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George B, Aswathymana Raju J, Mundappaliyil Leela L, Appukkuttan Omana M, Bhaskaran D, Saradamma R, Sarasamma L, Madhavan Amrutha L, Kunjumon R, Indiradevi L, Mahendran P. Development and Validation of a Tool for Assessing Pre-Writing Skills of 2-5 y old Children. Indian J Pediatr 2024; 91:1014-1020. [PMID: 37725329 DOI: 10.1007/s12098-023-04776-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/23/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVES To develop a tool to assess pre-writing skills of 2-5 y old children in India. METHODS The tool development process followed the recommendations by Fitzpatrick et al. and the Consensus based Standards for the selection of health Measurement Instruments (COSMIN), and included 4 phases. In Phase I, an initial 35-item draft tool was developed by an expert panel for the tool-development. In Phase II, the 35-item draft tool was prevalidated through peer and expert reviews, pilot-study to assess the tool-comprehensibility, and assessment of test-retest and inter-rater reliability. In Phase III, the 35-item draft tool was administered on the 575 typically developing children aged 2-5 y, recruited from rural, urban, slum, and coastal areas through stratified random sampling. In Phase IV, the normative age-range for development of each item was generated by calculating the age-percentiles (10th, 25th, 50th, 75th, 90th). Factor analysis and item reduction was done for items in 2-3, 3-4, and 4-5 y age-groups. The final tool was converted to graphic format with 10th-90th age-percentile bars. RESULTS The final tool had 26 items with a three-factor structure. Cronbach's alpha was within acceptable limits for all three age-groups (0.723, 0.778, and 0.823 in 2-3 y, 3-4 y, and 4-5 y respectively). Kappa coefficients of the items ranged from 0.6-1 in interrater reliability and 0.64-1 test-retest reliability analysis reflecting substantial agreement between ratings. CONCLUSIONS A 26-item screening tool "Prewriting skills Assessment Tool" (PAT) to assess writing readiness of 2-5 y old children was developed. Tool reliability and construct validity have been established.
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Affiliation(s)
- Babu George
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India
| | - Jubyraj Aswathymana Raju
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India
| | - Leena Mundappaliyil Leela
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India
| | - Mini Appukkuttan Omana
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India
| | - Deepa Bhaskaran
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India.
| | - Remadevi Saradamma
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India
| | - Letha Sarasamma
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India
| | - Lekshmi Madhavan Amrutha
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India
| | - Reshma Kunjumon
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India
| | - Lalikumari Indiradevi
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India
| | - Preema Mahendran
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India
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Vico R, Martín J, González M. Functional Assessment of Handwriting Among Children: A Systematic Review of the Psychometric Properties. Am J Occup Ther 2023; 77:7705205050. [PMID: 37877571 DOI: 10.5014/ajot.2023.050174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
IMPORTANCE Handwriting legibility and speed assessments have a critical role in identifying and evaluating handwriting problems, which are common among children. OBJECTIVE The objective was to evaluate the psychometric properties and clinical utility of handwriting assessments for children ages 3 to 16 yr. DATA SOURCES A systematic review was conducted in CINAHL, PubMed (MEDLINE), Scopus, and education databases, with no time limits. The search strategy included a combination of the following keywords: handwriting, write, children, assessment, and validity. The exclusion criteria were assessment tools that were electronic, that focused on cognitive components of handwriting, or that only evaluated alphabets other than Latin. STUDY SELECTION AND DATA COLLECTION The systematic review was carried out on the basis of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The protocol was registered in the Prospective Register of Systematic Reviews (PROSPERO). FINDINGS The 14 included instruments had a total sample of 4,987 children. Internal consistency ranged from moderate (.73; Writing Readiness Inventory Tool in Context) to high (.98; Letter Writing). The interexaminer reliability values of the 11 direct assessment instruments ranged from .77 (Systematic Screening for Handwriting Difficulties) to 1.00 (Handwriting Speed Test). CONCLUSIONS AND RELEVANCE In this systematic review, existing tools were evaluated by clinical utility and the quality of psychometric properties. Direct assessments showed good psychometric properties. Indirect and self-assessment tools demonstrated poor psychometric properties. Further research on screening tools and tools in other languages is needed. What This Article Adds: Specific learning disorders (e.g., dysgraphia) negatively affect academic learning and, when prolonged in time, self-concept. However, handwriting legibility and speed assessments could be used to identify and evaluate these learning disorders if an early referral to occupational therapy is carried out.
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Affiliation(s)
- Rocío Vico
- Rocío Vico, OTD, OTR/L, is PhD Candidate, Department of Physiotherapy, University of Malaga, Malaga, Andalucía, Spain, and Occupational Therapist, Department of Occupational Therapy, Hospital Juan Ramón Jiménez, Andalusian Public Health Service, Huelva, Andalucía, Spain
| | - Jaime Martín
- Jaime Martín, PhD, is Assistant Professor, Department of Human Anatomy, Legal and Forensic Medicine Area, University of Malaga, Malaga, Andalucía, Spain, and Researcher, Malaga Institute of Biomedical Research, Malaga, Andalucía, Spain;
| | - Manuel González
- Manuel González, PhD, is Associate Professor, Department of Physiotherapy, University of Malaga, Malaga, Andalucía, Spain, and Researcher, Malaga Institute of Biomedical Research, Malaga, Andalucía, Spain
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Delgado P, Melo F, de Vries L, Hartingsveldt M, Matias AR. Translation, Cross-Cultural Adaptation, and Psychometric Properties of Writing Readiness Inventory Tool in Context (WRITIC). CHILDREN 2023; 10:children10030559. [PMID: 36980119 PMCID: PMC10047591 DOI: 10.3390/children10030559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023]
Abstract
This article describes the translation and cultural adaptation process of the WRITIC (Writing Readiness Inventory Tool in Context) into European Portuguese. We examined the content and convergent validity, test-retest, and interrater reliability on the norm-referenced subdomain of the Portuguese (PT) WRITIC Task Performance (TP). To establish content validity, we consulted six experts in handwriting. Internal consistency was found with 70 children, test-retest reliability with 65, inter-rater reliability with 69, and convergent validity with 87. All participants were typically developing kindergarten children. Convergent validity was examined with the Beery–Buktenica Developmental Test of Visual-Motor Integration (Beery™VMI-6) and the Nine Hole Peg-Test (9-HPT). On content validity, we found an agreement of 93%, a good internal consistency with Cronbach’s alpha of 0.72, and an excellent test-retest and inter-rater reliability with ICCs of 0.88 and 0.93. Correlations with Beery™VMI-6 and 9-HPT were moderate (r from 0.39 to 0.65). Translation and cross-cultural adaptation of WRITIC into European Portuguese was successful. WRITIC-PT-TP is stable over time and between raters; it has excellent internal consistency and moderate correlations with Beery™VMI-6 and 9-HPT. This analysis of the European Portuguese version of WRITIC gives us the confidence to start the implementation process of WRITIC-PT in Portugal.
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Affiliation(s)
- Paulo Delgado
- Comprehensive Health Research Centre (CHRC), Department of Sport and Health, School of Health and Human Development, University of Évora, 7004-516 Évora, Portugal;
| | - Filipe Melo
- Comprehensive Health Research Centre (CHRC), Faculty of Human Kinetics, University of Lisbon, 1649-004 Lisbon, Portugal;
| | - Liesbeth de Vries
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1000 CC Amsterdam, The Netherlands;
- Occupational Therapy Programme, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
| | - Margo Hartingsveldt
- Occupational Therapy Programme, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- Correspondence: (M.H.); (A.R.M.)
| | - Ana Rita Matias
- Comprehensive Health Research Centre (CHRC), Department of Sport and Health, School of Health and Human Development, University of Évora, 7004-516 Évora, Portugal;
- Correspondence: (M.H.); (A.R.M.)
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Haberfehlner H, de Vries L, Cup EHC, de Groot IJM, Nijhuis-van der Sanden MWG, van Hartingsveldt MJ. Ready for handwriting? A reference data study on handwriting readiness assessments. PLoS One 2023; 18:e0282497. [PMID: 36867627 PMCID: PMC9983835 DOI: 10.1371/journal.pone.0282497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/16/2023] [Indexed: 03/04/2023] Open
Abstract
INTRODUCTION Early evaluation of writing readiness is essential to predict and prevent handwriting difficulties and its negative influences on school occupations. An occupation-based measurement for kindergarten children has been previously developed: Writing Readiness Inventory Tool In Context (WRITIC). In addition, to assess fine motor coordination two tests are frequently used in children with handwriting difficulties: the modified Timed Test of In-Hand Manipulation (Timed TIHM) and the Nine-Hole Peg Test (9-HPT). However, no Dutch reference data are available. AIM To provide reference data for (1) WRITIC, (2) Timed-TIHM and (3) 9-HPT for handwriting readiness assessment in kindergarten children. METHODS Three hundred and seventy-four children from Dutch kindergartens in the age of 5 to 6.5 years (5.6±0.4 years, 190 boys/184 girls) participated in the study. Children were recruited at Dutch kindergartens. Full classes of the last year were tested, children were excluded if there was a medical diagnosis such as a visual, auditory, motor or intellectual impairment that hinder handwriting performance. Descriptive statistics and percentiles scores were calculated. The score of the WRITIC (possible score 0-48 points) and the performance time on the Timed-TIHM and 9-HPT are classified as percentile scores lower than the 15th percentile to distinguish low performance from adequate performance. The percentile scores can be used to identify children that are possibly at risk developing handwriting difficulties in first grade. RESULTS WRITIC scores ranged from 23 to 48 (41±4.4), Timed-TIHM ranged from 17.9 to 64.5 seconds (31.4± 7.4 seconds) and 9-HPT ranged from 18.2 to 48.3 seconds (28.4± 5.4). A WRITIC score between 0-36, a performance time of more than 39.6 seconds on the Timed-TIHM and more than 33.8 seconds on the 9-HPT were classified as low performance. CONCLUSION The reference data of the WRITIC allow to assess which children are possibly at risk developing handwriting difficulties.
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Affiliation(s)
- Helga Haberfehlner
- Department of Rehabilitation Sciences, KU Leuven, Campus Bruges, Bruges, Belgium
| | - Liesbeth de Vries
- Research Group Occupational Therapy, Urban Vitality, Centre of Expertise, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Occupational Therapy Programme, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Edith H. C. Cup
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Imelda J. M. de Groot
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Margo J. van Hartingsveldt
- Research Group Occupational Therapy, Urban Vitality, Centre of Expertise, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- * E-mail:
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Kaelin VC, van Hartingsveldt M, Gantschnig BE, Fisher AG. Are the school version of the assessment of motor and process skills measures valid for German-speaking children? Scand J Occup Ther 2018; 26:149-155. [PMID: 29293031 DOI: 10.1080/11038128.2017.1397190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND There are no validated assessment tools for evaluating quality of schoolwork task performance of children living in German-speaking Europe (GSE). OBJECTIVE To determine whether the international age-normative means of the School Version of the Assessment of Motor and Process Skills (School AMPS) are valid for use in GSE. METHODS The participants were 159 typically-developing children, 3-12 years, from GSE. We examined the proportions of School AMPS measures falling within ±2 standard deviation (SD) of the international age-normative means, and evaluated for significant group differences (p < 0.05) in mean School AMPS measures between the GSE sample and the international age-normative sample using one-sample Z tests. When significant mean differences were found, we evaluated if the differences were clinically meaningful. RESULTS At least 95% of the GSE School AMPS measures fell within ±2 SD of the international age-normative means for the School AMPS. The only significant mean differences were for 6- (p < 0.01) and 8-year-olds (p = 0.02), and only the 6-year-old school process mean difference was clinically meaningful. CONCLUSIONS Because the only identified clinically meaningful difference was associated with likely scoring error of one rater, the international age-normative means of the School AMPS appear to be valid for use with children in GSE.
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Affiliation(s)
- Vera C Kaelin
- a School of Health Professions , Institute of Occupational Therapy, Zurich University of Applied Sciences , Winterthur , Switzerland
| | - Margo van Hartingsveldt
- b Department of Occupational Therapy, ACHIEVE Center of Expertise, Faculty of Health , Amsterdam University of Applied Sciences , Amsterdam , The Netherlands
| | - Brigitte E Gantschnig
- a School of Health Professions , Institute of Occupational Therapy, Zurich University of Applied Sciences , Winterthur , Switzerland.,c Department of Rheumatology, Immunology and Allergology , University Hospital (Inselspital), and University of Bern Switzerland , Bern , Switzerland
| | - Anne G Fisher
- d Division of Occupational Therapy, Department of Community Medicine and Rehabilitation , Umeå University , Umeå , Sweden.,e Department of Occupational Therapy, College of Health and Human Services , Colorado State University , Fort Collins , CO , USA
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de Vries L, van Hartingsveldt MJ, Cup EHC, Nijhuis-van der Sanden MWG, de Groot IJM. Evaluating fine motor coordination in children who are not ready for handwriting: which test should we take? Occup Ther Int 2015; 22:61-70. [PMID: 25706348 DOI: 10.1002/oti.1385] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 12/19/2014] [Accepted: 01/12/2015] [Indexed: 11/08/2022] Open
Abstract
When children are not ready to write, assessment of fine motor coordination may be indicated. The purpose of this study was to evaluate which fine motor test, the Nine-Hole Peg Test (9-HPT) or the newly developed Timed Test of In-Hand Manipulation (Timed-TIHM), correlates best with handwriting readiness as measured by the Writing Readiness Inventory Tool In Context-Task Performance (WRITIC-TP). From the 119 participating children, 43 were poor performers. Convergent validity of the 9-HPT and Timed-TIHM with WRITIC-TP was determined, and test-retest reliability of the Timed-TIHM was examined in 59 children. The results showed that correlations of the 9-HPT and Timed-TIHM with the WRITIC-TP were similar (rs = -0.40). The 9-HPT and the complex rotation subtask of the Timed-TIHM had a low correlation with the WRITIC-TP in poor performers (rs = -0.30 and -0.32 respectively). Test-retest reliability of the Timed-TIHM was significant (Intraclass Correlation Coefficient = 0.71). Neither of these two fine motor tests is appeared superior. They both relate to different aspects of fine motor performance. One of the limitations of the methodology was unequal numbers of children in subgroups. It is recommended that further research is indicated to evaluate the relation between development of fine motor coordination and handwriting proficiency, on the Timed-TIHM in different age groups.
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Affiliation(s)
- Liesbeth de Vries
- Center for Rehabilitation, University of Groningen, University Medical Center Groningen, CD 35, Dilgtweg 5, 9751 NJ, Haren, The Netherlands
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