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OTSH 72: Journal Club - How Much of School is Fine Motor, Anyways?

OT School House Podcast Episode 72 journal club how much of school is fine motor anyways?

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Welcome to the show notes for the Episode 72 of the OT School House Podcast.

Today, we are focusing on the activities children participate in during education in 3 specific grade levels as we discuss a recent brief report published in the American Journal of OT. The report is titled Fine Motor Activities in Elementary School Children: A Replication Study and was published in January of 2020. Together, we are going to discus what percentage of the day students spend completing various fine and gross motor activities.

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Episode 72 Transcript
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Jayson Davies 00:01

Good morning, everyone. Welcome to the OT School House podcast. This is episode number 72. Now I can't believe we're 72 episodes in, this is going to be one that really helps you understand the role of occupational therapy in the school. And to do that we're going to have a discussion about a recent journal article from the American Journal of OT, the article that we're going to be looking at is titled Fine Motor Activities in Elementary School Children, A Replication Study. This is actually as the name suggests a replication study from a study back in 1992, a long time ago. All right, so almost 30 years ago, that is, I think, when this study was actually done, it was around 2015, maybe 2017. They said 25 years had passed since that previous study. So we're gonna jump all in to that in just a moment. But first, let's cue the intro music.

Amazing Narrator 00:54

Hello, and welcome to the OT School House podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. here's your host, Jayson Davies, class is officially in session.

Jayson Davies 01:11

Welcome back to the show. Again, I say this several times. But I just love that intro music. It gets me going. You know, I just realized a moment ago in the intro, I said, Good morning. But it's morning right now, and I'm recording this but I know for you this may be in the evening, maybe you're on your way home from work. I don't know what time it is. So I'm just gonna say this real quick. Good morning. Good afternoon, and good evening, because I don't know when you might be listening to this. But I am super glad you are here. really appreciative of you learning from this podcast and trying to improve yourself as an occupational therapist through the OT School House podcast. So let's go ahead and get started with our journal of discussion.

Jayson Davies 01:50

As occupational therapists, we know that education is listed as one of the nine occupations categorized by AOTA in the OT practice framework, which of course is that like, Holy Grail document of the OT profession. And as a whole education consists of all the education that we as humans participate from our very first day of preschool, perhaps maybe even before and all the way through our adult life. So I mean, from pre K, all the way through to maybe, I don't know, I'm still learning about finances and stock trading or not trading any more and more investing long term investing, but we are always learning right now you're learning through this podcast. And so education is a huge part of our life. Today, we're focusing on the routines children participate during education in three specific grade levels. As we discuss a recent brief report published in the American Journal of Occupational Therapy. The report is titled fine motor activities in elementary school children a replication study, and was published in January of 2020. But like I think I said earlier, I believe the study was actually completed back in 2017.

Jayson Davies 03:50

The first two authors Sierra, sorry, I'm going to try to say your name as best as I can see our Sierra Caramia and Amanpreet Gil were assisted by Alisha Ohl and David Schelly, I believe it is in observing and coding activities of students in grades kindergarten, second, and fourth grade.

Jayson Davies 04:11

As I mentioned before, this was a replication study. So real quickly, I want to talk about the original study that was completed in 1992. By McHale and Cermak. that study was completed. Again, way back before technology was really a thing in public education. And in 1992, they observed second, fourth and sixth graders and found the students spend anywhere from 31 to 60% of the school day, engaging in fine motor activities with most of that time, being on paper and pencil tasks. Again, they didn't look at technology because in 1992 technology looked very different. I'm not sure even laptops were around yet in 1992. So everything was big, bulky, and definitely not a touchscreen. Likewise, new legislation has also been put in place

Jayson Davies 05:00

It has changed general education and special education in general. In the past 30 years Ida has been renewed, and the No Child Left Behind Act, as well as other acts have increased the amount of testing required in public education. I'm sure you all have seen this more testing, less time actually spent on teaching students it seems like right. So whether you love or hate Common Core, it has to be known that it has changed education. For the time being, things are very different, whether you like that they teach one math skill set, how to multiply and 18 different ways, or whether you really dislike that they do that either way, you can't deny that common core has changed education today. Now, this study is not a true replication study. Like I said earlier, they changed the grades a little bit. And they also wanted to look a little bit more broad since education has changed. They looked at three different grade levels, kindergarten, second and fourth. But it did change. Remember, they had second, fourth and sixth grade in the original study. They also had a slightly more general research question, and that is, what are the motor and technology demands of elementary school, that was their overall goal. But they did kind of break it down a little bit more than that. They hypothesize that with an increased emphasis on testing, it was likely that the number of minutes spent on fine motor activities would decrease. They also imagined that technology may replace some of the time spent handwriting. So let's talk about the participants of this research study. The study included three elementary school classrooms with about 20 students per classroom, and a small college town in New York. The reason I mentioned that is because this is a small study, this cannot really be generalized for everyone. You know, again, demographics were very specific, a small town in New York, they didn't find elementary schools across the nation. It was just one school, and three classrooms. So it wasn't a very big study. The two principal authors on this study, I mentioned them earlier, they took terms of observing the three different classrooms and took detailed notes after some initial training, I'm not going to go into all the training, but they did actually train, how to take notes for the study. Before going into the classroom. They each observed the kindergarten class one day, and then one author observed the second grade classroom for two days. And the third author observed the sorry, not the third author, the second author observed the fourth grade classroom for two days. While in the classroom, the observers noted the time that each activity began as well as what time it ended. So they could keep track of how much time the students participated in that activity. If there were multiple activities going on, they notated both activities going on, or all three activities that were going on, because that's kind of what the study required. They would do this, for instance, maybe if there were centers going on. And one group of students were at one table doing math, and another group was at another table using the iPads or whatever that might be what they didn't really calculate. They might have noted it in their notes, but they weren't really trying to calculate were behavioral outbursts, or instances where maybe one student did something out of the norm. They're trying to look at the entire group as a whole, or as smaller groups per se. They didn't want to calculate time for a student who maybe got sent to the principal's office or maybe had to go use the restroom. They didn't mark that as a group activity, right? They're looking at the larger group. Alright, so now the best part, the part that everyone looks forward to hearing on this type of a podcast where we look at a journal, and that is the results.

Jayson Davies 08:57

After coding all of the data that was taken all the notes that the two authors looked at, they came up with 10 activity categories that were developed, based upon the coding by all four of the authors, they all had to have consensus on each minute of the day, fitting into one of these 10 categories. They didn't go in with these 10 categories, these 10 categories were developed based upon the notes that they were taken. So, here is the 10 categories that they looked at. fine motor, non academic content, fine motor, academic content, academic no fine or gross motor involvement, non academic content, no fine motor or gross motor involvement. Alright, I know those repetitive the next few are not as repetitive computer or other technology used by students leisure or academic, unstructured, gross motor activity, structured gross motor activity, handwriting transition time and dining. I really actually liked that they looked at the transition time and the dining. I'm going to get into that

Jayson Davies 10:00

Little bit more in a second. They also developed a fine motor and gross motor composite that included those 10 activities and kind of broke it down or put all the ones that belong to fine motor and the fine motor composite, and those that fit the gross motor activities into a gross motor composite. I'm not sure they explain that very well, in the article, actually, I was a little confused. But when I did the math that kind of add it all up. Sure enough, all the activities that kind of revolved around fine motor, including the computer and technology used by the students was put into the fine motor composite, they did describe well, that transition time, they actually split that time up 25% of the transition time went into the fine motor composite, while 75% of the transition time went to the gross motor composite. And that was again, based upon the notes that they took. They found that 25% of the time with the transition time students were doing fine motor tasks such as opening and closing their backpack, opening books, closing books, getting out papers or doing something that required fine motor use. The other 75% of the time might be walking from class to recess or from recess or lunch or whatever it might be. So again, 25% of transition went to fine motor 75% of transition time went to gross motor. So what did that fine motor and gross motor composite look like? Let's go ahead and start with the fine motor component. They found that kindergarten students spent about an average of 145 minutes a day, or 37% of their school day on fine motor activities. second graders spent 198 minutes, which is about 50% of their day on fine motor tasks. And fourth graders spent 20 sorry, not 20 235 minutes, or 60% of their day on fine motor activities. In comparison, the gross motor composite stayed relatively similar, while the fine motor composite grew, like I just said, from 37% in kindergarten up to 60%. in fourth grade, the gross motor composite remained between 25 and 28% of the day, so it didn't change a whole lot like the fine motor composite did. Now I know you all want to know how much of the day did students spend with handwriting tasks, you know, since that's what most of our referrals tend to be for? Well, they found that kindergarteners spend only 3.4% of their day on handwriting, that's only about 13 to 14 minutes, which I actually think that might make some of you kind of happy because I know you like to see kindergarteners doing things other than writing. So some of you may be a little happy about that some of you might be well that's it, but 13 to 14 minutes, that's it for kindergarteners, spending time on writing, second graders jumped up to about 17.8% of their day. And then fourth grade, just another small jump to only 18% of their day, which is about 75 minutes per day spent on handwriting in the fourth grade. Surprisingly, to both the researchers and myself. students spend on average about 20% of their day, just in transitions, transitions alone, they didn't note dining being a surprise to them. But to me, it was 10% of the day was spent on dining. So perhaps that's a little bit of breakfast, maybe an afternoon snack or recess time snack. And then of course lunch. You know, when you actually look at a school day, you sometimes forget about those periods outside of the academic time, you know, you forget about how much time is really spent in recess and how much time is spent in the cafeteria. And you know, that's important for us as OTs because we don't just look at education, we look at the independence within the entire educational environment. And that does absolutely include both recess and the cafeteria. The authors were also expecting the time spent with technology to be higher than it actually was. It came out to be below 5% for kindergarteners and second graders, and at just under 14% for fourth graders, the researchers actually thought that these numbers were quite low. They were expecting technology to be more incorporated based upon the studies that they had looked at previously before getting into the classroom that looked at how much technology was being used in the classrooms. So they were actually quite surprised that it was so low under 5% for the lower grade kids and at only 14% for those fourth graders. And as I mentioned earlier, that technology use was included within the fine motor composite because well I don't know about you, but I do see most technology use as being a fine motor activity, whether it's typing or drawing on an iPad with or without a stylist, that tends to be a fine motor activity.

Jayson Davies 15:05

So one final comment in regards to the numbers. I know every OT is always interested about recess, we kind of have this whole kids need recess mentality, which is absolutely necessary for the students, right? Well, under the category of unstructured gross motor activity, kindergarteners were found to have 38 minutes of unstructured gross motor activity. second graders were found to have 13 minutes. And fourth graders were found to have 16 and a half minutes. So we see this pretty high number relatively high number and kindergarten, and then it goes down for second graders, and then it increases back up. For fourth graders, I found that a little interesting that it dips down so low for those second graders. But they didn't quite have a reason for this. But it was interesting just to see that fluctuation of high low, and then backups lately as students get older. Alright, so let's go ahead and talk about the author's hypothesis and their conclusions. The author's hypothesis that there would be less fine motor demands now than in the past back in 1992, that was actually found to be inaccurate, students are still engaging in a similar amount of fine motor activities throughout the school day as they did back in 1992. However, it does appear that less time is spent on paper and pencil fine motor activities. In 1992, it was reported that 85% of fine motor activities involve paper and pencil tasks. And the current study, however, showed that pencil and paper tasks range from a mirror. And I say mirror because this is in comparison to 85%, a mere 17.8 to 37.4% of the time, the author's attribute this to curricular changes over time, such as the implementation of Common Core State Standards, which really put an emphasis on group activities, and sometimes getting away from those more traditional paper and pencil tasks. Overall, the authors were slightly surprised by how much of the day children engage in fine motor activities, and not just the fine motor activities that we can think of like handwriting or using scissors, but also all the fine motor activities that go into transition time. And the time spent with dining, and even potentially some time spent with outside of the classroom with technology, and even potentially at recess or leisure time. Those are all fine motor aspects that sometimes aren't thought about in the school. Remember, we're not in the schools as occupational therapists, just to support what students do directly in the classroom for academic tasks, we're there to help them be independent in their entire educational environment. And that does include other areas. All right, I may have gotten a little bit ahead of myself and shared most of my takeaways already. But I do have one more, one more that I really want you to take away from this article. And that is that I'm surprised that all grade levels spend more time on fine motor manipulation tasks than they do on fine motor paper and pencil tasks. That means they're spending more time with zippers, and manipulating their food, and manipulating items for counting, or maybe using scissors or glue. Other activities that are not pencil and paper, maybe they're also spending more time typing with a keyboard or using an iPad. I know the author's showed that that number was relatively low compared to what they thought it might be. But other studies are potentially showing that it is higher than what they saw in this study. All of those activities that they spend one to maybe five to 10 minutes a day on, they all add up. And so kids, you know, they spend two minutes a day using the zipper, they spend 10 minutes a day using a computer, they spend five minutes a day opening and manipulating maybe their lunch pail. But that all adds up to so much more time than what they actually do spend on paper and pencil activities.

Jayson Davies 19:11

So I guess what I'm trying to convey is that if you're going to go share this article with a teacher or program specialist and administrator, or maybe even another occupational therapist, really the key point is that there is more to school than just handwriting, there is so much more that OTs can do to support students outside of that traditional. This is how we write our letters, thinking of OT that I think used to be so prevalent. We are moving on from that there's so much we can do have a really good evaluation that shows those other areas where the strengths and where the weaknesses are. So that you can say in that IEP, Hey, you know what, yes, handwriting might be an area of concern, but there's other areas of concern. And that's what a strong evaluation does for us.

Jayson Davies 20:00

Now, I wasn't planning to plug this in here. But since I just kind of mentioned it, if you are having some struggles with your evaluations and conveying your assessment results at an IEP, I definitely recommend looking into the A-Z School-Based OT Course, which you can find at That's my course where I dive into basically nine different modules about how to be a school based OT and we absolutely do cover evaluations and conveying your results at an IEP. So go ahead and check that out if that would be of interest to you.

Jayson Davies 20:36

Alright, and with that said, thank you so much for listening to the OT School House podcast. Please remember, if you haven't already, subscribe or follow this podcast so you don't miss any future episodes. We have a great guest coming on next week to talk a little bit about ADHD and sensory processing. You won't want to miss that one. So be sure to subscribe or follow. With that. Take care. Have a great week, and we'll see you next time on the podcast.

Amazing Narrator 21:03

Thank you for listening to the OT School House podcast. For more ways to help you and your students succeed right now. Head on over to until next time, class is dismissed.

Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs.

Have any questions or comments about the podcast? Email Jayson at


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