IntroductionEarly evaluation of writing readiness is essential to predict and prevent handwriting difficulties and its negative influences on school occupations. An occupation-based measurement for kindergarten children has been previously developed: Writing Readiness Inventory Tool In Context (WRITIC). In addition, to assess fine motor coordination two tests are frequently used in children with handwriting difficulties: the modified Timed Test of In-Hand Manipulation (Timed TIHM) and the Nine-Hole Peg Test (9-HPT). However, no Dutch reference data are available.AimTo provide reference data for (1) WRITIC, (2) Timed-TIHM and (3) 9-HPT for handwriting readiness assessment in kindergarten children.MethodsThree hundred and seventy-four children from Dutch kindergartens in the age of 5 to 6.5 years (5.6±0.4 years, 190 boys/184 girls) participated in the study. Children were recruited at Dutch kindergartens. Full classes of the last year were tested, children were excluded if there was a medical diagnosis such as a visual, auditory, motor or intellectual impairment that hinder handwriting performance. Descriptive statistics and percentiles scores were calculated. The score of the WRITIC (possible score 0–48 points) and the performance time on the Timed-TIHM and 9-HPT are classified as percentile scores lower than the 15th percentile to distinguish low performance from adequate performance. The percentile scores can be used to identify children that are possibly at risk developing handwriting difficulties in first grade.ResultsWRITIC scores ranged from 23 to 48 (41±4.4), Timed-TIHM ranged from 17.9 to 64.5 seconds (31.4± 7.4 seconds) and 9-HPT ranged from 18.2 to 48.3 seconds (28.4± 5.4). A WRITIC score between 0–36, a performance time of more than 39.6 seconds on the Timed-TIHM and more than 33.8 seconds on the 9-HPT were classified as low performance.ConclusionThe reference data of the WRITIC allow to assess which children are possibly at risk developing handwriting difficulties.
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Background: Practicing handwriting is important for learning reading and spelling. The Writing Readiness Inventory Tool In Context (WRITIC) is an occupation-based assessment that enables early identification of kindergarten children at risk for developing handwriting difficulties. For children with non-handwriting readiness based on the WRITIC we developed a classroom group program with emphasis on engagement and motivation to practice paper-and-pencil tasks and improve handwriting readiness.Objective: We performed a proof of concept study to evaluate effectiveness and feasibility of the classroom group program.Methods: A within-group comparison design was used. Twenty-four children, 5-6 years old (score below the 15th percentile on WRITIC), participated. The Wilcoxon signed-rank test evaluated the difference in scores on the WRITIC before and after the classroom group program. Feasibility was tested by interviewing.Results: A significant difference was found on the WRITIC assessment (Z=-4,3; p<0,001). The classroom group program was feasible in the existing educational program.Conclusions: This proof of concept study shows that the classroom group program is effective and feasible within kindergarten education. This program contributes to the handwriting readiness of kindergarten children and provides them a good start for learning handwritings skills important for their further school career and self-esteem.
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Introduction: Writing Readiness Inventory Tool In Context (WRITIC) is an activity-based assessment tool to evaluate which kindergarten children are at risk of developing handwriting difficulties. WRITIC-assessment is valid, reliable, feasible, predictive, and norm-referenced. Broad international interest in translating WRITIC-assessment exists.Objectives: Making WRITIC available to professionals internationally to enable participation in handwriting at school. Methods: Composing translation teams with universities in different countries, back- and forth translation, cross-cultural assessment adaptation, carrying out feasibility and validation studies, starting courses for training the professionals.Results: Translation teams have been started in different countries resulting in an English, Portuguese and Slovenian translation, validation studies in Flanders, UK, Portugal and Slovenia and translation projects in Greece, Bulgaria, Germany, Austria, and Switzerland. A Figshare environment was developed to safely store, exchange the data and to support international research. An international digital platform has been constructed to sell e-manuals, share e-learning and support people worldwide.Conclusion: The translation and cross-cultural adaptation in different languages and the international digital platform made WRITIC-assessment accessible to children’s therapists around the world with the same results: enabling school participation of all children in contributing to inclusive education.
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We investigated the predictive value of a new kindergarten assessment of handwriting readiness on handwriting performance in first grade as evaluated by the Systematic Screening for Handwriting Difficulties (Dutch abbreviation: SOS). The kindergarten assessment consisted of the Writing Readiness Inventory Tool In Context (WRITIC), the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery™VMI) and the Nine-Hole Peg Test (9-HPT). The WRITIC evaluates in kindergarten children (aged 5-6 years) prewriting skills, the Beery™VMI and 9-HPT evaluate visual motor integration and fine-motor coordination, all elements important for handwriting readiness. In kindergarten, 109 children (55 boys; mean age 70 months, SD 4.8 months) were tested with the WRITIC, Beery™VMI and 9-HPT and one year later in first grade (mean age 85 months, SD 4.5 months) with the SOS. A multivariable linear mixed model was used to identify variables that independently predict outcomes in first grade (SOS): baseline scores on WRITIC-TP, Beery™VMI, 9-HPT, 'sustained attention,' 'gender,' 'age' and 'intervention' in the intermediate period. The results showed that WRITIC-TP, Beery™VMI, and 9-HPT, 'sustained attention,' 'gender' and 'intervention' had all predictive value on the handwriting outcome. Thereby WRITIC-TP was the main predictor for outcome of SOS-Quality, and Beery™VMI and 9-HPT were the main predictors of SOS-Speed. This kindergarten assessment of WRITIC-TP, Beery™VMI, and 9-HPT contributes to the detection of children at risk for developing handwriting problems.
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When children are not ready to write, assessment of fine motor coordination may be indicated. The purpose of this study was to evaluate which fine motor test, the Nine-Hole Peg Test (9-HPT) or the newly developed Timed Test of In-Hand Manipulation (Timed-TIHM), correlates best with handwriting readiness as measured by the Writing Readiness Inventory Tool In Context-Task Performance (WRITIC-TP). From the 119 participating children, 43 were poor performers. Convergent validity of the 9-HPT and Timed-TIHM with WRITIC-TP was determined, and test-retest reliability of the Timed-TIHM was examined in 59 children. The results showed that correlations of the 9-HPT and Timed-TIHM with the WRITIC-TP were similar (rs = -0.40). The 9-HPT and the complex rotation subtask of the Timed-TIHM had a low correlation with the WRITIC-TP in poor performers (rs = -0.30 and -0.32 respectively). Test-retest reliability of the Timed-TIHM was significant (Intraclass Correlation Coefficient = 0.71). Neither of these two fine motor tests is appeared superior. They both relate to different aspects of fine motor performance. One of the limitations of the methodology was unequal numbers of children in subgroups. It is recommended that further research is indicated to evaluate the relation between development of fine motor coordination and handwriting proficiency, on the Timed-TIHM in different age groups.
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Introduction: Writing Readiness Inventory Tool In Context (WRITIC) is a context-based assessment tool to evaluate which kindergarten children are at risk of developing handwriting difficulties. WRITIC-assessment is valid, reliable, feasible, predictive, and norm-referenced tool. Objectives: Building a network to enable professionals internationally using WRITIC-assessment in kindergarten. Methods: Build contacts internationally, compose translation teams within different universities, train translation teams, support back- and forth translation and cross-cultural assessment adaptation, carry out feasibility and validation studies, publish WRITIC-manuals in different languages, provide train-the-trainer courses, support organization of courses for professionals in different countries. Results: Different international projects started resulting in an English, Portuguese, German and Slovenian translation; validation studies in Flanders, UK, Portugal and Slovenia; translation projects in Greece and Bulgaria and contacts build in France, Spain, Japan, Indonesia, South Africa and Australia. A Figshare environment was developed to safely store and exchange data and to support international research. A digital platform was constructed to share information, sell manuals, and provide assessment requirements. Conclusion: The growing international network and the resulting projects make it possible to support future-proofing school-based occupational therapy worldwide. WRITIC-assessment helps to enable participation in handwriting for all children and contributes to inclusive education.
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This article describes the translation and cultural adaptation process of the WRITIC (Writing Readiness Inventory Tool in Context) into European Portuguese. We examined the content and convergent validity, test-retest, and interrater reliability on the norm-referenced subdomain of the Portuguese (PT) WRITIC Task Performance (TP). To establish content validity, we consulted six experts in handwriting. Internal consistency was found with 70 children, test-retest reliability with 65, inter-rater reliability with 69, and convergent validity with 87. All participants were typically developing kindergarten children. Convergent validity was examined with the Beery–Buktenica Developmental Test of Visual-Motor Integration (Beery™VMI-6) and the Nine Hole Peg-Test (9-HPT). On content validity, we found an agreement of 93%, a good internal consistency with Cronbach’s alpha of 0.72, and an excellent test-retest and inter-rater reliability with ICCs of 0.88 and 0.93. Correlations with Beery™VMI-6 and 9-HPT were moderate (r from 0.39 to 0.65). Translation and cross-cultural adaptation of WRITIC into European Portuguese was successful. WRITIC-PT-TP is stable over time and between raters; it has excellent internal consistency and moderate correlations with Beery™VMI-6 and 9-HPT. This analysis of the European Portuguese version of WRITIC gives us the confidence to start the implementation process of WRITIC-PT in Portugal.
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Handwriting Readiness, auf Deutsch so viel wie „Bereit zum Schreibenlernen“, ist das Konstrukt, das dem Assessment Writing Readiness Inventory Tool In Context (WRITIC) zugrunde liegt. Es wurde für Kinder im Vorschulalter (5-6 Jahre) entwickelt, um festzustellen, ob sie für das Erlernen der Handschrift in der ersten Klasse bereit sind. Das WRITIC-Assessment kann bei Kindern durchgeführt werden, bei denen die Pädagog*innen sich Sorgen um die Handwriting Readiness machen. Der beste Zeitpunkt zur Durchführung des WRITIC-Assessments ist zu Beginn des letzten Halbjahrs vor der Einschulung.Die Entwicklung eines standardisierten, zuverlässigen und validen Assessments ist ein zeitintensives Unterfangen. 2008 wurde internationale Fachliteratur systematisch nach einem Assessment zum Thema Handwriting Readiness bei Vorschulkindern durchsucht. Nachdem sich herausgestellt hatte, dass ein solches nicht existiert, begann 2009 die Entwicklung des WRITIC-Assessments. 2016, also sieben Jahre später, wurde das niederländische WRITIC-Handbuch publiziert. Die Entwicklung des Assessments erfolgte im Rahmen einer Forschungsarbeit für die Dissertation der erstgenannten Autorin. In dieser Zeit haben 371 Kinder an verschiedenen Studien teilgenommen und anhand der Auswertung wurde festgestellt, dass das WRITIC ein zuverlässiges, valides Assessment mit guten prognostischen Werten ist. Anschließend wurden die WRITIC-Normwerte bei 374 Kindern erfasst und der Cut-off Wert bei der Subdomäne „Task Performance“ (Aufgabenperformanz) des WRITIC-Assessments (WRITIC-TP) festgelegt.
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This paper presented at the American Speech and Haering Association Convention provides information on the accomplishments in international cooperation, education, consumers issues and collaborative research projects on cluttering
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Aim: In-hospital prescribing errors (PEs) may result in patient harm, prolonged hospitalization and hospital (re)admission. These events are associated with pressure on healthcare services and significant healthcare costs. To develop targeted interventions to prevent or reduce in-hospital PEs, identification and understanding of facilitating and protective factors influencing in-hospital PEs in current daily practice is necessary, adopting a Safety-II perspective. The aim of this systematic review was to create an overview of all factors reported in the literature, both protective and facilitating, as influencing in-hospital PEs. Methods: PubMed, EMBASE.com and the Cochrane Library (via Wiley) were searched, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, for studies that identified factors influencing in-hospital PEs. Both qualitative and quantitative study designs were included. Results: Overall, 19 articles (6 qualitative and 13 quantitative studies) were included and 40 unique factors influencing in-hospital PEs were identified. These factors were categorized into five domains according to the Eindhoven classification (‘organization-related’, ‘prescriber-related’, ‘prescription-related’, ‘technologyrelated’ and ‘unclassified’) and visualized in an Ishikawa (Fishbone) diagram. Most of the identified factors (87.5%; n = 40) facilitated in-hospital PEs. The most frequently identified facilitating factor (39.6%; n = 19) was ‘insufficient (drug) knowledge, prescribing skills and/or experience of prescribers’. Conclusion: The findings of this review could be used to identify points of engagement for future intervention studies and help hospitals determine how to optimize prescribing. A multifaceted intervention, targeting multiple factors might help to circumvent the complex challenge of in-hospital PEs.
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