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Lopez C, Vaivre-Douret L. Exploratory Investigation of Handwriting Disorders in School-Aged Children from First to Fifth Grade. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1512. [PMID: 37761473 PMCID: PMC10528446 DOI: 10.3390/children10091512] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/17/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
Handwriting disorders (HDs) are prevalent in school-aged children, with significant interference with academic performances. The current study offers a transdisciplinary approach with the use of normed and standardized clinical assessments of neuropsychomotor, neuropsychological and oculomotor functions. The aim is to provide objective data for a better understanding of the nature and the etiology of HDs. Data from these clinical assessments were analyzed for 27 school-aged children with HD (first to fifth grade). The results underline a high heterogeneity of the children presenting HDs, with many co-occurrences often unknown. However, it was possible to highlight three levels of HDs based on BHK scores: mild HD not detected by the BHK test (26% of children), moderate HD (33%) and dysgraphia (41% of children). The mild nature of the HDs not detected by the BHK test appears to occur at a relatively low frequency of the associated disorders identified during clinical evaluations. On the contrary, dysgraphia appears to be associated with a high frequency of co-occurring disorders identified in the clinical assessment, with a predominance of oculomotor disorders (55% of children), leading to visual-perceptual difficulties and a high level of handwriting deterioration. Finally, children with moderate HD have fewer co-occurrences than children with dysgraphia, but have more difficulties than children with mild HD. This highlights the importance of differentiating between different degrees of HDs that do not respond to the same semiologies. Our findings support the interest in performing a transdisciplinary and standardized clinical examination with developmental standards (neuropsychomotor, neuropsychological and oculomotor) in children with HD. Indeed, HDs can therefore be associated with a multitude of disorders of different natures ranging from poor coordination of the graphomotor gesture to a more general and more complex impairment affecting perceptual-motor, cognitive and/or psycho-affective functions.
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Affiliation(s)
- Clémence Lopez
- Unit 1018-CESP, PsyDev/NDTA Team, National Institute of Health and Medical Research (INSERM), Faculty of Medicine, University of Paris-Saclay, UVSQ, 91190 Villejuif, France;
| | - Laurence Vaivre-Douret
- Unit 1018-CESP, PsyDev/NDTA Team, National Institute of Health and Medical Research (INSERM), Faculty of Medicine, University of Paris-Saclay, UVSQ, 91190 Villejuif, France;
- Department of Medicine Paris Descartes, Faculty of Health, Université Paris Cité, 75006 Paris, France
- Clinical Neurodevelopmental Phenotyping, University Institute of France (Institut Universitaire de France, IUF), 75005 Paris, France
- Department of Child Psychiatry, AP-HP Centre, Necker-Enfants Malades University Hospital, 75015 Paris, France
- Department of Endocrinology, IMAGINE Institute, Necker-Enfants Malades University Hospital, 75015 Paris, France
- Necker-Enfants Malades University Hospital, “Neuro-Développement et Troubles des Apprentissages (NDTA)”, INSERM UMR 1018-CESP, Carré Necker Porte N4, 149, Rue de Sèvres, 75015 Paris, France
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Čunek L, Ondřej J, Blažíčková I, Pupíková V, Lacko D, Prošek T, Šafárová K. Handwriting Quality: Psychometric Properties of Two Evaluation Scales With a Czech Sample. Am J Occup Ther 2023; 77:7703205130. [PMID: 37326571 DOI: 10.5014/ajot.2023.050029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
IMPORTANCE Approximately 7% to 30% of children contend with handwriting issues (HIs) in their school years. However, research studies to define and quantify HIs, as well as practical assessment tools, are lacking. OBJECTIVE To confirm the validity and reliability of two screening scales for HIs: the Handwriting Legibility Scale (HLS) and the Concise Assessment Scale of Children's Handwriting (BHK). DESIGN Structural equation modeling (SEM) and confirmatory factor analysis (CFA) of five different models were used to examine the construct and discriminant validity of both scales. Furthermore, internal consistency and interrater agreement were evaluated. The association among scales, grades, and children's self-evaluation was also explored. SETTING Elementary schools and state counseling centers in the Czech Republic. PARTICIPANTS On a voluntary basis, 161 children from elementary schools and state counseling centers in the Czech Republic were enrolled. The variable of children with typical handwriting development versus HIs was missing for 11 children. Thus, for discriminant validity analysis, 150 data records from children were used. OUTCOMES AND MEASURES The HLS and BHK were used to evaluate the handwriting quality of the transcription task. The Handwriting Proficiency Screening Questionnaires for Children was used for children's self-evaluation. RESULTS The study confirmed the validity and reliability of the shortened BHK and HLS. A strong relationship was found between the BHK and HLS, grades, and children's self-evaluation. CONCLUSIONS AND RELEVANCE Both scales are recommended for occupational therapy practice worldwide. Further research should focus on developing standards and providing sensitivity studies. What This Article Adds: Both the HLS and the BHK are recommended for occupational therapy practice. Practitioners should also take the child's well-being into consideration in handwriting quality assessment.
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Affiliation(s)
- Lukáš Čunek
- Lukáš Čunek, Mgr, is Postgraduate Student, Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic;
| | - Jan Ondřej
- Jan Ondřej, Bc, is Student, Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic
| | - Ivana Blažíčková
- Ivana Blažíčková, Bc, is Student, Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic
| | - Veronika Pupíková
- Veronika Pupíková, Bc, is Student, Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic
| | - David Lacko
- David Lacko, Mgr, is Postgraduate Student, Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic, and Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | - Tomáš Prošek
- Tomáš Prošek, Mgr, is Postgraduate Student, Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic
| | - Katarína Šafárová
- Katarína Šafárová, PhD, is Postdoctoral Fellow, Institute of Psychology, Department of Research Methodology, The Czech Academy of Sciences, Brno, Czech Republic
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Gerth S, Festman J. Muscle Activity during Handwriting on a Tablet: An Electromyographic Analysis of the Writing Process in Children and Adults. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040748. [PMID: 37189997 DOI: 10.3390/children10040748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023]
Abstract
Handwriting is a complex task that includes planning the content and the execution of handwriting movements on paper or on a tool (e.g., a tablet). This execution depends on the involvement of specific muscles in the hand (distal) and arm (proximal). The present study combines the parallel recording of the writing process on tablets and the related muscle activity with electromyography to investigate the differences in handwriting movements in two groups. A total of 37 intermediate writers (third and fourth graders, mean age 9.6 years, SD 0.5) and 18 skilled adults (mean age 28.6 years, SD 5.5) participated in three handwriting tasks. The tablet data results replicate previous findings in handwriting research for the writing process. The muscle activity data reflected a differential relationship between distinct muscle activity and handwriting performance depending on the handwriting skill (intermediate or advanced writers). Furthermore, the combination of both methods revealed that skilled writers tend to involve rather distal muscles to control the pressure of the writing pen on the surface, whereas developing writers mainly use their proximal muscles to control the velocity of their handwriting movements. This research contributes to a deeper understanding of the underlying processes of handwriting and the development of efficient handwriting execution.
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Affiliation(s)
- Sabrina Gerth
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
| | - Julia Festman
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
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Lopez C, Vaivre-Douret L. Concurrent and Predictive Validity of a Cycloid Loops Copy Task to Assess Handwriting Disorders in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020305. [PMID: 36832434 PMCID: PMC9955141 DOI: 10.3390/children10020305] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023]
Abstract
Handwriting disorders (HDs) are mainly assessed using script or cursive handwriting tasks. The most common is the scale for children's handwriting, with a French adaptation (BHK). The present study aims to assess the concurrent validity of a pre-scriptural task (copying a line of cycloid loops) with the BHK for the diagnosis of HDs. Thirty-five primary school children (7 females, 28 males) with HD aged 6-11 years were recruited and compared to 331 typically developing children (TDC). Spatial/temporal/kinematic measures were collected using a digital pen on a paper. Posture and inter-segmental writing arm coordination were video recorded. A logistic regression statistical method, including a receiver-operating characteristic curve, was used to assess the ability of the task to predict HD. Gestural patterns were significantly less mature in HDs than in TDC (p < 0.05), and associated with poorer quality, less fluid, and slower drawing (p < 0.001). Moreover, good correlations between temporal and kinematic measures and the BHK scale were found. Number of strokes, total drawing time, in-air pauses times, and number of velocity peaks showed very good sensitivity (88%) and specificity (74%) to diagnose HDs. Consequently, the cycloid loops task is an easy, robust, and predictive tool for clinicians to identify HDs before the alphabet is mastered.
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Affiliation(s)
- Clémence Lopez
- Unit 1018-CESP, PsyDev/NTDA Team, National Institute of Health and Medical Research (INSERM), Faculty of Medicine, University of Paris-Saclay, UVSQ, 91190 Villejuif, France
| | - Laurence Vaivre-Douret
- Unit 1018-CESP, PsyDev/NTDA Team, National Institute of Health and Medical Research (INSERM), Faculty of Medicine, University of Paris-Saclay, UVSQ, 91190 Villejuif, France
- Faculty of Health, Department of Medicine Paris Descartes, Université Paris Cité, 75006 Paris, France
- University Institute of France (Institut Universitaire de France, IUF), CEDEX 5, 14032 Paris, France
- Department of Child Psychiatry, AP-HP Centre, Necker-Enfants Malades University Hospital, 75015 Paris, France
- Department of Endocrinology, IMAGINE Institute, Necker-Enfants Malades University Hospital, 75015 Paris, France
- Clinical Neurodevelopmental Phenotyping Hôpital Universitaire Necker-Enfants Malades, INSERM UMR 1018-CESP, “Neuro-Développement et Troubles des Apprentissages (NTDA)”, Carré Necker Porte N4, 149, rue de Sèvres, 75015 Paris, France
- Correspondence: ; Tel.: +33-(0)-144494014
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Frey A, Lessard A, Carchon I, Provasi J, Pulido L. Rhythmic training, literacy, and graphomotor skills in kindergarteners. Front Psychol 2022; 13:959534. [PMID: 36571064 PMCID: PMC9773882 DOI: 10.3389/fpsyg.2022.959534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction The aim of this manuscript is twofold: first, to investigate the relationship between rhythmic, phonological and graphomotor skills in kindergarten children; and second, to evaluate the possible impact of rhythmic training on the two other skills. Methods To that end, we selected a sample of 78 children in Québec. Forty-two children received rhythmic training (experimental group) and 34 arts training (active control group) during the same period (10 weeks). Before and after training, children in both groups were assessed for general skills (forward and backward memory span, vocabulary, non-verbal ability), rhythmic skills (synchronization and discrimination tasks), literacy skills (phonological skills - syllable counting, syllable deletion, rhyme discrimination - and invented spelling skills) and graphomotor skills (legibility of letter writing, quality of copying of geometric shapes). Results Results showed correlations between the child's rhythmic and literacy skills, as well as between rhythm synchronization and pen pressure. In addition, rhythmic training showed improvement in rhythmic abilities, but this did not transfer to literacy or graphomotor development (apart from a significant increase in the duration of pauses in both groups at post-test, with a larger improvement for the rhythm group). Discussion These results are discussed in terms of duration and intensity of learning, and they highlight the possible benefits of informal rhythm practices in the classroom.
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Affiliation(s)
- Aline Frey
- Laboratoire de Neurosciences Cognitives, UMR 7291, CNRS – INSPE de l’Université d’Aix-Marseille, Marseille, France,*Correspondence: Aline Frey,
| | - Andrée Lessard
- Département des sciences de l’éducation, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada,Centre de recherche interuniversitaire sur la formation et la profession enseignante (CRIFPE), Montréal, QC, Canada,Consortium régional de recherche en éducation (CRRE), Saguenay, QC, Canada,Observatoire interdisciplinaire de création et de recherche en musique, Université Laval (OICRM-ULaval), Québec, QC, Canada
| | - Isabelle Carchon
- Laboratoire CHArt, Cognitions Humaine et ARTificielle, EPHE - PSL, École Pratique des Hautes Études - Paris Sciences Lettres, Campus Condorcet, Aubervilliers, France
| | - Joëlle Provasi
- Laboratoire CHArt, Cognitions Humaine et ARTificielle, EPHE - PSL, École Pratique des Hautes Études - Paris Sciences Lettres, Campus Condorcet, Aubervilliers, France
| | - Loïc Pulido
- Consortium Régional de Recherche en Éducation (CRRE) et département des sciences de l’éducation, Université du Québec à Chicoutimi, Saguenay, QC, Canada,Centre de Recherche et d’Intervention sur la Réussite Scolaire (CRIRES), Université Laval, Québec, QC, Canada
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Bondi D, Robazza C, Lange-Küttner C, Pietrangelo T. Fine motor skills and motor control networking in developmental age. Am J Hum Biol 2022; 34:e23758. [PMID: 35613316 PMCID: PMC9541226 DOI: 10.1002/ajhb.23758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 04/30/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives We investigated the relationships between fine motor skills, fitness, anthropometrics, gender and perceived motor performance in school beginners. The aim of our study was to delineate whether and to what extent fine motor control would show meaningful synchrony with other motor variables in the age of onset of handwriting in school. Methods A sample of N = 239 of 6‐to‐8‐year‐old children were tested with an array of tasks measuring fine motor (i.e., dexterity and speed) and grapho‐motor performance (tracing on a tablet screen), anthropometric indexes, and fitness (shuttle run) measures. A subset of 95 children was also tested for perceived motor competence. Results In spite of an overall poor anthropometric condition, our participants were relatively fit. As expected, older children performed better in both, fine motor tasks and the shuttle test. The girls were better in fine motor skills, and an original speed‐quality trade‐off in the drawing was found. However, the magnitude of difference by grade was greater for boys' fine motor skills than those of girls'. A network analysis revealed three specific clusters, (1) perceived competencies, (2) fitness, and (3) fine motor skills. Conclusions Given the relative independence of these areas of physical performance, we suggest focusing on these three clusters as distinct areas of physical education. Fine motor skills deserve further consideration, especially at an early school age. We have demonstrated that network analysis and technology devices used to evaluate motor development are useful and meaningful tools.
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Affiliation(s)
- Danilo Bondi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Claudio Robazza
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Christiane Lange-Küttner
- Department of Psychology, University of Greifswald, Germany.,Department of Psychology, University of Bremen, Bremen, Land Bremen, Germany
| | - Tiziana Pietrangelo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
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Minoofam SAH, Bastanfard A, Keyvanpour MR. RALF: an adaptive reinforcement learning framework for teaching dyslexic students. MULTIMEDIA TOOLS AND APPLICATIONS 2022; 81:6389-6412. [PMID: 35035266 PMCID: PMC8744040 DOI: 10.1007/s11042-021-11806-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/09/2021] [Accepted: 12/14/2021] [Indexed: 05/07/2023]
Abstract
Dyslexia is a learning disorder in which individuals have significant reading difficulties. Previous studies found that using machine learning techniques in content supplements is vital in adapting the course concepts to the learners' educational level. However, to the best of our knowledge, no research objectively applied machine learning methods to adaptive content generation. This study introduces an adaptive reinforcement learning framework known as RALF through Cellular Learning Automata (CLA) to generate content automatically for students with dyslexia. At first, RALF generates online alphabet models as a simplified font. CLA structure learns each rule of character generation through the reinforcement learning cycle asynchronously. Second, Persian words are generated algorithmically. This process also considers each character's state to decide the alphabet cursiveness and the cells' response to the environment. Finally, RALF can generate long texts and sentences using the embedded word-formation algorithm. The spaces between words are proceeds through the CLA neighboring states. Besides, RALF provides word pronunciation and several exams and games to improve the learning performance of people with dyslexia. The proposed reinforcement learning tool enhances students' learning rate with dyslexia by almost 27% compared to the face-to-face approach. The findings of this research show the applicability of this approach in dyslexia treatment during Lockdown of COVID-19.
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Affiliation(s)
| | - Azam Bastanfard
- Department of Computer Engineering, Karaj Branch, Islamic Azad University, Karaj, Iran
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Lopez C, Vaivre-Douret L. Influence of visual control on the quality of graphic gesture in children with handwriting disorders. Sci Rep 2021; 11:23537. [PMID: 34876643 PMCID: PMC8651655 DOI: 10.1038/s41598-021-02969-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022] Open
Abstract
Handwriting disorders (HD) are considered one of the major public health problems among school-aged children worldwide with significant interference on academic performances. The current study hypothesized that HD could be partly explained by a deficit in sensory feedback processing during handwriting. To explore this hypothesis, we have analyzed the effect of vision suppression on postural-gestural and on spatial/temporal/kinematic organization of drawing during an early pre-scriptural loop task with a digital pen, under two conditions: eyes open and eyes closed. Data collected from 35 children with HD were compared to data collected from typical children (typical group) from primary schools. The HD group showed significantly poorer postural control and an improvement on the spatial/temporal/kinematic organization of drawings when they closed their eyes compared to eyes opened. While in the typical group, postural-gestural organization became significantly more mature but there was no significant influence found on spatial/temporal/kinematic parameters of the loops. Thus, handwriting disorders could be explained by both proprioceptive/kinesthetic feedback disabilities and a disruptive effect of the visual control on the quality of the pre-scriptural drawings among these children who have kinesthetic memory and visuospatial disabilities. The ability of directing the strokes would remain dependent on sensory feedbacks, themselves insufficiently efficient, which would lead to difficulties in reaching a proactive control of handwriting. This current research is a liable contribution to enhance clinical practice, useful in clinical decision-making processes for handwriting disorders remediation.
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Affiliation(s)
- Clémence Lopez
- Faculty of Society and Humanity, Department of Psychology, Université de Paris, Paris, France
- National Institute of Health and Medical Research (INSERM UMR 1018-CESP), Paris-Saclay, UVSQ, Villejuif and Necker-Enfants Malades University Hospital, Carré Necker Porte N4, 149, rue de Sèvres, 75015, Paris, France
| | - Laurence Vaivre-Douret
- National Institute of Health and Medical Research (INSERM UMR 1018-CESP), Paris-Saclay, UVSQ, Villejuif and Necker-Enfants Malades University Hospital, Carré Necker Porte N4, 149, rue de Sèvres, 75015, Paris, France.
- Faculty of Health, Department of Medicine, Université de Paris, Paris, France.
- Institut Universitaire de France (IUF), Paris, France.
- Necker-Enfants Malades University Hospital, AP-HP.Centre, Paris, France.
- Department of Paediatric Endocrinology, Imagine Institute, Necker-Enfants Malades University Hospital, Paris, France.
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Online Handwriting, Signature and Touch Dynamics: Tasks and Potential Applications in the Field of Security and Health. Cognit Comput 2021. [DOI: 10.1007/s12559-021-09938-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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