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31 October 2021 | Story Elsabé Brits | Photo Supplied
Dr Monique De Milander
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 (https://kinderkinetics.co.za/) 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.

News Archive

Stem cell research and human cloning: legal and ethical focal points
2004-07-29

   

(Summary of the inaugural lecture of Prof Hennie Oosthuizen, from the Department of Criminal and Medical Law at the Faculty of Law of the University of the Free State.)

 

In the light of stem cell research, research on embryo’s and human cloning it will be fatal for legal advisors and researchers in South Africa to ignore the benefits that new bio-medical development, through research, contain for this country.

Legal advisors across the world have various views on stem cell research and human cloning. In the USA there is no legislation that regulates stem cell research but a number of States adopted legislation that approves stem cell research. The British Parlement gave permission for research on embryonic stem cells, but determined that it must be monitored closely and the European Union is of the opinion that it will open a door for race purification and commercial exploitation of human beings.

In South Africa the Bill on National Health makes provision for therapeutical and non therapeutical research. It also makes provision for therapeutical embryonical stem cell research on fetuses, which is not older than 14 days, as well as for therapeutical cloning under certain circumstances subject to the approval of the Minister. The Bill prohibits reproductive cloning.

Research on human embrio’s is a very controversial issue, here and in the rest of the world.

Researchers believe that the use of stem cell therapy could help to side-step the rejection of newly transplanted organs and tissue and if a bank for stem cell could be built, the shortage of organs for transplants would become something of the past. Stem cells could also be used for healing of Alzheimer’s, Parkinson’s and spinal injuries.

Sources from which stem cells are obtained could also lead to further ethical issues. Stem cells are harvested from mature human cells and embryonic stem cells. Another source to be utilised is to take egg cells from the ovaries of aborted fetuses. This will be morally unacceptable for those against abortions. Linking a financial incentive to that could become more of a controversial issue because the woman’s decision to abort could be influenced. The ideal would be to rather use human fetus tissue from spontaneous abortions or extra-uterine pregnancies than induced abortions.

The potential to obtain stem cells from the blood of the umbilical cord, bone-marrow and fetus tissue and for these cells to arrange themselves is known for quite some time. Blood from the umbilical cord contains many stem cells, which is the origin of the body’s immune and blood system. It is beneficial to bank the blood of a newborn baby’s umbilical cord. Through stem cell transplants the baby or another family member’s life could be saved from future illnesses such as anemia, leukemia and metabolic storing disabilities as well as certain generic immuno disabilities.

The possibility to withdraw stem cells from human embrio’s and to grow them is more useable because it has more treatment possibilities.

With the birth of Dolly the sheep, communities strongly expressed their concern about the possibility that a new cloning technique such as the replacement of the core of a cell will be used in human reproduction. Embryonic splitting and core replacement are two well known techniques that are associated with the cloning process.

I differentiate between reproductive cloning – to create a cloned human embryo with the aim to bring about a pregnancy of a child that is identical to another individual – and therapeutically cloning – to create a cloned human embryo for research purposes and for healing human illnesses.

Worldwide people are debating whether to proceed with therapeutical cloning. There are people for and against it. The biggest ethical objection against therapeutical cloning is the termination of the development of a potential human being.

Children born from cloning will differ from each other. Factors such as the uterus environment and the environment in which the child is growing up will play a role. Cloning create unique children that will grow up to be unique individuals, just like me and you that will develop into a person, just like you and me. If we understand this scientific fact, most arguments against human cloning will disappear.

Infertility can be treated through in vitro conception. This process does not work for everyone. For some cloning is a revolutionary treatment method because it is the only method that does not require patients to produce sperm and egg cells. The same arguments that were used against in vitro conception in the past are now being used against cloning. It is years later and in vitro cloning is generally applied and accepted by society. I am of the opinion that the same will happen with regard to human cloning.

There is an argument that cloning must be prohibited because it is unsafe. Distorted ideas in this regard were proven wrong. Are these distorted ideas justified to question the safety of cloning and the cloning process you may ask. The answer, according to me, is a definite no. Human cloning does have many advantages. That includes assistance with infertility, prevention of Down Syndrome and recovery from leukemia.

 

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