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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

Media: Sunday Times
2006-05-20

Sunday Times, 4 June 2006

True leadership may mean admitting disunity
 

In this edited extract from the inaugural King Moshoeshoe Memorial Lecture at the University of the Free State, Professor Njabulo S Ndebele explores the leadership challenges facing South Africa

RECENT events have created a sense that we are undergoing a serious crisis of leadership in our new democracy. An increasing number of highly intelligent, sensitive and committed South Africans, across class, racial and cultural spectrums, confess to feeling uncertain and vulnerable as never before since 1994.

When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. We have the sense that events are spiralling out of control and that no one among the leadership of the country seems to have a definitive handle on things.

There can be nothing more debilitating than a generalised and undefined sense of anxiety in the body politic. It breeds conspiracies and fear.

There is an impression that a very complex society has developed, in the last few years, a rather simple, centralised governance mechanism in the hope that delivery can be better and more quickly driven. The complexity of governance then gets located within a single structure of authority rather than in the devolved structures envisaged in the Constitution, which should interact with one another continuously, and in response to their specific settings, to achieve defined goals. Collapse in a single structure of authority, because there is no robust backup, can be catastrophic.

The autonomy of devolved structures presents itself as an impediment only when visionary cohesion collapses. Where such cohesion is strong, the impediment is only illusory, particularly when it encourages healthy competition, for example, among the provinces, or where a province develops a character that is not necessarily autonomous politically but rather distinctive and a special source of regional pride. Such competition brings vibrancy to the country. It does not necessarily challenge the centre.

Devolved autonomy is vital in the interests of sustainable governance. The failure of various structures to actualise their constitutionally defined roles should not be attributed to the failure of the prescribed governance mechanism. It is too early to say that what we have has not worked. The only viable corrective will be in our ability to be robust in identifying the problems and dealing with them concertedly.

We have never had social cohesion in South Africa — certainly not since the Natives’ Land Act of 1913. What we definitely have had over the decades is a mobilising vision. Could it be that the mobilising vision, mistaken for social cohesion, is cracking under the weight of the reality and extent of social reconstruction, and that the legitimate framework for debating these problems is collapsing? If that is so, are we witnessing a cumulative failure of leadership?

I am making a descriptive rather than an evaluative inquiry. I do not believe that there is any single entity to be blamed. It is simply that we may be a country in search of another line of approach. What will it be?

I would like to suggest two avenues of approach — an inclusive model and a counter-intuitive model of leadership.

In an inclusive approach, leadership is exercised not only by those who have been put in some position of power to steer an organisation or institution. Leadership is what all of us do when we express, sincerely, our deepest feelings and thoughts; when we do our work, whatever it is, with passion and integrity.

Counter-intuitive leadership lies in the ability of leaders to read a problematic situation, assess probable outcomes and then recognise that those outcomes will only compound the problem. Genuine leadership, in this sense, requires going against probability in seeking unexpected outcomes. That’s what happened when we avoided a civil war and ended up with an “unexpected” democracy.

Right now, we may very well hear desperate calls for unity, when the counter-intuitive imperative would be to acknowledge disunity. A declaration of unity where it manifestly does not appear to exist will fail to reassure.

Many within the “broad alliance” might have the view that the mobilising vision of old may have transformed into a strategy of executive steering with a disposition towards an expectation of compliance. No matter how compelling the reasons for that tendency, it may be seen as part of a cumulative process in which popular notions of democratic governance are apparently undermined and devalued; and where public uncertainty in the midst of seeming crisis induces fear which could freeze public thinking at a time when more voices ought to be heard.

Could it be that part of the problem is that we are unable to deal with the notion of opposition? We are horrified that any of us could be seen to have become “the opposition”. The word has been demonised. In reality, it is time we began to anticipate the arrival of a moment when there is no longer a single, overwhelmingly dominant political force as is currently the case. Such is the course of history. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than seek to prevent it. We see here once more the essential creativity of the counter-intuitive imperative.

This is the formidable challenge of a popular post-apartheid political movement. Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it is currently, and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest in different articulations, which then contend for social influence. In this way, the vision never really dies; it simply evolves into higher, more complex forms of itself. Consider the metaphor of flying ants replicating the ant community by establishing new ones.

We may certainly experience the meaning of comradeship differently, where we will now have “comrades on the other side”.

Any political movement that imagines itself as a perpetual entity should look at the compelling evidence of history. Few movements have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early ’90s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed leading up to the adoption or our Constitution?

This is not a time for repeating old platitudes. It is the time, once more, for vision.

In the total scheme of things, the outcome could be as disastrous as it could be formative and uplifting, setting in place the conditions for a true renaissance that could be sustained for generations to come.

Ndebele is Vice-Chancellor of the University of Cape Town and author of the novel The Cry of Winnie Mandela

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