Motor Learning Strategy: The Five-Step Approach

Motor Learning Strategy: The Five-Step Approach

As pediatric therapists, we constantly utilize motor learning strategies to help children acquire new motor skills.  One motor learning strategy that has been heavily researched is Singer’s Five-Step Approach.  This approach to learning a new motor task consists of the following five steps:

Step One – Readying:  The learner adopts a mechanical, attitudinal, and emotional position for delivering a high-quality attempt at the new motor task. This step may involve adopting a particular posture, completing preparatory activities such as a practice swing, or a breathing exercise.

Step Two – Imaging:  The learner uses visual or kinesthetic imagery for the desired action or outcome.

Step Three – Focusing: The learner focuses his or her attention on one relevant cue or feature of the task, blocking out all distractions.

Step Four – Executing: The learner attempts to execute the skill without consciously guiding the movement.  Just do the motor task without thinking about it.

Step Five – Evaluating:  The learner must evaluate the performance and how effectively steps 1-4 were applied.  Determine what to adjust when completing the motor task again.

The Five-Step Approach has been shown to be effective in a range of tasks, with various populations and with children and adults.  In addition, studies have indicated that once taught this approach, learners can transfer the strategy to learning a new novel motor task.  Recent research even indicates that learners who were taught the five-step learning strategy successfully recalled and applied it after a 1-month interval, and they demonstrated superior performance on both acquisition and transfer tasks, relative to the control group (Kearney & Judge, 2017).

When you are teaching a new motor skill, such as catching, throwing or higher level gross motor skills such as skipping, perhaps give the Five -Step Approach a try.

References:

Kearney, P. E., & Judge, P. (2017). Successful Transfer of a Motor Learning Strategy to a Novel Sport. Perceptual and Motor Skills, 0031512517719189.

Singer, R. N. (1988). Strategies and metastrategies in learning and performing selfpaced athletic skills. The Sport Psychologist, 2, 49–68. Retrieved from: http:///www.humankinetics.com/tsp

Singer, R. N., & Cauraugh, J. H. (1985). The generalizability effect of learning strategies for categories of psychomotor skills. Quest, 37, 103–119. doi:10.1080/00336297.1985.10483824

Do you need help teaching children to catch, throw and kick?  Teaching Catching, Throwing and Kicking Skills: Help children learn how to catch, throw and kick with this packet full of information of age progression of skills, visual picture cards, tips, letter to parents and more!  FIND OUT MORE INFORMATION.

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Motor Learning in Children with Unilateral Cerebral Palsy

Motor Learning in Children with Unilateral Cerebral Palsy

Disability and Rehabilitation published research to examine explicit and implicit learning in children with unilateral cerebral palsy.  The study compared the motor learning of children with left and right unilateral cerebral palsy and typically developing children while they shuffled disks toward a target using a prism-adaptation design.  Each trial consisted of pre-exposure, prism exposure, and post-exposure phases with half of the participants being instructed about the function of the prism glasses while the other half were not.

To measure motor learning, the distance between the target and the shuffled disk was measured.  Explicit and implicit motor learning was determined using the prism adaptation design.  Prism adaptation is when the motor system adapts to new visuospatial coordinates imposed by prisms that displace the visual field. Once the prisms are withdrawn, the degree and strength of the adaptation can be measured by the spatial deviation of the motor actions in the direction opposite to the visual displacement imposed by the prisms, a phenomenon known as after effect.

The results indicated the following:

• no significant effects were revealed between typically developing participants and participants with unilateral cerebral palsy.
• participants with right unilateral cerebral palsy had a significantly lower rate of adaptation than participants with left unilateral cerebral palsy, but only when no instructions were provided.
• the magnitude of the negative after-effects did not differ significantly between participants with right and left unilateral cerebral palsy.

The researchers concluded that the capacity for explicit motor learning is reduced among individuals with right unilateral cerebral palsy when the accumulation of declarative knowledge is unguided (i.e., discovery learning).  It was recommended to use implicit motor learning interventions for individuals with cerebral palsy, especially for children with right unilateral cerebral palsy.  When using explicit motor learning interventions use singular verbal instruction.

References:

Fernández-Ruiz, J., & Díaz, R. (1999). Prism adaptation and aftereffect: specifying the properties of a procedural memory system. Learning & Memory, 6(1), 47-53.

van der Kamp, J., Steenbergen, B., & Masters, R. S. (2017). Explicit and implicit motor learning in children with unilateral cerebral palsy. Disability and Rehabilitation, 1-8.

Therapeutic Play Activities for Children digital download includes 100 play activity pages and 12 tip sheets. The play activities encourage the development of fine motor skills, bimanual skills, rolling, crawling, tall kneeling, standing balance and cruising with a strong focus on children with cerebral palsy.  FIND OUT MORE INFORMATION.

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Why Do Children Need Opportunities to Use New Motor Skills They Learn?

During therapy sessions, we frequently break down activities into smaller parts or chunks to make it easier for children to learn new motor or life skills.  As the child progresses with those individual parts of the skill, the child then practices the entire activity as a whole. Sometimes this is done in an isolated environment (ie therapy room) and sometimes in the real environment (ie classroom).

Keep in mind, in order for the child to learn and retain the skill, the child must apply that skill in meaningful and functional activities.  This helps to lay the neural networks to achieve and retain the skill.

After the child completes the skill provide formal and informal feedback to help them improve. Use self assessment techniques allowing the child to determine what needs improvements.   This will again help lay the groundwork for strong neural networks for the skill.

So why do children need meaningful opportunities to practice new motor or life skills?  It creates strong neural networks in order to transfer the skill in different situations or to learn additional new skills.

The post Why Do Children Need Opportunities to Use New Motor Skills They Learn? appeared first on YourTherapySource.com Blog.

Cognitive Orientation to Daily Occupational Performance Approach

Cognitive orientation to daily occupational performance or CO-OP is defined by Polatajko and Mandich as a  “a client-centred, performance based, problem solving approach that enables skill acquisition through a process of strategy use and guided discovery”.  CO-OP is an evidence based approach that has been successful for children with developmental coordination disorder (DCD) and autism spectrum disorder (Rodger & Brandenburg, 2008).

According to Missiuna et al. the main objectives of CO-OP are:

1. skill acquisition in child-chosen tasks
2. development of cognitive strategies
3. generalization and transfer of learned skills and strategies.

There steps to the CO-OP approach include client chosen goals, dynamic performance analysis, cognitive strategy use, guided discovery, enabling principles, parent/significant other involvement and intervention format.

Generally, the CO-OP approach is GOAL - PLAN - DO - CHECK.

Step 1:  The child along with the parents determine a goal or task that needs to be accomplished.  The therapist performs evaluations and assessments to determine if the goal is feasible.

Step 2:  Create a plan together to reach the goal.  To begin, the therapist performs a task analysis of the child performing the skill.  The child can explore different strategies such as body position, attention to the current task, modifications, self talk, self monitoring, etc.

Step 3:   Carry out the plan with the child using the planned strategies to accomplish the task.

Step 4:  Check the plan.  How well did it all work?  What was successful? What can I change? What needs improvement?  This can be done through self-interrogation, self-monitoring, self-observation and self-evaluation.

There are many resources to learn more about this cognitive based approach to achieving new motor skills.  This pdf is a great place to start to explore this approach further -   Polatajko & Mandich (2010). Cognitive Orientation to daily Occupational Performance
(CO-OP). Retreived from the web on 11/18/15 from http://www.dyspraksi.no/uploads/7/0/4/9/7049202/co-op-info-jolien.pdf.

Here is a helpful list of peer reviewed, evidence based articles on CO-OP http://ot.utoronto.ca/coop/research/publications/articles.html

Reference:

Missiuna, C., Mandich, A., Polatajko, H. & Malloy-Miller, T. (2001). Cognitive orientation to daily occupational performance (CO-OP): Part I — Theoretical foundations. Physical and Occupational Therapy in Pediatrics, 20, 69–81.

Polatajko, H. & Mandich, A. (2004). Enabling occupation in children: The cognitive orientation to daily occupational performance (CO-OP) approach. Ottawa, ON: CAOT Publications.

Polatajko & Mandich (2010).  Cognitive Orientation to daily Occupational Performance
(CO-OP).  Retreived from the web on 11/18/15 from http://www.dyspraksi.no/uploads/7/0/4/9/7049202/co-op-info-jolien.pdf.

Rodger, S. & Brandenburg, J. (2008). Cognitive Orientation to (daily) Occupational Performance (CO-OP) with children with Asperger’s syndrome who have motor-based occupational performance goals. Australian Occupational Therapy Journal. doi: 10.1111/j.1440-1630.2008.00739.x

My Goal Tracker:
This is an electronic book of data collection forms for students to track their own progress.  The student can track his/her goals over time, by monitoring the skills over the course of a day, week, month or quarter. This allows the student to get a visual picture of improvement,
decline or maintenance of different skills.

FIND OUT MORE at http://www.yourtherapysource.com/goaltracker.html

Implicit and Explicit Motor Learning in Boys with Autism

Research in Developmental Disabilities published an article comparing implicit versus explicit motor learning in 30 boys with autism spectrum disorder (ASD) and their age and IQ matched peers.  Each children participated in a serial reaction time task (SRTT).  The children were separated into different groups based on diagnosis and implicit or explicit learning for the SRTT.

The results indicated the following:
1.  implicit motor learning occurred in both children with ASD and typical children with no significant differences between groups
2.  explicit motor learning was only observed in typical children not children with ASD with a significant difference between groups for explicit learning.

The researchers concluded that implicit motor learning is not affected in children with ASD. They discuss applying to the cognitive orientation to daily occupational performance (CO-OP) approach of motor learning with children with ASD.  Check out the next blog post for more information on the CO-OP approach of motor learning.

Reference:
Sara Izadi-Najafabadi et al.  Implicit and explicit motor learning: Application to children with Autism Spectrum Disorder (ASD). Research in Developmental Disabilities. Volume 47, December 2015, Pages 284–296

Adventure Skill – Self-Regulation Flash Cards

By:  Move with Me

Summary: This 16 Flash Card Set in printable PDF format – includes health lessons and self-regulation techniques that combine creative movement, yoga and Brain Gym(R),

FIND OUT MORE at http://www.yourtherapysource.com/movewithmeselfregulation.html

Do You Use Congruent Feedback?

Congruent feedback is an excellent tool to help children learn and improve motor skills.  Here is how it works -  decide upon one step or motion of the skill that you and the child thinks needs improvement or refinement.  Tell the child exactly what you are looking for during the skill.  It should only be one thing.  Provide a visual demonstration of that one aspect of the skill.  Once the child is performing the skill only look at that step or motion during the skill and reinforce it if it is correct.  Reinforce with consistent verbal cues.  If it is incorrect, provide verbal, visual or physical cues to correct that part of the skill.  Continue doing this for different parts of the skill.  But remember, only focus on one (1) part of the skill at a time.

For example, perhaps you are teaching or practicing skipping with a child.  Ask the child to focus on just one aspect of the skill at a time.  To begin with ask the child to "step and hop, step and hop".  Only provide feedback on lower extremity motion.  Do not provide feedback on arm swing, timing, rhythm of movement or speed.  When the child is able to perform the lower extremity motions of skipping correctly, target a new area of the skill.

To repeat the steps of congruent feedback:

1.  Tell the child what aspect of the skill he/she will focus on.

2.  Provide a visual demonstration with verbal cue for the child.

3.  Child performs the skill and observe only that aspect of the skill you demonstrated or discussed.

4.  Provide positive reinforcement feedback if correct.  Be specific with the positive reinforcement.  Don't just say "good job".  Use the same verbal cues from the specific task.

5,  If incorrect, provide verbal, visual or physical cues as feedback regarding only that one aspect of the skill.

Have you had success using this type of feedback?

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25+ Bilateral Coordination Exercises is a collection of bilateral coordination exercise sheets including QR codes with links to video demonstration of exercises.  Find out more at http://www.yourtherapysource.com/bilateralcoordination.html

Personal Space Journey - Body Awareness Freebie

Here is a freebie page from Personal Space Journey which is a collection of activities to teach children about maintaining personal space.  You can download the body cards at http://yourtherapysource.com/personalspacejourneyfreebie.html

Here are some suggestions to use the cards for:

1.  Musical Body Poses:  Scatter the cards around the room.  Move to music.  Turn the music off.  Determine what body card is closest to you.  Make your body into the same position like the card.  Turn music on again and repeat.

2.  Guess Who I Am:  Make your body into a pose.  The other player has to determine what pose your are mimicking.

3.  Memory Match:  Print the cards twice.  Play a game of memory but in order to keep the match you have to mimic the body position.

4.  Quick Brain Break:  Match the body positions on the card completing each one scanning from left to right.  Continue for 1 minute.  Rest and repeat 3 times.

Download your copy at http://yourtherapysource.com/personalspacejourneyfreebie.html

Be sure to check out the complete Personal Space Journey.



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Quick Brain Break - Q and A Body Game

Need a quick game to rest and refresh your student's brain?  Try this Q and A Body Game:

Purpose: Promote body awareness, motor skills and listening skills.

Materials: none

Activity: This can be played with one player or a group of children. The adult faces the group. Explain the directions of the game. The adult is going to ask the children to move certain body parts based on questions. The children are not to answer the questions. They should move the body part that is the answer to the question.

Here is an example:
Question: What body part waves hello?
Answer: Children wave hands in air.

Here is a list of several questions and answers or make up your own. See what questions the children can come up with.

Q: What body part makes funny faces?
A: Child moves mouth or tongue

Q: What body part wears socks?
A: Child moves feet.

Q: What body part uses crayons?
A: Child wiggles fingers.

Q: What body part smells skunks?
A: Child moves nose.

Q: What body part climbs ladders?
A: Child moves arms and legs

Now change the game and request actions based on different noises:

Make a clapping sound with your body.
Stomp your feet
Snap fingers
March in place
Smack lips
Slap knees
Tap shoulders quietly

Now have children close their eyes. Make one of the sounds with your body that you practiced together. Can the children guess what body part you are using to make the sound.

Need brain break ideas? Check out all of our Brain Break downloads at http://yourtherapysource.com/brainbreaks.

Or order our Brain Breaks Card Set at http://yourtherapysource.com/growingplaycards.html



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Mental Practice versus Physical Practice for Finger Opposition Skills in Children

Research Quarterly for Exercise and Sport published research on the effects of mental practice (MP) and physical practice (PP) on a finger opposition task among 36, nine to ten years old, children. The children were randomly assigned to either a MP group, PP group or no practice (NP) group. The MP and PP groups participated in a single session of training with the dominant trained hand. The MP group was trained by mentally rehearsing the movements, the PP group was trained by executing the movements, and the NP group had no training. The performance of three groups was evaluated under identical conditions before training, after 5 min, and at 4 days, 7 days, and 28 days after training.

The results indicated the following:
1. both trained groups (MP and PP) showed statistically significant improvement in the trained sequence using the trained hand at all assessment points after the training
2. only MP participants were able to transfer the performance gains from the trained sequence to the untrained reverse sequence and from the trained hand to the untrained opposite hand.

The researchers concluded that children were able to learn the finger to thumb opposition sequence task through MP or PP with a similar level of performance. Although, MP allowed for the transfer of untrained reverse sequence performance gain and transfer to the opposite hand, suggesting that the internal representations developed by MP were effector-independent.

Reference: Sabrina Kyoko de Paula Asa, Mara Cristina Santos Melo and Maria Elisa Pimentel Piemonte. Effects of Mental and Physical Practice on a Finger Opposition Task Among Children. Research Quarterly for Exercise and Sport. Volume 85, Issue 3, 2014, pages 308- 315
Published online: 20 Aug 2014. DOI: 10.1080/02701367.2014.931557

Imagination Action Journeys are 10 fun filled stories that encourage literacy, physical activity, imagination and creativity. Children will enjoy reading and acting out the stories. These can be completed indoors or outdoors with one child or a group of children. What a great way to promote literacy and physical activity!  Find out more at http://yourtherapysource.com/imagine.html

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Physical Activity and Executive Control in Children

Pediatrics published research on 221 children (7-9 years old) who were randomly assigned to either a 9 month after school physical activity program or a wait list group. Following the intervention various measurements were recorded: changes in maximal oxygen consumption, electrical activity in the brain and behavioral measures (accuracy, reaction time) of executive control.

The intervention was every school day for two hours. Each session included at least 70 minutes of moderate to vigorous physical activity.

The results indicated the following:
1. fitness improved more among intervention participants from pretest to posttest compared with the wait-list control group.
2. inhibition and cognitive flexibility improved more in the intervention group from pretest to posttest compared with control.
3. only the intervention group increased attentional resources from pretest to posttest during tasks requiring increased inhibition.
4. improvements in brain function on the inhibition task and performance on the flexibility task correlated with intervention attendance.

The researchers concluded that the physical activity intervention enhanced cognitive performance and brain function during tasks requiring greater executive control. These findings demonstrate a causal effect of a physical activity program on executive control.

Reference: Effects of the FITKids Randomized Controlled Trial on Executive Control and Brain Function. Charles H. Hillman, Matthew B. Pontifex, Darla M. Castelli, Naiman A. Khan, Lauren B. Raine, Mark R. Scudder, Eric S. Drollette, Robert D. Moore, Chien-Ting Wu, and Keita Kamijo. Pediatrics peds.2013-3219; published ahead of print September 29, 2014, doi:10.1542/peds.2013-3219

Want to Improve Motor Learning? Go to Sleep.

 



Researchers from the University of Montreal taught a group of subjects a new sequence of piano-type finger movements on a box.  Using functional MRIs, the subject's brains were analyzed during their performance of the task before and after a period of sleep. In addition, the same test was performed by a control group at the beginning and end of the day, without a period of sleep.

Previously, the researchers had shown that the putamen, a central part of the brain, was more active in subjects who had slept and they had observed improved performance of a task after a night of sleep and not just the passage of daytime.

Using brain connectivity analysis the results of this study indicated that one brain network emerged from the others—the cortico-striatal network—composed of cortical and subcortical areas, including the putaman and associated cortical regions.  In other words, after a night of sleep, the cortico-striatal network was more integration among these regions when consolidation had occurred. A night of sleep appeared to provide active protection of the cortico-striatal network, but the passage of daytime did not provide.  Only a night of sleep resulted in better performance of the task.

Reference:  Medical Express. Learning to play the piano? Sleep on it! Retrieved from the web on 8/22/14 at http://medicalxpress.com/news/2014-08-piano.html#nwlt



This book is an easy-to-read manual to help people with sensory
processing difficulties, Autism Spectrum Disorders or a restless mind, achieve
an overall healthy sleep experience.  Find out more at http://yourtherapysource.com/autismsleeps.html

 

 

Go Ahead, Make a Mistake - Your Brain Will Learn Faster

 

We all know that we learn from our mistakes. But new research specifically indicates that our brains learn faster from our mistakes.

Researchers at Johns Hopkins university determined that people learn an identical or similar task faster the second, third and subsequent time around because they are helped by memories of how to perform the task and by memories of the errors made the first time.

Motor learning theorists know that when learning a new motor skill the brain notes their brains notes small differences in the environment during motor skill practice and uses this information to perform the motor skill task more smoothly next time. Those small differences are called prediction errors and the process of learning from them is mostly automatic.

This experiment where participants manipulated a joystick that they could not see helped the researchers determine that prediction errors also teach the brain how to learn faster from errors, even when those errors are encountered in a completely different task. Therefore, the brain can generalize from one motor skill task to another by keeping a memory of the errors. The participants learned to give frequent errors more value as learning cues while not paying as much attention to errors that appeared as by chance.

To summarize, the researchers determined that the brain is giving weight to different types of errors to provide feedback when learning a motor skill task. This "coaching" that the brain is doing helps a person to learn similar future motor tasks quicker because the brain remembers what errors it should pay closer attention to.

Reference: "A memory of errors in sensorimotor learning," by D.J. Herzfeld; P.A. Vaswani; M. Marko; R. Shadmehr, Science, 2014. www.sciencemag.org/lookup/doi/10.1126/science.1253138


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Type of Practice Matters

Some new research published in Psychological Science reinforces motor learning theories on how to practice to learn a skill quickly. 

Data was analyzed from over 800,000 people playing an online game called Axon which tested participants' ability to use rapid perception, decision making, and motor responses.

The data revealed that some players achieved higher scores than others even though they all practiced for the same amount of time.  The players who learned more quickly than the others had either spaced out their practice time or had more variable early performance (exploration). 

The researchers concluded that learning can be improved by using the same practice time to learn more efficiently and to a higher level. 

Reference:   Tom Stafford and Michael Dewar. Tracing the Trajectory of Skill Learning With a Very Large Sample of Online Game Players. Psychological Science 0956797613511466, first published on December 30, 2013 doi:10.1177/0956797613511466

Active Prospective Control Necessary for Sensorimotor Learning

Recent research studied 36 adults with no history of motor or neurological impairments were assigned to one of three groups - active (participant actively guides movement), passive (therapist or robot guides movement) or control group.  This study used haptic tracking for the passive movement.  The results indicated the following:

• no effective learning with passive movement while active practice with prospective control resulted in significant improvements in performance.
• for the passive movement it was not the inaction that was the problem but the lack of prospective control was the issue.

The researchers concluded that the results suggest:

• active generation and control of limb movements is required for effective motor learning. 
• passive forms of training did not yield good learning. 
• ‘active’ means does not simply mean stimulated musculature and active sensorimotor loops, that was present in during the passive training task, but these factors alone failed to yield good learning.
• active means prospective control of limb movement trajectories, control in which perceptual information is used to anticipate the required trajectory and to overcome potential inaccuracy and instability caused by biologically determined delays in control. 
• the results present a challenge when developing robotic interventions for people with movement disorders.

The researchers suggest to only provide when the limb leaves a pre-defined zone to allow active control of the movement.

You can read the full text article here. 

Reference: Snapp-Childs W, Casserly E, Mon-Williams M, Bingham GP. Active prospective control is required for effective sensorimotor learning. PLoS One. 2013 Oct 23;8(10):e77609. doi: 10.1371/journal.pone.0077609. 

Truly Learning a New Skill

Did you ever stop to assess whether some of your students have truly learned a new skill when you mark off "goal achieved" on a IEP?  Meaning has the child learned the skill so that it can be performed with no physical or verbal cues?  Does the child choose to use the skill in all environments at home and school?  Does the child ever even use the new skill at all?

It is something to think about.  Sometimes the best time to check if someone has truly learned a new skill is to wait a bit and then check on that skill at a later date. 

One of two things will happen - yes, the child has learned the new skill or no the child has not.  But, important information will be gained.  If yes, provide that child again with positive reinforcement and congratulations on using the new skill.  Is there a higher level skill that the child can work towards building upon this skill?  Ask the child if the skill has helped him or her.  This helps you to formulate future goals for other students.

If no, determine what requires further advancement.  For example, does the child require occasional reminders?  Is the child unable to perform the skill only in art class?  Does one small part of the overall skill need review?  By answering these questions, one can help a child reach his/her full potential. 

Reflective Questions for Motor Learning

How do you provide feedback to children regarding their performance on a motor skill?  Do you provide constructive criticism, positive praise, additional motor commands, additional demonstrations or more trials? Why not ask the child to verbally plan or review their own performance on a motor task.  For example, once you request a motor task to be completed ask an open ended question such as:

• What do you plan to do? 

Then once the motor skill has been completed ask more open ended question(s) such as:

• How did you think you did?
• What could you have done differently?
• Could you have done anything better?
• Did you accomplish what you planned to do?

If necessary provide more detailed question(s) such as the following examples:

• Did you perform the skill fast enough?
• Did you stay on the line?
• Did the ball go into the basket?
• Did you avoid the obstacles?
• Did you climb to the top?

And don't forget to allow the children 5-10 seconds to answer the question.  

By involving the children in planning and feedback it provides additional input during motor learning trials.

Immersion in the Skill

Here is something to try that does not have to necessarily do with swimming - immersion in one particular motor skill.  When we are teaching a child a new motor skill or perhaps working on refining a motor skill, try bombarding the child with the skill.  Here are some examples:

• The goal is to write a circle.  Overload the child with circles during the therapy session.  For example, cardboard tube slices, tub tops, jar lids, paper plate stencils, hot glue rubbings, salt tray, etc all to practice manipulating and writing circles.  
•  The goal is to jump forward 6 inches with two feet together.  Overload jumping skills with watching videos of children jumping, model the proper jump, play a game with frogs who jump, jump on a trampoline and more.
• The goal is to perform a sit to stand transfer with verbal cues.  Practice sit to stand transfers in many different chairs, video tape the sit to stand transfer and watch it, practice manipulating action figures or Barbie type dolls moving from sitting to standing, etc.

Take the time to discuss with the child the importance of the skill.  By providing all the opportunities and examples of the skill will hopefully teach the child how important the skill is and to help provide the child with internal motivation to achieve the goal.

What do you do to "overload" a child to learn or refine a motor skill?  

Schedule Practice Time for Motor Skills

A new school year brings new students and new goals.  Most students who receive therapy services have goals related to fine and gross motor skill development.  As we know from motor learning theories individuals need practice time to learn and maintain motor skills.  Therefore, therapists need to provide suggestions for ample practice time during the school day beyond therapy services.


Therapists should provide the student and the teacher with some suggestions to squeeze in practice time during the school day.  Not only should therapists provide the practice activity ideas it would be very helpful to also provide ideas regarding what time to perform the practice sessions.  In order for therapists to do this, you will need to have access to the students entire school schedule.  Look closely at the schedule and perhaps provide the student and teacher with highlighted areas where the practice can occur.     

Gross motor skills can be practiced during transition times, recess, free play and physical education.  If you need to get more creative an add more practice time, provide the teacher with some quick brain breaks (ie Roll Some Fun or Mini Movement Breaks) throughout the day. 

Fine motor skill practice tends to be easier to accomplish during the school day.  Arts and crafts projects can be geared toward specific practice skills.  Therapists can help teachers plan literacy and math lessons that encourage fine motor skill practice. 

To summarize, try to not only provide motor skill practice activity ideas but also provide a simple schedule to complete the activities throughout the regular routine of the student's day.  The schedule would be meant to provide suggested activity practice times for teachers and students.  Don't forget to check back in a week or two to see if the suggested times are working for the student.
 

Feedback Frequency with Children

Physical Therapy will be publishing research on the frequency of feedback that you should provide for children when learning a motor task.  Previous research with adults indicates that providing feedback 100% of the time when learning a new task is less effective than when less feedback is provided.  In addition, previous research has indicated that children with cerebral palsy benefit from less feedback whereas typical developing children benefit from more feedback.  For this research, children threw beanbags for accuracy at an unseen target while walking or while standing still. Knowledge of results was provided 100% of the time and 33% of the time. Retention tests without feedback were performed 5 minutes later and then one-week later. Also, transfer tests were completed to check the generalizability of learning.

The results indicated the following: learning was improved on the easy version of the task when knowledge of results was provided 33% of the time during practice and learning was improved in the difficult version when knowledge of results was provided 100% of the time during practice.

The researchers suggest that when teaching motor skills to children one should provide feedback based on the complexity of the task.

When you are teaching children new motor skills do you take into account how difficult the task is and how often you provide feedback?  In my opinion, I find it to be human nature - when a child is struggling to learn a new task I provide more feedback and if the task is easier you do not need to provide as much feedback.  

Reference:    Sidaway B, Bates J, Occhiogrosso B, Schlagenhaufer J, Wilkes D. Interaction of Feedback Frequency and Task Difficulty in Children's Motor Skill Learning. Phys Ther. 2012 Mar 15. [Epub ahead of print]

Motor Learning Versus Neurodevelopmental Treatment

A recent article in Clinical Rehabilitation compared two groups of children with cerebral palsy. Seventy eight children (ages 66-146 months) with spastic cerebral palsy (gross motor functional levels II and III) were divided into two groups. One group received motor learning coaching for 3x/week, one hour sessions, over three months. The other group received the same 3x/week, 1 hour sessions for three months of neurodevelopmetnal treatment (NDT). After the three months and at 6 months, the Gross Motor Function Measure (GMFM-66) was performed along with parent questionnaire and stair climbing was assessed.

The results showed the following:

• both groups showed increased scores in GMFM-66 at 3 months
• at 6 months retention was significantly better in the motor learning group level II children
• stair climbing also showed improved retention after 6 months in the motor learning group (increased by 1.1% compared to a decreased of 0.3% in the NDT group)
• mobility improved by 13% for the motor learning coaching group and decreased by 12% with the NDT group

The researchers concluded that motor learning coaching resulted in significantly better results in gross motor function and mobility for higher level functioning children with cerebral palsy.

Reference: Simona Bar-Haim et. al. Effectiveness of motor learning coaching in children with cerebral palsy: a randomized controlled trial Clin Rehabil November 2010 vol. 24 no. 11 1009-1020