US GRANT KITS

Deficits in Visual-Perceptual Skills. Children with visual-perceptual problems may have a history of reading problems because of difficulty with letter and word recognition. In addition, if a child cannot accurately visually discriminate the letter b from the letter d, he/she will be unable to reliably reproduce these letters upon demand. If students have problems with visual closure, they may have difficulty with accurate letter formation and handwriting legibility may be poor. For example, they may print the letter o with a space in the top, but perceive the letter as closed. When deficits in visual-perceptual skills are suspected, they can be readily identified by informal or standardized tests.

Deficits in Orthographic Coding. Students who have trouble with orthographic coding will often forget how to form certain letters in the middle of a writing task. They frequently retrace letters or exhibit false starts or hesitancies as they write. Observations of their written output may show that they have formed the same letter several different ways. When asked, these students can usually report if they have difficulty remembering what letters look like. Children who cannot reliably make use of visual recall to form letters and words often prefer to print rather than write in cursive because print involves only twenty-six different visual letter patterns, whereas letters written in cursive have a seemingly endless number of visual patterns. Their spelling errors may be phonetic in nature (Levine, 1987, 1994).

Deficits in Motor Planning and Execution. Poor motor planning and execution is referred to as dyspraxia. Deuel and Doar (1992) define dyspraxia as the "inability to learn or perform serial voluntary movements with the proficiency expected for age and/or verbal intelligence" (pg. 100). Helmer and Myklebust (1965) discuss the role that memory for motor sequences play in correctly forming letters when writing. Luria (1966) described two forms of dyspraxia. The first form involves difficulty in creating an image of a required motor movement. The second involves a breakdown in the central nervous system mechanism that is responsible for putting the plan into action. Thus, the child has the blueprint for the action/behavior, but has difficulty implementing it motorically (Levine, 1987).

Ayres (1972, 1975, 1985) suggested that the problem in developmental dyspraxia is in the neural activity that takes place prior to motor execution. According to Ayres, dyspraxia is generally viewed as an output problem because the motor component is more observable than the sensory component. However, in her view, dyspraxia is an inability to integrate sensory and motor information, rather than merely motor production.

Children who suffer from fine motor dyspraxia show poor motor coordination. At times, they assign too many muscles to stabilizing the pencil or pen and too few muscles to mobilizing it. At other times, they assign too many muscles to mobilizing the writing utensil and too few muscles to stabilizing it. Thus, their pencil grips are often inefficient. They may develop a hooked grip in which they stretch out the tendons in the back of the arm so that the fingers move very little if at all during writing. With this grip, they are using the larger muscles of the wrist and forearm which may be easier to control than the smaller muscles in the fingers. They often perform poorly with other fine motor tasks that involve coordinated motor movements such as tying shoes or holding a fork correctly (Levine, 1987).

• Another pencil grip which suggests fine motor dyspraxia is one in which the child holds the pencil very tightly and near the point when writing. Further, students with dyspraxia often change pencil grips and prefer writing in cursive rather than print. They do not like to write and complain that their hand hurts when they write. Writing for them is a labor-intensive task. Fine motor dyspraxia is frequently associated with speech production problems because these children often have difficulty assigning the muscles in the mouth to specific speech sounds (Levine, 1987, 1994).
• Impaired Kinesthetic Feedback. Children with impaired kinesthetic feedback often develop a fist-like grip of the writing instrument. With this grip, they extend their thumb over the index and middle finger, limiting the mobility of the fingers. They may also press very hard on the paper with the writing utensil in an attempt to compensate for the lack of kinesthetic feedback. Further, they may look closely at the pencil or pen when writing thus attempting to guide the hand using visual feedback which is a much slower process. This is why children with impaired kinesthetic feedback may produce legible handwriting at a greatly reduced pace. As they progress in school, however, the demands placed on written output are too great and legibility deteriorates. These are the children who are often accused of writing neatly "when they want to". They also often prefer to use mechanical pencils and "scratchy" pens because these provide more friction on the paper when writing. They complain that their hand hurts when writing and they do not like to write. Performance in other fine motor skills may be adequate or good because many fine motor skills do not place such reliance on kinesthetic feedback.
• Research has shown that tasks which were designed to improve kinesthetic sensitivity improved handwriting performance more than a task that involved only practice in handwriting (Harris and Livesay, 1991).

Deficits in Visual-Motor Coordination. Children with visual-motor incoordination function much differently than those with impaired kinesthetic feedback because of the different demands of certain motor tasks. Poor visual-motor integration may lead to problems with fine motor tasks that rely heavily on visual feedback. These include threading a needle, drawing, painting, craftwork, building things with blocks, repairing things, playing games such as Nintendo and using a mouse on a computer.

• Complete references are available at: http://www.cdl.org/resource-library/articles/graphomotor.php?type=subject&id=45 DESCRIPTION OF GRAPHOMOTOR SKILLS