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10 January 2022 | Story Elsabé Brits
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 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

Sarah, our own champion
2008-11-05

 
Sarah Shannon at the Paralympic Games in Beijing

 

Sarah Shannon, a second-year student in the Postgraduate Certificate in Education, has been involved in disability sport on national level for the past 12 years. Sarah has cerebral palsy.

In 1996 she participated at the South African National Championships for the physically disabled for the first time, entering for several sporting codes and winning five gold medals. In swimming she participates in the S3 class together with other swimmers that have comparable abilities to hers.

In 1997 she decided to focus on swimming competitively. She participated in her first national championships for swimming that year. After that (1998) she represented South Africa on international level at the International Paralympic Committee’s (IPC) Swimming World Championships in New Zealand where she ended 4th in the 50m backstroke and 7th in both the 50m and 100m freestyle in her class.

In 1999 she represented South Africa in Johannesburg at the 7th All Africa Games and won a silver medal for the 50m freestyle and a bronze medal for the 100m freestyle.

In 2000 she was part of the South African team at the Sydney Paralympic Games where she reached the finals and finished 7th in the 50m backstroke and 8th in the 50m freestyle. Northern-KwaZulu-Natal also awarded her the Junior Sportswoman of the Year award in 2001. In 2002 she participated at the South African Senior National swimming championships for KwaZulu-Natal in the multi-disability category.

In 2005 she completed the Midmar Mile. She also represented South Africa at the world championships for athletes with cerebral palsy in Boston in the United States of America. She won two gold medals for respectively the 50m freestyle and the 50m backstroke and two silver medals in the 100m and 200m freestyle. She was also nominated to represent South Africa as athlete’s representative on the world committee of CPISRA (Cerebral Palsy International Sports and Recreation Association). In this year Sarah also received the KwaZulu-Natal Premier’s Sportswoman with a disability award of the year.

In 2006 she qualified for the IPC world championships but could not attend.

In 2007 she represented South Africa once more at the Visa Paralympic World Cup in Manchester in the United Kingdom where she broke the South African record in the 50m backstroke, finishing 7th in the 50m freestyle and 6th in the 50m backstroke.

She was also part of the very successful Team South Africa to the Paralympic Games in Beijing. She reached the finals in both the 50m backstroke and 50m freestyle. She finished 7th in the 50m freestyle and 6th in the 50m backstroke in personal best times for both events. She has been participating in the able bodied South African National Swimming Championships since 2002. She is currently ranked 2nd in the world for short course items and 11th for the long course items. She is truly our best swimmer in the S3 class.
 

 

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