Handwriting Intervention, SML vs. Conventional Occupational Therapy (OT), in a Junior High School

Developmental Dysgraphia Clinical Trial

— SML  

Official title:

Handwriting Intervention, With vs. Without a Rightward Bias, in a Junior High School-A Randomized Controlled Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03514992
• Other study ID #: Sensory Motor Lateralization
• Secondary ID: Conventional Sch
• Status: Completed
• Phase: N/A
• Start date: September 12, 2012
• Est. completion date: June 12, 2013

Study information

• Verified date: May 2018
• Source: Teng, Mary H.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Children who attend School-Based Occupational Therapy (SBOT) show mixed dominance and a liable decreased in the structural and functional differentiation between the two hemispheres. The lack of right-left disparity has been found to link to mirror invariance, poor spatial organization, fragmentary reversals, and handwriting difficulty. This study intends to find out, whether, Sensory Motor Lateralization (SML), "With" a rightward bias, profits handwriting more than the conventional (CON) "Without".

Description:

10 to 30% of school children suffer handwriting difficulty. Many of them are eventually referred to SBOT for remedial intervention. Among these children, 70% show mixed dominance in their hand and/or leg use, and a likely functional and structural interhemispherical asymmetry reduction. This would make them right-left symmetrical. Learning, thus, may be challenged, because people who are right-left balanced would not have a consistent reference point to process the learning materials regularly in any pre-determined directions. They are, thus, prone to suffer mirror invariance, fragmentary reversal errors, and handwriting difficulty, especially with the fast and accurate construction of asymmetrical letters from memory.

To enhance right-left disparity, dispel mirror invariance, and facilitate the automatized handwriting, SML preferentially belabors one's right eye, ear, hand and leg in therapy, that would greater engage the left hemisphere for its acclaimed vantages over learning. This study investigates, whether SML, wielding such a rightward bias, profits handwriting greater than CON.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 16
• Est. completion date: June 12, 2013
• Est. primary completion date: January 4, 2013
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Any Special or Regular Education students with Individualized Education Plans (IEPs), OT mandates, and handwriting goals.

• Has Intelligence Quotient (IQ) equal to or above 60.

• Ambulatory.

• Proficient in English, and fluent in naming, identifying, and accessing the sequence of letters in the alphabet.

• The students who attend Physical Therapy (PT), Adaptive Physical Education (PE), and any other programs are included, if the programs being provided are skill-, theme-, or task-oriented, not involving any muscle strengthening activities.

Exclusion Criteria:

• All are excluded, if the study candidates have any medical condition(s) that would prohibit them from the full physical participation in school.

Related Conditions & MeSH terms

• Agraphia
• Developmental Dysgraphia

Intervention

Behavioral:
• SML
SML consists of supervised handwriting practice, fitness exercises, and fine motor speed drills that preferentially belabor a participant's right eye, ear, hand and leg during therapy.
• CON
CON consists of supervised handwriting practice, fitness exercises, and fine motor speed drills on the participant's dominant hand.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Mary H. Teng

References & Publications (23)

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* Note: There are 23 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	SML excels CON in Visual Motor Integration	Assess by the Developmental Test of Visual Motor Integration (DTVMI)	Change from Baseline raw score at 3 months
Other	SML excels CON in Visual Perception	Assess by DTVMI	Change from Baseline raw score at 3 months
Other	SML excels CON in Motor Coordination	Assess by DTVMI	Change from Baseline raw score at 3 months
Primary	SML excels CON in manuscript letter legibility	Assess by the Wold Sentence Copying Test (WSCT)	Change from Baseline percent accuracy score at 3 months
Primary	SML excels CON in script letter legibility	Assess by WSCT	Change from Baseline percent accuracy score at 3 months
Primary	SML excels CON in manuscript transcription speed	Assess by WSCT	Change from Baseline letters per minute at 3 months
Primary	SML excels CON in script transcription speed	Assess by WSCT	Change from Baseline letters per minute at 3 months

External Links

•   Bédard, P., Wu, M., & Sanes, J. N. (2011). Brain Activation Related to Combinations of Gaze Position, Visual Input, and Goal-Directed Hand Movements. Cerebral Cortex, 21(6), 1273-1282.
•   Beeson, P. M., Rapcsak, S. Z., Plante, E., Chargualaf, J., Chung, A....Trouard, T. P. (2003). The neural substrates of writing: A functional magnetic resonance imaging study. Aphasiology, 17(6/7), 647-665.
•   Corballis, M. C. (2014). Left brain, right brain: facts and fantasies. PLoS Biology, 12(1), e1001767.
•   Feder, K. P., & Majnemer, A. (2007). Handwriting development, competency, and intervention. Developmental Medicine and Child Neurology, 49(4), 312-7
•   Frey, S. H. (2008). Tool use, communicative gesture and cerebral asymmetries in the modern human brain. Archives of Philosophical Transactions of the Royal Society of London Biological Sciences, 363, 1951-7.
•   Gonzalez, C. L. R., Ganel, T., & Goodale, M. A. (2006). Hemispheric specialization for the visual control of action is independent of handedness. Journal of Neurophysiology, 95, 3496-3501.
•   Gotts, S. J., Jo, H. J., Wallace, G. L., Saad, Z. S., Cox, R. W., & Martin A. (2013). Two distinct forms of functional lateralization in the human brain. Proceedings of the National Academies of Sciences of USA, 110(36), E3435-344
•   Guerraz, M., Blouin, J., & Vercher, J. L. (2003). From head orientation to head control: evidence of both neck and vestibular involvement in hand drawing. Experimental Brain research, 150, 40-9.
•   Heilman, K. M., Howell, G., Valenstein, E., & Rothi, L. (1980). Mirror-reading and writing in association with right-left spatial disorientation. Journal of Neurology, Neurosurgery, and Psychiatry, 43(9), 774-80.
•   Sibley, B. A. and Jennifer L. Etnier, J. L. (2003). The relationship between physical activity and cognition in children: A meta-analysis. Review Article. Pediatric Exercise Science, 15, 243-256.
•   Weintraub, N., & Graham, S. (2000). The contribution of gender, orthographic, finger function, and visual-motor processes to the prediction of handwriting status. The Occupational Therapy Journal of Research, 20(2), 121-140