← Ideas at Play: An Occupational Therapy (OT) Podcast
Ideas at Play: An Occupational Therapy (OT) Podcast
Ep. 11 Handwriting & OT: Guiding Principles for Today and the Future (with AI)
00:40:36
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- [00:02]
A
Today we're diving into a challenge we all know well, that's handwriting in a classroom where up to 10% of children struggle with dysgraphia. A one size fits all approach is not effective and remediation can be really tough. Join me as we review best practices for handwriting instruction and discover how AI powered tools may be in your future therapy toolbox.
- [00:34]
B
Welcome to Ideas at Play where we discuss pediatric research and help you apply the ideas to your daily practice. Each week we'll review evidence based ideas to make you a better therapist. I'm Dr. Michelle Alanis, director of Pediatrics at a rehab hospital in Southern California. And with me is my good friend and former co worker Lacey.
- [00:56]
A
That's me. I'm Dr. Lacey Wright, an occupational therapy professor in Kansas city. We're PEDs OTs who love research and making it fun. We've helped thousands of therapists just like you to become more informed, more playful and more effective in their sessions.
- [01:14]
B
This week we'll be discussing what we currently do to address handwriting and what the future of handwriting will be. Let's get started.
- [01:24]
A
I usually listen to podcasts when I'm driving or doing chores around the house and that's a really great way to make the most of that time and it makes it less boring too. But if you're like me and in the same boat, it's terrible for taking notes. So we've got you covered. Sign up for our weekly newsletter and we will send you those notes every week. Email us@ideasatplaypodcastmail.com.
- [01:52]
B
Up first is our nailed it and Failed it segment where we discuss what worked and what didn't in our practice this week. Because if you're pushing for that just right challenge, sometimes you're going to nail it and sometimes you're going to fail it. Lacey, you're up first with the Failed it for this week.
- [02:09]
A
In my pediatric class that I was teaching recently, we set up a bunch of pediatric assessments for our students to practice. And it was actually really fun because I brought in my own boys and they were practicing with my boys and some other staff kids.
- [02:24]
B
I love it when people bring in kids like that. First of all, you get to see everyone's kids and second of all, it's just so good.
- [02:30]
A
Yeah, the PEDS assessment actually went really well, but what I was remembering was when I was learning how to do the M Fun the first time and.
- [02:41]
B
For our listeners, the M FUN stands for Miller Function and Participation Scales.
- [02:46]
A
Perfect. And actually Michelle, do you remember we learned the M Fun. We we pulled out the supplies. We were excited to try it, and we actually brought in your son and videotaped you with your son, like, practicing how to do it. And that's how we learned it.
- [03:03]
B
And it's the funniest video too, because he was like, I don't know, seven, and he really wanted to just go ride the scooters in the backyard at the clinic. And so I said, look, we're just going to do this real quick, and then we can ride the scooter. So the entire video, he's wearing a helmet because he was like, I'm ready to go.
- [03:19]
A
It's so cute. So after we did that and watched the adorable video of your son, I decided it was time gonna actually do it with a kiddo. So I was all prepared. I had this stuff set up, and it was gonna be my first eval where I was trying it. And of course the kiddo and his family showed up, like, 10 minutes late. And I. And I was already stressed out about, like, getting this new assessment and all the parts and pieces done in a short amount of time. And here I was starting off behind the eight ball. So the kiddo came in, we sat down. I'm feeling a little nervous. I had everything set up, which was the worst idea ever, because that was the first thing he did. He just started grabbing everything and playing with it and twirling it around, throwing it, and everything got messed up. I had no rapport with the kid, and I was, like, trying to, like, take the things away from him and hide it, put it back in the bag. And it was so disorganized, and I was just so flustered.
- [04:21]
B
Great first impression.
- [04:22]
A
Yes. Right. So it was a total rookie mistake not managing assessment materials. And in hindsight, I should have just practiced it with, like, a reassessment kiddo instead of a brand new kid that I had not met yet.
- [04:39]
B
Oh, that's a hard lesson to learn. I mean, I always get so excited to get a new test because I have these, like, visions that it's going to be perfect for all the kids, but then to actually implement it. I just got the new bot3, and I'm thinking, oh, I've got to learn. Even though it's, like, similar, but there's enough. And then the new Peabody, you know, now everything's online, so it's just all this new learning, and it's hard to do that when you're also trying to eval a kid that you've never met before.
- [05:07]
A
Yeah. And there's something about the Assessments with all the parts and pieces that feel extra fun to me, but those ones are even harder to learn because, again, it has all the parts and pieces that are, like, super specific and have to do it in just the right way.
- [05:21]
B
Oh, you know what I say? You gotta be a disaster before you can be a master. So you got the disaster part down and now look at you.
- [05:27]
A
Well, Michelle, that means you are up for a nailed it this week. Tell us about it.
- [05:33]
B
Before I tell you about my nailed it, I have to tell you about the funniest research that I read. This is a study that came out at mit and they were looking sort of like at motivation, and they had participants where they were building LEGO kits and they got paid per kit that they built.
- [05:50]
A
That sounds like a dream assessment. Like, yes, I will build Legos and get paid. Like, my boys would be the first to sign up for that.
- [05:57]
B
Yeah, totally. I would not sign up for that because I'm terrible at building legos. But nonetheless, the participants built the Legos and they got their money. Built a LEGO set, got their money. But the experimental group built the LEGO set, handed it to the researcher, and they broke it down in front of them and then gave them the money.
- [06:19]
A
Oh, it's soul crushing.
- [06:21]
B
Yeah. So what do you think? Which group produced the most LEGO kits?
- [06:27]
A
Well, obviously the first one where their work was. At least there was the appearance of their work being valued.
- [06:35]
B
Yes. And even though they're both getting paid the same amount for it, you know, just that. That sense of having it just destroyed right in front of you. And then to make it even funnier, they did another one where they had, like, a paper pencil task. So the experiment group did the task, handed it to the researcher, got their money, did the task, handed it off, got their money. The experimental group did the task, handed it to the researcher, and they put it in a shredder right in front of them. It's like they gave them the method.
- [07:06]
A
It's the most dramatic way to destroy it.
- [07:11]
B
I know. That's why I love this study. I heard about it a while ago, and it's always stuck with me. I have a client who I'm working with teaching them how to tie his shoes. And I realized that so many times when we're teaching a motor skill, because we have to get high frequency trials, you have to do it over and over again to make progress. But we'll have them tie it and.
- [07:31]
A
Then what do we do?
- [07:32]
B
We untie it right in front of them and we want them to do it again. And again and again. And so instead, I gathered up all of my son's old shoes that don't fit him anymore, took him in the clinic, and made a line of shoes on the table. And I pulled the first one. Adam tie it, and then I let him throw it into the gym. And then another one. He tied it and he threw it into the gym until they were all done, and then we got to go up and go play.
- [08:00]
A
That's awesome. It's a reward at the end. You could even, like, make it almost like a basketball thing, like, hit the target with the shoe.
- [08:07]
B
It's so much more fun to just randomly throw it into the air and.
- [08:10]
A
See what it did the shoe and goodbye.
- [08:14]
B
Exactly. So take a tip from these researchers and do not destroy it right in front of the child's eyes, because that will definitely squash their determination to keep practicing.
- [08:27]
A
Oh, I love that. What a fun idea. The clinic now has many, many shoes, and shoes will go flying.
- [08:34]
B
Just don't walk through the gym when I'm doing shoe tying. Our next segment is the research review, where we break down the latest in pediatric research and explore how to apply it to our sessions. This week, Lacey has an article about handwriting and how products with AI may help ot intervention in the future. Lacey, tell us about your article.
- [08:56]
A
This article is called Teaching and Rehabilitation of Handwriting for Children in the Digital Age. Issues and Challenges. And this article is from 2023 from the Journal called Children. It's also free access from that title.
- [09:15]
B
I cannot tell at all what type of study this was. Was it a intervention study? A randomized control trial? What'd you find?
- [09:23]
A
This study is a narrative review, and they looked at so many articles, they ended up citing over 150 articles. Like, half of the article was just the references section.
- [09:35]
B
That's amazing.
- [09:36]
A
Yeah. And the other thing that's really cool is that the articles that they looked at were from all kinds areas of research. There was the OT literature, education, psychology, computer education, and some technology ones.
- [09:53]
B
Oh, that's cool. Yeah.
- [09:54]
A
And the authors were from France, so they not only had articles in English, but they included a bunch of articles written in French. So it had this really cool, like, international vibe to it that I really liked.
- [10:09]
B
Ooh, sifu play. Tell me more.
- [10:13]
A
Actually, Michelle, I wanted to ask you a question because I said it's a narrative review, and I always mix up the different kinds of reviews. Can you just tell us about the different types of reviews?
- [10:26]
B
Why, yes, I can, Lacey. I love reviews. Not only am I working on trying to produce and publish one right now. But I just think they're a treasure trove when you find them because it saves you so much time because it's all right there. Summarized. So the first type of review is a meta analysis. And this is like the biggest, baddest of the reviews, a meta analysis. They have a systematic protocol of how they're searching the literature and they have multiple people that are looking through and trying to find all the articles, and they're hand searching the reference pages and they get all the articles that they can find and then they summarize the findings, but they also take all of the data that was reported in the studies. They do a unique statistical analysis of all of the data combined together. Does that make sense?
- [11:14]
A
Yeah. So it's looking at the articles and then doing like an extra layer of research on top of the articles?
- [11:20]
B
Yeah, kind of. Because they're producing new data through it by taking all the data points from each of the studies and then doing a statistical analysis of it. So it's a very powerful way of reviewing the literature. And then from there you would have a systematic review. And that's where it's similar, where you, you have your set protocol and you have your multiple people and you're looking at all the sources. The only difference is for whatever reason, the authors aren't able to analyze the data. Often it's because the data is not reported in the articles or it is reported, but it's so different from article to article that they can't combine it and look at it as a whole. So that is a systematic review. And then from there you have a scoping review or a narrative review. And these are super interesting because the authors will look at all these different articles and they are not just setting a protocol and looking at everything that comes through the protocol. They're looking for specific articles to be able to paint the bigger picture and show it from all different sides. So they're picking these articles and bringing them in and then making a cohesive story about what's going on in that topic. So this article is the. Probably the reason you see that they're looking at all these different types of literature ot literature and education and psychology is because they're trying to tell the whole story from all different sides.
- [12:42]
A
Yeah, that's great. That makes a lot of sense. And with this article, it was interesting. They said what their keywords were and I was looking for like the tables, talking about how many articles they found and those different things, and it wasn't in there. But that makes sense. Following A narrative review process. Mm.
- [13:00]
B
Exactly.
- [13:01]
A
Before we get much further, I think it's really important that we also highlight the conflict of interest that the authors disclosed at the end of the article. The authors are working with the Learn and Go company to co create a new AI platform called Caligo. So they haven't vested interest, but I thought the article was still really good, and I still want to talk about it.
- [13:24]
B
Well, who better to put together all of the research on a topic than people that are trying to produce something to make money off of? Because they want to make sure it's going to work and they want to make sure that it's going to be relevant. So I think that that's actually probably a good thing.
- [13:39]
A
Yeah, and they sure did a good job.
- [13:41]
B
All right, Lacy, well, let's get into it. Having read this amazing study, what were your main takeaways that you had?
- [13:48]
A
One of the things that was interesting right off the bat was that the researchers did a really nice job explaining how complex handwriting is. And it was so validating for me and maybe other OTs to just consider all of the different variables that we're looking at with instruction with handwriting, all the different client factors, and just taking it all in and realizing, wow, this is a really big skill that's so important and so challenging to address.
- [14:22]
B
And I think that's why whenever we write IEP goals for penmanship, I always like to put underperson responsible, never just ot, because there's so many elements. There's a language production piece to it, there's a reading and comprehension, there's the written expression piece, and then there's the mechanics of writing. So there's a lot going into it. You gotta have a lot of people addressing it.
- [14:45]
A
Yeah, 100%. I also really liked how the authors gave us six guiding principles that should be used for handwriting instruction for all children.
- [14:56]
B
Oh, it's like a fidelity measure for handwriting.
- [15:00]
A
Yeah, exactly. And then later on, when they talked about OT specific intervention, they said, well, first you have to make sure you're following these other six. And then these are some other things you could look at. So let's break them down. The first guiding principle is practice, practice, practice.
- [15:19]
B
Yes, it is. Motor learning.
- [15:21]
A
Yes, this is the key for learning handwriting and for improving handwriting writing.
- [15:28]
B
So I wonder, though, like, when I think about classrooms in today's day and age, it feels like they don't actually spend a lot of time practicing handwriting. In fact, they spend hardly any time practicing handwriting. I wonder how that's impacting things.
- [15:43]
A
Yeah, I think there's so many standards and so many different curriculums and the advent of iPads and just keeping kids busy. The researcher said that the amount of time spent in class on handwriting and handwriting activities has greatly reduced over the past 30 years. Yeah, for sure.
- [16:04]
B
I mean think about when you were in kindergarten. Like I came in, I didn't know how to write yet. The whole thing was to learn your letters and numbers and writing. And now the expectation is coming in, they already have those skills. They're not spending any time on that instruction.
- [16:17]
A
All right. The second guiding principle is that it is important to focus on the task of handwriting itself. So you do writing to work on writing. And the other thing, I have an actual quote here from the article that I really wanted to share. The author said, quote, sensory motor interventions that addressed isolated component skills such as visual perception, kinesthesia in hand manipulation, visual motor integration or biomechanical features of handwriting have no effect on, on handwriting legibility and should not be used. And that was supported by five different articles that they cited.
- [17:00]
B
Yeah, I think that's really consistent with the literature I've seen as well. There's been a real shift away from learning through those sensorimotor intervention practices and going really into the writing.
- [17:12]
A
Yeah. And I think for OTs, it's really important that we follow that evidence too because I think we at least I used to have a natural inclination to more of the sensory motor activities and they are more fun but keeping the focus again, occupation based. The occupation is writing. We're working on writing.
- [17:32]
B
Yeah. And you know, the literature shows that is, I think there's a 17 year gap between research and implementation. And this is an excellent example of that. We as OTs love therapy and we love little like fine motor exercises. And it's just, it's so core to what we've done for so many years that it's hard to get away from that and just recognize that actually based on the theory base, the frame of reference of motor learning and based on the evidence, what the research has shown, we shouldn't be doing that.
- [18:06]
A
Principle three is actually tied into this really well and that is that handwriting instruction should be explicit. It doesn't just happen. It needs to be very intentionally taught. This would include like when you do an A, make a line, then make a circle. Or actually when you do a capital A. That was a bad example. When you do a capital A, you're going to do a diagonal line down, another diagonal line and a line across. Make sure you're hitting that top line. With the top of your A, make sure the bottom parts of your A are sitting on that bottom line. So those really explicit things about what a letter should look like and the formation of it is really important.
- [18:50]
B
Yeah. And definitely teachers are not doing that.
- [18:52]
A
No. In fact, the article said that only 12% of teachers reported that they feel like they have been adequately trained to teach handwriting in the classroom. I thought it would be low, but that's even lower than I was expecting. 12%?
- [19:08]
B
Yeah. I mean, when we think about how we discussed earlier about the tier 1, 2, 3 intervention approaches and about using a mindset of building capacity instead of just like one on one teaching. This is exactly why. Because teachers don't get instruction in their education about how to do this. They need the OT to come alongside them and help them know how to teach handwriting. And if we're just working with the kid one on one, the teacher's not getting that capacity building skill set.
- [19:40]
A
Yeah, they are stretched really thin.
- [19:42]
B
I have a friend who's an occupational therapist and actually professor of OT as well and she does con ed courses for teachers where she teaches them about handwriting instruction. So she'll go to like, you know how we have AOTA and everybody goes, well, teachers have stuff like that too. And she'll go and teach her course on handwriting and it's all like hands on. And she's a fabulous teacher. Dr. Jennifer Wade.
- [20:05]
A
That's brilliant. I'm sure they love it.
- [20:08]
B
Yeah, they do.
- [20:09]
A
That brings me to guiding principle number four. That feedback needs to be given to the students about their handwriting performance. And the more immediate the feedback, the better. If it can be right after they're done writing, then that's really the best. And the feedback can be from the teacher or the student can self reflect. Or you could get more fancy with like haptic feedback where you're using the sense of touch or some sort of sound if you're using some sort of computer based software system.
- [20:39]
B
Or you could just be like Cha Ching. That's right. Which is the sound effect that I like to use.
- [20:45]
A
I make my own sound effects. Exactly.
- [20:49]
B
I mean, again, this just dovetails right into the motor learning theory which focuses on high frequency repetition having some sort of feedback schedule which is either going to be implicit based on what you're experiencing through your body or explicit based on what other people are providing you. And then there's different types of feedback schedules too, either doing it immediate or delayed. And so it fits right into that motor learning theory.
- [21:16]
A
Yeah. And it also dovetails into the teacher capacity I think it'd be almost impossible for a teacher to give immediate feedback to every single student in the classroom as they're writing. And it was interesting. The study also shared that a lot of teachers feel like their present isn't really important when students are practicing handwriting. And I've seen this with my own boys, where the teacher is maybe working with a small group of students doing a reading activity, and then the rest of the class is just doing their handwriting practice worksheets. And then maybe my boys would get, like, a star or something on their worksheet, and that was about all that they could get. Not blaming the teachers, but that's just. That's just how it goes.
- [22:03]
B
Imagine the teacher jumping around. Ka ching, kaching.
- [22:06]
A
Ka ching, kaching.
- [22:08]
B
That would not work. But, you know, especially at this age level, there are so many parents that want to volunteer in the classroom, and it doesn't take that much, you know, just a little bit of instruction. And parents could also provide that explicit feedback in the small groups with the kids.
- [22:24]
A
Yeah, good idea. Guiding principle number five is that instruction should be variable. And this goes along with that motor learning theory again, where you want the kids to write with different sizes, maybe different fonts. Just mixing it up as much as possible. That really helps facilitate memorization. Whoa, whoa, wait.
- [22:45]
B
Am I supposed to be like, do the Times New Romans font now? And now do the Ariel font, and now try the Roboto font. I mean, like, what is it? Different font.
- [22:54]
A
I didn't know what the font meant either.
- [22:58]
B
They're doing, like, block letters. They're learning to do, like. Like cheerleading posters.
- [23:05]
A
I remember actually doing that when I was little. I would do, like, bubble letters. Yeah. And then block letters. And then, like, curly Q letters. Yeah. Like, different doodling. I'm not exactly sure what they meant, but I really like doing bubble letters.
- [23:19]
B
So I low key, still doodle. If I go to, like, a course and I'm sitting and having to listen, I'm definitely doodling all over everything. So, hey, doodling for the win.
- [23:28]
A
Yep. And that brings us to number six, that learning environments need to be motivating and supportive for our students. And this makes a lot of sense because handwriting just isn't the most fun thing to do. But if you're writing about something that you're really excited to learn about, or you're, like, writing a note that you want to pass to a friend, like, that's really motivating. If the teacher is supportive and has a fun learning environment, then I could see how that is easily, very, very Good.
- [24:01]
B
Yeah, just getting creative with how you're doing the writing practice and not just doing the letter A over and over and over again. But I mean, you could even partner kids together and have them one write the A and the other one say what they like about it, what needs to improve just to, you know, increase that interaction, that feedback, that. That doing it in a different way every time. Or you could try what the other researchers did, have them write the paper, hand it to the teacher, and the teacher can shred it right in front of them. That's an example of what not to do.
- [24:32]
A
No, don't do that. Don't do that. This principle is also kind of a sneak peek for one of our mechanisms of action, which is non linear pedagogy. And that basically says that individuals learn at their own pace. So the classroom environment and the activities ideally should be individualized for students to learn at their own pace. But again, that's so hard to do in a giant classroom.
- [24:58]
B
I don't even know how you do that. And what's interesting too is that, like, all kids learn at their own pace. That's true. But regardless, this week we have to cover this topic, and next week we have to cover this topic. So I'm wondering, realistically, is that where homework comes into play and you're helping to shape what they're doing at home with the parents, maybe, you know, having different assignments based on how well the child is picking it up? You know, potentially you could do that. Like you have your three different homework sets. And it's like this kid gets this one and this kid gets that one. I mean, that would be even hard too, though, because when they come back, a lot of times the kids grade their own homework, like as a group, you know, so then again, parent volunteers coming in for the rescue.
- [25:40]
A
Yeah, yeah, that's funny you bring it up, Michelle, because I felt like this was kind of a guiding principle number seven, like a bonus one where the author said that handwriting instruction and learning, especially for kids getting remediation through ot, it occurs best when the child, the teacher and the family are all on the same page doing the same thing, kind of supporting the child along the way. And again, we know it's so hard in a school setting to have parents as an integral part. You can send papers back and forth, you can call a parent. But I know there were some kids I worked with in a school setting where I only saw the parents at the iep. So it's just logistically really hard to do.
- [26:25]
B
Well, it takes a village The OT can't expect to do it all by themselves. The teacher can't do it all by themselves, you know.
- [26:31]
A
Yeah, that was my favorite part of the article, going through the six guiding principles. They also had a really nice section about what rehabilitation for handwriting looks like. I was thrilled when I was reading this section because they gave OTs a shout out. They said that if a student is having trouble with handwriting, then an occupational therapist is usually brought in for support. So I love that. It wasn't an OT article, but OT was featured prominently. So after the article got through all of the best practices for handwriting intervention, they started looking to the future to see how AI infused products could help with some of these shortfalls that we talked about with all of these principles to make handwriting instruction better for kids with disabilities. Yes, but all kids in general and help out the teachers too. The platform that they talked about was Caligo. And with this platform, students use styluses on an iPad and it takes all kind of data and gives a lot of feedback. The students use this software for assessing their handwriting. It also provides instruction on how to improve their writing and also collects data for progress monitoring that can be shared with the teacher, the student and the family.
- [28:02]
B
That's really helpful because all of those things that we talked about that would be so hard for a teacher, it's kind of taking over those tasks for them. Have you used Letter School before?
- [28:15]
A
Yes.
- [28:15]
B
Yeah, it seems like it's like a more advanced version of something like Letter School, which I have always liked Letter School because it's engaging, it's fun, and also it gives them automatic feedback so they can't just rush through it because it legitimately won't let them go on unless they do it correctly. And as a therapist, if you're trying to give them feedback, you kind of like frustrate them by having them do it again. But with the app, they tolerate it.
- [28:45]
A
Yeah, I think that is actually a really good comparison. When I was looking it up online, it does seem like a letter school where kids are writing either pre writing shapes, individual letters, two letters at a time, or words, and they're getting that feedback right away about their writing performance.
- [29:06]
B
So it's like an active, ready to use already out there application.
- [29:11]
A
Yeah. And they just actually just updated it a couple weeks ago.
- [29:13]
B
Does it have a free trial?
- [29:15]
A
They do have a free trial, yeah. Two weeks free. And then I'm not sure what the price is after that. I think they're really trying to target schools or school districts to use it rather than Individual users, at least at this point.
- [29:29]
B
But couldn't you see how great that would be? Like they're using it at school, the parents can use it at home. They're getting the same feedback. That would be really useful for getting everyone on the same page.
- [29:40]
A
So yeah, it really hits on those guiding principles of like, practice, practice, practice. You're working on the task of handwriting. It's explicit instruction and it's giving that immediate feedback with every trial. And I'm sure they're varying their different approaches along the way. Maybe they have bubble letters in there too, I'm not sure. And last, it's very individualized for each learner and it's growing and learning with them at their own pace.
- [30:09]
B
Sounds like a really cool product. Anything else highlighted?
- [30:13]
A
That was it for that article. But just to make sure I wasn't turning this into a commercial for Caligo, I also wanted to give a shout out to another product that I recently heard about called Cymark. It's spelled like psychology for psy. So P S Y M A R K symark. And this tool is similar but is really focusing at screenings for school districts. It's think of it as like an AI powered Beery vmi. So once a year, a couple times a year, the whole school can get assessed on either their pre writing shapes or their numbers or their letters. And it's just a really nice kind of population based tier one intervention for schools. Cool. My takeaway in general for AI products when looking at handwriting is that it makes meeting those six guiding principles a lot easier. And it can really help facilitate that collaboration between kids, potentially OTs, teachers and families to again build capacity. Wouldn't that be great if OTs weren't so stuck in like our handwriting box? Maybe if that was reduced a little bit more, kids would get riding faster, easier, sooner without waiting for an ot and we could start doing some of those tier one, tier two interventions that we want to get to so badly.
- [31:45]
B
Okay, Lacey, so thanks for bringing this amazing article to us. Let's wrap it up like we always do, talking about three key elements, starting with the population.
- [31:54]
A
They were really looking at handwriting for all children. But with the topics that they talked about, it seemed like they were focusing primarily on elementary age kids. Kids.
- [32:04]
B
Yeah, that makes sense. And the key ingredients we talked a lot about with the six principles that guide good handwriting instruction. Anything else that you want to highlight on that?
- [32:15]
A
Yeah, let's summarize those six principles again. The first one, practice, practice, practice. Tap into that motor learning theory to get the most improvement. Number two, focus on the task of handwriting. Again, we do writing to work on writing. Number three, instruction should be explicit. It doesn't just happen. It needs to be intentionally taught. Number four, feedback also needs to be given and the more immediate the feedback is, the better. Number five, instruction should include variability. Don't just teach the same thing over and over and over. Mix it up. And six, the learning environment needs to be motivating and supportive. And then I threw in a bonus that the authors talked about and that is to include collaboration between the teacher, the child and the family.
- [33:10]
B
Great. Yeah. And then we also discussed the mechanism of action, which is why we think this intervention works. We already talked about the motor learning theory and anything else you want to highlight.
- [33:21]
A
Yeah, I had my sneak peek earlier with the non linear pedagogy and that's where individuals learn at their own pace. And I definitely agree with this. But I also see a little bit of the developmental frame of reference. And the developmental frame of reference says that children tend to learn in a predictable pattern that follows typical development, like those developmental milestones. So when we're trying to balance both of these at the same time, we we know there's a typical development pattern and we also know that children still learn at their own pace. This is quite the challenge when there's like 20 to 30 different kids in a classroom.
- [34:01]
B
God bless those teachers. And that's it for our research review. We hit the highlights and shared our own thoughts. Please check out the article and let us know how it's impacted your therapy sessions.
- [34:14]
A
And now it's time for people, places and products where we shout out something or someone that is making our therapy hearts happy. Michelle, what do you have for us today?
- [34:25]
B
I have a routine that I implemented last year. I do this every single workday when I'm leaving the clinic and getting into my car and driving home. And it has made a world of difference for me being able to emphasize that self care and leave the work behind and transition into my other occupation of being a family member. When I get home and what this routine is, I turn on a song that is called the Waitlist song and it's by Marconi Union so you can find it free on YouTube or Apple Music has it. There's lots of different ways that you can find it. It's called Weightless and it's just this very calming instrumental song that is a couple minutes long and I'll play that song and I'll review the day from beginning to end. Everything that happened, what I liked What I didn't like as a way of saying, like, thank you and good night to everything that I did that day and something about having the song playing and the routine that it helps me to kind of wrap up my day. But also like if you go onto YouTube and you search the waitlist song, you're going to find like a 10 hour version because it was used in a study where they were looking at its impact on reducing anxiety and it was found to be an effective intervention. So sometimes if I'm working with a kid and they're seeming a little anxious, I'll play the waitlist song. Or if I'm feeling stressed out, I play the Waitlist song. So I think that everybody should have this on their playlist.
- [35:58]
A
That sounds great. I'm definitely going to check it out and add it to my playlist. I work from home two days a week doing grading, class planning, various things and those are the days that are the hardest for me to turn off my brain and transition from work to home. So I will definitely be trying that out. Thanks for the suggestion.
- [36:21]
B
You have to tell me what you think about it.
- [36:25]
A
And now it's time for our listener question. Our question this week comes from Sherry. Sherry asked, as I was listening to episode eight about sensory integration, I was thinking about a kid that I see for feeding who has significant tactile defensiveness. Do you sometimes focus only on tactile modulation? Is that best for these kinds of kids because of their tactile defensiveness?
- [36:52]
B
Oh, that's an interesting question. I like that I don't do a lot of feeding. And I would say, Sherry, you should check out episode 10 where we have a feeding specialist on for our very special episode with a guest and you might find some additional thoughts and ideas is there. But for me, if I'm using an SI frame of reference, regardless if it's tactile defensiveness that's impacting their ability to get dressed or their ability to eat, I'm still going to follow those principles of airs si, which means that I'm going to be incorporating at least two sensory systems to create sensory rich activities.
- [37:29]
A
Yeah, I agree. If a child is demonstrating tactile defensiveness for feeding, there's probably a good chance that they are also tactile defensive in other areas as well. So I'd encourage you to not just be so focused on the feeding. I know feeding is really important and a lot of times parents are really invested and kind of stressed out about feeding. But take a look back and consider the whole child and go Back to your evaluation, maybe do an additional sensory assessment and see what other things you can find to target this skill. Using at least two sensory systems along the way.
- [38:09]
B
Yeah, the easiest one to incorporate is going to be proprioception because that's going to help modulate the tactile input. So even if you don't see deficits with like vestibular or in the probe system, you could still embed probe into the tactile activity to make it a sensory rich and a more powerful intervention. And then I also like to use vibration because that's like a mixed type of sensory input. It's touch and movement all together.
- [38:34]
A
One thing that I've seen feeding therapists do that look really fun is they would adapt different board games like Candy Land for example, and if they landed on a green square, then they would take a bite of whatever was green. If they landed on a purple square, then they would do like 10 jumping jacks. So naturally, as you would play the game, different sensory experiences would unfold in addition to the eating. And it just brought kind of a fun motivating element to it too. And the therapist would take turns and play and do the activities along the way. So it really kind of diffused the feeding piece as well.
- [39:12]
B
I saw a therapist doing something on Friday actually, where she had a trampoline pulled up to the table and the kid was just jumping and doing the feeding and jumping and doing the feeding. So, you know, I mean that you can think creatively about how you might be able to combine those two activities.
- [39:28]
A
Great. Well, if you have a question, we want to answer it as well. Email us@ideaslaypodcastmail.com or DM us on social media and we may include your question in a future episode. This week we reviewed an article looking at the current evidence for handwriting and got a sneak peek at what AI can offer us in the future. Remember to use the six guiding principles that were laid out and include the bonus one on collaborating with the teacher and the family.
- [39:59]
B
Thanks for listening to Ideas at Play. If you've learned something new from today's podcast, be sure to leave a rating and review. This helps others find our podcast so we can all be evidence based therapists. If you want more ideas for your sessions, you can find us on Instagram under Ideas at Play or email us@ideasplaypodcastmail.com.
- [40:21]
A
Until next time, stay informed, stay curious, and stay playful. Pedagogy, pedagogy. Pedagogy, pedagogy.
- [40:34]
B
Okay, that was ridiculous.