04 SES 10 C, Innovative Approaches To Training And Diagnosis In The Special Area
Reading and writing are fundamental skills to participate in society and education. Furthermore, reading and writing are crucial skills for academic achievement and success in the workplace. Automated handwriting allows children to express their knowledge and thoughts (Berninger & Winn, 2006; Fears & Lockmann, 2018; Puranik & Al Otaiba, 2012; Weintraub et al., 2009). Despite technological advances, handwriting remains indispensable. The legibility and orthography of handwriting and the speed of handwriting (graphomotor coordination) were shown to meaningfully impact grading, text length, and the quality of the content of the text (Graham et al., 2011; Hayes, 2012; Santangelo & Graham, 2016).
No less than 30 to 60% of daily classroom activities in first grade involve fine motor and graphomotor skills (McHale & Cermak, 1992). Not surprisingly, for children with difficulties in fine and graphomotor skills, the transition to school is often exhausting and frustrating. Moreover, difficulties in handwriting may negatively impact motivation, self-confidence, and academic achievement (Conelly et al., 2005; Christensen, 2005; Eckhart & Sägesser, 2016; Malloy-Miller et al., 1995). Therefore, it is crucial to identify children with graphomotor difficulties early on and to develop adequate interventions.
To approach this aim, Sägesser and Eckhart (2016) developed at Bern University of Teacher Education (PHBern) the graphomotor diagnostic instrument “GRAFOS”. Embedded in a cover story, the GRAFOS allows measuring child appropriately the graphomotor skills of kindergarten and early primary school children. The instrument involves three different parts: A screening, a systematic observation, and a differential diagnosis. The screening was developed for children aged 4;8 to 8;6 and measures the relevant predictors of handwriting, namely fine motor skills and visuomotor integration. In the screening, children are asked to copy eight basic handwriting elements (e.g., stroke, square, triangle, circle). The copies' accuracy is scored according to specific set criteria and then compared to age-adjusted norms. The screening's reliability and validity is high (Sägesser & Eckhart, 2016). By analysing only the product of writing, not all graphomotor difficulties can be detected. Consequently, the processes during copying, such as the coordination of writing movements, are additionally observed and documented in the observation sheet. The third part of the GRAFOS, the differential diagnosis, is applied individually to those children who showed difficulties in the screening and/or the observation sheet. The differential diagnosis provides an in-depth analysis of children’s graphomotor development and allows to intervene in central domains. The differential diagnosis showed high validity and reliability and was evaluated based on more than one hundred children with stated graphomotor difficulties.
The instrument GRAFOS is well-established in German-speaking schools in Switzerland. The instrument’s multi-professional approach is highly appreciated also because it promotes collaboration between the different education teams in schools working with the children. However, as the GRAFOS was primarily designed to identify children with poor graphomotor skills, the items to be copied were rather too easy for older children and children with better graphomotor skills. To overcome this ceiling effect and better detect individual differences in older children aged 7–8, we aimed to extend the GRAFOS instrument by including more difficult items. Moreover, by including more complex items, we will also be better able to differentiate individual performance in visual-motor integration. Visual-motor integration was repeatedly found to play a crucial role for school readiness and academic achievement (e.g., Cameron et al., 2012; Carlson et al., 2013). Finally, as also practitioners requested an extension of the screening instrument to use in first and second graders, we decided to extend and evaluate the GRAFOS screening.
In line with the theoretical conceptualization of the GRAFOS, the extension aims to measure visual-motor integration (shape) and fine motor skills (stroke). However, a factor analysis indicated that the two factors, shape and stroke, could not clearly be separated (Sägesser & Eckhart, 2016, 54). As the factor stroke is assumed to be comparatively less useful in the school context, the extension focuses solely on the factor shape. Nevertheless, fine motor skills are still being measured as the copied shapes are small and should therefore involve fine motor movements. Following the drawing trajectory (e.g., Beery et al., 2010), our aim was to include and evaluate five additional, more complex shapes in the GRAFOS screening, specifically a lying eight, two connected loops, the shape of a fish, and a vertical and a horizontal rhomb. We evaluated these additional shapes of the extension of the GRAFOS as well as the already existing shapes in a sample of 460 first and second-grade children. The children's mean age was 7 years 6 months (range = 6;1–9;9, SD = 8.9 months, 48.8 % girls). We investigated the criterion validity of the extended screening with a valid external criterion measuring visual-motor integration, namely the Beery-Buktenica Developmental Test of Visual-Motor-Integration (Beery VMI; Beery et al. 2010). To investigate reliability, we investigated both the interrater reliability as well as the internal consistency of the additional shapes of the extension. We calculated a linear regression analysis to model the relationship between age and performance on visual-motor integration and graphomotor skills. Furthermore, we analysed each shape's item difficulty to test whether the shapes that are part of the extension were more difficult to copy for the children.
Data analyses on the five additional shapes of the newly developed extension of the GRAFOS generally revealed promising results. Criterion validity was investigated by testing bivariate correlations between performance on the GRAFOS screening and the Beery VMI test. The results revealed a correlation coefficient of r = .62 (p < .001), indicating satisfactory validity. It is not surprising that the correlation coefficient is not closer to 1. The shapes of the GRAFOS are substantially smaller. Therefore, copying likely required fine motor skills more strongly than copying the bigger shapes of the Beery VMI test. Furthermore, interrater agreement on the scoring of the copied shapes revealed an interrater reliability of Κ = .66 (n = 262), indicating acceptable to good reliability. The internal consistency across the eight original shapes and the five shapes of the extension revealed a coefficient of α = .78, which is good. Importantly, we aimed to increase the shapes' difficulty by including additional, more complex shapes. The calculated item difficulties of the five new shapes varied between .29 and .54, indicating that children achieved on average between 29 and 54% of the maximal score in the five new, more complex shapes. In contrast, item accuracies of the eight original shapes varied between 73 and 86%. In line with our expectations, these findings suggest that the extension's additional items are indeed more difficult to copy. Taken together, by including those additional, more challenging shapes, we successfully increased not only the difficulty of the shapes but also statistical variance, which allows a more fine-grained picture of individual performance differences in older children and those with better developed graphomotor and visual-motor integration skills. Besides, we will evaluate the newly developed GRAFOS comprehensively in an extensive data collection starting in autumn 2021.
Berninger, V. W., & Winn, W. D. (2006). Implications and Advancements in Brain Research and Technology for Writing Development, Writing Instruction and Educational Evolution. In S. Graham & J. Fitzgerald (Eds.), Handbook of Writing Research (pp. 96-114). New York / London: Guilford Press. Carlson, A. G., Rowe, E. W., & Curby, T. W. (2013). Disentangling fine motor skills’ relation to academic achievement: The differential impact of visual-spatial integration and visual motor coordination. Journal of Genetic Psychology, 175(5), 514–533. Cameron, C. E., Brock, L. L., Murrah, W. M., Bell, L. H., Worzalla, S. L., Grissmer, D., & Morrison, F. J. (2012). Fine motor skills and executive function both contribute to kindergarten achievement. Child Development, 83(4), 1229–1244. Connelly, V., Dockrell, J. E., & Barnett, J. (2005). The slow handwriting of undergraduate students constrains overall performance in exam essays. Educational Psychology, 25(1), 99-107. Christensen, C. A. (2005). The Role of Orthographic–Motor Integration in the Production of Creative and Well‐Structured Written Text for Students in Secondary School. Educational Psychology, 25(5), 441-453. Eckhart, M., & Sägesser, J. (2016). Förderplanung im Unterricht - Exemplarische Umsetzung am Beispiel der Grafomotorik. Schweizerische Zeitschrift für Heilpädagogik, 2, 13-19. Fears, N.E., & Lockman, J.J. (2018). How beginning handwriting is influenced by letter knowledge: Visual-motor coordination during children’s form copying. Journal of Experimental Child Psychology, 171, 55-70. Graham, S., Harris, K., & Hebert, M. (2011). Informing Writing: The Benefits of Formative Assessment. A Carnegie Corporation Time Act report. Washington, DC: Alliance for Excellent Education. Hayes, J.R. (2012). My past and present as writing researcher and thoughts about the future of writing research. In V. Berninger (Ed.), Past, Present, and Future Contributions of Cognitive Writing Research to Cognitive Psychology (pp. 3-26). New York: Psychology press. Malloy-Miller, T., Polatajko, H.J., & Anstett, B. (1995). Handwriting Error Patterns of Children with Mild Motor Difficulties. Canadian Journal of Occupational Therapy, 62(5), 258-267. Puranik, C.S., & AlOtaiba, S. (2012). Examining the Contribution of Handwriting and Spelling to Written Expression in Kindergarten Children. Reading and Writing: An Interdisciplinary Journal, 25(7), 1523-1546. Sägesser, J., & Eckhart, M. (2016). GRAFOS. Screening und Differentialdiagnostik der Grafomotorik im schulischen Kontext. Bern: Hogrefe. Santangelo, T., & Graham, S. (2016). A Comprehensive Meta-analysis of Handwriting Instruction. Educational Psychology Review, 28(2), 225-265. Weintraub, N., Yinon, M., Hirsch, I. B. E., & Parush, S. (2009). Effectiveness of Sensorimotor and Task-Oriented Handwriting Intervention in Elementary School-Aged Students with Handwriting Difficulties. OTJR: Occupation, Participation and Health, 29(3), 125-134.
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