An action research case study on the impact of systematic and individualised instruction along with motor-skill practice on the development of handwriting skills and self-confidence of primary school children with dysgraphia.
What is the impact of ‘application of appropriate strategies in teaching and developing self-confidence’ on the primary school children with dysgraphia, in Sri Lanka?
Dysgraphia is an inability to produce clear accurate handwriting in a functional amount of time despite sufficient teaching, motivation, and mental and physical health (Eide & Eide, 2006). Elementary school children typically spend up to 50% of the school day engaged in writing tasks (Amundson & Weil, 1996). A chilld’s ability to write legibly, as well as quickly and efficiently, enables him or her to achieve both functional written communication and academic advancement (Phelps et al., 1985). However, the act of writing presents difficulties for 10-30% of elementary school children. Moreover, as Mayer (1996) brings forth, when handwriting skills are deficient, children suffer various consequences related to their academic performance, emotional well-being, and social interactions (Cornhill & Case-Smith, 1996). If children meet constant failure and frustration, they feel that they are inferior to others, and develop low level of self-efficacy, which may have negative impact on their future as well (Handley et al., 2003).
Identifying students who have dysgraphia can be a challenge because it affects them to different degrees or is often combined with other types of learning problems (Cavey, 1987). Although the accurate determination of dysgraphia requires the input of a qualified clinician, parents and teachers can observe symptoms of distorted handwriting. There is no total cure for dysgraphia, instead, students must be taught both compensation and remediation strategies in early age to help them cope with or improve their writing ability (Richards 1999). This reinforces the importance of identifying handwriting difficulties as early as possible both as a preventive and as a corrective aid (Phelps & Stempel, 1988).
In Sri Lanka, though the school system practises inclusive education, no special strategies are employed to identify children with dysgraphia. But it can be observed, at average, there are at least two or three children in a class of thirty five who are unable to produce legible handwriting even in their first language. Unfortunately, these children are neglected through-out their schooling due to common hindrances in a school system such as over-crowded classrooms, lack of knowledge of teachers to deal with dysgraphia, and so forth.
In light of this, a case study will be carried out to study an action research that will be implemented to develop handwriting of two primary school children with mild and severe dysgraphia in a semi-urban mainstream-school in Kandy district, in Sri Lanka.
The findings of this study may give an insight to teachers to assist their students with dysgraphia, in similar contexts.
The International Dyslexia Association (ADA) explains dysgraphia as follows; ‘Dysgraphia is a Greek word. The prefix dys indicates that there is impairment. Graph refers to producing letter forms by hand. The suffix ia refers to having a condition. Thus, dysgraphia is the condition of impaired letter writing by hand, that is, disabled handwriting and sometimes spelling'(2013). A similar definition is given in the Dictionary of Psychology, dysgraphia as an inability to write properly or to express oneself through writing (Arthur, Reber & Emily , 2001). Unfortunately, a more precise definition is lacking because there is little agreement regarding both the cause of the disorder and the characteristic features of dysgraphic writing (Michelle & Eialitz, 1999).
Previous studies have reported that handwriting distortions are associated with neurological and developmental disorders (Angela & Fawcett, 2011). According to Arthur and Emily (2001), dysgraphia is usually associated with lesions in the inferior parietal lobe, and, Mather (2003) states that it is due in part to the left hemisphere of the brain not being fully developed before the introduction of handwriting. Another view regarding the cause of dysgraphia is that it can be genetic. Since Dysgraphia has a genetic component, in the process of its treatment, a history of familial health and academic problems should be obtained (Feifer & Defina, 2002). On the other hand, Feizabadi, et al., (2013) argue that the difficulty with motor memory is one of the most common causes of handwriting difficulty and a major contributor to dysgraphia.
When considering the types of dysgraphia, there are several classifications found in the literature. Subjects with disproportionate difficulty novel words as compared to familiar words ‘phonological disgraphia’ (Assal, et al, 1981) and subjects with consisting of more accurate performance on novel words than familiar words ‘surface dysgraphia’ (Baxter & Warrington, 1985). In the later years, two more categories were added to these two, named ‘Motor dysgraphia’; due to deficient fine motor skills leading to distorted written work, and ‘Spatial dysgraphia’; due to a deficit in understanding of space. (Dysgraphia Guidance Document, 2012).
However, not all writing problems are the results of dysgraphia (Berninger, 2000; Berninger, Winn, et.al. 2008). According to them, some children fall outside the normal range in all areas of development (i.e. cognitive, language, motor, attention and executive function, and social, emotional) and they are also likely to have writing problems, but the biological bases for their written language are different from those of children with dysgraphia.
The diagnosis of dysgraphia was usually based on measures such as the Hebrew Handwriting Evaluation (Erez & Parush, 1999). Due to the development of new tools (e.g. digitalized tablets) and appropriate software, several ‘hidden’ variables of the handwriting process have now been made available, permitting a more complete characterization of handwriting performance. (Je?? re??my et al., 2013).
However, a teacher or a parent can identify dysgraphic handwriting by careful observation (Craig, 2012). According to Richards (1999), the most common features of dysgraphia are illegible handwriting, inconsistent spacing between letters and words; irregular letter sizes and shapes; inappropriate mixture of upper and lower case letters, etc. She explains further stating that by looking at a child’s written result does not necessarily determine if he is dysgraphic, because similar looking products may be produced by a student with delayed skills, poor writing habits. Only by watching the writing process will an astute teacher or parent observe, that the child forms the same letter using different sequences throughout the sample, or that the child needs to think about how to create specific letters (Berninger et al., 2001).
As for treatment for Dysgraphia, it can be diagnosed, and challenged if appropriate remedial strategies such as direct instructions are conscientiously carried out (Smits-Engelsman, et al., 1996). Richards (1999) advises on three forms of assisting the children with dysgraphia; Accommodations, providing alternatives to written expression; Modification, changing expectations or tasks to minimise or avoid the areas of weakness; and Remediation, providing instruction for improving handwriting and writing skills.
In the literature, majority of the research carried out on dysgraphia are based on neuropsychological aspect of the disability. However, in 2006, Crouch and Jakubecy, carried out an action research to find out which technique, between drill activities and fine motor activities worked better in improving handwriting of a student with dysgraphia, and observed that the combination of both techniques assisted in increasing the student’s score by 50%.
In light of this, a case study will be conducted on an action research exploring the impact of routinely exercises on motor skills, individualized, and step-by-step instructions, thorough practice of handwriting activities, continuous assessment and constructive feedback on the development of the self-confidence, thus promoting the handwriting of two children with severe and moderate levels of dysgraphia.
Paradigm and Method
The study will employ a mixed approach with both quantitative and qualitative methods, data collection techniques and data analysis procedures to produce more trustworthy data (Tashakkori & Teddie, 2003).
The research involves a case study, based on an action research. (Yin, 2009) argues that different methods can be used for different purposes in a study, to best answer the research question(s). Since quantitative and qualitative approaches each have their own strengths and weaknesses, it makes sense to use different approaches to cancel out such negative effect and this will lead to greater confidence being placed in the conclusions (Smith, 1981).
A case study is a strategy which involves an empirical investigation of a particularly contemporary phenomenon within its real life context using multiple sources of evidence (Robson, 2002). An action research combines diagnosis, action, and reflection focus on practical issues that have been identified by participants and which are somehow both problematic yet capable of being changed (Swann, 2012). The case study, as well as, action research will be of particular interest to the researcher if he wishes to gain a rich understanding of the context of the research and the processes being enacted (Morris, 1991). In addition, the case study strategy also has considerable ability to generate answers to the questions ‘why’? as well as the ‘what’? and ‘how’? questions.
The greatest criticism regarding the trustworthiness of action research and case study is ‘subjectivity’, but, far from having a negative impact on the research, this is what gives the investigation credibility in terms of problem solving, solution testing or illuminating the issue in question in depth (Swann, 2012). In addition, a well-constructed case study, or an action research may enable the researcher to challenge an existing theory and also provide a source of new research questions.
The participants of the study will be a fourth grade boy with severe dysgraphia, and a girl of the same age with mild dysgraphia, in a mainstream school in Kandy district, Sri Lanka. Purposive sampling will be adopted in selecting the participants, since it will best answer the research question and meet the objectives of the research (Saunders, 2009). Although a small sample may contain cases that are completely different, as above, Patton (2002) argues that this in fact a strength. Generalizability is a limitation with small samples, however, all research are not always interested in generalisability but may aim to understand an issue in more depth and provide an insight to other researchers in similar contexts (Neuman, 2005).
A group of students with poor handwriting will be given two short texts in Sinhala, and English to copy-write, and their work will be evaluated according to the check list of ‘Identifying Pupils with Dysgraphia’ (Dysgraphia Guidance Document, 2012). From these, the two participants will be selected. The class-teachers of these participants from grades 1-5, and English teachers from grades 3-5 will be grouped-interviewed for 45 minutes following the semi-structured interview strategy to gain knowledge about the academic and social behaviour of the participants.
Individualised learning and teaching programmes (Howe, 2013), and step-by-step instructions (Van Galen, 1997) will be conducted to the participants. The child with severe dysgraphia will be taught the 26 simple letters of the English alphabet in 8 weeks, 30 minutes each day, 5 days a week. Similarly, the child with mild dysgraphia will be taught how to write the English alphabet, two-letter words, three-letter words, simple sentences, small paragraphs with correct writing mechanisms. Each day, prior to the commencement of teaching, sufficient practice in hand-strengthening activities, correct pencil-grip and posture etc., will be given (Marr and Cermak, 2001). The lessons will be conducted in a multisensory dysgraphic-friendly environment (Berninger, 2008), and a thorough practice of the lessons will be given to develop automaticity and proficiency in handwriting (Smits-Engelsman, 1997). At the end of each step of the intervention, a teacher-made test will be administered, and constructive feedback will be given to students to develop their performance and self-confidence (Pickard, 2007). The participants will be observed and interviewed in the pre, while, and post stages of the intervention, and field notes will be obtained.
Semi-structured group interviews, participant-observation, and teacher-made tests will be employed in the study ‘to pick triangulation sources that have different biases, different strengths, so they can ‘complement’ each other’ (Miles & Huberman, 1994, 267).
Semi-structured interviews will be conducted to the teachers to identify general patterns and to seek in-depth information (King, 2004). However, a major challenge in interviewing children will be the access to the unerstandings of them (Glassner, 1976). The use of group interviews may provide an efficient way to interview a larger number of individuals simultaneously, and to allow them to range more freely in discussion revealing data that may provide important information. (Saunders, 2009). However, there may emerge a group effect where certain participants effectively try to dominate the interview while others may feel inhibited (Stokes and Bergin 2006). Probs and prompts will be utilised in such situations. In addition, the questions will be carefully designed, piloted and refined to obtain rich and in-depth data.
The aim of the researcher as a participant observer in an action research is to bring about a change in the situation and observe (Sharp et al.,2002). Participant-observation is very high on ecological validity because it involves studying the phenomena in its natural contexts (Saunders, 2009). Semi-structured observation facilitates obtaining frequencies of behavioural patterns of the participants as well the opportunity for the researcher to observe the ‘real life’ emotions of them. The use of standardised observation and interview schedules, and the need to create a full record of them soon after their occurrence, control bias and produce reliable data for analysis (Ghauri and Gronhaug, 2005).
Criterion-referenced teacher-made tests will be conducted at the end of each stage of the intervention process, to monitor the progress of the participants. Cautions will be taken in the design and conduct of the tests not to lower the self-efficacy of the participants due to any negative effects of the tests.
Prior to the commencement of the study, informed consent from the Zonal Education Office, the principal, teachers, and parents of the two participants, and an assent from the two participants will be obtained. Necessary actions will be taken to ensure the design of research to be methodologically sound and morally defensible to all those who are involved. (Zikmund, 2000).
The quantitative data will be analysed taking frequencies and marks and representing them in percentages and bar graphs for unambiguous and accurate interpretation. (Cohen et al., 2007). Analysis of data will be completed through construction of criterion-referenced scoring guides, and numerical values will be assigned to each level of success (Ross-Fisher 2005). Numerical analysis facilitates comparisons and contrasts of the findings demonstrating realistic and meaningful interpretation of data (Pickard, 2007).
Qualitative data are of diverse nature and they can be analysed by processes of summarising, categorising and structuring of meanings ( Miles & Huberman, 1994). Coding, the process of ‘de-assembling and reassembling’ the data, based on emergent themes and subthemes (Ezzy, 2002) will be used for this purpose. Deductive, and inductive theoretical frames will be employed in the analysis, to study the data from different perspectives (Easterby-Smith et al., 2008).
Reliability refers to the extent to which the data collection techniques or analysis procedures will yield consistent findings (Easterby-Smith et al., 2008). Validity, on the other hand, concerns the extent to which the research measures what it is supposed to measure. (Grundy, 1987). Constructing the teacher-tests by maintaining the content, construct, predictive, and face validity of tests (Punch, 2002); piloting the tests, interviews, and observations prior to the implementation in the actual research (Hammond et al., 2006); using semi-structured observations and interviews to combine the strengths and compensate for the weaknesses of the techniques (Smith et al., 1995); employing triangulation of quantitative and qualitative research methods, data collecting techniques and analysis procedures to obtain quality data (Saunders et al., 2009) will enhance the research design to promote the reliability and validity it.
Though external validity, sometimes referred to as generalizability is mainly a concern for explanatory researches. This logic is inapplicable to exploratory research such as case studies and action research which are not concerned with generalising the findings to populations, but transferring them to theoretical propositions (Yin, 2009).
A proper data base will be maintained throughout the research for comprehensive and systematic management of data facilitating proper storage and easy retrieval of the collected data. (Pickard, 2007).
Every stage of the research will be designed and conducted rigorously and efficiently, to produce credible and wider applicable findings.