Abstract:Thepurpose of this experimental study was to investigate the effects of a SystematicManipulative Skills Motor Activity (SMSMA) Programme on the Eye-Hand coordinationof children with Autism Spectrum Disorder (ASD). 10 children aged between 5years to 7 years with moderate level of ASD were selected using thenon-probability based convenience sampling technique. These children underwent a6 week SMSMA Programme designed by the Researcher for 45mins, 5 days a week.The Eye-Hand coordination of these children was assessed using a Modified MinnesotaManual Dexterity (MMMD) assessment instrument. Descriptive statistics showed anincrease in the mean performance from (523.25 sec, ±8.
61) to (327.10 sec, ±5.46).Paired sample ‘t’ test was used to compare the change in performance which showedthat the calculated ‘t’ value (70.275) was significant at 0.05 level ofsignificance (p=0.000). Hence it was concluded that a 6 week SMSMA programmehas a significant effect on the Eye-Hand coordination of children with ASD.
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__________________________________________________________________________________ Keywords:Manipulative Skills Motor Activity, Autism Spectrum Disorder, Eye-Hand coordination. Introduction: According to the AmericanPsychiatric Association (2013), presence of restricted or repetitive behavioursand impaired social-communication are the basic characteristics of AutismSpectrum Disorder (ASD). Recent studies also suggest deficits in gross and finemotor skills of children with ASD (Miyahara et al., 1997; Wing, 1981; Ming etal., 2007; Greenspan and Wieder, 1997; Provost et al., 2007; Fournier et al.,2010) which include underdeveloped fundamental motor control (Adrien et al.,1993; Jansiewicz et al.
, 2006; Teitelbaum et al., 1998), inability to performmovements skilfully (Mostofky et al., 2006; Jones and Prior, 1985), impropermotor learning patterns (Hughes, 1996; Haswell et al., 2009), and impaired Eye-Handcoordination and hand grasping movements (Noterdaeme et al., 2002; Mari et al.,2003). Even now these underdeveloped motor skills are considered to be symptomsof ASD (Ming et al.
, 2007) and are considered to hinder the development ofadaptive skills (Baranek et al., 2005; Leary and Hill, 1996; Bauman, 1992;Mostofsky et al., 2006). Underdeveloped motor skills may not only affect thedevelopment of basic daily motor activities (such as eating with a spoon), butalso social behaviour, by hindering the child’s participation in otheractivities that are age-appropriate (team games). Well-developed fundamentalmotor skills form the base for the efficiency in later movements and physicalskills in games and sports (Gallahue, 1982; Gabbard, 2000; Haywood andGetchell, 2002; Payne and Isaacs, 2002; Seefeldt, 1982). A mastery offundamental motor skills is crucial in the optimum development of a child (Gallahue,1982; Kogan, 1982; Seefeldt, 1980), and these skills are observed and enhancedat the elementary school level (Ulrich, 2000).
It is assumed that to be able toperform complex skills at a later stage, it is important that children developfundamental gross motor skills to a certain proficiency at the elementaryschool level (Seefeldt, 1982). Eye-Hand coordinationrefers to the capacity of what the brain has to understand and interpret afterwhat the eyes have seen (Gardner, 1986). Eye-Hand coordination is known as theability to recognise, interpret and respond to visual stimulants based onprevious experiences. It is an output in the form of a physical skill after theindividuals understanding and interpreting the visual stimulus (Frostig, 1964).The combination of basic visual functions and fundamental gross motor skillsand Eye-Hand coordination allows us to perform many daily activities (Chaikinand Downing-Baum, 1997; Erhardt and Duckman, 2005; Van Waelvelde et al., 2004). Considering impaired motorabilities and perceptual abilities, literature states that both are related (Hulmeet al.
, 1982; Lord and Hulme, 1987; Lord and Hulme, 1988; Sigmundsson et al.,2003; Wilson and McKenzie, 1998). While many studies have been conducted tostudy the impaired motor skills of children (Hulme et al., 1982; Lord andHulme, 1988; Parush et al., 1998; Schoemaker et al., 2001) Eye-Hand coordinationis rarely an object of investigation considering the development of motorabilities of children with ASD. Wilson (2002) suggests that cognitivefunctioning should be considered while working on adapted behaviour.
This maybe interpreted as complex adaptive behaviours like those of hands may beclosely related to cognitive functioning than compared to simple ones likewalking. Eye-Hand coordination is a complex aspect of fundamental motoractivities that needs to be explored while studying the development of motorabilities of children with ASD (David et al., 2012). The ability to recognisethe pattern of the visual stimulus and execute the action is an importantaspect towards achieving a goal integrated in the environment (Schmitz et al.,2003). The effect of a systematic manipulative skills motor activity programmeon the Eye-Hand coordination of children with ASD was investigated in thisstudy. The researcher is of the opinion that Eye-Hand coordination may providea base for further motor development of children with ASD. As such, enhancementin the Eye-Hand coordination may affect how children with ASD play, explore,use tools, and engage socially.
Materialsand Method:Variables: After athorough review of literature in the concerned area, various aspects of motordevelopment of children were analysed based on priority. Considering theseaspects, the researcher identified the variables and formulated the researchproblem. A Systematic Manipulative Skills Motor Activity Programme wasidentified as the Independent variable and the Eye-Hand coordination ofChildren with Autism Spectrum Disorder was identified as the Dependantvariable.AssessmentInstrument: Consideringthe assessment of the Eye-Hand coordination of children with ASD, the”Minnesota Manual Dexterity Test” was modified by the researcher to measure theEye-Hand coordination of the subjects. The validity of the modified assessmenttool was established by experts in the related field. The modified assessment instrumentwas based on 2 subtests:- a.
Dominant hand – placing test and, b. Non-dominanthand – placing test. Each subject was given 2 attempts for each subtest and thefinal score was measured to be the total of the average time taken to complete bothattempts of both the subtests.
ResearchDesign: The One group Pre-test Post-testresearch design was adopted by the researcher for this experimental study. Thesubjects were required to undergo the assessment of their Eye-Hand coordinationboth before and after the implementation of the programme.Sampleand Sampling: All the children with ASD, agedbetween 5 years to 7 years from the city of Pune were considered to be thepopulation for the study, of which 10 were selected as sample for the studyusing the non-probabilitybased convenience sampling technique.
Convenience sampling technique, forsample selection was adopted by the researcher as he had to consider the levelof ASD of each child, and children with only moderate level of ASD wereselected for the study.Procedure:Phase1: The “Minnesota Manual Dexterity Test” which is used to measure the Eye-Hand coordinationand arm-hand dexterity was modified by the researcher. The testcomprises of 5 subtests which include the Placing Test, Turning Test,Displacing Test, One-hand Turning and Placing Test and the Two-Hand Turning andPlacing Test. 4 attempts are to be givenand the time in seconds is recorded on the score sheet for each attempt. Thefinal scoring is interpreted by the total seconds for all the attempts. Foreach test all disks must be fully inserted and inserted in the proper hole. Thesubject performs all tests from a standing position.
Asthe eye-hand coordination of children with ASD was to be measured, theinstrument was modified to suit the main objective considering the physical andintellectual ability of the subjects. The modification now comprised of only 2subtests that included Dominant hand Placing Test and Non-Dominant hand PlacingTest. 2 attempts instead of 4 was to be given for each subtest, as less than 2would be inadequate and more than 2 may cause the cognitive functioning to tire.The final scoring is to be interpreted as the total of the average time takenfor completing both the attempts of both the subtests which was measured inseconds. The validityof the modified instrument was established by three experts from the field ofPhysical Education and two experts from the field of Child Psychological Development.PhaseII: Before implementing the programmethe Eye-Hand coordination of the subjects was measured. The SystematicManipulative Skills Motor Activity programme designed by the researcher wasthen implemented for a period of 6 weeks, 5 days a week for 45min. The Eye-Handcoordination of the subjects was measured again after the implementation of theprogramme and the collected data was analysed to study the change inperformance.
Results: The Eye-hand coordination of 10children with moderate ASD was assessed before and after the implementation ofa Systematic Manipulative Skills Motor Activity programme. The mean performanceof the Pre-test was 523.25 sec. (± 8.61) whereas that of Post-test was 327.10sec (± 5.
46). Comparative Analysis of Pre-Test and Post Test (N = 10) Test M S.D. M.
D. S.D. S.E. Df ‘t’ ratio Sig. (2-tailed) Pre 523.25 8.
61 196.15 8.83 2.79 9 70.257 0.000 Post 327.10 5.
46 *Significant at 0.05 level of significance The effect of the programme wasfound to be significant as an increase in the performance was seen, the meandifference of 196.15 sec (± 8.83) for degree of freedom 9 the calculated ‘t’value (70.257) is significant at 0.05 level of significance (p=0.
000).Discussionand Findings: Thepurpose of this study was to investigate the effect of a Systematic ManipulativeSkills Motor Activity programme on the Eye-Hand coordination of children with AutismSpectrum Disorder. The programme was designed based on manipulative skillsmotor activities that involved tossing, catching, throwing, striking, dribblingwith hands; activities that involved more use of hands and visual stimulus. Strong evidences areavailable from motor development, motor planning, motor execution and motorcorrection that movement in children with ASD in impaired. As they grow, impairedmotor planning, delays in initiating movement and inefficiency in performingcomplex motor tasks are seen in children with ASD (Papadopoulos et al., 2012; Dowdet al., 2012; Hughes, 1996; Glazebrook et al., 2008).
These children are notable to use on-going visual feedback, as well as information from a previousmovement to plan subsequent movements more effectively (David et al., 2009;2012; Schmitz et al., 2003). In this study, asystematic manipulative skills motor activity programme was implemented with anaim to develop the Eye-Hand coordination at a low level, and the therapeuticeffects were examined.
The findings show that the programme had a positiveinfluence on the Eye-Hand coordination. It should be considered that a motoractivity programme based on manipulative skills could be used as a clinicalmethod for the functional development of Eye-Hand coordination which may form abase for further motor development in children with ASD. Rehabilitationprograms for autistic children should be age appropriate and match their functionalcondition (Parush et al., 1998). A systematic study over a long term isrequired for establishing the results of this study.Conclusion: From this experimental study it wasconcluded that a 6 week Systematic Manipulative Skills Motor Activity Programmehas a significant effect on the Eye-Hand coordination of children with AutismSpectrum Disorder.