10 January 2022
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Story Elsabé Brits
Dr Monique de Milander, Lecturer in Exercise and Sport Sciences at the UFS, is leading research on attention-deficit hyperactivity disorder (ADHD) and visual and motor control difficulties.
Research done by the University of the Free State (UFS) has shown that
Grade 1 learners not only experience visual problems, but also
developmental coordination disorder. Teachers and parents can help to
identify this.
In the first study published in the
South African Journal of Child Health (
https://doi.org/10.7196/SAJCH.2021.v15i1.1705),
Dr Monique de Milander, Lecturer in
Exercise and Sport Sciences at the UFS, led research on attention-deficit hyperactivity disorder (ADHD) and visual and motor control difficulties.
“Visual
problems are often overlooked and are seen as a hidden disability.
Thus, children are labelled as ADD/ADHD, but in fact, they have
learning-related visual problems. Our eyes connect the world with the
brain, and we receive 80-90% of information from our eyes. Consequently,
visual problems lead to poor vision, and these visual problems will
interfere with children’s ability to learn in the classroom,” she
explains.
During the study, ADHD symptoms were found to be
significantly associated with half of the visual functioning
difficulties. These skills include fixation – the ability to fixate on a
stationary object with both eyes – in addition to fixating with the
eyes independently.
Ocular alignment of the right eye was
indicated as a problem – the ability of the two eyes to work together in
order to view an object clearly. Therefore, the eyes must move in a
coordinated manner. Visual tracking was the skill that the children
struggled with the most in both screening tests; thus, to follow a
moving object. This was found for both eyes – the right eye on an X
shape, and the left eye on a circle.
She added that science
suggests that although children at the age of five or six can perform a
variety of manipulative skills such as catching, throwing, kicking, and
hitting, the manipulative skills that require visual tracking or the
ability to intercept moving objects, develop somewhat later (eight
years) due to the sophisticated visual-motor requirements.
Furthermore,
although maturation plays a role in achieving these skills, children
need opportunities to practise the skills in a variety of settings.
Parents and teachers should encourage children to take part in physical
activities and sports, in addition to proper instruction on how to
perform the manipulative skills.
How will these visual difficulties be identified?It
is important to note that children can fixate, visually pursue objects,
and reach accurate decisions about the size and shape of an object;
however, some refining still has to take place. In other words, the
perceptual abilities of the young child are not yet complete. Some
examples of visual perception problems in a young child, as indicated by
perceptual motor skills involving the eyes, are as follows:
1. Using control to intercept a ball
2. Interchanging letters and numbers
3. Poor perception of moving objects
4. Poor figure-ground perceptual abilities
5. Distance perception
6. Anticipating timing
What is the next step after identifying visual difficulties?The
first aspect to take into consideration is the age of the child, since
we now know that their perceptual abilities need to be refined. If the
problem continues, screening tests can be done. If the child is at risk,
it is recommended that the parent see an optometrist who specialises in
visual problems.
How does one assist a child with ADHD in the classroom?Five tips for teaching students with ADHD:
1. Change activities frequently to accommodate short attention span
2. Use a positive behaviour modification programme to keep student focused on task
3. Incorporate 3-5 min of conscious relaxation at the end of the physical education period
4. Give brief instructions
5. Use activities that promote cooperation among all students
In another study led by Dr De Milander and published in the
South African Journal of Childhood Education (https://sajce.co.za/index.php/sajce/article/view/930), the early identification of learners with developmental coordination disorder was researched.
In
children experiencing poor motor skills (fine and gross motor
coordination difficulties), without evidence of a neurological disorder
and which cannot be linked to a general medical difficulty such as
cerebral palsy or a pervasive development disorder, the low motor skills
are significant – to such an extent that it interferes with their
social competence, academic performance, and physical development,
leading to problems with completing daily activities, Dr De Milander
explains.
The characteristics of developmental coordination disorder are:
• Experiencing problems getting dressed and tying shoelaces
• Finding it difficult to run, skip, or jump
• Experiencing problems with visual perception
• Poor pencil grip
• Slow and hesitant movement
• Poor spatial concepts about in front, behind, next to, below, and above
• Unable to catch or kick a ball
• Finding it difficult to work in group context
She
gives the following advice: Children should be motivated and challenged
to participate in simple, yet enjoyable and relaxing physical
activities. The focus should be on the child's strengths and not his/her
weaknesses. Allow the child to play regularly in sandboxes and with
clay. Improve the child’s ball skills by catching and throwing. Motor
skills must be learnt through simple mastery steps. Improve the child's
movement skills and make participation in movement activities enjoyable
and challenging. Concentrate on reaction skills and play in which the
child can participate. In extreme cases, specialised treatment by an
occupational therapist and a kinderkineticist is important.
It is
important to know that children do not outgrow these disorders as
previously believed; therefore, many children still experience these
difficulties as adolescents. Thus, if your child is experiencing any
problems, take cognisance of the problem and address it as soon as
possible. Professionals such as kinderkineticists are available in
private practice and at various schools to assist your child in
improving a variety of deviations. The kinderkineticist can evaluate
your child through a standardised test to determine the problem, and
then suggest an intervention to address the specific problem, as well as
to prevent secondary problems such as low self-esteem, physical
inactivity, overweight and obesity, etc., which are associated with
these disorders.
For help, visit the website of the South African Professional Institute for
Kinderkinetics where you will be able to find a kinderkineticist in your area.
Kinderkinetics
is a profession aimed at promoting and optimising the neuromotor
development of young children (0-13 years) through science-based
physical activity. All programmes within this profession have a
preventative, stimulating, developing, and rehabilitative nature. In
summary, it has the following goals:
• Promoting functional growth and proper motor development in young children.
• Focusing on certain movement activities to promote/facilitate sport-specific skills.
•
Implementing appropriate rehabilitation programmes for children with
growth and/or developmental disabilities in order to maintain an active,
healthy lifestyle.