Cerebral Palsy Clinical Trial
Official title:
Effectiveness of Interactive Computerized Handwriting Training Program on Handwriting Performance in Children With Cerebral Palsy
Visual perception impairment and upper limb disability will affect the handwriting
performance. Children with cerebral palsy (CP) who have good function on upper extremity may
associated with visual perception impairment, which will impact the handwriting performance.
However, there were few studies to investigate the handwriting problems in children with CP
who have good upper limb functions. To date, there are no studies to investigate the
effectiveness of computerized handwriting training programs on handwriting performance in
children with CP. The aims of this study were to establish the relationships of visual
perception, visual motor integration, and motor coordination of handwriting performance in
children with typical development (TD) in Taiwan, to establish the norms of handwriting
performance in children with TD in Taiwan, to compare handwriting performance in children
with CP and children with TD, to clarify the relationship of visual perception function and
handwriting performance in children with CP, and to examine the effectiveness of interactive
computerized handwriting training program (ICHTP) on handwriting performance in children
with CP.
The investigators will collect 90 children with TD and 48 children with CP in the 1st phase.
All children will receive clinical and Chinese handwriting assessment tool (CHAT)
assessments. The CHAT and ICHTP will be modified as Taiwan-version handwriting assessment
tool and training programs for children in Taiwan, respectively. Clinical assessments
include the visual perception, visual motor integration, fine motor skill, and handwriting
performance. The CHAT assessed the handwriting legibility, accuracy, pen pressure and
writing speed. In the 2nd phase, the investigators will collect 48 children with CP, who
were randomly classified into ICHTP group and Traditional Handwriting Training Program
(THTP). All children with CP will receive clinical and CHAT assessments before and after
interventions.
The expected results of this study are the visual perception function is related to
handwriting performance in children with CP, and the improvements in the handwriting
legibility, accuracy, pen pressure and writing speed of ICHTP training group are greater
than THTP training group.
This study were to establish the relationships of visual perception, visual motor
integration, and motor coordination of handwriting performance in children with TD in
Taiwan, to establish the norms of handwriting performance in children with TD in Taiwan, to
compare handwriting performance in children with CP and children with TD, to clarify the
relationship of visual perception function and handwriting performance in children with CP
in the first phase, and to examine the effectiveness of interactive computerized handwriting
training program (ICHTP) via a randomized controlled study in children with CP in the second
phase.The subjects are ninety children with typical development aged between 6-12 years from
elementary school and forty-eight children with CP aged between 6-12 years from Chang Gung
Memorial Hospital (Taipei branch, Linkou branch, Taoyuan branch, Kaohsiung branch), Far
Eastern Memorial Hospital, Taipei Veterans General Hospital and Buddhist Tzu Chi General
Hospital (Taipei branch)etc.Experimental design In first phase, we establish the
relationships of visual perception, visual motor integration, and motor coordination of
handwriting performance in children with TD in Taiwan, to establish the norms of handwriting
performance in children with TD among different age groups in Taiwan, a comparison designed
study to compare the handwriting performance among 2 CP groups and TD groups. All children
were assigned into diplegia group, hemiplegia group, and typical development (TD) group.
Then we will assessment the fine motor skill, visual perception and handwriting performance
by occupational therapist.
Experimental procedures:
All children were assessed with clinical assessments and the Chinese handwriting assessment
tool (CHAT). Clinical assessments included Manual Ability Classification System (MACS),
Bruininks-Oseretsky Test of Motor Proficiency-second edition (BOT-II), the Test of
Visual-Perceptual Skills Revised (TVPS-R), Beery-Buktenica Developmental Test of
Visual-Motor Integration (Berry VMI) and comprehensive test of basic reading and writing.
Evaluations were performed in about 1.5-2 hours in a silent and restful room, eliminating
factors such as fatigue and distraction of attention and concentration, which could have an
impact on the results. All the tests used in the study were individually administered to all
children. The performance of all children was videotaped for later scoring.
In second phase, all CP children were randomized assigned into ICHTP group or THTP group.
All participations will received clinical and CHAT assessments before and after
intervention. Clinical assessments included Manual Ability Classification System (MACS),
Bruininks-Oseretsky Test of Motor Proficiency-second edition (BOT-II), the Test of
Visual-Perceptual Skills Revised (TVPS-R), Beery-Buktenica Developmental Test of
Visual-Motor Integration (Berry VMI) and comprehensive test of basic reading and writing.
Evaluations were performed in about 2 hours in a silent and restful room, eliminating
factors such as fatigue and distraction of attention and concentration, which could have an
impact on the results. All the tests used in the study were individually administered to all
children. The performance of all children was videotaped for later scoring. The intervention
consisted of ICHTP and THTP training programs, which is 45 min/once, three times/one week,
and sustain four weeks.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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