Volume 04 Issue 03-2022
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The American Journal of Social Science and Education Innovations
(ISSN
–
2689-100x)
VOLUME
04
I
SSUE
03
Pages:
19-32
SJIF
I
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FACTOR
(2020:
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525
)
(2021:
5.
857
)
(2022:
6.
397
)
OCLC
–
1121105668
METADATA
IF
–
8.106
Publisher:
The USA Journals
ABSTRACT
The present study focuses on psychomotor development disorders of a 5.9-year-old child early diagnosed with Specific
Learning Disorder. Data analysis indicated the occurrence of psychomotor disorders in coexistence with other
cognitive and language difficulties of case A. Regarding the psychomotor development, main difficulties were
recorded in the fields of div shape, spatiotemporal orientation, left-right discrimination, and visual-motor
coordination. The ABA single-subject research design was applied. In the baseline phase (A), difficulties were revealed
in specific psychomotor skills (dependent variable), which were treated assigned to a well-adjusted 4-month
Research Article
PSYCHOMOTOR DEVELOPMENT DISORDERS IN THE EARLY
DIAGNOSIS AND INTERVENTION IN SPECIFIC LEARNING DISORDER.
A CASE STUDY
Submission Date:
February 21, 2022,
Accepted Date:
March 08, 2022,
Published Date:
March 20, 2022 |
Crossref doi:
https://doi.org/10.37547/tajssei/Volume04Issue03-03
V. Zakopoulou
Department of Speech and Language Therapy, Laboratory of New Approaches in Communication
Disorders, University of Ioannina, Ioannina, Greece
P. Christodoulides
Department of Speech and Language Therapy, Laboratory of New Approaches in Communication
Disorders, University of Ioannina, Ioannina, Greece
V. Koutsobina
Department of Psychology, School of Social Sciences, University of Ioannina, Ioannina, Greece
N. Anagnostou
Department of Physical Education & Sport Science, Aristotle University οf Thessaloniki, Thessaloniki,
Greece
M. Vergou
Department of Preschool Education, University of Ioannina, Ioannina, Greece
D. Sarris
Department of Preschool Education, University of Ioannina, Ioannina, Greece
Journal
Website:
https://theamericanjou
rnals.com/index.php/ta
jssei
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 04 Issue 03-2022
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The American Journal of Social Science and Education Innovations
(ISSN
–
2689-100x)
VOLUME
04
I
SSUE
03
Pages:
19-32
SJIF
I
MPACT
FACTOR
(2020:
5.
525
)
(2021:
5.
857
)
(2022:
6.
397
)
OCLC
–
1121105668
METADATA
IF
–
8.106
Publisher:
The USA Journals
intervention program (phase B), and successfully decreased. This variation led to the withdrawal of the intervention’s
implementation (phase A), while in the final assessment after 4 months, the case recorded high performance,
indicating steadily minimized difficulties, and thus emphasizing the effect of the psychomotor skills. A thorough
interpretation of the results sheds light on the significant role of psychomotor development both in the early
occurrence and in the intervention of SLD. Overall, our findings suggest that further and more targeted research is
needed to investigate the complex and strong interactions that arise early between the components of SLD structure,
such as neurobiological, cognitive, linguistic, and psychomotor.
KEYWORDS
Specific Learning Disorder; multifactor approach; early diagnosis; early intervention; psychomotor disorders; single-
subject research design.
INTRODUCTION
The term ‘Specific Developmental Learning Difficulties’
describes a wide range of weaknesses in the procedure
of learning, composing the clinical profile of Specific
Learning Disorder (SLD) (APA, 2013). They vary among
individuals and may affect different skills, such as
reading, writing, and/or math.
Early diagnosis and intervention in SLD are considered
essential and crucial (Pennington & Lefty, 2001). It is
pointed out that if SLD children attend appropriate
retraining programs since kindergarten or 1st grade,
they manifest better progress as intervention lasts less
time.
At the preschool age, SLD is characterized (Carroll et
al., 2016) by dysfunctions or slow rate or difficulties in
obtaining one or more of the aspects of development,
such as: language, cognitive, psychomotor, and social
development, as well as phonological awareness.
Regarding the psychomotor system (laterality, fine and
gross motor skills, spatiotemporal orientation), several
studies (Teixeira et al., 2015) agree about its
effectiveness on the development of writing and
reading skills. Such aspects totally strengthen those
research findings (Denisa et al., 2021; Zakopoulou et al.,
2021) that not only consider the psychomotor
development as a key and effective mental component
during preschool but mostly, indicate strong
interactions between impairments in psychomotor
skills and the difficulties in learning, which could
potentially predict the early occurrence of SLD.
Specifically, researches described difficulties focusing
on the construction of div shape and dominant
laterality (Helland & Asbjørnsen, 2001), the
discrimination and perception of right-left terms, the
acquisition of fine motor skills (specialized movements
of hand and fingers via drawing- sketching, pencil
manipulation, usage of tools as scissors) bilateral
coordination, the acquisition of spatial-temporal
orientation and visual-motor coordination, the
acquisition of graphomotor behavior, underlying
difficulties on motor coordination and balance (Marr &
Cermak, 2003). The child commonly copes with
difficulties regarding discrimination terms (concept)
‘up - down’, ‘in front of - behind’. Equivalent difficulties
are displayed at the mathematic sequence of numbers
and identification of their symbols and ‘random’
sequences such as days of the week, months, alphabet,
Volume 04 Issue 03-2022
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(2022:
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METADATA
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–
8.106
Publisher:
The USA Journals
multiplication tables (timetables) (Desoete, & Baten,
2017).
Moreover, a great part of research (Łockiewicz &
Matuszkiewicz, 2016; Mati-Zissi et al., 1998) focuses on
the value of drawing (sketching) and cognitive
strategies used by SLD children while drawing. The
final drawing depends on structural difficulties that the
child faces, such as visuospatial perception problems
regarding coding and decoding of information,
organization, planning and sequence of drawing
(sketching) (Zakopoulou et al., 2011).
In the present study all skills, such as div shape,
graphomotor
ability,
laterality,
spatio-temporal
orientation, and prewriting skills are treated as core
components of psychomotor development. In
essence, they reflect the cognitive process of their
interaction with the human mind and div, which
combine for the acquisition of gross and fine motor
skills, and with visual-motor coordination to contribute
to the acquisition of the visuospatial perception, which
is considered a core function of obtaining reading and
writing skills (Carroll et al., 2016).
Based on the above theoretical aspects, the aim of the
present study is to investigate the role of psychomotor
development difficulties in the early diagnosis and
intervention of SLD via a preschooler’s case study. It
should be mentioned that in the current study we paid
attention only to the diagnosis and intervention on the
case’s psychomotor development disorders.
METHODOLOGY
Case A. Study
Given the approval of his parents, case A. volunteered
to participate in the implementation of the research
entitled "Formulating profiles of children with early
signs of specific learning difficulties to develop early
types of appropriately adjusted intervention", which
was conducted by the Laboratory of New Approaches
in Communication Disorders of the Department of
Speech
Therapy,
University
of
Ioannina,
in
collaboration with the Medical-Pedagogical Centre of
the Child Psychiatric Clinic of the University Hospital of
Ioannina. The whole survey was carried out during the
period 10/05/2016 to 10/06/2017 in accordance with
ethics, as adopted by the General Assembly of the
World Medical Association (2013), while the protocol
was approved by the Scientific Committee of the
University Hospital of Ioannina (code id: 1-15/4/2016).
In this context, a baseline evaluation was carried out
showing difficulties in perceiving, coding, and
processing the features of linguistic information and
sequential symbols (visual and auditory), as well as
difficulties in psychomotor development, such as:
difficulties
in
spatio-temporal
perception,
graphomotor skills and graphomotor performance.
This poor performance was indicative of a pattern of
slowed acquisition in the areas of psychomotor,
cognitive and language development of the child,
crucial for the later acquisition of the mechanisms of
reading and writing. Therefore, it was deemed
necessary to involve this case in an appropriately
tailored individualized intervention program aimed at
strengthening these domains.
Four months from the onset of the implemented
intervention program an inter evaluation was carried
out, followed by a final evaluation 4 months after the
completion of the intervention.
MATERIALS
To investigate possible early signs of specific learning
difficulties, a battery of assessments was carried out at
the baseline research phase.
Volume 04 Issue 03-2022
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(2021:
5.
857
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(2022:
6.
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1121105668
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8.106
Publisher:
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Specifically, the case A. parents were asked to
complete: (a) a parent's developmental and family
history and (b) the following questionnaires: (i) the
Symptom Checklist-90-R (SCL-90-R) scale for the
investigation of psychological, behavioral and physical
symptoms of parents (Donias et al., 1991), (ii) the
Parental Stress Index-Short Form (PSI-SF) for the
assessment of possible parental distress, difficult
behaviors of the child and possible dysfunctional
interaction with the child (Haskett et al., 2006), and (iii)
the Child Behavior Checklist (CBCL), assessing six areas
related to: anxiety/depression, social withdrawal, sleep
disorders, physical problems, aggressive behavior and
destructive behavior (Achenbach & Ruffle, 2000).
Moreover, three cognitive diagnostic tools were
administered to the child:
(a)
Early Dyslexia Identification Test (EDIT),
(Zakopoulou, 2003): a 20-minute individually
administered screening tool (mean degree of
reliability 0.98) of the early identification of
signs
of
developmental
dyslexia
in
kindergartners (5.4 to 6 years old). Targeted to
identify the early developmental dyslexia’s
profile, three sectors were examined through
the following 7 tasks, as follows: (a) Visual-
spatial Abilities (Sketching, Copying Shapes,
Visual
Discrimination,
Laterality/Left-right
discrimination),
(b)
Grapho-phonological
Awareness (Phonemes Discrimination; Name
Writing), and (c) Working Memory (Phonemes
Discrimination, Name Writing, Copying shapes,
Visual-verbal correspondence).
(b)
ATHINA Test (Paraskevopoulos et al., 1999): a
well-standardized in Greek test of learning
disorders (mean degree of reliability 0.85).
Targeted to detect difficulties in cognitive,
perceptual, psycholinguistic, and motor
processes, four sectors were examined
through the following 14 tasks: (a) Verbal
Intelligence
(Verbal
Correspondence,
Vocabulary, Copying Shapes), (b) Short-term
Sequence
Memory
(Numbers
Memory,
Pictures Memory, Shapes Memory), (c)
Integration of Incomplete Performances
(Sentences completion, Words completion),
(d)
Grapho-phonological
Awareness
(Phonemes
Discrimination,
Phonemes
Composition, Grapheme Discrimination), and
(e) Neuro-psychological Maturity (Laterality,
Left-right
Discrimination,
Visual-motor
Coordination).
(c)
The Greek edition of the Wechsler Preschool
and Primary Scale of Intelligence (WPPSI-IIIGR)
(Sideridis & Antoniou, 2015), (only the core
subtests for children ages 4.0-7.3 years were
examined). Four scales through 8 subtests
were tested, representing the Verbal IQ (VIQ)
(Information,
Vocabulary,
and
Word
Reasoning), the Performance IQ (PIQ) (Block
Design, Matrix Reasoning, and Picture
Concepts), the Processing Speed Quotient
(PSQ) (Coding), and the Full-Scale IQ (FSIQ)
(Information, Vocabulary, Word Reasoning,
Block Design, Matrix Reasoning, Picture
Concepts, and Coding).
(d)
The Greek version of the Child Behavior
Checklist forms for ages 1½ to 5 (CBCL 1½–5)
included in the Achenbach System of
Empirically
Based
Assessment
(ASEBA)
(Roussou, 2009). ASEBA is a multi-level system
assessing
behavioral
and/or
emotional
problems, as well as competencies. The CBCL
(1½–5) form provides scores creating profiles
classified in normal, borderline, and clinical
ranges for Total Problems, Internalizing,
Externalizing, and 7 syndromes: Emotionally
Volume 04 Issue 03-2022
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(2020:
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(2021:
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)
(2022:
6.
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)
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–
1121105668
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IF
–
8.106
Publisher:
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Reactive, Anxious, Depressed, Aggressive
Behavior,
Attention
Problems,
Somatic
Complaints, and Withdrawn.
(e)
ProAnaGraPho (Zakopoulou & Tsarouha,
2009): a method targeted to support children
between 5-7 years old with early occurrence of
neurodevelopmental disorders, such as SLD. It
includes 79 exercises assessing the acquisition
of three main sectors through the following 11
sub-sectors, such as: (A) Visuospatial Abilities
(A1. Body Shape, A2. Spatial Orientation, A3.
Temporal
Sequences,
A4.
Right-left
Discrimination, A5. Ordering, and A6. Visual-
motor coordination); (B) Working Memory (B1.
Visual Working Memory, B2. Audio Working
Memory, and B3. Sequence Working Memory);
(C) Grapho-phonological Awareness (C1.
Phonological Awareness and C2. Phoneme-
grapheme Correspondence).
It should be mentioned that, to assess possible
disorders related to the psychomotor development of
the case, we considered only the recordings in five
tasks of the EDIT test (Sketching, Copying Shapes,
Visual Discrimination, Left-right discrimination, Name
Writing) and in three tasks of the ATHINA test (Copying
Shapes,
Left-right
Discrimination,
Visual-motor
Coordination).
Based on the difficulties revealed in the domain of the
psychomotor
development,
a
well-adjusted
intervention program was designed, while appropriate
stuff (set of suitable implemented tasks) of the
ProAnaGraPho intervention method was selected,
respectively (Fig. 1).
Tasks of psychomotor
assessment of the EDIT &
ATHINA tests
Respective intervention exercises of
ProAnaGraPho method
Psychomotor Development
Sectors
Exercises
A1: Construction of Body Shape
S = Sketching
1. Knowing my div
2. Guiding the wand to find his way
3. My div left & right
4. Where is everything?
5. Playing & learning my div in the space
6. Completing the face (a) & the div (b)
7. Joining the parts
8. Finding the right place
A2: Spatio-temporal Orientation
CSh= Copying Shapes
GD= Grapheme
D= Discrimination
NW= Name Writing
1. The div silhouette
2. Where am I every time?
3. Around the well… but more specifically?
4. The geometric shapes
5. Playing with colors
6. Where is the little mouse?
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Publisher:
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7. Reading the pictures
A3: Temporal Sequences
1. Describing my day
2. Putting the pictures in the right order:
morning, noon, afternoon, or evening
3. The seasons
4. Learning the days of the week and the
seasons
5. Reading the days of the week and the
seasons
6. Listening and understanding a story
7. The calendar with days and months
A4: Left/Right Discrimination
1. Playing with multicolor jewelry
2. Left or right positions?
3. Painting partial elements in each side
4. Which is on the right and which on the
left?
5. Do I go right or left from the smallest to
the biggest?
6. The boat and the arrow: where is each
one looking at’?
7. What do I do right and what do I do left?
A5: Sorting
Visual-motor coordination:
Copying Shapes; Grapheme
Discrimination; Name Writing;
visual-verbal correspondence
1. Sorting the shapes from the big to the
small
2. Making a story from the beginning
3. Putting the pictures in order
4. Following the order to draw the circles
5. Joining the birds with the right number
and color
6. Completing the boxes
7. Filling in the numbers in the windows
A6: Visual-motor Coordination
1. Complementing the brooms
2. Leading the mouse to his food
3. I lost someone on the road
4. I change my hand as soon as I see a tree
5. Finding the exit
6. Strange routes
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SJIF
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(2022:
6.
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OCLC
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1121105668
METADATA
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Publisher:
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Fig. 1. Assessment tasks and intervention exercises in the field of psychomotor development.
The whole psychomotor intervention program was
totally implemented in 43 sessions, which took place
over a 4-month period on a weekly basis (3 sessions per
week), each session lasting 45 minutes (Fig. 2).
Sectors
A1
A2
A3
A4
A5
A6
Total
N of sessions
8
7
7
8
7
6
43
Fig. 2. Number of Sessions (S) per sector of the ProAnaGraPho method.
STATISTICAL
ANALYSIS
Aiming to investigate the effects of the intervention
program on the case’s psychomotor difficulties, we
used the ABA single-subject research design (Scruggs
& Mastropieri, 2001).
During the Baseline phase (A) the case was evaluated
in specific psychomotor tasks, which indicated the
level of his psychomotor difficulties (the dependent
variable). Following the baseline phase, a well-adjusted
4-month intervention program was assigned to the
case (phase B), during which his difficulties were seen
to decrease. This variation led to the withdrawal of the
intervention’s implementation (phase A). During this
period the case’s difficulties were steadily minimized,
while he recorded higher performance in the final
evaluation, thus indicating the effect of the
psychomotor difficulties in the early onset of SLD.
RESULTS
In the Baseline phase (A), the following results were
obtained regarding the overall profile of case A.:
1.
According to the Developmental and Family
history, typical motor and language development
with signs of emotional immaturity were
recorded.
2.
According to the Achenbach Questionnaire for
Parents, the child's behavior was classified within
the standard range with no records of syndromes
or internalizing/externalizing problems.
3.
According to the PSI and SCL-90 Scales increased
rates (high levels) of stress control were recorded
by the mother.
4.
According to the results of the WPPSI-III TEST,
normal intelligence emerged.
5.
According to the EDIT results, a particularly low
and insufficient performance was recorded on the
tasks of Sketching, Copying Shapes, Visual
Discrimination,
Left-right
Discrimination,
Phonemes Discrimination, and Name Writing,
indicating early signs of SLD.
6.
According to the ATHINA results, insufficient
performance was recorded on the areas of
copying, composition, and memory of shapes
(visual), and discrimination of graphemes, sounds
and vocabulary, reinforcing the early profile of
SLD.
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SJIF
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(2020:
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)
(2022:
6.
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In detail, the results per measurement were the following (Fig. 3):
Developmental and family history
Crawled: 7 months
Walked: 11 months
Babbling: 3 months
Word production: 10 months
Enuresis when tired or stressed
Caesarean section due to placental
abruption
Divorced parents
Domestic violent incidents
Nervousness – Possessiveness –
Jealousy
Achenbach CBCL
Normal Range
Test EDIT (Psychomotor development
tasks):
B2. Sketching: Particularly low
performance
B6. Name Writing: Particularly low
performance
B3. Copying Shapes: Particularly low
performance
B4. Visual Recognition: Unsuccessful
performance
B5. Left/Right discrimination:
Unsuccessful performance
B8. Visual-verbal Correspondence:
Unsuccessful performance
Test ATHINA:
Copying Shapes: Insufficient
performance
Grapheme Discrimination: Insufficient
performance
Phonemes Discrimination: Insufficient
performance
Visual-motor Coordination: Incomplete
Laterality: right-hand side
Foot / eye / ear – left-hand side
Remarks:
Visual type problems and
semantic coding problems in tasks
Test WPPSI-III:
VIQ: 80
PIQ: 91
PSQ: 74
FSIQ: 87
Remarks:
Νormal IQ without significant
deviation of verbal and Performance IQ
Fig. 3. Baseline evaluation results per measurement.
Volume 04 Issue 03-2022
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(2021:
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(2022:
6.
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)
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–
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–
8.106
Publisher:
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Regarding the domain of the psychomotor
development, the recordings on the tasks in the
Baseline phase, were as follows:
(a)
Body Shape: Sketching= particularly low
performance
(b)
Spatio-temporal Orientation: Copying Shapes =
particularly low performance; Grapheme
Discrimination = unsuccessful performance;
Name Writing = particularly low performance
(c)
Left/Right
Discrimination:
unsuccessful
performance
(d)
Visual-motor Coordination: Copying Shapes =
particularly
low
(EDIT)
&
insufficient
performance
(ATHINA);
Grapheme
Discrimination = unsuccessful performance;
Name Writing = particularly low performance;
Visual-verbal Correspondence = unsuccessful
performance
Interestingly, 4 months upon the completion of the
intervention, the case’s performance improved in the
inter-evaluation phase (B), as follows:
(a)
Body
Shape:
Sketching
=
successful
performance
(b)
Spatio-temporal Orientation: Copying Shapes =
successful
performance;
Grapheme
Discrimination = successful performance;
Name Writing = unsuccessful performance
(c)
Left/Right
Discrimination:
unsuccessful
performance
(d)
Visual-motor Coordination: Copying Shapes =
successful
performance;
Grapheme
Discrimination = successful performance;
Name Writing = unsuccessful performance;
Visual-verbal Correspondence = successful
performance.
Moreover, in the final evaluation four months after the
inter-evaluation phase, the case recorded successful
performance in four out of five tasks and marginally
successful in only one task. Thus, it became obvious
that the dependent variables reached a successfully
steady state (Fig. 4).
DISCUSSION
Although it is commonly accepted that motor
difficulties often coexist with dyslexia (Scarborough,
1990), more research is needed to investigate the
possible connections between delayed achievement of
psychomotor development and later reading and
writing skills in children at risk of SLD. In an attempt to
add to this research perspective, in the present study
we examined whether possible difficulties in the field
A
B
C
D
E
F
A
B
C
D
E
F
A
B
C
D
E
F
A
B A
Volume 04 Issue 03-2022
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Pages:
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SJIF
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(2020:
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(2021:
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)
(2022:
6.
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)
OCLC
–
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METADATA
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Publisher:
The USA Journals
of psychomotor development in addition to the
difficulties in cognitive and language skills could be
considered as a core component of an SLD profile.
Interestingly, the results of the current case indicated
both the occurrence of psychomotor disorders as well
as their coexistence with other cognitive and language
difficulties of the case A.
Specifically, the data analysis led to the following
findings:
I.
Main difficulties were recorded regarding the
fields
of
div
shape,
spatiotemporal
orientation, left/right discrimination, and
visual-motor coordination that well indicate
the child’s delay to the acquisition of
psychomotor and graphomotor development,
which, in turn, are considered crucial for the
acquisition of the writing mechanism. In
particular, the emerged difficulties describe
the difficulties of the case in acquiring the skills
of writing, copying shapes, spatial processing
and drawing skills, indicating the presence of
difficulties
in
graphomotor
skills
(graphomotoricity). It is important to note that
assessing a limited range of functional skills is
likely to underestimate the extent of a child's
problems. For this reason, the significance of
the difficulties in this area have been
considered as a whole, thus clearly indicating
that difficulties in the field of psychomotor
development can be detected and faced at an
early developmental stage, before entering
school.
II.
Overall, the case presented difficulties in
moving, symmetry and maintaining the spatial
boundaries, as well as additions and
replacements while writing his name.
According to Davis & Broitman (2011), similar
difficulties are attributed to difficulties in
understanding
spatial
concepts
and
correlations. In addition, low performances in
drawing,
name
writing,
and
sound
discrimination are related to the presence of
symptoms of SLD (Zakopoulou, 2003).
Considering the difficulties in graphomotor
behavior associated with the difficulties in
grapho-phonologic awareness (ATHINA Test),
vocabulary, information (WPPSI-III) and coding
(WPPSI-III), it could be supported that the
presence of similar difficulties in preschool age
seem to be considerable for predicting
impairments in acquiring reading and writing
skills at the school age.
III.
In detail, our findings underline the significance
of specific sectors of the psychomotor
development as early key components of the
SLD structure, as follows:
(i)
Body
shape
construction:
Psychomotor
therapists working with individuals with
neurodevelopmental
disorders,
usually
evaluate
and
treat
psychomotor
developmental disorders, and report that div
shape is considered as one of the basic
elements
for
constructing
individual’s
personality as he moves in a three-dimensional
environment with his div being the focus of
reference, having already acquired the sense of
his div (Nikiforou-Tsitsika, 2005). They base
their intervention on movement, action, verbal
and non-verbal communication, emotions, and
images, including div experience, space, and
time.
(ii)
Space Orientation: The development of the
concept of space orientation requires div’s
position awareness, that is, the position and
orientation in relation to persons and things,
the awareness of the position of things
Volume 04 Issue 03-2022
29
The American Journal of Social Science and Education Innovations
(ISSN
–
2689-100x)
VOLUME
04
I
SSUE
03
Pages:
19-32
SJIF
I
MPACT
FACTOR
(2020:
5.
525
)
(2021:
5.
857
)
(2022:
6.
397
)
OCLC
–
1121105668
METADATA
IF
–
8.106
Publisher:
The USA Journals
between them, and the ability of the individual
to set himself in the world around, to organize
things together, to place them and make them
move. The perception of the concept of space
significantly contributes to the writing and
reading processes, as he will understand the
direction of the letters (up-down, left-right)
and will avoid the inversion of letters or words.
Children who have difficulty perceiving and
organizing space often make letter inversions.
(iii)
Time Orientation: According to De Meur &
Staes (1990) the concept of time is closely
related to the concept of space. These two
concepts are interrelated as they are
simultaneously acquired. Time sequence
occurs when different events occur at close
moments. The child discovers the above
concepts, by learning to classify and memorize
his movements and events according to their
chronological
order.
Time
orientation
facilitates the learning of reading, the
sequence of letters and words. The child with
special learning difficulties finds it difficult to
retain the order and sequence of events, does
not perceive and distinguish the time intervals
and cannot organize his time.
(iv)
Visual-motor coordination: This ability is a
complex developmental function that requires
typical
sensory,
motor,
and
cognitive
mechanisms as well as accurate coordination,
in order to design and execute a planned
movement properly (Smits-Engelsman et al.,
2001). The writing acquisition and, in particular,
the graphomotor ability, depends directly on
the development of visual-motor skills
(Germano et al., 2013). According to research
findings (Vasileva, 2015) fine motor activities
help children to be able to use their hands with
the greatest dexterity, achieving visual-motor
perception and fine motor skills coordination,
thus resulting in correct writing and reading.
(v)
Left/Right discrimination: The ability to
discriminate left-right is based on a
complicated neurophysiological process and is
related to age and intelligence. The child’s
awareness of the left-right should be
consistently obtained around the age of 5-6
years, whereas the child's ability to recognize
the right or left hand of the opposite person
(reversibility), is acquired at the age of 6.5
years (Feder & Majnemer, 2007). According to
researchers (Weintrau & Graham, 2000), there
is a relationship between hand preference,
specific learning disability and other forms of
language disorders. A child who has not
mastered the left-right discrimination will face
problems with orientation and positioning in
space and with the placement and orientation
of objects within it, resulting in an inability to
recognize the difference between them, thus,
negatively affecting the reading and writing
skills’ acquisition.
IV.
As regards the intervention program, the
observed results seem particularly promising.
Considering the measurements of the
diagnostic tools as well as the direct
observations during their administration to the
case, we registered the difficulties of obtaining
sectors, which were addressed within a well-
designed individualized intervention program.
As evidenced by the data, even from the
intermediate evaluation phase, a progressive
significant improvement and successful
achievement of all intervention objectives was
recorded, while four months after the
completion of the program implementation, a
steady degree of readiness of the case to
master the mechanisms of reading and writing,
Volume 04 Issue 03-2022
30
The American Journal of Social Science and Education Innovations
(ISSN
–
2689-100x)
VOLUME
04
I
SSUE
03
Pages:
19-32
SJIF
I
MPACT
FACTOR
(2020:
5.
525
)
(2021:
5.
857
)
(2022:
6.
397
)
OCLC
–
1121105668
METADATA
IF
–
8.106
Publisher:
The USA Journals
has been signalized. These findings are
considered to add to research data that
support the larger effect sizes of interventions
applied with kindergarten (Vasileva, 2019),
indicate the importance of executive skills in
predicting the children’s low readiness for
learning to read (Thompson et al., 2015), and
argue that when the children ‘at risk’ for SLD
improve their psychomotor skills early, they
become progressively familiar with writing
(Toffalini et al., 2017).
However, it should be noted that the current findings
cannot support per se that the successful achievement
of psychomotor skills could be indicative of a
comprehensive intervention of early signs of SLD.
Instead, they strongly emphasize the appropriate
implementation of individualized, well-adjusted to the
child’s strengths and weaknesses, multi-tiered and
multisensory interventions.
CONCLUSION
Overall, our findings suggest that further and more
targeted research is needed regarding complex and
strong interactions early occurred between the
components of the SLD, such as neurobiological,
cognitive, language, and psychomotor. Due to this
multidimensional nature of SLD, a holistic framework
of multifactorial assessments and interventions should
be implemented to address these difficulties, which
allow not only to identify early signs of SLD, but rather
to successfully treat them during the preschool years,
before children fail to learn to read and write.
In general, the contribution of successful interventions
to enhance the development of social and emotional
skills at an early stage, positively affect children's social
interaction, and improve their cognitive and behavioral
skills as well as their academic achievements should be
acknowledged.
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