The Journal of Korean Academy of Sensory Integration (대한감각통합치료학회지)

Korean Academy of Sensory Integration (대한감각통합치료학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Interactive Metronome Training on Postural Control and Hand Writing Performance of Children With Attention Deficit Hyperactivity Disorder (ADHD): Single Subject Research

상호작용식 메트로놈(Interactive Metronome) 훈련이 주의력결핍 과잉행동장애 아동의 자세조절과 글씨쓰기 수행에 미치는 영향: 단일사례연구

  • Park, Min-Kyoung (Dept, of Occupational Therapy, Graduate School Konyang University) ;
  • Kim, Hee (Dept. of Occupational Therapy, Konyang University)
  • 박민경 (건양대학교 일반대학원) ;
  • 김희 (건양대학교 작업치료학과)
  • Received : 2018.05.16
  • Accepted : 2018.06.08
  • Published : 2018.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : The purpose of this study was to identify the effect of Interactive Metronome (IM) training on postural control and hand writing performance of children with Attention Deficit Hyperactivity Disorder (ADHD). Methods : Participant was a third grade elementary school student diagnosed with ADHD. ABA design was used and a total of 30 sessions were held for 3 sessions every week for a total of 10 weeks. In the intervention period, IM training was conducted for 40~50 minutes before intervention for writing, and the writing task was carried out. We evaluated the handwriting legibility and speed. Before baseline A and within a month after A' phase, Clinical Observation of Motor and Postural Skills (COMPS) was evaluated to examine the changes in postural control of the student. Results : After the IM intervention, the postural control of the student improved in the score of slow movement, finger-nose touching, and asymmetrical tonic neck reflex. The handwriting legibility and speed has also tended to increase during the intervention period, but it has not significantly changed. Conclusion : This study could be used as an evidence that the IM training aimed at postural control and handwriting ability could enhance the ability to improve postural control and thereby provide fundamental knowledge for future studies.

목적 : 본 연구는 Attention Deficit Hyperactivity Disorder(ADHD) 아동에게 시행한 상호작용식 메트로놈(Interactive Metronome; IM) 중재가 자세조절과 글씨쓰기에 미치는 영향에 대해 알아보고자 하였다. 연구방법 : 본 연구는 ADHD로 진단받은 초등학교 3학년 아동 1명을 대상으로 시행하였다. 개별실험 연구방법 중에서 ABA 설계를 사용하였고, 총 30회기로 매주 3회기 씩 총 10주 진행하였다. 기초선과 재기초선 기간에는 글씨쓰기 과제의 측정만 실시하였고, 중재기 동안에 IM 훈련을 40~50분간 실시하고 난 후에 글씨쓰기의 명료도와 속도를 평가하였다. 기초선을 시작하기 전과 재기초선이 끝나고 한 달 이내에 Clinical Observation of Motor and Postural Skills(COMPS)를 실시하여 자세조절의 변화를 알아보았다. 결과 : IM 중재를 시행한 후 대상자의 자세조절 변화는 하위항목 중 슬로모션, 손가락-코 운동, 비대칭 경반사의 점수가 향상되었고, 글씨쓰기 명료도와 속도는 중재 기간 동안 상승하는 경향을 보였으나 유의하게 변화되지 않았다. 결론 : 본 연구를 통해 ADHD 아동을 대상으로 한 IM 훈련의 중재가 자세조절과 글씨쓰기 수행능력을 향상시키는데 긍정적인 효과를 확인할 수 있었고, 향후 연구에 새로운 방향에 접근할 수 있는 기회를 제공하였다는 근거로 사용될 수 있을 것이다.

Keywords

References

  1. Barkley, R. A. (2005). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (Vol. 1). New York, NY: Guilford Press.
  2. Cassily, J. F., & Jacokes, L. E. (2001). The Interactive metronome: A new computer-based technology to measure and improve timing, rhythmicity, motor planning, sequencing and cognitive capabilities. Paper presented at The Infancy and Early Childhood Training Course, Advanced Clinical Seminar, Arlington: Virginia.
  3. Case-Smith, J., & O'Brien, J. C. (2013). Occupational therapy for children. St. Louis, MO: Elsevier Mosby.
  4. Christensen, C. A. (2004). Relationship between orthographic-motor integration and computer use for the production of creative and well-structured written text. British Journal of Educational Psychology, 74(4), 551-564. http://dx.doi.org/10.1348/0007099042376373
  5. Cosper, S., Lee, G., Peters, S., & Bishop, E. (2009). Interactive metronome training in children with attention deficit and developmental coordination disorder. International Journal of Rehabilitation Research, 32, 331-336. http://dx.doi.org/10.1097/MRR.0b013e328325a8cf
  6. Diamond, S. J. (2003). Processing speed and motor planning: The scientific background to the skill trained by interactive metronome technology. Unpublished manuscript, Department of Psychology, University of British Columbia, Vancouver: Canada.
  7. Feder, K., Majnemer, A., & Synnes, A. (2000). Handwriting: current trends in occupational therapy practice. Canadian Journal of Occupational Therapy, 67(3), 197-204. http://dx.doi.org/10.1177/000841740006700313
  8. Feder, K. P., & Majnemer, A. (2007). Handwriting development, competency, and intervention. Development Medicine and Child Neurology, 49, 312-317. http://dx.doi.org/10.1111/j.1469-8749.2007.00312.x
  9. Graham, S., & Weintraub, N. (1996). A review of handwriting research: Progress and prospects from 1980-1994. Educational Psychology Review, 8(1), 1-87. http://dx.doi.org/10.1007/BF01761831
  10. Greenspan, S. I. (1997). The growth of the mind and the endangered origin of intelligence. Journal of Religion and Health, 36(1), 100-101.
  11. Ham, B. H., Kim, S. K., Lee, J. S., & Jeon, B. J. (2012). The effects of sensory integration treatment on handwriting performance in children with attention deficit hyperactivity disorder. The Journal of Korean Society of Occupational Therapy, 20(2), 55-71.
  12. Jeanetta, B., Valerie, D., Sheila, F., Mary, K., Jane, K., & Deborah, M. (2001). Theoretical and clinical perspective on the Interactive Metronome (IM): A view from a clinical occupational therapy practive. American Journal of Occupational Therapy, 55, 163-166. https://doi.org/10.5014/ajot.55.2.163
  13. Kim, M. S., Ji, S. Y., Keum, H. J., & Kim, S. H. (2009). Developmental standard of the short sensory profile for Korean children of school age (7 to 9 years old). The Journal of Korean Academy of Sensory Integration, 7(1), 27-36.
  14. Libkuman, T. M., Otani, H., & Stegar, N. (2002). Training in timing improves accuracy in golf. Journal of General Psychology, 129(1), 77-96. http://dx.doi.org/10.1080/ 00221300209602034
  15. Lim, K. M., Yoo, E. Y., Jung, M. Y., Lee, J. S., Kim, J. R., & Park, H. Y. (2018). Development of the evaluation tool of school-aged children's handwriting. The Journal of Korean Society of Occupational Therapy, 26(1), 103-118. http://dx.doi.org/10.14519/jksot.2018.26.1.08
  16. Luft, A. R., McCombe-waller, S., Whitall. J., Forrester, L. W., Macko, R., & Sorkin, J. D. (2004). Repetitive bilateral arm training and motor cortex activation in chronic stroke: A randomized controlled trial. Journal of the American Medical Association, 292, 1853-1861. http://dx.doi.org/10.1001/jama.292.15.1853
  17. Mackay, N., McCluskey, A., & Mayes, R. (2010). The log handwriting program improve children's writing legibility: A pretest-posttest study. American Journal of Occupational Therapy, 64(1), 30-36. https://doi.org/10.5014/ajot.64.1.30
  18. Melinda, L. B., & Robin, L. D. (2005). Interactive metronome training for a 9-year-old boy with attention and motor coordination difficulties. Physiotherapy Theory and Practice, 21(4), 257-269. https://doi.org/10.1080/09593980500321085
  19. Nam, G. Y., Son, D. I., & Kim, K. M. (2015). Effect of interactive metronome training on timing, attention and motor function of children with ADHD: Case report. The Journal of Korean Academy of Sensory Integration, 13(2), 63-73. http://dx.doi.org/10.18064/ JKASI.2015.13.2.063
  20. Parush, S., Lifshitz, N., Yochman, A., & Weintraub, N. (2010). Relationship between handwriting components and underlying perceptual-motor functions among students during copying and dictation tasks. Occupational Therapy Journal of Research: Occupation, Participation and Health, 30, 39-48. http://dx.doi.org/1 0.3928/15394492-20091214-06
  21. Pollock, N., Lockhart, J., Blowes, B., Semple, K., Webster, M., & Farhat, L. (2009). Handwriting assessment protocol (2nd ed.) Hamilton, OH: Mcmaster university.
  22. Preston, A. S., Heaton, S. C., McCann, S. J., Watson, W. D., & Selke, G. (2009). The role of multidimensional attentional abilities in academic skills of children with ADHD. Journal of Learning Disability, 42, 240-248. http://dx.doi.org/10.1177/ 0022219408331042
  23. Racine, M. B., Majnemer, A., Shevell, M., & Snider, L. (2008). Handwriting performance in children with Attention Deficit Hyperactivity Disorder (ADHD). Journal of Child Neurology, 23, 399-406. http://dx.doi.org/10.1177/0883073807309244
  24. Reisman, J. (1991). Poor handwriting: who is referred? American Journal of Occupational Therapy, 45(9), 849-852. https://doi.org/10.5014/ajot.45.9.849
  25. Robert, G. I., Siever, J. E., & Mair, J. A. (2010). Effects of a kinesthetic cursive handwriting intervention for grade 4-6 students. American Journal of Occupational Therapy, 64(5), 745-755. http://dx.doi.org/10.5014/ajot.2010.08128
  26. Polatajko, H. J., Macnab, J. J., Anstett, B., Malloy-Miller, T., Murphy, K., & Noh, S. (1995). A clinical trial of the process-oriented treatment approach for children with developmental coordination disorder. Developmental Medicine and Child Neurology, 37(4), 310-319. http://dx.doi.org/10.1111/j. 1469-8749.1995.tb12009.x
  27. Rosenblum, S., Weiss, P. L., & Parush, S. (2003). Product and process evaluation of handwriting difficulties: A review. Educational Psychology Review, 15(1), 41-81. http://dx.doi.org/10.1023/A:1021371425220
  28. Schoemaker, M. M., Niemeijer, A. S., Reynders, K., & Smits-Engelsman, B. C. (2003). Effectiveness of neuromotor task training for children with developmental coordination disorder: A pilot study. Neural Plasticity, 10(1-2), 155-163. http://dx.doi.org/10.1155/NP.2003.155
  29. Seok. I. S. (2009). Effect of interactive metronome training on children with impulsive and inattentive behavioral problem. Journal of Emotional & Behavioral Disorders, 25(1), 109-122.
  30. Shaffer, R. J., Jacokes, L. E., Cassily, J. F., Greenspan, S. I., Tuchman, R. F., & Stemmer, P. J. (2001). Effect of interactive metronome training on children with ADHD. American Journal of Occupational Therapy, 55(2), 155-162. http://dx.doi.org/10.5014/ ajot.55.2.155
  31. Shen, I., Lee, T., & Chen, C. L. (2012). Handwriting performance and underlying factors in children with attention deficit hyperactivity disorder. Research in Developmental Disabilities, 33(4), 1301-1309. http://dx.doi.org/10.1016/j.ridd.2012.02.010
  32. Shin, M. K., & Park, J. H. (2016). Effects of a task-oriented intervention on handwriting of school aged children with ADHD: A case study. The Journal of Korean Society of Occupational Therapy, 24(1), 65-74. http://dx.doi.org/10.14519/jksot.2016.24.1.06
  33. Taub, G. E., Mc Crew, K, S., & Keith, T. Z. (2007). Improvements in interval time tracking and effects on reading achievement. Psychology in the school, 44, 849-863. http://dx.doi.org/10.1002/pits.20270
  34. Thomas, J. P. (2009). Editorial note: Research updates on teacher consultation for children with Attention Deficit Hyperactivity Disorder. School Psychology Review, 38(1), 3-4.
  35. Thaut, M. H., Stephan, K. M. Wunderlich, G., Schicks, W., Tellmann, L., Herzog, H., et al. (2009). Distinct cortico-cerebellar activations in rhythmic auditory motor synchronization. Cortex, 45(1), 44-53. http://dx.doi.org/10.1016/j.cortex.2007.09.009
  36. Thaut, M. H., & Abiru, M. (2010). Rhythmic auditory stimulation in rehabilitation of movement disorders: A review of current research. Music Perception: An Interdisciplinary Journal, 27(4), 263-269. http://dx.doi.org/10.1525/mp.2010.27.4.263
  37. Van Galen, G. P., & Weber, J. (1998). On-line size control in handwriting demonstrates the continuous nature of motor programs. Acta Psychologica, 100(1-2), 195-216. http://dx.doi.org/10.1016/S0001-6918(98)00034-1
  38. Whitall, J., McCombe, W. S., Silver, K. H., & Macko, R. F. (2000). Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic. Stroke, 31(10), 2390-2395. http://dx.doi.org/10.1161/01.STR.31.10.2390
  39. Wilson, B. N., Pollock, N., Kaplan, B. J., & Law, M. (2000). Clinical Observations of Motor Postural Skills COMPS (2nd ed.). Framingham, MA: Therapro.
  40. Wuang, Y. P., Wang, C. C., Huang, M. H., & Su, C. Y. (2008). Profiles and cognitive predictors of motor functions among early school-age children with mild intellectual disabilities. Journal of Intellectual Disability Research, 52(15), 1048-1060. http://dx.doi.org/10.1111/j.1365-2788.2008. 01096.x