International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
Bootstrap Slider

Indexed and Abstracted in: SCOPUS, Crossref, CAS Abstracts, Publons, CiteFactor, Open J-Gate, ROAD, Indian Citation Index (ICI), Indian Journals Index (IJINDEX), Internet Archive, IP Indexing, Google Scholar, Scientific Indexing Services, Index Copernicus, Science Central, Revistas Medicas Portuguesas, EBSCO, BOAI, SOROS, NEWJOUR, ResearchGATE, Ulrich's Periodicals Directory, DocStoc, PdfCast, getCITED, SkyDrive, Citebase, e-Print, WorldCat (World's largest network of library content and services), Electronic Journals Library by University Library of Regensburg, SciPeople.

Search Articles

Track manuscript

Readers around the world

Full Html

IJCRR - Vol 05 Issue 11, June, 2013

Pages: 64-70

Date of Publication: 18-Jun-2013


Print Article   Download XML  Download PDF

MOTOR PROFICIENCY IN HEARING IMPAIRED AND HEALTHY CHILDREN: A COMPARISON

Author: Atiya A. Shaikh, Aparna Sadhale

Category: Healthcare

Abstract:Objective: To score and compare gross motor and fine motor skills in hearing impaired and healthy children and to find co-relation between age and motor proficiency scores in both groups. Material and Method: 180 healthy children and 180 hearing impaired children were scored and compared with each other using short form battery test of Bruininks Osterestky Test of motor Proficiency. Results: There was a significant difference in scores of both groups in running speed, agility, balance, bilateral co-ordination activities, upper limb speed and dexterity and a positive correlation of scores with age in both groups. Conclusion: Hearing impaired children lack significantly in running speed, agility, balance, bilateral co-ordination activities, upper limb speed and dexterity as compared to healthy children, but both groups follow same trend of maturation

Keywords: Motor proficiency, children, healthy, hearing impaired

Full Text:

INTRODUCTION
There are about 360 million people suffering from ‘Disabling Hearing Impairment’ all over the world. Another 32 million affected by hearing loss are children under age of 15. Hearing loss is the 7th most common cause of ‘Years lived with disability’ (YLD) globally. It contributes to a loss of over 36 million years of healthy & productive years of life, imposing a heavy social and economic burden on individuals, families, communities and countries. In India there are 63 million people who suffer from profound hearing loss. Of this, large percentage is of children between 0-14 years. There are 3 million hearing impaired children in India with almost 25,000 hearing impaired babies born every year 1 . Children with hearing impairment often experience delayed development of speech language and cognitive skills. This may result in slow learning and difficulty in progressing in school, thus difficulty to obtain, perform and keep employment. Both children and adult may suffer from social stigmatization and isolation as a result of hearing impairment. This also makes it more difficult for the individual to escape poverty by slowing progress in school and workplace. The cost of special education and lost employment due to hearing impairment can also impose a substantial economic burden on countries. Few investigators like Mykelbust2 , Wiegersma P H 3 , Crowe T K4 and Gonclave V M5 etc have tried to unmask such problems in other countries; none of such efforts have been documented in India. India being a developing country with limited resources it becomes all the more important for us to know the exact impairments in hearing impaired children so that correct management in those areas can be done. For above purpose a suitable proficiency assessment scale was required. When literature was searched, Bruininks Osterestky Test of Motor Proficiency was found to be the most suitable test according to the objectives. It has reliability of 0.84-0.87 and validity of 0.4-0.9 .It has been widely used in assessment of motor proficiency in children by previous researchers and has proved its sensitivity in various conditions7,8. Thus an attempt was made to compare motor proficiency in hearing impaired and healthy children with the help of short form battery of Bruininks Osterestky Test of Motor Proficiency. Keeping in mind the vast number of hearing impaired children in our society, above information will help to tackle the need of the hour of working towards their optimal performance in academics, sports, occupational skills and thus social participation.

MATERIALS AND METHODS RESEARCH DESIGN:
Cross sectional Inclusion Criteria: Healthy children and hearing impaired children of both genders between age group of 4. 6 yrs to 14.6yrs Exclusion Criteria Children with Mental retardation, known behavioral, cognitive, sensory, musculoskeletal or neuromuscular disorders Setting of the study Special schools, public schools in Pune Sample Size: 180 children with hearing deficit, 180 healthy children Sample Selection: Convenience Materials Used Balance beam, Ball, Blocks, Boxes, Measuring tape, Score sheet, Chairs, Clipboard, Stopwatch, Table, Target, Bruininks Ostrestky Test of motor Proficiency. 

PROCEDURE
Ethical committee clearance from college authorities and consents from the school authorities and parents were obtained. Children were divided in 2 groups as hearing impaired and healthy. They were assessed for their motor proficiency using subtests from Bruinink’s Osterestky Test of Motor Proficiency. Scores for each test were noted.

OBSERVATION AND RESULTS
The hearing impaired group consisted of 95 male and 85 female subjects with mean age being 9.4 years .The healthy children group had 94 male and 86 females with mean age being 9.5 years (Table-1). When gross motor function scores of both groups were compared,using unpaired t test,there was a significant difference in scores for jumping up and clapping hands,walking forward heel to toe on balance beam,standing on preferred leg on balance beam,running speed and agility(p< 0.0001).The scores of catching a tossed ball with both hands and throwing ball at target with preferred hand in both groups did not have a significant difference (Table -2). On comparison of fine motor skill scores of both groups with unpaired t test, it was onserved that,there was a significant difference in scores of making dots in circle,sorting shape cards(p,0.0001).The scores of drawing a line through straight path ,copying a circle ,copying overlapping pencils did not show significant difference in both groups(Table-3) Analysis of trend of maturation was done by corelating age of children with total motor proficiency scores using spearman’s co-relation values .It showed a positive co-relation with r values being 0.904 and 0.906 for hearing impaired children group and healthy children group (graph-1).

DISCUSSION
A significant difference was found in scores of both groups for the test of running speed and agility. The test examined dynamic balance, balance in linear and angular acceleration. Affected predictive function of semicircular duct, faulty push pull mechanism and VOR can be the cause of affected dynamic balance9 and hence reduction of scores in hearing impaired children. For the test-standing on preferred leg on balance beam, hearing impaired children scored significantly low than healthy children. This can be attributed to the fact that the hearing impaired children receive abnormal input from a structurally abnormal vestibular system10,11,12,13 . The vestibular system serves to maintain a static position of the head in relation to the gravity for the purpose of maintaining balance and gaze stabilization14,15. Abnormal input from the vestibular system and lack of auditory perception leading to degeneration of infragranular layer of auditory cortex16 resulting in impaired motor output .The central auditory pathways can influence the cerebellum through the connections from the inferior colliculus and also can influence the motor neurons in spinal cord through the tectospinal tract17thus controlling postural control. Due to all these reasons, the balance in standing on preferred leg is affected in hearing impaired children. Walking heel to toe on balance beam is a relatively complex task which puts more demands on vestibular system which is already compromised in hearing impaired children9 ,so with reference to the mechanisms explained before13,14,15,16,17, scores are significantly reduced for this item in them. Normally the output relays from the inferior colliculus influence motor neurons of the spinal cord. Also the outputs from the inferior colliculus influence tectonuclear fibers which are responsible for controlling eye and head movements. The superior colliculus also sends signals to cerebellum17. Integration of all these leads to a co-ordinated reciprocal movement. Since the inputs to central auditory pathway are absent in hearing impaired children, there is degeneration of neurons in cochlear nuclei, superior and inferior colliculi,reduction in number of synapses along with degenerative changes in motor auditory cortex10,11,12,13. Hence leading to inappropriate processing so, when the child had to do a co-ordinated reciprocal movement like tapping feet alternately while making circle with fingers and jump up and clap hands, hearing impaired children scored significantly low as compared to healthy children. All these findings support the hypothesis that, hearing impaired children lack significantly in gross motor skill2, 3, 5,6,18 . Further two tests were used to assess upper limb coordination where the child had to catch a tossed ball with both the hands and throw a ball at a target with preferred hand. According to the literatures, the task was difficult to perform for hearing impaired children as the activities involve special and temporal co-ordination19, which is affected in hearing impaired children9 . Throwing a ball was done using preferred hand and the accuracy of throwing was judged which was equally good in hearing impaired children. Hearing impaired children used their visual and somatosensory system to judge the shift of centre of mass and maintain balance19. This is the most commonly played game in schools, hearing impaired children are trained to catch and throw the ball. It has been studied that when a function is lost, compensation and plasticity of the CNS may play some role in improvement motor performance. In cases of congenital sensoryneural hearing impairment, the other systems like visual system may try to compensate for the function of auditory and vestibular system. .With advancing age, there is increased experience which may be responsible for improved performance 20, 21 , hence hearing impaired children could perform equal with healthy children due to learning of compensatory mechanisms while practicing the game .Similar findings supported by few of other previous studies3, 4, 18 . Children were asked to draw a line through a straight path, copy a circle and copy overlapping pencils with preferred hand to assess visuomotor coordination. The children performed same in quality but took more time to finish the task. As the test does not consider the time required to finish the task, both the groups scored same on the point scale. Increase in duration to perform the task can be explained by Fitt’s law. According to it, movement time increases linearly with difficulty index due to visual constraints. More time is needed to upgrade the strategy22 . To test upper limb speed and dexterity children were asked to do sorting shape cards and making dots in circle with preferred hand. Both were time limited tests. Hearing impaired children showed significantly low scores in both tests as compared to healthy children. Visuomotor area 6A and parieto-occipital area 5 make the part of distributed network of retinal eye and hand related signals. These signals are all combined to form eye hand co-ordination. All these signals and information are processed in parieto occipital cortex. They also send signals to cerebellum leading to a controlled movement. Due to lack of signals from central auditory pathways, the neurons in parieto-occipital area are degenerated10, 11, 12 thus leading to compromised processing, hence the skills are slow in hearing impaired children. Previous studies have shown that hearing impaired children lack in gross motor skills9,10this study supports this fact and proves that ,all three systems (somatosensory, visual and vestibular) are needed to maintain good postural control15 The myelination of vestibulospinal, reticulospinal pathways, corticospinal, corticoreticulospinal pathways, ascending reticular activating system is complete by 8-10years in children23, 24. Synaptogenesis and requirement of appropriate motor unit results in a coordinated performance with advancing age22.Similar trend has been observed by other investigators15 . All this information can be used in screening of hearing impaired children for flaws in motor proficiency. They can be trained to use other compensatory strategies using the same information. Post training performance can again be judged using same scale. Job prescriptions and training can be started in schools depending on their capabilities. This would help them to gain maximum confidence and to come in main stream. The study was done in same geographic area and local schools with convenience sampling method, but the children of same age were selected to minimize error. Since Bruinninks Osterestky test of motor proficiency was used as outcome measure, we selected children of 4.6 years to 14.6 years. For minimizing further error, children were selected according to 3 groups as 4.6 yrs to 7.11 yrs, 8yrs to 10.11 yrs and 11 yrs to 14.6 yrs and 30 children in each group were selected. In future, detailed study can be done using a larger sample size for specific age groups from different schools. Children with different degrees and causes of hearing impairment, multiple impairments or trained vs. untrained children can also be studied for their motor proficiency in detail using this scale.

CONCLUSION
From the above study we conclude that, hearing impaired children lack significantly in running speed, agility, balance, bilateral co-ordination activities, upper limb speed and dexterity as compared to healthy children, but they follow same trend of maturation as that of healthy children.

ACKNOWLEDGEMENT
We would like to thank students, parents and principals of all schools visited. Dr. Shilpa Parab (PT), Principal, Chaitanya Medical Foundation’s College of Physiotherapy, Pune for their support and encouragement. We acknowledge the great help received from scholars whose articles cited and included in references of this manuscript. We are grateful to authors, editors and publishers of all those articles, journals and books from where the literature of this article has been reviewed and discussed. We are also grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript.

Permissions to reproduce published material:
Project published in book format by Lambert Academic Publishing. According to company policy author has a right to publish the material in article format.

References:

1. World Health Organization, health statistics and health information ,data and statistics:2013

2. Mykelbust H: Auditory disorders in children: A manual for differential diagnosis. Deafness and motor functioning. Grune and Stratto .New York, 1954. Pg 180-201.

3. Wiegresma O H, Vander Velde A: Motor development of deaf children. Journal of child psychology psychiatry 1983. Jan (24) ;( 1):103-11.

4. Crowe T k, Horak F B: Motor proficiency associated with vestibular deficits in children with hearing impairments. Physical therapy 1988 0ct; 68(10) 1493-9.

5. Goncalves V M, Piovesana A M, De Moura Riero M V: Evaluation of static equilibrium in a population of hearing impaired children. Arg. Neuropsychiatry 1993 Sept; 51(3):346- 51.

6. Gayle G W, Pohlman R L: Comparative study of dynamic, static and rotary balance of deaf and hearing children.perceptual motors skills 1990 june; 70(3) 883-8.

7. Bruininks R H (1978),Bruininks osterestky test of motor proficiency,Examiners manual(Revised edition)

8. BOTMP Technical information:AGS Publishing 2004

9. Gyton A C, Hall J E, Textbook of medical physiology.Function of cerebral cortex in hearing, 10th edition. Noida. Harcourt,Asia PTE Limited, 2001 pg 608-11

10. Moore D R: postnatal development of mammalian central auditory system and the neural consequences of auditory deprivation –Acta Otolaryngology suppl 1985: 421:19- 30.

11. Perier O, Alegria J, Buyse M, D’ Alimonte G, Gilson D: Consequences of auditory deprivation in animals and humans. –Acta Otolaryngology suppl 1984; 411:60-70.

12. Red E E, Cahill H B, Pongstaporn T, Ryugo D K: The effect of congenital deafness on auditory nerve synapses: Type I and Type II, miltipolar cells in anteroventral cochlear nucleus of cats –Journal of Assoc. Reaserch otolaryngology 2002 Dec; 3(4):403-17.

13. Deafness induced changes in auditory pathways Audi –Neurology:2001;6:305-318.

14. Shummway Cook A, Horak F, Black FO: Critical examination of vestibular function in motor impaired learning disabled children international journal of pediatric otorhinolaryngology, 1987 Nov 14(1):21-30.

15. Kaga K:Vestibular ‘compensation in infant and children with congenital and acquired vestibular loss in both ears’, International journal of pediatric otorhinology 2007 vol49(3):215-224

16. Rine R M,Cornwell G, Gank, Locascico C, O’ Hare T: Evidence of progressive delay of motor development in children with sensorineural hearing loss and concurrent vestibular dysfunction –Perceptual motor skills, 2000 June;90(3-2)1101-12.

17. Singh I B, Text book of human neuroanatomy, Cranial nerve nuclei and Brainstem: Internal structures . 7th edition.New delhi.Jaypee Brothers Publishers;2006 pg:105-122 and pg:124-143

18. Cynthia and Potter, Lyn Newman Silverman: Characteristics of vestibular function and static balance skills in deaf children – physical therapy. Vol 64 No.7, July 1984.

19. Gayle G W, Pohlman R L: Comparative study of dynamic, static and rotary balance of deaf and hearing children.perceptual motors skills 1990 june; 70(3) 883-8.

20. Siegel J C, Marchetti M, Tecklin J S: age related balance changes in hearing impaired children –Physical therapy 1991 March;71(3):183-81.

21. Surez H,Angeli S,surez A,Rosels B:Balance,sensory organization in children with profound hearing loss and cochlear implants,International journal of pediatric otorhinology 2007 Apr71(4):629-31

22. Shumway –Cook A, Wollacot MH : Motor control:Theory and practical application.Motor control Posture and balance, Development of postural control , Reach Grasp and manipulation .Motor Control,4th edition,city, Lippoincort, Williams & Wilkins , pg:119-139,143- 65,462

23. Lance J W, Mcleoid J G: A physiological approach to clinical neurology. supraspinal control of motor neurons .3rd edition.Great Britain.William Clowes(Beccles);1981 pg:108-111

24. Umphred D A , Byl N,Lazearo R T,Roller M. Neurological rehabilation, normal sequential, behavioural & physiological change through developmental arc pg.4th edition.china,Mosby Inc2001 page no:58-73

Hearing Impaired children lack significantly in skills like jumping up and clapping hands,walking forward heel to toe on balance beam,standing on preferred leg on balance beam,running speed and agility as compared to healthy children.
 


Research Incentive Schemes

Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma COLAKOGLU entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by Arpita M. et al entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09
Late to bed everyday? You may die early, get depression
Egg a day tied to lower risk of heart disease
88 Percent Of Delhi Population Has Vitamin D Deficiency: ASSOCHAM Report

List of Awardees

Awardees of COVID-19 Research

Woman Researcher Award

A Study by Neha Garg et al. entitled "Optimization of the Response to nCOVID-19 Pandemic in Pregnant Women – An Urgent Appeal in Indian Scenario" published in Vol 12 issue 09

A Study by Sana Parveen and Shraddha Jain entitled "Pathophysiologic Enigma of COVID-19 Pandemic with Clinical Correlates" published in Vol 12 issue 13

A Study by Rashmi Jain et al. entitled "Current Consensus Review Article on Drugs and Biologics against nCOVID-19 – A Systematic Review" published in Vol 12 issue 09

Emerging Researcher Award

A Study by Madhan Jeyaraman et al. entitled "Vitamin-D: An Immune Shield Against nCOVID-19" published in Vol 12 issue 09


RSS feed

Indexed and Abstracted in


Antiplagiarism Policy: IJCRR strongly condemn and discourage practice of plagiarism. All received manuscripts have to pass through "Plagiarism Detection Software" test before forwarding for peer review. We consider "Plagiarism is a crime"

IJCRR Code of Conduct: We at IJCRR voluntarily adopt policies on Code of Conduct, and Code of Ethics given by OASPA and COPE. To know about IJCRRs Code of Conduct, Code of Ethics, Artical Retraction policy, Digital Preservation Policy, and Journals Licence policy click here

Disclaimer: International Journal of Current Research and Review (JICRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal.



Company name

International Journal of Current Research and Review (JICRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

Contact

148, IMSR Building, Ayurvedic Layout,
        Near NIT Complex, Sakkardara,
        Nagpur-24, Maharashtra State, India

editor@ijcrr.com

editor.ijcrr@gmail.com


Copyright © 2020 IJCRR. Specialized online journals by ubijournal .Website by Ubitech solutions