MOVEMENT DISORDERS and their
effect on educational progress.
Sheila E. Henderson, Institute of
Education, University of London
and University of Leeds.
Children with movement difficulties
Experience a range of problems, which vary considerably in
severity e.g.
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From being in a wheelchair to being ambulatory
From having no use of the hands to have apparently normal
functioning
From having no speech to being able to communicate
normally.
Also, they may have a clear “diagnosis”, no diagnosis, a query,
or more than one.
Difficulties have an impact on:
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Progress in the classroom
Progress in PE
Participation in other school activities (e.g. in the
dining room, at clubs).
Participation in the playground and other outdoor
activities
Which in turn affects
 Self esteem, Social interactions/Peer relationships
etc
One very common problem:
Many of these children will have difficulty
with HANDWRITING which is known to
have an impact on academic attainment.
Outline of the talk
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Children with handwriting difficulties
Handwriting and writing as interacting
processes.
The assessment of speed of handwriting.
Boy with Benign Joint Hypermobility
Syndrome aged 7.
Girl, age 9, with mild cerebral palsy
Boy, age 7, with Developmental
Coordination Disorder (DCD) /Dyspraxia.
Boy with Dyslexia, age 10
Boy, age 9, Asperger's Syndome
Typically developing boy age 11
Children with movement/handwriting
difficulties? - group 1.
Movement difficulties are PRIMARY:
 Children with Juvenile arthritis
 Children with genetic conditions e.g. BJHS.
 Children with cerebral palsy (known brain
damage)
 Children with progressive movement disorders
e.g. Muscular dystrophy.
 Children with Developmental Coordination
Disorder (DCD) or dyspraxia.
Children with movement/handwriting
difficulties - group 2.
Other developmental disorders in which
movement difficulties are SECONDARY:
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Dyslexia
Specific Language Impairment
Asperger’s Syndrome
ADHD
Group 3:
Children who fall into more than one
diagnostic category
And don’t forget group 4:
Typically developing children who have:
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Not been taught to write systematically.
Have missed crucial early lessons in school
Who have been absent when joining was being taught
Who have changed schools and found a different
system in place.
Henderson and Rubin, (1982); Barnett, Stainthorp,
Henderson and Scheib, (2006);Graham et al, (2009).
Why bother with handwriting
difficulties – do they matter? I
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Computers have not taken over yet in schools.
In many, particularly primary schools, not all
children have a computer.
If/when they do, children have to be taught
keyboarding – which can be difficult for those
with movement difficulties
Why bother with handwriting
difficulties – do they matter? II
Writing :
 takes up much of the school day (McHale &
Cermak, 1992)
 required across the school curriculum
 Used for note taking and recording homework
 Assessed work may still be handwritten
 required for examinations
 useful in everyday life
Why be concerned about poor
handwriting skill - III
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Work that is difficult to read gets lower marks.
(e.g. Briggs, 1970; Sloan & McGinnis (1992),
Simner et al., 1996).
Most importantly – legibility and speed of
handwriting is related to reduced quantity and
quality of content (Connelly et al, 2002; 2005;
Stainthorp, 2009; Webb, Henderson and Stuart,
2011).
Need Further convincing?
Go to:
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www. hw21summit.com.
What is handwriting?
Handwriting differs from other motor skills,
such as running, jumping, catching a ball,
cutting with scissors, in at least three ways.
What is handwriting?
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It has a language base.
(It is the recording of thought, through
language, on paper).
It is an " invented" skill.
It is a taught skill.
Different languages - different rules
Chinese
Spanish
Vietnamese
Greek
Some of the concepts (Rules) behind
our writing system
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The direction of writing is from left to right.
Each letter has a correct movement sequence – the
strokes must begin in the right place and proceed
in the correct direction (s).
Letters have specific height differentials.
It is essential to have consistent spacing between
letters and words.
Capital letters and small letters have different uses
In sum,
Handwriting is a complex skill involving:
 Motor
 Perceptual
 Cognitive and
 Linguistic abilities,
Linked directly to the processes involved in
writing.
Links between poor handwriting
and writing.
Speed of handwriting related to quality of text
written:
1. 15% pf the variance in quality of text writing on
the TOWL accounted for by handwriting speed
(Stainthorp and Rauf (2009)
2. Correlations between legibility and speed of
handwriting and quality of text written (grammar,
generation of ideas etc) in excess of 0.5 (Webb,
2012).
Handwriting is a tool
Learning to Write
Writing to learn
Our objectives as teachers:
All children should be able to write:
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Legibly
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Fluently
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Fast enough.
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Flexibly and comfortably
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What if they can’t or won’t?
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Provide extra help in the classroom
Seek help from outside
Apply for other help –
ACCESS ARRANGEMENTS.
To help with this -
We need a tool to:
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Identify those with difficulties
QUANTIFY THE LEVEL OF DIFFICULTY
Describe the difficulty in detail
Evaluate intervention programmes
Aid research
What was wrong with existing tests?
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Main problem: Only one task used
Norms not up-to-date
Don’t differentiate different types of
difficulty.
Reliability and validity data not adequate
Detailed Assessment of Speed of Handwriting
(DASH and DASH 17+)
Anna Barnett, Sheila Henderson,
Beverly Scheib & Joerg Schulz.
Published by Pearson Assessment
www.pearson-uk.com
DASH & DASH 17+
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Range of writing tasks (5)
Age range: 9-16 years; 17-25 years
Properly representative sample
Psychometrically sound
Alongside revision of Movement ABC
(Henderson & Sugden, 1992) for 3-16 year
olds
5 tasks in the DASH (and 17+)
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1. Alphabet task
2. Copy best
3. Copy fast
4. Free writing
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5. Graphic speed.
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Alphabet Writing
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Alphabet writing for 1 minute
Write out the letters of the alphabet continuously
(lower case). Write as quickly as possible but make sure
that every letter is readable
Scoring. Number of correctly sequenced lower case
letters written.
Copying a sentence
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Copy for 2 minutes. Divided into 1-minute periods.
Two conditions:
Copy Best – write in your best handwriting.
Copy Fast - write as quickly as possible but make sure
every word is readable.
Scoring. Words per minute. Copy difference score
Handwriting Samples
Background
Alex
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Age: 11 years 8
months
Handedness: Left
School: Year 7
Referral : EP
Reason: Difficulty
producing
handwritten work;
illegibility
Billy
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Age: 11 years 8
months
Handedness: Left
School: Year 7
Referral : SENCO
Reason: Difficulty
producing
handwritten work;
illegibility
Alex
Billy
Difference Between Best and Fastest for Alex
and Billy
Number of Words Written per
Minute
Comparison in Number of Words Written per
Minute Between Boys in Both Conditions
45
40
35
30
25
Best
20
Fastest
15
10
5
0
1
2
Alex
Billy
Free writing Task
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Task which represented ‘every day’ writing for the
child : ‘My Life’, ideas given, one minute thinking/
planning time.
Ten minutes total with 2 minute markers
Scoring. Number of legible words between time
marks. Detailed scoring criteria.
Ideas for writing about ‘My Life’
hobbies
music
dance
sports
friends
My Life
birthdays
holidays
clubs
pets
fashion
television
school
An example of ‘free writing’
Graphic Speed
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Making Xs in circles for 1 minute.
Demonstration to emphasize the ‘rules’: write an X
not a cross (+), lines must extend to at least touch
inner circle, lines must not extend beyond outer
circle, intersection must be within inner circle,
work quickly but accurately
Practice with feedback
Scoring. Number of correctly produced Xs. Scoring
is strict
Quantitative data from DASH tasks.
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Standard scores for each task (mean 10, SD 3)
Profile across tasks
Total DASH score - sum of ‘language-based’
tasks, converted to Total Standard Score (mean
100, SD 15) with percentile equivalents
Cut off points: 5th/15th percentile for Total DASH
standard score
Supplementary scores
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Copy Difference score
Free Writing Profile.
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Graphic Speed score >
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Movement ABC test??
Qualitative information from the DASH
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Factors affecting performance
attitude to the tasks/motivation
attention/concentration
Observations during testing (the 4 Ps)
Posture, pen grip, paper position, pressure &
fluency
Observations of the writing scripts (the
7 Ss)
Shape/formation, spacing words/letters, size,
slant/slope, site, stringing together, shakiness
Individual vs. group testing – free
writing
Words per minute
19
17
15
13
Group
11
Individual
9
7
5
Individual first
Order
Group first
The National Handwriting
Association
(www.nha-handwriting.org.uk
Aims:
Raise awareness of handwriting
as a crucial component of literacy
Promote and foster good practice
in the teaching of handwriting
Provide support for those working
with children and adults who have
handwriting difficulties
DSM–IV Criterion A for DCD
Performance in daily activities that require motor
coordination is substantially below that expected given
the person’s CA and measured intelligence. This may
be manifested by marked delays in achieving motor
milestones (e.g., walking, crawling, sitting), dropping
things, “clumsiness”, poor performance in sports, or
poor handwriting.
International consensus statements on DCD
Polatajko et al. (1995), Sugden (2006)
European guidelines (EACD, 2011) to be adapted
for the UK