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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

Small things matter
2017-01-17

 Description: Prof Felicity Burt  Tags: Prof Felicity Burt

Prof Felicity Burt (right) and Dr Dominique Goedhals
from the Department of Medical Microbiology and
Virology at the University of the Free State.
Photo: Anja Aucamp



The newly established virology section at the University of the Free State (UFS) boasts world class expertise. Not only are they one of just five laboratories in the country tasked with specialised HIV testing, but current research generates publications and subsidised funding.

The driving force behind this initiative is passionate and dedicated people who invest long hours into vital research. One such person is Prof Felicity Burt, who eloquently guides her students while making impressive progress within her own field of interest: vector-borne and zoonotic diseases. Prof Burt was recently awarded a research chair (2016-2020) to, among other areas, investigate medically significant vector-borne and zoonotic viruses currently circulating.

That means that her research focus is mainly on viruses transmitted by mosquitoes and ticks, and viruses transmitted from animals to humans. “Yes,” she laughs, “I catch mosquitoes and check them for viruses.”

Becoming familiar with different viruses
As if big screen moments like Outbreak and Contagion did not create enough virus paranoia, the world was recently bombarded by real world Ebola and Zika outbreaks. But awareness, Prof Burt says, is not a bad thing. “Years ago, when people heard that I did Ebola research, they got that distant look in their eyes, and changed the subject. One outbreak later, backed by many media reports, and Ebola is almost a household name. The same goes for the recent Zika virus outbreak in South America.”

The more familiar people become with these types of viruses, the better, Prof Burt feels. However, getting the right message across is not always that easy. The Zika virus outbreak, for example, was a very large outbreak and therefore presented large numbers of affected people. Generally, not everyone infected with an arbovirus will necessarily present with symptoms. But because vector-borne viruses can spread to new areas, surveillance and awareness is important. Here in Bloemfontein, Prof Burt and her team are establishing surveillance programmes.

Gaining knowledge and preventative measures
So, next time you get all wound up about a “biological disaster”, rest assured that competent people like Prof Burt and her colleagues continuously scan the environment to gain knowledge and develop preventive measures should any risks be looming. For example, developing next-generation vaccines that are very effective, but without risk – since they are not built on the virus itself, but only on the part of the virus that will induce an immune response.

Currently, Prof Burt is also looking into the relationship between the Sindbis virus and arthritis. It is clear that we can expect many exciting findings from the UFS’s new virology unit.

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