grasp on either legibility or speed. CONCLUSION Pencil grasp patterns did not influence handwriting speed or legibility in this sample of typically developing children. This finding adds to the mounting body of evidence that alternative grasps may be acceptable for fast and legible handwriting.

Writing forces associated with four pencil grasp patterns in grade 4 children.

OBJECTIVE. We investigated differences in handwriting kinetics, speed, and legibility among four pencil grasps after a 10-min copy task. METHOD. Seventy-four Grade 4 students completed a handwriting assessment before and after a copy task. Grip and axial forces were measured with an instrumented stylus and force-sensitive tablet. We used multiple linear regression to analyze the relationship between grasp pattern and grip and axial forces. RESULTS. We found no kinetic differences among grasps, whether considered individually or grouped by the number of fingers on the barrel. However, when grasps were grouped according to the thumb position, the adducted grasps exhibited higher mean grip and axial forces. CONCLUSION. Grip forces were generally similar across the different grasps. Kinetic differences resulting from thumb position seemed to have no bearing on speed and legibility. Interventions for handwriting difficulties should focus more on speed and letter formation than on grasp pattern.

Grip force variability and its effects on children's handwriting legibility, form, and strokes.

A comprehensive understanding of the underlying biomechanical processes during handwriting is needed to accurately guide clinical interventions. To date, quantitative measurement of such biomechanical processes has largely excluded measurements of the forces exerted radially on the barrel of the writing utensil (grip forces) and how they vary over time during a handwriting task. An instrumented writing utensil was deployed for a direct measurement of kinematic and temporal information during a writing task, as well as forces exerted on the writing surface and on the barrel of the pen. The writing utensil was used by a cohort of 35 students (19 males), 16 in first grade and 19 in second grade, as they performed the Minnesota Handwriting Assessment (MHA) test. Quantitative grip force variability measures were computed and tested as correlates of handwriting legibility, form, and strokes. Grip force variability was shown to correlate strongly with handwriting quality, in particular for students classified by the MHA as nonproficient writers. More specifically, static grip force patterns were shown to result in poor handwriting quality and in greater variation in handwriting stroke durations. Grip force variability throughout the writing task was shown to be significantly lower for nonproficient writers (t-test, p<0.01) while the number of strokes and per-stroke durations were shown to be higher (p<0.03). The results suggest that grip force dynamics play a key role in determining handwriting quality and stroke characteristics. In particular, students with writing difficulties exhibited more static grip force patterns, lower legibility and form scores, as well as increased variation in stroke durations. These findings shed light on the underlying processes of handwriting and grip force modulation and may help to improve intervention planning.

Client-centred coaching in the paediatric health professions: a critical scoping review

Abstract Purpose: Coaching is mainstream in business and is expanding into paediatric health care. With the focus on evidence-informed health practice, it is imperative to identify the key active components of interventions. Coaching is by definition a complex intervention with numerous components. The purpose of this critical review is to determine how coaching is currently defined, its prevalence in paediatric health care services and the frequency of the active components of coaching and to consider the findings of research to date. Method: A critical review of the literature was conducted. Inclusion/exclusion criteria were based on the International Coach Federation, which stipulates that coaching is a collaborative process that involves client-centred goal setting, facilitation, self-discovery and capacity building. Seventeen studies were selected for thorough review. Results: Throughout the literature, there was inconsistency in how coaching was defined. Studies included various components, but overall the literature lacked cohesion. Conclusion: To advance the field, a list of components that foster client engagement was developed along with a comprehensive definition of coaching involving affective, behavioural and cognitive components and a path of research necessary to evaluate this complex intervention. Implications for Rehabilitation A comprehensive approach to coaching involves consideration of multiple components. A coaching approach can enhance engagement in rehabilitation interventions. The operationalization of holistic ABC coaching that encapsulates the important components, which are affective, behavioural and cognitive in nature.

Cognitive Orientation to daily Occupational Performance (CO-OP): A New Approach for Children with Cerebral Palsy

ABSTRACT Aims: The results of a small single-case study series suggested that Cognitive Orientation to daily Occupational Performance (CO-OP) may be a successful approach for children with cerebral palsy (CP). Therefore a pilot randomized controlled trial was conducted with the following research questions—is CO-OP a feasible approach to use with children with CP, what are the effects of CO-OP when compared to usual practice, and is a larger study warranted? Methods: 18 children between age 7 and 12 (nine in CO-OP group and nine in Current Usual Practice Approach (CUPA) group) received ten 1-hour sessions of intervention on average once per week at home. Primary outcome measures were the Canadian Occupational Performance Measure and the Performance Quality Rating Scale (PQRS). PQRS assessors were blind to group allocation and timing of assessment. Results: All children in the CO-OP group were able to learn the strategies and achieve their chosen goals, thus demonstrating the feasibility of the approach. Both approaches equally promoted skill acquisition and skill maintenance at follow-up. Effect sizes suggest that CO-OP may show some advantage for transfer and maintenance. Conclusion: Based on these initial findings, further research is warranted.

Effect of pencil grasp on the speed and legibility of handwriting after a 10-minute copy task in Grade 4 children.

AIM To investigate the impact of common pencil grasp patterns on the speed and legibility of handwriting after a 10-minute copy task, intended to induce muscle fatigue, in typically developing children and in those non-proficient in handwriting. METHODS A total of 120 Grade 4 students completed a standardised handwriting assessment before and after a 10-minute copy task. The students indicated the perceived difficulty of the handwriting task at baseline and after 10 minutes. The students also completed a self-report questionnaire regarding their handwriting proficiency upon completion. RESULTS The majority of the students rated higher effort after the 10-minute copy task than at baseline (rank sum: P = 0.00001). The effort ratings were similar for the different grasp patterns (multiple linear regression: F = 0.37, P = 0.895). For both typically developing children and those with handwriting issues, the legibility of the writing samples decreased after the 10-minute copy task but the speed of writing increased. CONCLUSIONS AND SIGNIFICANCE OF THE STUDY: The quality of the handwriting decreased after the 10-minute copy task; however, there was no difference in the quality or speed scores among the different pencil grasps before and after the copy task. The dynamic tripod pencil grasp did not offer any advantage over the lateral tripod or the dynamic or lateral quadrupod pencil grasps in terms of quality of handwriting after a 10-minute copy task. These four pencil grasp patterns performed equivalently. Our findings question the practice of having students adopt the dynamic tripod pencil grasp.

The development of the tool for optimizing written productivity (TOW-P).

Many school-aged children experience difficulties in written productivity, which result in a large number of referrals for school-based Occupational Therapists (OTs). Health care practitioners are being called upon to establish consistent practice, yet there are presently no guidelines to facilitate consistency in this clinical area. The Tool for Optimizing Written Productivity (TOW-P) was developed to assist OTs in decision-making regarding intervention selections for this population. A pilot study and a province-wide survey yielded specific frequencies of intervention for different written productivity issues that can be used to guide a therapists selection of interventions.