Attention Difficulty Education workshops

Zone’in and Move’in Training Workshops

Zone’in Program

Program Development

The Zone’in Program was originally designed by Cris Rowan while working for a decade as a Pediatric Occupational Therapist with the Sunshine Coast School District No. 46. Zone’in started as The Sensory Integration Observations and Strategies Assessment and Intervention, developed by Cris and administered by parents and teachers following workshop training and certification. As the attention deficit population grew, Cris wondered if she could design a classroom based, kid-driven assessment and intervention to better address need. Hence…the creation of the Zone’in Program! Cris began by distributing a questionnaire to the Sunshine Coast Special Education Teachers to determine incidence of attention deficits in the elementary population and found that 30% of children had attention delays that significantly impacted their ability to learn.

Prototype Testing

Prior to prototype testing, Cris held a meeting with the Sunshine Coast Special Education Committee where she surveyed the Resource Teachers regarding what parameters should be met with the final Zone’in Program, and they responded with the following requests:

No paper, booklets or folders
All inclusive kit
No requirement for teacher preparation time
Kid-driven to optimize motivation
FUN!

The Zone’in Program prototype was repeatedly implemented, revised and evaluated over a four month period at Madeira Park Elementary School with grade 1, 2, 3 and 6 students and teachers, resulting in a program that has proven to meet the Sunshine Coast Special Education Committee requirements, as well as be fun for the students.

Original Research

Ms. Helen Gilbert, principal with Bert Ambrose Elementary School in School District #60, Fort St. John will be completing the requirements for her Master’s thesis by conducting a study to determine Zone’in Program efficacy in improving children’s self regulation in a school based setting. This study will be implemented on a school wide basis, and the results are expected to be completed in 2009.

Sensory Integration Research

American Academy of Pediatrics, Committee on Communications (2006) Children, Adolescents, and Advertising. Pediatrics Vol 118 No 6, 2562-2569. This paper points out that exposure of children to TV advertising correlates with obesity, poor nutrition, and cigarette and alcohol use.

Antonuccio D, Burns D, Danton W (2002) Antidepressants: A Triumph of Marketing Over Science? Prevention and Treatment, Vol 5 No 1, July 2002 pages 1-21. The authors of this paper performed a meta-analysis of the Food and Drug Administration database of 38 controlled trials on 6,944 patients used in the initial approval for the most popular anti-depressants (fluoxetine, paroxetine, sertraline, venlafaxine, nefazadone and citalopram). Kirsch I, Moore T, Scoboria A, and Nicholls S (2002) found that antidepressants demonstrated and clinically negligible advantage over inert placebo, and state how these results are surprising because they come from studies underwritten by drug manufacturers. Doesn’t this imply that it is an ‘industry standard’ to assume that drug trials by pharmaceutical companies are essential biased (C. Rowan comment)? The meta-analysis goes on to state that these finding do not appear to justify the popularity of anti-depressants, which may have been fueled in part by publication bias and outstanding marketing. This paper reports that the US pharmaceutical industry is a $250 million annual business, of which $19 million goes to advertising, making it the most profitable industry in America, number one in return on revenues, return on assets, and return on equity (Fortune 2000). Surprised? Read on. The pharmaceutical industry had a combined lobbying and campaign contribution budget of $197 million in 1999 and 2000 alone, larger that any other industry (Wayne and Peterson 2001), and has 625 registered lobbyists (more than there are members of congress)!

Autism Society America (2003) Facts and Statistics. Autism Spectrum Disorder. www.autism-society.org/site/PageServer?pagename=FactsStats. This article states that autism is the fastest growing developmental disability with 2003 prevalence of 0.7% with a 10-17% annual growth.

Ayres A (1985) Developmental Dyspraxia and Adult Onset Dyspraxia. Sensory Integration International, California.

Ayres, A (1972) Sensory Integration and Learning Disorders. Western Psychological Services, California.

Ayres, A (1979) Sensory Integration and The Child. Western Psychological Services, California.

Barthell, K (2004) Evidence and Art: Merging Forces in Pediatric Therapy. Workshops and book available at www.labyrinthjourneys.com.

Becker-Weidman A (2001) Attachment Disorder Checklist. Mental Health Matters http://www.mental-health-matters.com/articles/article.php?artID=573. Checklist designed to identify children with Reactive Attachment Disorder.

Bragdon, A and Gamon D (2000) Brains That Work A Little Bit Differently: Recent Discoveries About Common Brain Diversities. Allen D. Bragdon Publishers Inc, The Brain Wave Centre, MA. Authors explore ten brain phenomena including left-handedness, dyslexia, ADHD, perfect pitch, SAD, Autism, alcoholism, déjà vu, photographic memory and synesthesia. Fascinating!

Braswell J and Rine R (2006) Evidence that Vestibular Hypofunction Affects Reading Acuity in Children. International Journal of Pediatric Otorhinolaryngology Vol 70 Issue 11, 1957-1965. Study results found that reading acuity scores were significantly worse in children with vestibular hypofunction, and that reading acuity scores correlated with dynamic not static visual acuity scores. This reports high lights that gaze instability due to vestibular hypofunction affects reading ability in young children.

Braswell J and Rine R (2006) Preliminary Evidence of Improved Gaze Stability Following Exercise in Two Children with Vestibular Hypofunction. International Journal of Pediatric Otorhinolaryngology Vol 70 Issue 11, 1967-1973. This study found that visual-vestibular exercises improved critical print size and reading acuity.

Block, J (2008) Issues for DSM – V: Internet Addiction. American Journal of Psychiatry Vol 165 March pg 306-307. This editorial advocates for inclusion of Internet Addiction into the upcoming fifth edition of the psychiatric Diagnostic and Statistical Manual. Conceptually the diagnosis is a compulsive-impulsive spectrum disorder that involves online and offline computer usage, and consists of three subtypes: excessive gaming, sexual preoccupations and email/text messaging. All of the variants share the following four components: 1) excessive use 2) withdrawal 3) tolerance 4) negative repercussions.

Bundy A, Lane S and Murray E (2002) Sensory Integration Theory and Practice, 2nd Edition. F.A. Davis, Philadelphia.

Burdette, H and Whitaker R (2005) A National Study of Neighborhood Safety, Outdoor Play, Television Viewing, and Obesity in Preschool Children. Pediatrics Vol 116, 657-662. This study reports that mother’s perceptions of safety was related to their children’s TV viewing time.

Centre for Disease Control and Prevention (2003) Mental Health in the United States: Prevalence of Diagnosis and Medication Treatment for Attention Deficit/Hyperactivity Disorder. www.cdc.gov/mmwr/preview/mmwrhtml/mm5434a2.htm. This reports a 7.8% ADHD prevalence in 2003 with 56.3% of this population on medication.

Christakis D and Zimmerman F (2007) Violent Television During Preschool Is Associated With Antisocial Behavioural During School Age. Pediatrics Vol 120, 993-999. This study concluded that violent television programming was associated with an increased risk for antisocial behaviour for boys, but not for girls.

Christakis D, Zimmerman F, DiGiuseppe and McCarty C (2004) Early Television Exposure and Subsequent Attentional Problems in Children. Pediatrics Vol 113, 708-713. This study reports that for every one hour of television watched per day, there is a 10% increase in attention problems by the age of 7 years.

Chow S, Choy S, Mui S (2003) Assessing Handwriting Speed of Children Biliterate in English and Chinese. Perceptual and Motor Skills Vol 96 pages 685-694. This study describes the psychometric properties of a handwriting speed test developed for children who are biliterate in English and Chinese, and reports the Handwriting Assessment Tool is a reliable and potentially useful handwriting test for children biliterate in English and Chinese.
Frick S and Hacker C (2001) Listening With the Whole Body. Vital Links Press, Wisconsin.

Cotman C, Berchtold N and Christie L (2007) Exercise Builds Brain Health: Key Roles of Growth Factor Cascades and Inflammation. Trends in Neuroscience Vol 30 No 9, 464-472. This research profiles how exercise improves cerebral vascular perfusion, increases the production of neurogenic growth factor, and decreases inflammation with subsequent increase in the number and length of survival of nerve cells in the hippocampal region, implicated in learning and memory. This article also shows the positive effects of exercise on reducing depression.

Dennision, Paul (1992) Brain Gym: Simple Activities for Whole Brain Learning. Edu-Kinesthetics Inc, California. Loads of Brain Gym exercises for classroom and at home!

DeGangi, G (2000) Pediatric Disorders of Regulation in Affect and Behaviour. A Therapist’s Guide to Assessment and Treatment. Academic Press, New York.

Diagnostic and Statistical Manual of Mental Disorders 3rd Edition (1987), 313.89 Reactive Attachment Disorder of Infancy or Early Childhood. American Psychiatric Association.

Diller LH (1999) Running on Ritalin: A Physician Reflects on Children, Society, and Performance of a Pill. Published by Bantam Publishing. Dr. Diller, a Pediatrician explores the escalation of diagnosis of American children with ADHD and treatment with Ritalin, and highlights how research often obscures social or environmental factors. Dr. Diller points out that it is misleading to hold that Ritalin’s success in treating ADHD children means that ADHD can be reduced to biological phenomenon, to chemical imbalance. Diller convincingly suggests that part of the reason that many wish to portray ADHD as a purely ‘neurobiological’ disorder and Ritalin is the ‘cure’ is political. As victims of biology, children and adults diagnosed with ADHD become legally entitled to rights not given to others. But so what? If Ritalin helps those diagnosed with ADHD perform better, what difference does it make whether it treats the causes of ADHD or just the symptoms? Diller’s answer is that America should be concerned because the 700% increase in Ritalin use points to societal imbalance that prescribing the drug covers up: “The surge in ADHD diagnosis and Ritalin treatment is a warning to society that we are not meeting the needs of our children”. Whether or not one entirely accepts Diller’s argument is that American psychiatrists have ignored the evidence against Ritalin’s effectiveness as a cure for ADHD, this is an important book for anyone interested in the narcoticising of America’s youth.

Driver J and Frith C (2000) Shifting Baselines in Attention Research. Nature Reviews Neuroscience Vol 1, 147-148. This commentary profiles new studies indicating that the attention state of the observer affects processing of incoming stimuli, and that the sensory cortex can actually prepare and modulate incoming stimuli. This information substantiates the importance of educating children regarding how to attain body energy necessary to improve attention by using Zone’in Tools and Techniques.

Dunn, Winnie (1999) The Sensory Profile. The Psychological Corporation, USA.

Elkind D (2007) The Hurried Child: Growing Up Too Fast Too Soon. Published by Da Capo Press, New York City, USA. David Elkind has often been referred to as the voice of parenting reason, calling our attention to the crippling effects of hurrying our children through life. He shows that by blurring the boundaries of what is age appropriate, by expecting-or imposing-too much to soon, we force our children to grow up too fast, to mimic adult sophistication while secretly yearning for innocence. Dr. Elkind provides a detailed, up to the minute look at the internet, classroom culture, school violence, movies, television, and a growing societal instability to show parents and teachers where hurrying occurs and why. He offers parents and teachers insight, advice and hope for encouraging healthy development while protecting the joy and freedom of childhood.

Engel A, Fries P, and Singer W (2001) Dynamic Predictions: Oscillations and Synchrony In Top-Down Processing. Nature Reviews Neuroscience Vol 2 704-716. This paper reports how descending pathways (expectations, attention, knowledge and memory) modulate ascending stumuli, and profiles how “the human brain should be regarded as a much more active and adaptive system”.

Field T, Ironson G, Scafidi F, Nawrocki T, Gonclaves A, Burman I, Pickens J, Fox N, Schanberg S Kuhn C (1996) Massage Therapy Reduces Anxiety and Enhances Eeg Pattern of Alertness and Math Computations. Journal of Neurocsience, Vol 86, Issue 3 & 4, pages 197-205. This study reports that two 15 minute massages per week to a group of 26 adults raised frontal delta power (suggesting relaxation), decreased frontal alpha and beta power (suggesting increased alertness), increased speed and accuracy on math exams, lowered anxiety, lower salivary Cortisol levels, lower depression scores on the Chronic POMS Depression Scale.

Fisher R and Fisher S (1996) Antidepressants for Children – Is Scientific Support Necessary? The Journal of Nervous and Mental Disease Vol 184 No 2 pages 99-102. This article is concerned with issues pertaining to the degree to which clinical therapeutic decisions can reasonably depart from the best available scientific data, and state that ambiguity exists as to how much freedom practitioners have to accept or reject the existing scientific paradigm.

Goodwin R, Gould M, Blanco C, Olfson M (2001) Prescription of Psychotropic Medications to Youths in Office-Based Practice. Psychiatric Services Vol 52 No 8 pp 1081-1087. The study reports 84.8% of prescriptions for psychotropic medications were provided by general practitioners or pediatricians. 53.9% of psychotropic medications prescribed were stimulants, 30% antidepressants, 7.2% anxiolytics, 7.2% antipsychotics, 12.7% mood stabilizers.

Hall L and Case-Smith J (2007) The Effect of Sound Based Intervention on Children With Sensory Processing Disorders and Visual-Motor Delays. American Journal of Occupational Therapy Vol 61 No 2, 209-215. Results of this study indicate that a therapeutic listening program and sensory diet significantly improved participants scores on the Sensory Profile, with parents reporting improvement in their children’s behaviours related to sensory processing. This information validated use of therapeutic sound in the Zone’in Program.

Hancox R, Milne B and Poulton R (2005) Association of Television During Childhood With Poor Educational Achievement. Archives of Pediatric and Adolescent Medicine Vol 159 No 7, 614-618. This study concluded that television viewing in childhood and adolescence is associated with poor educational achievement by 26 years of age.

Hannaford, Carla (1997) The Dominance Factor: How Knowing Your Dominant Eye, Ear, Brain, Hand, and Foot Can Improve Your Learning. Great River Books Publishing, Utah. This book explores the linkages between the side of the body we favor for seeing, hearing, touching, and moving, and the way we think, learn, work, play and relate to others. Hannaford describes 32 dominance profiles and how each profile relates to learning and behavior styles.

Hannaford, Carla (2005) Smart Moves: Why Learning Is Not All In Your Head. Great River Books Publishing, Utah. Probably the most fascinating book I’ve read. Hannaford eloquently describes the neurobiology of learning, with incredible research references.

Healy J (1999) Endangered Minds: Why Children Don’t Think and What We Can Do About It. Simon and Schuster Publishing Company.

Healy J (1998) Failure to Connect: How Computers Affect Our Children’s Minds – For Better or For Worse. Simon and Schuster Publishing Company.

Healy J (1990) Endangered Minds: Why Children Don’t Think – and What We Can Do About It. Simon and Schuster Publishing Company, New York. An awesome ‘text book’ and a ‘must read’ for all educators and parents regarding the escalating educational crisis for our children resulting from TV and videogames. Dr. Healy reviews neurological research and analyzes current educational practices, and makes numerous recommendations for how to get our educational systems and our children back on track.

Hewlett SA (1992) When the Bow Breaks: The Cost of Neglecting Our Children
Published by HarperCollins Publishing Co., Toronto, Canada. Sylvia Ann Hewlett is an economist, consultant, lecturer and a volunteer with homeless children and has written a powerful, extensively researched and often shocking book that explores the plight of the vast number of our children today. She delves into a multitude of problems – substance abuse, emotional instability and broken homes that contribute to parental and public neglect. Hewlett also outlines ways society can help to rectify this situation, including educational reform, changes in the workplace, and government policies. The author’s approach to the harsh reality of neglect stirs the emotions and will no doubt cause a public reaction. This book is of great interest to professionals and general readers, as it is a well documented; compelling study that fully analyzes a nation wide problem.

Hillman C, Erickson K and Kramer A (2008) Be Smart, Exercise Your Heart: Exercise Effects of Brain and Cognition. Nature Reviews Neuroscience Vol 9 58-65. This article profiles the following studies: achievement in standardized test of reading and math was positively correlated with physical fitness scores; social isolation reduced positive effects of exercise on hippocampal neurogensis; exercise training improved depression; cognitive, physical and social engagement decreased the risk of dementia.

Hofler D and Kooyman M (1996) Attachment Transition, Addiction and Therapeutic Bonding – An Integrative Approach. Journal of Substance Abuse Treatment Vol 13 No 6, 511-519. This article profiles the concept that addiction is a maladaptive attachment transition and results from a fear of intimacy, and states the clinical implication of using therapeutic bonding as a treatment intervention.

Horvath C (2004) Measuring Television Addiction. Journal of Broadcasting and Electronic Media Vol 48(3), 378-398. Information from this paper was used in the design of the Zone’in “TVVG Help Module for Parents and Teachers”.

Hubert, Bill (2001) Bal-A-Vis-X: Rhythmic Balance/Auditory/Vision eXercises for Brain and Brain-Body Integration. Bal-A-Vis-X Inc, Kansas. This book contains a series of rhythmic exercises that integrate balance, auditory, and visual systems to improve learning and behavior.

Hulit L and Howard M (2005) Born to Talk, An Introduction to Speech and Language Development, 4th Edition. Allyn and Bacon, Needham Heights Press. This book defines components of attention as orientation, motivation, arousal and memory, and types of attention as focused, sustained, selective, divided and alternating.

Grossberg S (2005) Linking Attention to Learning, Expectation, Competition, and Consciousness. Neurobiology of Attention (Eds. Itti, Rees and Tsotsos). Elsevier Academic Press Chapter 107, 652-662. Grossberg discusses his Adaptive Resonance Theory which predicts that “All conscious states are resonant states”, and that there is a resonance between top-down attention modulation and bottom-up stimuli, and that this resonance leads to a synchronization which facilitates learning as “cells that fire together wire together”.

Insel T and Young L (2001) The Neurobiology of Attachment. Nature Reviews Neuroscience Vol 2 129-137. This article profiles the importance of attachment and quotes Baruch Spinoza who states “Humans are primarily a social animal, and it’s our social attachments we live for”. Insel and Young define a mother’s attachment to her infant as a process of “approach, identify and select/reject”, which are mediated by the neuropeptides oxytocin and vasopressin, found in the dopamine rich areas of the brain, the substantia nigra and preoptic areas. This study points out the similarity between social attachment and psychostimulant addiction, as they apparently use the same neurological pathways, resulting in social recognition, reward and euphoria.

Jordan A, Hersey J, McDivitt J and Heitzler C (2006) Reducing Children’s Television-Viewing Time: A Qualitative Study of Parents and Their Children. Pediatrics Vol 118, 1303-1310. This study profiles barriers to reducing TV viewing time such as parents using TV as a safe and affordable distraction, parent’s own heavy TV viewing patterns, the prominent role TV plays in the family’s day to day routine, and a belief that children should spend their leisure time as they wish.

Kirsch I and Antonuccio D (2004) FDA Testimony On the Efficacy of Antidepressants With Children. Review of this testimony indicates that there are a total of 12 published randomized clinical trials in the entire world literature regarding the efficacy of antidepressant use with children. 8 of these 12 trials failed to find any significant benefit of medication over placebo, and the other 4 that did show benefit were clinician rated, not patient rated measures. This testimony also reports that overall, the effects of antidepressant medication on children is actually weaker than in adults.

Klenberg L, Korkman M, Lahti-Nuuttila P (2001) Differential Development of Attention and Executive Functions in 3 to 12 Year Old Finnish Children. Developmental Neuropsychology Vol 20(1) 407-428. This study profiles confusion in the literature regarding the terms attention, executive function and memory. Authors described attention as having 4 subfunctions of arousal, focus, sustain and shift, and describe 3 developmental sequences of attention as impulse control, sustained attention and executive function. 10 subtests used in this study on 400 normal 3-12 year olds measured impulse control, auditory and visual attention, visual search, planning and verbal and visual fluency. Girls out-performed boys on all subtests, and children of parents with higher education levels out performed children of parents with lower education only on the subtests of execute functioning (not on inhibition or visual/auditory attention subtests). Results suggest a staging of development that begins at age 6 years with maturing of inhibitory functions, followed by a relative maturation of auditory and visual attention at age 10 years.

Korkman, M (2001) Introduction to the Special Issue on Normal Neuropsychological Development in the School-Aged Years. Developmental Neuropsychology Vol. 20(1) 325-330. This article points out that lack of neuropsychological research on age-related changes in school-aged children, and recommends utilization of existing databases for study on normal development.

Landhuis C, Poulton R, Welch D and Hancox R (2007) Does Childhood Television Viewing Lead to Attention Problems in Adolescence? Pediatrics Vol 120, 532-537. This study found that not only does childhood television viewing contribute to attention problems in adolescence, but that these effects may be long lasting.

Learning Disabilities Association of British Columbia – Fact Sheet Statistics (2007) Learning Disabilities Fact Sheet. www.ldav.ca/info.html. This document states that 15% of the elementary population has learning disabilities, with reading deficits the most prevalent condition. 35% of the learning disabled population will drop out of school, 60% will receive treatment for substance abuse, and they will have twice the unemployment rate of the non-disabled population.

Louv, Richard (2005) Last Child in the Woods – Saving Our Children From Nature-Deficit Disorder. Algonquin Books of Chapel Hill, NY and Thomas Allen and Son Limited, Canada. In his groundbreaking work about the staggering divide between children and the outdoors, journalist and child advocate Richard Louv directly links the absence of nature in the lives of today’s wired generation to some of the most disturbing childhood trends: the rise in obesity, attention disorders and depression. This is the first book to bring together a body of research indicating that direct exposure to nature is essential for healthy childhood development and physical and emotional health. More than just raising the alarm, Louv offers practical solutions to heal the broken bond.

Mandell D, Morales K, Marcus S, Stahmer A, Doshi J, and Polsky D (2008). Psychotropic Medication Use Among Medicaid-Enrolled Children With Autism Spectrum Disorders. Pediatrics Vol 121 No 3 pp e441-e449. This study reports that 56% of Medicaid-Enrolled children with diagnosed Autism were taking one psychotropic medication, and 20% were taking > three. Use was common even in children 0-2 years old (18%) and 3-5 years old (32%). Neuroleptic drugs were the most common class (31%), followed by antidepressants (25%) and stimulants (22%). Children who lived in countries with lower percentage of white residents were less likely to use medication.

Mannuzza S, Klein R, Bessler A, Malloy P, LaPadula M (1993) Adult Outcome of Hyperactive Boys. Educational Achievement, Occupational Rank and Psychiatric Status. Archives of General Psychiatry Vol 50 No 7 pages 1-9. This study involved 91 white males with mean age of 26 years with reported hyperactivity in childhood years, and found increased ADHD symptoms, antisocial personality disorders, and drug abuse disorders, with significantly compromised educational and occupational achievements.

Mate’ G (2008) In the Realm of Hungry Ghosts: Close Encounters with Addition
Published by Knopf Canada Publishing, Toronto. Dr. Maté’s book eloquently offers a more sympathetic and informed view of human addictions. Dr. Maté looks at the root causes of addiction, applying a clinical and psychological view to the physical manifestation and offering some enlightening answers for why people inflict such catastrophe on themselves. He takes aim at the hugely ineffectual US led war on drugs, challenging the wisdom of fighting drugs instead of aiding the addicts.

Mate, G (1999) Scattered Minds. A New Look at the Origins and Healing of Attention Deficit Disorder. Alfred A. Knopf Publishers, Toronto, Canada.

May-Benson T, Koomar J (2007) Identifying Gravitational Insecurity in Children: A Pilot Study. American Journal of Occupational Therapy Vol 61 No 2, 142-147. This study reports that the GI Assessment is a promising clinical tool for objectively identifying children with gravitational insecurity, and was referenced in the Zone’in Workshop when reporting movement related sensory processing disorders.

Mental Health: A Report of the Surgeon General, Overview of Mental Disorders in Children. This paper describes the general categories of mental disorders in children, assessment and treatment strategies, and goes into depth regarding psychopharmacology treatments stating that 1) there are no short or long term studies regarding safety and efficacy of psychotherapeutic medication in children, 2) there is limited information regarding the pharmacokinetics (drug concentrations in body over time), and 3) combined effectiveness of drugs and psychosocial treatments is rare. This report goes on to say that when the FDA approves a medication for general population use, approval is based on studies conducted on adults only. Therefore when a practitioner prescribes an “off label” drug for a child, the practitioner is required to “guess” the dosage parameters. Due to reluctance by the pharmaceutical companies to perform drug research on children as it was reportedly too “costly”, the US Congress subsequently passed the FDA Modernization Act 1999 Title 21 USC 505A (g) to create financial incentives for pharmaceutical companies to perform clinical research on children.

Michael K and Crowley S (2002) How Effective are Treatments for Child and Adolescent Depression? A Meta-Analytic Review. Clinical Psychology Review, Vol 22 pages 247-269. The authors of this paper reviewed and analyzed comprehensive sample 38 studies from 1980 – 1999 on the psychosocial and pharmacological treatment of child and adolescent depression and showed that while the psychosocial interventions provided moderate to large treatment gains, the pharmacological interventions were not effective in treating depressed children and adolescents.

Miller L, Coll J and Schoen S (2007) A Randomized Controlled Pilot Study of the Effectiveness of Occupational Therapy for Children with Sensory Modulation Disorder. American Journal of Occupational Therapy Vol 61 No 2, 228-238. Children diagnosed with Sensory Processing Disorder made significant gains following a sensory integration approach on goal attainment scaling and on the Attention subtest and the Cognitive/Social composite of the Leiter International Performance Scale-Revised. This study validates use of sensory integrative approach in design of the Zone’in Program.

Miller L, Anzalone M, Lane S, Cermak S, and Osten E (2007) Concept Evolution in Sensory Integration: A Proposed Nosology for Diagnosis. American Journal of Occupational Therapy Vol 61 No 2, 135-140. This article defines terminology for Sensory Processing Disorder diagnosis for eventual inclusion in the Diagnostic and Statistical Manual V, as described in the Zone’in Workshop.

Mirsky A, Anthony B, Duncan C, Ahern M, Kellam S (1991) Analysis of the Elements of Attention: A Neuropsychological Approach. Neuropsychology Review Vol 2 No. 2, 109-145. This study reports three elements of attention and their respective anatomical origins: focus/execution – temporal and parietal lobes, sustain/encode – hippocampus and amydgala, and shift – prefrontal cortex.

Mistry K, Minkovitz, Strobino D and Borzekowski D (2007) Children’s Television Exposure and Behavioural and Social Outcomes at 5.5 Years: Does Timing of Exposure Matter? Pediatrics Vol 120, 762-769. This study reports that by the age of 5.5 years 41% of children had televisions in their bedrooms, and that television exposure was associated with fewer social skills, and poor sleep.

Montagu, A (1978) Touching, The Human Significance of the Skin 2nd Edition. Harper and Row Publishers Inc. New York.

Mukaddes N, Bilge S, Alyanak B, Kora M (2000) Clinical Characteristics and Treatment Responses in Cases Diagnosed as Reactive Attachment Disorder. Child Psychiatry and Human Development Vol 30(4), 273-287. This study was conducted on 15 children with RAD who were misdiagnosed with PDD, and found that 66.6% of RAD children were exposed to 7.26 hours of TV use per day with age of onset at 7.16 months, and conclude that “excessive TV exposure might be a form of neglect that is specific for RAD patients”.

Murphy-Berman V and Wright G (1987) Measures of Attention. Perceptual and Motor Skills Vol 64 pages 1139-1143. This study measured vigilance and reaction time independently and reports that these are two separate skills. Authors also report that children with faster reaction time could handle a fester presentation of stimuli on the vigilance task, and suggest that children self-pace to match their actual attention capabilities.

Murray J, Liotti M, Ingmundson P, Mayberg H, Pu Y, Zamarripa f, Liu Y, Woldorff M. Gao J, and Fox P (2006) Children’s Brain Activations While Viewing Televised Violence Revealed by fMRI. Media Psychology Vol 8 No 1, 25-37. fMRI’s of eight children showed that TV violence viewing recruits a network of brain regions involved in the regulation of emotion, arousal and attention, episodic memory encoding and retrieval, and reports that extensive TV violence viewing may result in a large number of aggressive scripts stored in long-term memory in the posterior cingulated, which facilitates rapid recall of aggressive scenes that serve as a guide for overt social behavior.

Nelson M, Neumark-Stzainer D, Hannan P, Sirard J and Story M (2006) Longitudinal and Secular Trends in Physical Activity and Sedentary Behavior During Adolescence. Pediatrics Vol 118 No 6 1627-1634. This study documents increased computer use correlates with decreased physical activity.

National Dissemination Centre for Children With Disabilities - Fact Sheet 7 (2004) Learning Disabilities. www.nichcy.org/pubs/factshe/fs7txt.htm. This document reports that one in five children have a learning disability requiring the services of a school-based special education team, and prevalence of LD children have increased 22% over the past 25 years.

National Resource Center on ADHD – Statistical Prevalence (2007) About ADHD. www.help4adhd.org/en/about/statistics. This report states that 7% of elementary children have a diagnosis of ADHD, with 61% of these children also having learning disabilities.

Niederhofer H (2004) Family Conflict Tendency and ADHD. Psychological Reports Vol 94 pages 577-580. This study found that low conflict families with one or more ADHD child, reported lower scores on Physical Punishment scale, Anger and Disregard Scale, and increased openness to others needs.

Paavonen E, Pennonen M and Roine M (2006) Passive Exposure to TV Linked to Sleep Problems in Children. Journal of Sleep Research Vol 15, 154-161. This study documents that active TV viewing was correlated with sleep-wake transition disorders.

Parham L, Cohn E, Spitzer S, Koomar J, Miller L, Burke J, Brett-Green B, Mailloux Z, May-Benson T, Smith Roley S, Schaaf R, Schoen S, Summers C (2007) Fidelity in Sensory Integration Intervention Research. American Journal of Occupational Therapy Vol 61 No 2, 216-227. This article describes identification of 10 core sensory integration intervention elements, with subsequent review of 34 sensory integration studies showing only one core element was addressed in all studies. These results show that validity of sensory integration outcomes studies is threatened by weak fidelity in regard to therapeutic process, as described in the Zone’in Workshop.

Parker-Pope, T (2005) Risk of Over-Diagnosing ADHD. Wall Street Journal, Health Journal. January 25, 2005.

Paris B and Murray-Slutsky C (2005) Is it Sensory or is it Behavior? Behavior Problem Identification, Assessment and Intervention. Harcourt Publishing, San Antonio Texas. This book clearly outlines behavior as a coping strategy, and discusses that as this coping strategy is repeated, the behavior becomes firmly established appearing “willful”.

Pelligrini A. and Bohn C. (2005) The Role of Recess in Children’s Cognitive Performance and School Adjustment. Educational Researcher Vol 34 No 1, 13-19. This study reports that providing breaks over the course of a child’s school day enhances their ability to attend and learn. This study also reports that kindergarteners’ playground social behaviour was a significant factor in first grade achievement, and discussed that the playground may be the only area where “latch-key” kids get to socialize with their peers. This study support Zone’in premise that children learn first with their bodies, then their brain, and supports Zone’in recommendations that children should employ a variety of movement techniques to optimize learning.

Porges, S (2005) The Vagus. The Neurobiology of Autism, Eds Bauman & Kemper, John Hopkins University Press, 65-77.

Rideout V, Vandewater E and Wartella E (2003) Zero To Six: Electronic Media In The Lives of Infants, Toddlers and Preschoolers. The Henry J Kaiser Family Foundation Report, California. This report documents the recent explosion of electronic media targeted at the very youngest of children 0-6 years of age, and states that 99% of homes have a TV, 36% have a TV in their bedrooms, 50% have a videogame player, and 73% have a computer. Despite the fact that the American Academy of Pediatrics recommends toddlers under the age of 2 years should not use ANY electronic media, 68% use electronic media daily, 25% have TV’s in their bedrooms and average use is 2 hours 5 minutes per day. Regarding extent of TV usage, children are less likely to read in high use homes, TV use is not income dependent, but that there is less usage in homes where one parent holds a college degree.

Rine R, Braswell J, Fisher D, Joyce K, Kalar K, and Shaffer M. (2004) Improvement of Motor Development and Postural Control Following Intervention in Children with Sensorineural Hearing Loss and Vestibular Impairment. International Journal of Pediatric Otorhinolaryngology Vol 68 Issue 9, 1141-1148. This study showed that motor development scores increased significantly in children with sensorineural hearing loss and vestibular impairment following balance, visual and somatosensory training. This study substantiates that impaired vestibular development affects postural and motor ability.

Roberts D, Foehr U, Rideout V, Brodie M (1999) Kids and Media at the New Millennium: A Comprehensive National Analysis of Children’s Media Use. The Henry J Kaiser Family Foundation Report, California. This report documents that children spend on average 6.5 hours per day of combined media use (TV, videogames, computers), and 32% of 2-7 year olds and 65% of 8-18 year olds have TV’s in their bedrooms.

Rosack J (2003) Prescription Data on Youth Raise Important Questions. American Psychiatric Foundation – Clinical and Research News Vol 38 No 3 pp1-3. This interview with Julie Zito’s regarding her 2003 study reports that psychotropic prescriptions for children and adolescents rose between 200% and 300% between 1987 and 1996, and that between 5.9% and 6.3% of all youth were prescribed at least one psychotropic medication. Extrapolation for an additional 250% increase for the next ten year period from 1997 to 2006 would yield figures of between 14.75% and 15.75%. Interview with Peter Jensen, MD advocates for increased education and training of family practitioners, and points out the problems of attaining accurate psychiatric diagnosis for children, as there are only 7,500 child and adolescent psychiatrists in the US, and 12-17 million children and adolescents with psychiatric problems (20% of < 18 year old population).

Ruff, M (2005) Attention Deficit Disorder and Stimulant Use: An Epidemic of Modernity. Clinical Pediatrics Vol 44 pg 557. An excellent article that raises many pertinent questions regarding the prevalent drugging of ‘borderline’ ADHD children, and advocates for increased research into environmental as opposed to biological medication justification. Great lines are “When did prescribing stimulants go from success to excess”, “Nature is designed for and needs nurture”, with reference to parents of ADHD children “The apple doesn’t fall far from the tree, and if the tree subsists with suboptimal soil and moisture, it will not produce good fruit”, “We are an impulsive, impatient culture with a free-floating sense of time urgency that feeds on rapidly changing trends”, “The brain allocates neural real estate, depending on what we use most”. Dr. Ruff is concerned that if we are already giving stimulants to borderline ADHD children, will we also give them the new Alzheimer memory enhancer drugs as well? Dr. Ruff eloquently points out that if we ban physical performance enhancing drugs for athletes, shouldn’t we also ban academic enhancing drugs for students? Dr. Ruff goes on to state “Researchers should be required to reveal just how much compensation, in the course of a year, they are afforded by the drug companies. We may then be able to better assess the merit of their conclusions and recommendations”.

Schaaf R and McKeon Nightlinger, K (2007) Occupational Therapy Using a Sensory Integrative Approach: A Case Study of Effectiveness. American Journal of Occupational Therapy Vol 61 No 2, 239-246. This single subject design of a child with poor sensory processing indicates improvement in goal attainment and behaviour with occupational therapy using a sensory integrative approach. This study validates use of sensory integrative approach in design of the Zone’in Program.

Shaffer, D (1994) Attention Deficit Hyperactivity Disorder in Adults. Editorial in the American Journal of Psychiatry Vol 151 No 5 pages 633-638. This author reports that popular belief that children “out grow” ADHD is false, and advocates for additional research studies into adult ADHD.

Schilling D, Washington K, Billingsley F and Deitz J (2003) Classroom Seating for Children With Attention Deficit Hyperactivity Disorder: Therapy Balls Versus Chairs. American Journal of Occupational Therapy Vol 57 No 5, 534-541. This research found that use of therapy balls for students with ADHD facilitates in-seat behavior and legible word productivity.

Schmidt R and Lee T (2005) Motor Control and Learning: A Behavioral Emphasis. Human Kinetics Publishing, Illinois. This book reports the immense role that vision has in determining behavior, and states that 87.7% of behavior is driven by vision.

Schneider M, Moore C, Gajewski L, Laughlin N, Laron J, Gay C, Roberts A, Converse A, DeJesus O (2007) Sensory Processing Disorders in a Nonhuman Primate Model: Evidence for Occupational Therapy Practice. American Journal of Occupational Therapy Vol 61 No 2, 247-253. This study profiles development of a Sensory Processing Scale for monkeys that measured behavioual responses to a series of tactile stimuli in monkeys exposed to prenatal alcohol, stress or post-natal lead. Results showed while control monkeys from undisturbed pregnancies showed a habituation pattern, prenatally stressed monkeys showed sensitization, and prenatal alcohol-exposed monkeys showed relatively high responsiveness without habituation. Lead exposed monkeys showed sensitization, reduced with chelation.

Smith Roley S, Blanche Imperatore, E and Schaff R (2001) Understanding the Nature of Sensory Integration With Diverse Populations. Therapy Skill Builders, Arizona.

Spotts P (2003) Chemical Kids. The Christian Science Monitor, March 6, 2003 edition. This author looks at some of the reasons behind the trend in over-prescribing psychotropic medications to children listed as: research explosion in the 80’s and 90’s caused a shift toward attributing kid’s behavioral problems to physiological causes with subsequent medication prescription, skyrocketing healthcare costs caused outsourcing of psychiatric services to for-profit clinics who found drugs cheaper than counseling, physician pressure from teachers and parents. This article points out that up to 25% of ADHD diagnoses are actually children who have a sleep disorder.

Statistics Canada (2006) Time Spent With Family During a Typical Workday, 1986 to 2005. This study reports that parents spend an average 3.5 minutes per week in meaningful conversation with their children.

Thakkar R, Garrison M and Christakis D (2006) A Systematic Review for the Effects of Television Viewing by Infants and Preschoolers. Pediatrics Vol 118, 2025-2031. This study points out that although viewing educational programs broadens young children’s knowledge, viewing of cartoon content has a negative effect on children’s attentional abilities.
Thompson, D and Christakis D (2005) The Association Between Television Viewing and Irregular Sleep Schedules Among Children Less Than 3 Years of Age. Pediatrics Vol 116, 851-856. This study reports that the total number of hours of TV watched per day was associated with irregular nap and bedtime schedules.

Thomas C, Conrad P, Casler R, Goodman E (2006) Trends in the Use of Psychotropic Medications Among Adolescents, 1994 to 2001. Psychiatric Services Vol 57 No 1 pp63-69. This study reports that rates oif visits that resulted in psychotropic prescription increased from 3.4% in 1994-1995 to 8.3% in 2000-2001, and reports that by 2001, one out of every ten office visits for adolescent males resulted in a psychotropic medication prescription.

Tomchek S and Dunn W (2007) Sensory Processing in Children With and Without Autism: A Comparative Study Using the Short Sensory Profile. American Journal of Occupational Therapy Vol 61 No 2, 190-200. This study reports that 95% of sample of 281 children with Autism Spectrum Disorder demonstrated some degree of sensory processing dysfunction on the Short Sensory Profile, with greatest differences reported on the Underresponsive/Seeks Sensation, Auditory Filtering and Tactile Sensitivity sections.

Tsuzuku T. and Kaga K. (1992) Delayed Motor Function and Results of Vestibular Function Tests in Children with Inner Ear Anomalies. International Journal of Pediatric Otorhinolaryngology Vol 23 Issue 3, 261-268. This study reports that children with vestibular impairment demonstrated delayed motor function, supporting Dr. Jean Ayers findings that the vestibular system is the foundation for bilateral and ocular coordination and development of postural tone.

Vandewater E, Lee J and Shim M (2005) Family Conflict and Violent Electronic Media Use in School-Aged Children. Media Psychology Vol 7 No 1, 73-86. This research showed that family conflict is positively related to violent electronic media use, and that family tensions will be reflected in children’s interest in media with violent content.

Waldman M, Nicholson S and Adilov N (2006) Does Television Cause Autism? Cornell University, New York. This study showed that heavy TV use prior to age 3 years positively correlates to increase in prevalence of Autism.

The Wall Street Journal (January 25, 2005) Studies Linking Ritalin and Depression Highlight Risk of Overdosing ADHD. This article reports from the 2004 annual meeting of the American College of Neuropharmacology stating that researchers are concerned about he lack of long term studies regarding the use of Ritalin to treat ADHD in children, and point out that animal research found that Ritalin permanently alters brain structure and may lead to depression, as brain pathways involved in pleasure and aversion have been changed. This article also points out research done by Martin Teicher, director of the Developmental Biopsychiatry Research Program at McLean University which reports that teacher inter rater reliability is poor and “notoriously unreliable”.

Walson P (1999) Patient Recruitment: US Perspective. Pediatrics Vol 104 No 3 pages 619-622. This paper describes the difficulties in patient recruitment of children for clinical drug trials as the following: identification of eligible patient population, explaining the study, obtaining true informed consent, maintaining ethical standards, recruiting adequate, representative sample, retaining subjects until study completion, and minimizing the risk/benefit ratio. I suppose it would be difficult to convince a parent they should enroll their child in a clinical trial of a drug that has not been proven effective (C. Rowan comment).

Welch M, MD (1989) Holding Time. Published by Simon and Schoester, New York. In this fascinating book written by Dr. Martha Welch, child psychiatrist and president of The Mothering Center at Cos Cob, Connecticut describes a technique called ‘forced holding’, where the mother holds the child close to her on her lap, as if she were nursing the child, and doesn’t let go! Even if the child squirms and screams, the mother hangs onto the child, maintaining essential eye contact and repeating to the child ‘I love you’ over and over again. While this technique has met mixed reviews, it does offer interesting information regarding the mother child connection, and offers families with children with Autism an alternative technique for establishing bonding.

Williams M and Shellenberger S (1995) How Does Your Engine Run? Therapy Works Inc, New Mexico.

Zimmerman F, Christakis D and Meltzoff A (2007) Television and DVD/Video Viewing in Children Younger Than 2 Years. Archives of Pediatric Adolescent Medicine Vol 161 No 5, 473-479. This study showed that by 3 months of age, 40% of children regularly watched television, DVD’s or videos, and by 24 months 90%. Average duration rose form 1 hour per day for children less than one year old to 1.5 hours by 24 months.

Zimmerman F and Christakis D (2007) Associations Between Content Types of Early Media Exposure and Subsequent Attentional Problems. Pediatrics Vol 120, 986-992. This study showed that viewing of television prior to age 3 was significantly associated with attention problems.

Zito, J, Safer D, dosReis S, Gardner J, Boles M, Lynch F (2000) Trends in the Prescribing of Psychotropic Medications to Preschoolers. Journal of the American Medical Association Vol 283 No 8 pp 1025-1030. This study reports a dramatic increase in the prescription of psychotropic medication between 1991 and 1995 to two to four year old children; 28.2-fold for Clonidine (sedative), 3.0-fold for stimulants, and 2.2-fold for antidepressants. Authors report that these findings are “remarkable, in light of the limited knowledge base that underlies psychotropic medication use in very young children”. This study reports reasons for increased use are: expanded diagnostic criteria, more girls being treated for ADHD, greater acceptance for using biological treatment for behavioral disorders, expanded role of school and preschool personnel in identifying medical needs. Authors report grave concerns regarding the rise of prescriptions for Clonidine in conjunction with Ritalin due to lack of studies.

Move’in Program

Program Development

The Move’in Program was originally designed by Cris Rowan while working for a decade as a Pediatric Occupational Therapist with the Sunshine Coast School District No. 46. Move’in started as The Fine Motor Observations and Strategies Assessment and Intervention, developed by Cris and administered by parents and teachers following workshop training and certification. As the printing and reading delayed population grew, Cris wondered if she could design a classroom based, kid-driven assessment and intervention to better address need. Hence…the creation of the Move’in Program! Cris began by distributing a questionnaire to the Sunshine Coast Special Education Teachers to determine incidence of printing delays in the elementary population and found that 20% of children had printing delays greater than two years.

Prototype Testing

Prior to prototype testing, Cris held a meeting with the Sunshine Coast Special Education Committee where she surveyed the Resource Teachers regarding what parameters should be met with the final Move’in Program, and they responded with the following requests:

No paper, booklets or folders
All inclusive kit
No requirement for teacher preparation time
Kid-driven to optimize motivation
FUN!

The Move’in Program prototype was repeatedly implemented, revised and evaluated over a four month period at Madeira Park Elementary School with grade 1, 2, and 3 students and teachers, resulting in a program that has proven to meet the Sunshine Coast Special Education Committee requirements, as well as be fun for the students.

Original Research

During 2006/7 two University of British Columbia Occupational Therapy students Kelly Fletcher and Marie Jarvis-Rolfing completed their Masters thesis performing a Single Subject Multiple Baseline Across Subjects study on the Move’in Program titled Effect of a Home-Based Printing Program on Children’s Printing Speed: A Preliminary Study. As the University of British Columbia Ethics Review Committee prohibited classroom based research, their study was conduced in three homes. We are happy to report that implementation of the Move’in Program was associated with significant improvement in printing speed for 2 of the 3 participants. Please find a copy of Ms. Fletcher and Ms. Jarvis-Rolfing poster presentation of their study.

Supporting Child Development, Printing and Literacy Research

American Academy of Pediatrics, Committee on Public Education (2001) Children, Adolescents, and Television. Pediatrics Vol 107(2), 423-426. This policy statement describes the negative effects of television viewing as violent or aggressive behavior, substance use, sexual activity, obesity, poor body image, and decreased school performance. This statement recommends no TV or videogames for toddlers under the age of 2, and a limit of 1-2 hours per day for children.
Baines L, Baines C, Stanley G and Kunkel A (1999) Losing the Product in the Process. English Journal Vol 88(5) 67-72. These authors state the process of writing has become so ubiquitous as to mean anything, or perhaps more precisely, it has come to mean almost nothing. Tragically the art and soul of writing has been lost in the process.

Dennision, Paul (1992) Brain Gym: Simple Activities for Whole Brain Learning. Edu-Kinesthetics Inc, California. Loads of Brain Gym exercises for classroom and at home!

deSilva S. (2006) Director General Centre for Education Statistics reports results from Program for International Student Assessment (2006), a comprehensive survey of 15 year olds indicates that reading performance has declined to placing 4th in international standing, compared to placing 3rd in 2003.

Edwards, L (2003) Writing Instruction in Kindergarten: Examining an Emerging Area of Research for Children with Writing and Reading Difficulties. Journal of Learning Disabilities Vol 36 No 2 pages 136-148. This review examines the literature on how to teach kindergarten children with reading and writing difficulties how to write, and reports that text production is critical in writing development. Text production instruction should include modeling newly introduced letters, practicing letter names while writing letters, tracing letters with numbered arrow cues, practicing letters from memory, and asking children to circle letters that represent their best work. Edwards also points out that handwriting is not just a motor process, but rather draws on the importance of letter recognition (a visual memory skill), which is a skill that can be enhanced by repeated practice with letter production. Edwards also highlights the importance of explicit spelling instruction for kindergarten children, and goes on to say that there are only a limited number of empirical studies regarding how to teach kindergarten children with reading and writing difficulties how to write and highlights future direction for research.

Ehri L, Nunes S, Willows D, Schuster B, Zadeh Z, Shanahan T. (2001) Phonemic Awareness Instruction Helps Children Learn to Read: Evidence form the National Reading Panel’s Meta-Analysis. Reading Research Quarterly Vol. 36 No. 3 250-287. This article high lights that while phonemic awareness instruction improved reading, it did not improve spelling in disabled readers, and stated that PA was more effective when taught with, as opposed to without letters. This article supports the role of the visual in addition to the auditory component when teaching reading.

Gee M. (1989) Start the “Write” Way. Reading, 23(3), 150-159. This research showed that teaching letters in stroke-related families, using letter templates, and using visual and motor cues resulted in reduced errors in output. Results were used in design of the motor planning interventions in the Play’in the Lines Computer Program.

Goldberg E, Simner M. (1999) A Comparison of Children’s Handwriting Under Traditional vs. Whole Language Instruction. Results indicate that students who were taught using traditional instruction style demonstrated more legible handwriting, and were able to produce significantly more words, than students taught using whole language instruction style. Traditional instruction is defined as “copying, tracing, whole-arm movements, kinesthetic feedback, and writing on various materials (lined paper, blackboard, copybooks). Results were used in design of the motor planning interventions in the Play’in the Lines Computer Program.

Goldstand S, Koslowe K., and Parush S. (2007) Vision, Visual-Information Processing, and Academic Performance Among Seventh-Grade Schoolchildren: A More Significant Relationship Than We Thought? This article shows that visual ability correlates with academic performance, and report that visual deficits were found in 68% of study participants. Results of this study were used to substantiate the visual assessment components of the Move’in Program.

Graham S, Harris K, Mason L, Fink-Chorzempa B, Moran S, Saddler B (2008) How Do Primary Grade Teachers Teach Handwriting? A National Survey. To be published in Reading and Writing: An Interdisciplinary Journal. This US study reports that 90% of US primary school teachers college education did not adequately prepare them to provide lessons in penmanship, and therefore do not devote much time to teaching printing. Teachers spend an average 14 minutes per day teaching handwriting, far less than the 45 minutes per day spent in the 60’s and 70’s, and slightly less than the 15 minutes per day mandated in the 80’s. Textbooks offer less information on teaching printing, and universities have less instruction. Handwriting teaching methods and methods for student evaluation are inconsistent and non-standardized. 100% of the 169 primary teachers who participated in this study reported they thought printing should be taught as a separate subject.

Graham S, and Weintraub N. (1996) A Review of Handwriting Research: Progress and Prospects from 1980 to 1994. Educational Psychology Review, 8, 7-87. This study documents that in 1993 70% of teachers indicated that handwriting was “not as good as it should be”, and expressed concern regarding the “downward plunge in the standards of handwriting legibility required of elementary school children”. Authors also state that students who have difficulty with automaticity of writing, thus achieving poor quality and quantity of written output, results in avoidance and minimization of the writing process. Authors state that for beginning writers, both visual and verbal modeling appears to be the most effective means of introducing a letter prior to practice (i.e. the teacher demonstrates how a letter is made while describing how it is formed).

Graham S, Berninger V, Weintraub N and Schafer W (1998) Development of Handwriting Speed and Legibility in Grades 1 through 9. Journal of Educational Research, Vol 92, 42-52. The Move’in Program Handbook and Back to Basics Workshop have included with author Steven Graham’s permission a grade related letter per minute chart. Please note that this research is 10 years old, and scores may be higher than what our present day videogame and TV addicted child can perform.

Graham S, Harris K and Fink B (2000) Is Handwriting Causally Related to Learning to Write? Treatment of Handwriting Problems in Beginning Writers. Journal of Educational Psychology Vol 92, 620-633. This article profiles how poor handwriting can result in a disability in written expression.

Graham S (2006) Handbook of Writing Research, Ch 13 – Strategy Instruction and the Teaching of Writing. Eds. MacArthur C, Graham S and Fitzgerald G. Guilford Press, New York. This meta-analysis concludes that printing strategy instruction is effective in improving student’s writing performance in the areas of quality, elements, length, and revisions, with results maintained over time and generalized to new tasks and situations.

Graham S, MacArthur C and Fitzgerald J (2007) Best Practices in Writing Instruction. Eds. MacArthur C, Graham S and Fitzgerald G. Guilford Press, New York. This book was instrumental in design of the Move’in Program and Workshop and draws the correlation between poor printing and subsequent difficulty with spelling, sentence composition, math, science and any subject requiring printing skill. Graham states “Failure to develop legible and automatic letter and word formation interferes with content in writing.” and “Because of the excessive labor and unattractive results involved in such writing, students are more likely to avoid or minimize the process when possible”. Graham instructs that for beginners, both visual and verbal modeling is the most effective means of introducing a letter prior to practice.

Hannaford, Carla (1997) The Dominance Factor: How Knowing Your Dominant Eye, Ear, Brain, Hand, and Foot Can Improve Your Learning. Great River Books Publishing, Utah.

Hannaford, Carla (2005) Smart Moves: Why Learning Is Not All In Your Head 2nd Edition. Great River Book Publishers, Utah. This book reports the importance of determining developmental level of a child prior to introducing printing, and advocates introducing cursive prior to printing as requires less skill to achieve results. Hannaford reports that when faced with difficult tasks (printing too early) acquire a “learned helplessness” and low motivation for task completion.

Hasbrouck J. (1994) Objective Procedures for Scoring Student’s Writing. Teaching Exceptional Children, Winter, 18-25. This article was referenced when planning procedures for collecting writing samples for the printing speed component of the Move’in Program.

Hubert, Bill (2001) Bal-A-Vis-X: Rhythmic Balance/Auditory/Vision eXercises for Brain and Brain-Body Integration. Bal-A-Vis-X Inc, Kansas.

Jones D and Christensen C (1999) Relationship Between Automaticity in Handwriting and Student’s Ability to Generate Written Text. Journal of Educational Psychology Vol 91, 44-49. This article delineates how failure to develop legible and automatic letter and word formation may interfere with content in writing. Authors go on to states that students who struggle to retrieve letters from memory, to reproduce then on the page, and to scale them to other letters have less attention available to spend on spelling, planning and effectively expressing intended meanings.

Mannuzza S, Klein R, Bessler A, Malloy P, and LaPadula M (1993) Adult Outcome of Hyperactive Boys, Educational Achievement, Occupational Rank, and Psychiatric Status. Archives of General Psychiatry Vol 50 No 7 pp 565-576.

Olney C (1991) Where There’s a Will, There’s an A. Chesterbrook Educational Publishers. www.wheretheresawill.com. This two-part video is actually for high-school students, but its easy-to-follow, often funny approach makes it worth watching even if you have to fast forward through the parts that don’t apply. Olney’s excellent tips, based on research, are likely to help your child succeed not only on tests but in writing essays, doing projects and making presentations.
Parker-Pope, T (2005) Risk of Over-Diagnosing ADHD. Wall Street Journal, Health Journal. January 25, 2005.

Pritchard R and Honeycutt R (2006) Handbook of Writing Research, Ch 19 – The Process Approach to Writing Instruction. Eds. MacArthur C, Graham S and Fitzgerald G. Guilford Press, New York. This chapter reports that due to poorly defined parameters regarding the process approach, evidence based research regarding efficacy is lacking. Authors go on to state that since the process approach provided an instructional alternative at a time when traditional methods grounded in rhetorical theory were being challenged, the process model evolved in practice more quickly than did supporting research and theories.

Shaffer, David (1994) Attention Deficit Hyperactivity Disorder in Adults. The American Journal of Psychiatry. Vol 151, pp 633-638.

Schilling D, Washington K, Billingsley F, Deitz J (2003). Classroom seating for Children With Attention Deficit Hyperactivity Disorder: Therapy Balls Versus Chairs. American Journal of Occupational Therapy Vol 57 534-541. This study reports that children with ADHD who were seated on therapy balls had increased in-seat behaviour and legible word productivity. This study supports the Move’in Programs use of therapy balls to set postural tone and improve distal motor performance effecting word legibility.

Schlagal B (2007) Best Practices in Writing Instruction – Ch 9 Best Practices in Spelling and Handwriting. Eds. Graham S, MacArthur C and Fitzgerald J, Guilford Press, New York. This chapter highlights how handwriting instruction for teachers has reduced by pointing out that The Handbook of Research on Teaching the English Language (Flood, Lapp, Squire, and Jensen, 2003) has only devoted one page out of 1000 to handwriting instruction. Author goes on to state that poorly developed spelling and handwriting can affect the higher level literacy processes in which they are embedded, and should be given a more important role in school curriculum.

Shanahan T (2007) Early Literacy Development: Sequence of Acquisition. Encyclopedia of Language and Literacy Development 1-6. London, ON: Canadian Language and Literacy Research Network. This document clearly outlines the sequence of acquisition of precursor skills for eventual reading ability, and high lights letter recognition and print concepts such as directionality and laterality.

Sheridan S (2001) The Scribble Hypothesis: A Plea for Brain-Compatible Teaching and Learning. Poster Presentation “Toward A Science of Consciousness “ Conference, Sweden. www.drawingwriting.com/scribabs.pdf.

Simner M. (2003) Promoting Skilled Handwriting – The Kindergarten Path to Meaningful Written Communication. Canadian Psychological Association. This manual and Dr. Simner’s recommendations regarding printing instruction were instrumental in the planning of many components of the Move’in Program. Dr. Simner reports that documented cases in Toronto kindergarten classes spend just 2 minutes per day on letter formation instruction, and states that “It is my understanding that formal handwriting instruction, for the most part, has disappeared”.

Stage S, Sheppard J, Davidson M. and Browning M. (2001) Prediction of First-Graders’ Growth in Oral Reading Fluency Using Kindergarten Letter Fluency. Journal of School Psychology Vol 39, issue 3, 225-237. This study report that first graders’ growth in oral reading fluency was predicted by their kindergarten letter-naming and letter sound fluency. This study supports the Move’in Program’s premise that letter recognition is crucial for eventual reading fluency.

Zone’in Workshops

Zone’in and Move’in Training Workshops

Zone’in Program

Program Development

Prototype Testing

Original Research

Sensory Integration Research

Move’in Program

Program Development

Prototype Testing

Original Research

Supporting Child Development, Printing and Literacy Research