CH 18. Prewriting and handwriting 연세대학교작업치료학과김정란 1 성장과발달 5

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1 CH 18. Prewriting and handwriting 연세대학교작업치료학과김정란 1

2 Contents } Introduction } Prewriting skills } Development of prewriting skills } Handwriting 을위한준비도평가와증진활동 } Handwriting 의평가 } 포괄적인평가방법 } 글씨쓰기수행에서측정해야할요소 } 글씨쓰기평가도구 2

3 Introduction } 쓰기기술의중요성 } 학습활동 : 읽기, 쓰기, 수학등 } 일상생활 : 메시지남기기, 스케줄관리, 직업활동등 } 의사소통의도구 } MaHale and Cermak(1992) 연구 } Fine motor activity ; 31~60% } Pencil and paper activiey; 85% } 학령기아동의작업치료의뢰주요사유 3

4 } 주요평가와중재내용 : 작업치료사의역할 1 학생에게있어글씨쓰기의범위와어떤요소가문제가 되는지결정 2 아동의수행에영향을주는학교의환경 ( 예. 교실배치 ) 3 4 문화적, 시간적, 영적, 신체적특징과관계되는학생의개인적환경글씨쓰기의기능적인수행을방해하는학생의능력, 경험과수행기술 4

5 The Writing Process 1. Pre-literacy writing development of young children } 저학년시기아동의쓰기발달과정에포함되는과정 } Mechanical process : writing tool 잡기 (p.499, figure 18-1) } Perceptual : graphic( 그려놓은것들, 문자, 기호그림등등 ) } Acquisition of language } Learning of spelling and phonology: 철자법과음운체계 5

6 The Writing Process } Writing development of children } Tan-Lin(1981) 의연구 : 3~5세아동 110명 } Sequential stages of prewriting and handwriting 낙서 à 선, 점, 또는기호 à 직선또는원형대문자 à 대문자 à 소문자, 숫자또는단어 6

7 Development of prewriting and handwriting in young children (p. 500, Table 18-1) Scribbles on paper Imitates horizontal, vertical, and circular marks Copies vertical and horizontal lines and circles (, -, )(copy) Copies cross, right oblique line, diagonal left oblique cross, some letters and numerals; may write own name (+, /,, \,1,) Copies triangle, prints own name, copies most lower and uppercase letters (, 이름 ) months 2 years 3 years 4 5 years 5 6 years 7

8 Development of prewriting and handwriting in young children (, -, ) 출처 : 대한아동학교작업치료학회.(2013). 아동작업치료. 서울 : 계축문화사. 8

9 The Writing Process 2. Writing Development in School-aged Children } Fluency develops in 3rd or 4th grade } Adult speed by 9th grade } Perceptual motor processes } Visual perception(copying form), auditory processing( 받아쓰기 ), visual motor integration( 쓰기위한구성요소통합 ) } Cognition processes; 실행계획, working memory } 상관관계연구 : Linked to eye-hand coordination, dexterity, and visual-motor integration } Language process ; spoken language à written language } Vision; to guide hand movement ( 어린아이들처음배울때 ) à kinesthetic memory of letterform à automatic 9

10 The Writing Process 3. Handwriting Readiness( 쓰기준비 ) } 아동의성숙도, 환경적경험, 흥미의정도에따라발달차이가존재함 } Handwriting Readiness Factors } Letter formation : 감각운동통합 Visual, Motor, Sensory, Perceptual system 의통합 Performance components Motor planning Eye-hand coordination In-hand manipulation Kinesthesia } Good kinesthesia : 쓰기속도증진, visually monitor 필요감소, pressure 양조절해줌, 10

11 # Handwriting 에영향을주는 performance components 출처 : 대한아동학교작업치료학회.(2013). 아동작업치료. 서울 : 계축문화사. 11

12 } Cognitive skills } Attending to a writing task independently, over time, in a classroom } Recalling letter formations and handwriting strategies over periods of time through visual, verbal, and auditory memories } Generalizing handwriting from an intervention program to real-life situation } Psychosocial skills } Child s values and interests } Self-regulation, self-concept } Coping skills 12

13 The Writing Process 1) 연필잡기위한손사용의기초가되는 6 가지기본발달요소 (Benbow, 2006) 13 1 U/Ex support 2 Wrist and hand development 3 Visual control 4 Bilateral integration 5 Spatial analysis 6 kinesthesia 2) 기하학적형태를그리는능력 : Visual-Motor Integration (Beery et al., 1997) } 시각-동작통합 (VMI) 의첫 9개의모양을마스터할수있을때까지손으로쓰기미룸 à 즉, 숙달후에쓰기교육시작!! } 수직선à 수평선à 원 à cross à right-oblique line à 네모 à left oblique line à oblique cross à 세모

14 The Writing Process # 글씨쓰기교육을위한기본적기술영역 6 가지 (Zwicker & Hadwin, 2006) 1 Small muscle development 2 Eye hand coordination 3 Holds utensils or writing tools 4 Form basic strokes smoothly (circle and lines) 5 Letter perception : 유사점, 차이점, 형태생성에필요한움직임예상, 본것을말로설명하기등 6 Orientation to printed language : Right-left discrimination 14

15 # Handwriting readiness 발달을위한활동 (p.507, table 18-2) 1 Improving fine motor control, isolated finger movements 2 Promoting graphic skills 3 Enhancing Rt.-Lt. discrimination 4 Improving orientation to printed language 15

16 준비영역미세한움직임조절과분리된손가락의움직임향상그래픽기술향상 준비활동 엄지, 검지와중지의끝부분으로치료용찰흙 (putty) 을이용한활동 작은물체집어올리기 엄지와다른손가락의맞섬 (opposition) 을이용해서봉투밀봉하기 엄지와검지를이용해치약과같은작은튜브열기 손바닥에있는열쇠를손내조작을통해손가락끝으로옮기기 면도크림이나모래, 물감등을이용해서선을그리거나모양따라그리기 칠판에선 & 모양을그려서이야기완성하기 사람, 동물, 집, 나무등그림을그리거나색칠하기 점선으로된그림과미로완성하기 오른쪽 / 왼쪽구별증진 칠판이나종이에오른쪽과왼쪽을지나는점선연결하기 인쇄된글자에 대한오리엔테이션증진 아동이흥미를가지는주제 ( 예. 장소, 음식등 ) 로구성된책으로촉진하기 교실에있는일반적인물건에라벨붙이기 16

17 Pencil Grip Progression } Whole-hand primitive grip } 일반적연필잡기시작패턴 } 손전체로잡기, pronation, 어깨이용해서연필움직이기 } Transitional grip } 손가락 (1 st ~4 th ) 이용유지, pronation à supination } Mature grip } Thumb, index finger, middle finger radial side } Wrist slight extension, intrinsic muscle } Dynamic tripod pencil grip 17

18 } Grasp } Wholeà fine, mature grasp } Forearm } Pronatedà supinated } Move the pencil } Using shoulderà fine, isolated hand movement } 성숙한연필집기 } Dynamic tripod } Lateral tripod } Dynamic quadrupod } Lateral quadrupod 18

19 p. 502 figure Mature pencil grips in elementary school children 19

20 Schneck 과 Henderson 의연필잡기패턴과설명 20

21 출처 : 대한아동학교작업치료학회.(2013). 아동작업치료. 서울 : 계축문화사. 21

22 원시적잡기 (primitive grips) a. 손바닥을이용하여손바닥전체를이용하여주먹을쥐고, 전완을완전히회내하고, 요골측으로잡기팔의운동을최대로하여요골측으로잡음 (radial cross palmar) b. 손바닥을회외하여잡연필을척골측으로하여손바닥으로잡고, 주먹을뒤고, 수근관절은약간굴곡하고, 기 (palmar supinate) 회외하며, 팔의운동이최대로이루어지도록함 c. 검지만을이용하고, 회연필의끝을따라검지를신전하여손바닥으로잡고, 내하여잡기 (digital pron 팔은테이블에지지함이없이운동이가능하도록잡음 ate, only index) 연필의끝을손가락으로쥐고회내하여 d. 솔잡기 (brush) 전완이공중에위치하도록하여팔전체가움직이지않도록잡음 e. 신전한손가락으로잡손목을세우고약간척측편위하여회내하고, 기 (grasp with extende 전완을일정하게움직이며, 손가락을이용하여잡는다. d finger) 22

23 과도기적잡기 (transitional grips) 네손가락은주먹을쥐고, f. 엄지로잡기검지위에연필을놓아엄지로잡고, (cross thumb) 전완을테이블에받쳐손가락과손목을움직이도록함연필을중지의요측면에고정하고, g. 정적 3점잡기연필체에검지를세우고, (static tripod) 완전히대립하여엄지를고정하며, 손목은약간신전하고, 전완은테이블에놓음 h. 네손가락을이용대립하여네손가락으로연필을잡고하여잡기전완은테이블에놓음 (four fingers) 23

24 성숙한잡기 (mature grips) i. 외측 3점잡기 (lateral tripod) j. 동적 3점잡기 (dynamic tripod) 연필을검지끝으로중지의요측에고정, 엄지는내전하고검지의외측에고정손목은약간신전하고약지와소지는아취를고정하기위해굴곡하고전완은테이블에놓음연필을검지와엄지끝으로잡고중지의요측에고정, 엄지는완전히대립하며손목은약간신전하고약지와소지는아취를고정하기위해굴곡하고전완은테이블에놓음 24

25 Handwriting Evaluation 1) Occupational profile } 학생의 OT history, experience, 일상 patterns, 흥미, 가치, 요구 2) Interviews: 아동의부모, 교사, 다른팀원과의인터뷰 } 관계형성 / 중요한정보수집 } 교사 (p. 502, BOX 18-1) } 아동의능력, 성취도, 커리큘럼, 교우관계, 규칙준수 } 아동의교육적장점과관심사, 쓰기과제를언제잘수행하고언제흐트러지는지, 다른일상과제의수행정도등을파악 } 가족 } 발달, 병력, 가족력, 아동의흥미거리 } 집에서아동의반응 : 학습시, 수행방법, 바라는쓰기관련과제등 25 n

26 Handwriting Evaluation 3) Analysis of occupational performance (comprehensive evaluation) } Examination written work samples } Discussing the child performance with the teacher, parents, and other team member } Reviewing the child s educational and clinical records } Observing the child directly when he or she is writing in the natural setting : evaluation of context } Evaluating the child s actual performance of hand writing } Assessing any suspected performance components with hand writing 26

27 1 Work samples } 전형적인쓰기수행 철자훈련, 수리적문제풀이, 이야기쓰기 ( 일기 ) 등 } 완성한견본을또래아동의견본과비교함 2 File review } 교육기록 : 과거학업수행, 특별한검사나특별한서비스처방 } 의학적 치료적기록 27

28 3 Direct observation } 아동의교실에서과제수행, 과제의집중도, 문제해결력, 행동에 초점을두고관찰을실시 } School contextual features 조명, 소음수준, 학습교구, 학급배치등 } Structured protocol for direct observation a. Identify which writing tasks are most problematic b. Behaviors : 쓰기싫을때어떤행동을하는지등 c. Level of independence d. Attention distractions e. Environment where child sits, teacher f. Curriculum 28

29 Measuring handwriting performance 1) Domains of handwriting } Writing: 문자와숫자기억해서순서에맞게적는능력 } copy(near-point copying, far-point copying), } 비슷하게쓰여진모델에서숫자, 문자와단어를재생산해내는 능력 } 가까운모델로부터 ( 같은지면 ) 옮겨적을때 } 먼거리모델로부터 ( 수직지면이나칠판 ) 옮겨적을때 } 듣고받아쓰기 : 전화번호, 주소, 메세지등 } Composition: 창작하기 ( 시, 이야기, 편지등 ) 29

30 2) Legibility: 글자를알아볼수있도록썼는지를평가 } letter formation: 글자모양 } 불규칙한글자모양, 잘못된글자개시와마침, 글자의미완성, 글자의미숙한라운딩, } Alignment: 배열, 줄안에있는글자의위치 } Spacing: 간격, 단어 - 단어사이, 줄 - 줄사이비율등 } Size : 글자의크기, 비율 } Slant(angle) : 기울기 } Readability Formula: Total number of readable words = 4 = 50% Total number of written words 8 30

31 3) Writing speed } Number of words per minute } Consider within context of classroom, assignment, child } 쓰기양이나과제의복잡성이증가할경우 à 속도감소 4) Ergonomic Factors } 쓰기과제동안분석해야하는인간공학적요소 } Writing posture, U/Ex stability and mobility, pencil grasp 31

32 Handwriting Assessments } 표준화된평가도구의장점 } 객관적인수치와점수를제공함 } 경과를모니터하는데도움이됨 } 전문가의보다명확한의사소통을도움 } 연구통해서활동분야를발전시킴 } 평가도구의예 (p.581, Box 18-2) } the Children's Handwriting Evaluation Scale } the Evaluation Tool of Children's Handwriting(ETCH) } the Test of Handwriting Skills } Minnesota Handwriting Assessment } the Children's Handwriting Evaluation Scale-Manuscript, } Jebson-Taylor hand function 32

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38 Practice } Case study Natasha (p.506) } 일반적정보 } 나이 / 성별 : } 진단명 } 주요호소 (chief complain) : } 평가내용 } 1) } 2) } 3) } 4) } à 종합해보면, ( ) } Intervention plan 38

39 Reference } Case-Smith, J., & O`Brien, J. C. (2015). Occupational therapy for children and adolescents(7th ed.). St. Louis: Mosby. } 대한아동학교작업치료학회.(2013). 아동작업치료. 서울 : 계축문화사. 39 성장과발달 4

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