Graphomotor Intervention Program for Handwriting Difficulties Prevention in School-Age

March 26, 2020 updated by: Helena Isabel Falcão Coradinho, University of Évora

The Effects of a Graphomotor Intervention Program According to a Psychomotor Approach on Quality and Speed of Handwriting in School-Age Children: A Randomized Controlled Trial

12-30% of children present handwriting difficulties, which has negative repercussions on their school career. For this reason, it is fundamental to bet on their prevention. The aim of present study is to examine the effects of a graphomotor intervention program on quality and speed of handwriting in second-grade children. This experimental study is a randomized controlled trial. The program will run for 8 weeks (2 sessions/week of 30 minutes), followed by 6 months of follow-up without intervention. Participants will be assessed 1) at baseline, 2) at the end of the program, and 3) after the follow-up. Participants will be randomly allocated to two groups: experimental group (graphomotor intervention program) and control group.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

According to estimates (1), 30% to 60% of the school day is spent performing tasks involving handwriting. It is also in this period that the formal learning of handwriting begins (2). However, not all children are able to develop proficient handwriting (3-4).

According to Alhusaini, Melam and Buragadda (5) 12% to 30% of children present difficulties in handwriting, with negative consequences for school success (6).

Children who fail to develop proficient handwriting are entitled to "poor writers" or "dysgraphics" (7-8).

Dysgraphia refers to a "disturbance or difficulty in the production of written language related to the mechanics of writing" (9). Ajuriaguerra (8) defines it as a writing whose quality is deficient, without any neurological or intellectual deficit explaining it. Generally, handwriting is less legible and organized, contains more erasures and corrections, and exhibits a slower speed (9).

In addition, this is one of the main reasons for referral and consultation in psychomotricity in school-age (10), for this reason it is fundamental to bet on the prevention of them.

The need for prevention and early intervention is indisputable (11). Several studies indicate that both the benefits of late intervention are well-known, because the time is often difficult to correct handwriting difficulties (12-13).

Most of the existing studies focus on remediation of handwriting (14). There is evidence of its efficacy in handwriting improvement, depending on its duration, frequency and method of treatment (5, 7, 15).

There are few studies dedicated to the prevention of handwriting difficulties (14). In addition, to my knowledge, there is no study whose intervention is based on a psychomotor approach. Based on this, a graphomotor intervention program with a psychomotor approach was developed, by Matias and Vieira (16), who will apply in this study to children in the second grade of elementary school.

Study Type

Interventional

Enrollment (Actual)

47

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Portugal
      • Évora, Portugal, 7040
        • Helena Isabel Falcão Coradinho

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

7 years to 7 years (Child)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Children in the second grade (aged 7 years old);
  • Participation agreement;

Exclusion Criteria:

  • Diagnosed or suspected of neurological disabilities (e.g., cerebral palsy, epilepsy), psychiatric and/or behavioural disorders;
  • Presence of uncorrected vision and hearing problems;
  • Referenced by Special Education/National Service of Early Intervention in Childhood;
  • Presence of one or more school retentions;
  • Native language is not Portuguese;
  • Children with direct intervention in graphomotor skills or who had a similar intervention to that proposed less than 1 year ago;
  • Participation in the intervention program of less than 80%;
  • Children undergoing drug therapy (e.g., antihistamines) that interfere with the study variables;
  • Do not wish to participate in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Graphomotor intervention program
The experimental group (EG) intervention comprises a graphomotor intervention program according to a psychomotor approach. The program integrates two group sessions (6-8 children)/week of 30 minutes for 8 weeks (16 sessions).
Other: Graphomotor intervention program
The graphomotor intervention program aims to promote the development and reinforcement, different skills involved in the learning process of handwriting and has a preventive character. It follows a bodily, playful, multisensory, exploratory (sensory integration) and neuromotor task training approach and focuses on the following intervention domains: segmental awareness, passive relaxation, trunk-limb dissociation, interdigital coordination, attention, planning, spatial organization/orientation and perception.
No Intervention: Control Group
The control group (CG) participants will maintain their normal classroom activities. After the study, control group participants will be offered the opportunity to integrate a similar graphomotor intervention program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change from Baseline, between and within groups comparison, in Motor Performance
Time Frame: 0, 4, 10 months
Outcome Measure - Movement Assessment Battery for Children - Second Edition to assess manual dexterity, aiming and catching and balance
0, 4, 10 months
Change from Baseline, between and within groups comparison, in Computerized Handwriting Process Measures
Time Frame: 0, 4, 10 months
Outcome Measure - The MovAlyzeR to assess spatial, temporal and kinematic variables of handwriting
0, 4, 10 months
Change from Baseline, between and within groups comparison, in handwriting performance
Time Frame: 0, 4, 10 months
Outcome Measure - The Concise Assessment Scale for Children's Handwriting (BHK) to assess quality and speed of handwriting
0, 4, 10 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change from Baseline, between and within groups comparison, in Manual Preference
Time Frame: 0, 4, 10 months
Outcome Measure - Manual Preference Questionnaire to assess manual preference
0, 4, 10 months
Sociodemographic characteristics
Time Frame: 0 months
The Sociodemographic Questionnaire collects data on the identification of the child, the parents, the sociodemographic context and the socioeconomic status of the family based on the Graffar Social Classification Scale Adapted
0 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Évora

Investigators

  • Principal Investigator: Helena IF Coradinho, MSc

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 15, 2018

Primary Completion (Actual)

December 31, 2019

Study Completion (Actual)

December 31, 2019

Study Registration Dates

First Submitted

October 5, 2018

First Submitted That Met QC Criteria

October 5, 2018

First Posted (Actual)

October 9, 2018

Study Record Updates

Last Update Posted (Actual)

March 27, 2020

Last Update Submitted That Met QC Criteria

March 26, 2020

Last Verified

March 1, 2020

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 06102018

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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