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Determinants of handwriting capacity in children newly diagnosed with Attention Deficit Hyperactivity Disorder prior to and following treatment with stimulant medication.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Determinants of handwriting capacity in children newly diagnosed with Attention Deficit Hyperactivity Disorder prior to and following treatment with stimulant medication./
作者:	Brossard-Racine, Marie.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2012,
面頁冊數:	262 p.
附註:	Source: Dissertations Abstracts International, Volume: 74-04, Section: B.
Contained By:	Dissertations Abstracts International74-04B.
標題:	Occupational Therapy. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=NR78754
ISBN:	9780494787540

Determinants of handwriting capacity in children newly diagnosed with Attention Deficit Hyperactivity Disorder prior to and following treatment with stimulant medication.
Brossard-Racine, Marie.

Determinants of handwriting capacity in children newly diagnosed with Attention Deficit Hyperactivity Disorder prior to and following treatment with stimulant medication. - Ann Arbor : ProQuest Dissertations & Theses, 2012 - 262 p.

Source: Dissertations Abstracts International, Volume: 74-04, Section: B.

Thesis (Ph.D.)--McGill University (Canada), 2012.

This item must not be sold to any third party vendors.

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common disorders of childhood and its consequences extend beyond the child, to include important impacts on the family and community. At present, the primary focus of interventions is on management of symptoms and promoting academic success. There is a common misconception that many of the social, cognitive and motor deficits frequently documented in children with ADHD are attributed to their inattentiveness and other behavioral difficulties. Persisting difficulties in these domains can further challenge the child's developmental trajectory and academic productivity and therefore should be addressed as part of health and educational services. Handwriting is an example of an important life skill that is reportedly impaired in this population, and often requires remediation. Nevertheless, the extent and nature of handwriting difficulties and factors associated with poor legibility are poorly understood in this population. The primary aim of this doctoral thesis was to objectively describe handwriting capacity in medication naive-children with ADHD, to ascertain relationships between handwriting and motor and attentional abilities and to determine if handwriting improved significantly three months following treatment with stimulant medication. Children in our sample demonstrated wide variability in performance in terms of handwriting speed and legibility. As part of this doctoral project and with the collaboration of expert pediatric occupational therapists, clinical cut-off values that can be used to differentiate between children with and without legibility problems were developed for our outcome measure, the Evaluation Tool of Children's Handwriting. Applying these values, poor letter legibility was noted in 65.3% of the children at baseline (prior to initiation of medication) and persisted in 42.9% of the sample after treatment with stimulant medication. Concomitantly, motor difficulties were also highly prevalent (73.0% at baseline and 55.0% after treatment) with manual dexterity, as measured by the Movement Assessment Battery for Children, the most frequently impaired at both testing periods. Interestingly, handwriting difficulties were not more frequent in children with motor delays. Handwriting legibility was best determined by the visual-motor integration skills, as measured by the Developmental Test of Visual Motor Integration, prior to initiation of medication as well as three months after medication use. Change in legibility and speed of writing was also associated with change in visual-motor integration scores. Preliminary analyses did not consistently highlight particular factors associated with handwriting capacity, when comparing children with and without persisting motor difficulties. However, the severity of behavioral symptoms was significantly associated with components of motor performance. This study confirms that motor skills deficits, poor legibility and slow writing speed are highly prevalent in children with ADHD. The results of this study further suggest that use of stimulant medication to improve behavior in children with ADHD is not sufficient to eliminate these handwriting challenges nor the coexisting motor difficulties. These children would therefore greatly benefit from a routine evaluation by an occupational therapist focusing on motor performance and the child's performance in everyday meaningful activities such as handwriting so that problems may be readily identified and appropriately addressed to optimize the child's functional potential and participation in life roles.

ISBN: 9780494787540Subjects--Topical Terms:

617819
Occupational Therapy.
Subjects--Index Terms:

Attention deficit hyperactivity disorder

Determinants of handwriting capacity in children newly diagnosed with Attention Deficit Hyperactivity Disorder prior to and following treatment with stimulant medication.
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506 $a This item must not be added to any third party search indexes.
520 $a Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common disorders of childhood and its consequences extend beyond the child, to include important impacts on the family and community. At present, the primary focus of interventions is on management of symptoms and promoting academic success. There is a common misconception that many of the social, cognitive and motor deficits frequently documented in children with ADHD are attributed to their inattentiveness and other behavioral difficulties. Persisting difficulties in these domains can further challenge the child's developmental trajectory and academic productivity and therefore should be addressed as part of health and educational services. Handwriting is an example of an important life skill that is reportedly impaired in this population, and often requires remediation. Nevertheless, the extent and nature of handwriting difficulties and factors associated with poor legibility are poorly understood in this population. The primary aim of this doctoral thesis was to objectively describe handwriting capacity in medication naive-children with ADHD, to ascertain relationships between handwriting and motor and attentional abilities and to determine if handwriting improved significantly three months following treatment with stimulant medication. Children in our sample demonstrated wide variability in performance in terms of handwriting speed and legibility. As part of this doctoral project and with the collaboration of expert pediatric occupational therapists, clinical cut-off values that can be used to differentiate between children with and without legibility problems were developed for our outcome measure, the Evaluation Tool of Children's Handwriting. Applying these values, poor letter legibility was noted in 65.3% of the children at baseline (prior to initiation of medication) and persisted in 42.9% of the sample after treatment with stimulant medication. Concomitantly, motor difficulties were also highly prevalent (73.0% at baseline and 55.0% after treatment) with manual dexterity, as measured by the Movement Assessment Battery for Children, the most frequently impaired at both testing periods. Interestingly, handwriting difficulties were not more frequent in children with motor delays. Handwriting legibility was best determined by the visual-motor integration skills, as measured by the Developmental Test of Visual Motor Integration, prior to initiation of medication as well as three months after medication use. Change in legibility and speed of writing was also associated with change in visual-motor integration scores. Preliminary analyses did not consistently highlight particular factors associated with handwriting capacity, when comparing children with and without persisting motor difficulties. However, the severity of behavioral symptoms was significantly associated with components of motor performance. This study confirms that motor skills deficits, poor legibility and slow writing speed are highly prevalent in children with ADHD. The results of this study further suggest that use of stimulant medication to improve behavior in children with ADHD is not sufficient to eliminate these handwriting challenges nor the coexisting motor difficulties. These children would therefore greatly benefit from a routine evaluation by an occupational therapist focusing on motor performance and the child's performance in everyday meaningful activities such as handwriting so that problems may be readily identified and appropriately addressed to optimize the child's functional potential and participation in life roles.
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