**4. Conclusion**

234 Learning Disabilities

of gender differences across age. For 8 tasks, gender differences were not related to age, and

The results of Nikolić and Ilić-Stošović's (2009) study confirmed that the effect of a gender was statistically significant in the presence of neuromaturation symptoms. Girls had significantly better scores on evaluation of three symptoms of neuromaturation than boys. How can we explain such a difference in our results and the results of Nikolić and Ilić-Stošović's (2009) studies? It is necessary to do more research to give the answers to the question: why is that so? It is obvious that sensor impairment, in its own structure, influences development, functioning, experience of children affected with it, and somehow equalizes development of fine motor structure, between girls and boys. So, it is necessary to examine what is the issue, besides existing similarity in prevalention and distribution of neuromaturation symptoms overall and according the age between groups of children with

Venetsanou and Kambas (2011) examined the effect of age and gender on balance skills in preschool children. Gender was found to have a statistically significant effect on the total balance score. Regarding individual items, the girls outperformed the boys on standing on the preferred leg on the floor, standing on the preferred leg on a balance beam, standing on the preferred leg on a balance beam – eyes closed, walking forward heel-to-toe on a walking line, walking forward heel-to-toe on a balance beam while the boys had statistically

There are not a lot of studies related to gender differences and motor skill performance of children with sensor impairment. Most research addressed the relationship between gender and balance skill, but there are not many studies related to the relationship between gender and some other motor skill performances. Leonardo (1969, as cited in Houwen et al., 2009), found no differences in static balance between boys and girl with blindness, but found higher median dynamic balance scores for boys than girls with blindness. Similar results found in Pereira (1990, as cited in Houwen et al., 2009), examine static and dynamic balance in children with visual impairment aged 6-13. No relationship was found between gender and this motor skill performance. Ribadi et al. (1987, as cited in Houwen et al., 2009) examined dynamic and static balance in adolescents who were congenitally blind aged 14- 17, and did not find a relationship between gender and balance. Joseph (1984, as cited in Houwe et al., 2009) found a relationship between gender and success on dart throwing tasks

in children who were totally blind. Boys performed significantly better than girls.

Potter and Newman Silverman (1984) examined balance skill in children with hearing impairment and no significant sex differences were found in the vestibular or balance status of the deaf children. Butterfield and Ersing (1986), also, found no relationship between gender and performance on dynamic and static balance tasks in children ages 3-14 years,

The effect of a gender, in our research, was not statistically significant in the presence of neuromaturation symptoms. The girls did not have significantly better scores on evaluation of three symptoms of neuromaturation than the boys among the pupils with sensory impairments. There are the same results related to gender and neuromaturation symptoms in a group of children with hearing impairment, as much as in a group of children with

sensor impairment and without, influences this difference according to gender.

significant higher scores on walking forward on a balance beam.

effect sizes were small.

with hearing impairment.

visual impairment.

The aim of this research was to establish prevalence, form and the quality of motor skill performance in children with sensor impairment. The research results were focused on two groups of school aged children: children with visual impairment and children with hearing impairment. The findings on variables associated with prevalence, form, level of motor disorders and quality of motor skill performances was analyzed in each group of children. The quality of motor skill performances, in this research, was analyzed in three areas of motor functioning: neuromaturation, coordination and balance. The study provides data on interaction between: (1) motor skill performance and visual or hearing impairment (between groups and single analysis); (2) motor skill performance of children with visual impairment, as much as motor skill performance of children with hearing impairment, with the aim of establishing if there similarities or some kind of pathway which can help professionals in creating rehabilitation programmes, as much as programmes for adaptive physical education; (3) motor skill performance and common child variables, such as gender and age; (4) previous findings of the authors Nikolić and Ilić-Stošović (2009) that are related to motor skill performance of children with typical development with the aim of establishing differences or a similarity in prevalence and structure of motor skill performance in all three examined groups.

There are the same laws in the development of motor skills in the children with visual and hearing impairments as those in the development of the children without these impairments. But nevertheless, it is possible to notice constant deviations in some areas. Garet and Levin (1970) refer to the research of Norris, Spaulding and Brodie (1957), which indicates that the development of the children with severe visual impairment is approximately equal to the development of sighted children, except for the tasks requiring the ground of specific experience. According to these authors, the delayed mastering appears most expressively in some types of motor reactions. When talking about the manifestation of neuromaturation symptoms, the results of this research coincide with the results of Nikolić and Ilić-Stošović (2009), in the research of the neuromaturation of the children without sensory impairments: in the sample of the children with sensory impairments, the presence of the malfunction of neuromaturation was noticed in 25.49% of the total sample, and in the sample of the pupils attending mainstream schools, it was 25.74%. In relation to the type of sensory impairment, the results indicate an equal distribution of the symptom of synkinesia and of the motor impersistence, but the prevalence of the appearance of diadochokinesia is statistically significantly greater in the children with visual impairment. Almost the same frequencies also appear in the comparative analyses of balance situation i.e. of the appearance of balance dysfunction: in

Motor Skill Performance of Children with Sensor Impairments 237

The construction and the application of screening protocol which contain the evaluation of neuromaturation maturity (symptom of synkinesia, diadochokinesia and motoric impersistence), the evaluation of lateralization, balance, coordination (general motoric skills), enabled differentiated diagnostic criteria for establishing the level and the quality of motoric functioning, as well as of the prevalence and the form of the manifestation of

Interventions for motor deficits in children with hearing impairments must consider

However, this research has some limitations. First, in this research, correlation between type of hearing impairment (conductive or perceptual), as much as level of hearing loss, was not considered in the aim of establishing a relationship between motor skill performance. Second, correlation between congenital and other type of hearing loss or visual impairment was not considered in the aim of establishing a relationship between prevalence and distribution of motor skill performance. In that way, further research should consider this. Next, opportunities for movement experience of both groups of children with sensor impairment are very important factors that influence quality of motor skill performance. Restricted opportunities for movement and deprivation of practice have been shown to interfere with children's abilities to perform motor skills at adequate level (Gallahue & Ozmun, 2002, as cited in Houwen et al., 2009). In literature it is expressed that an adequate environment that reinforces positive environmental interactions is important for stimulating motor skill practice in children with visual impairment (Schneekloth, 1989, as cited in Houwen et al., 2009). There is no reason to believe that there is an opposite rule for children with hearing impairment. So, stronger evidence for a correlation between motor skill performance in children with sensor impairment could be found if further research considers it. Lastly, we examined only motor skill performance in children with sensor impairment educated in special schools. So, when we discuss our results, we must consider that our participants had such a level of sensor impairment what needed education in special circumstances. It might be possible that distribution and prevalence of symptoms of delayed motor skill performance would be different if we correlated motor skill performance in children with sensor impairment educated in mainstream schools and children educated in special schools. Unfortunately, this was not possible as, in the period that we did our research, inclusive education was not an option in the Republic of Serbia.

An, MH., Yi, CH., Jeon, HS. & Park, SY. (2009). Age-related changes of single-limb standing

Atkinson, SJ., Johnstone, B., Lindsay, A. (1981). *ACADIA test razvojnih sposobnosti*, Fakultet

Barnett, LM., van Beurden, E. & Morgan PJ. (2009). Childhood motor skill proficiency as a

No. 3, (March, 2009, Epub, 2008, Octobar), pp.252-259, ISSN 1054-139X. Brakke K., Fragaszy DM., Simpson K., Hoy E., & Cummins-Sebree, S. (2007). The production

balance in children with and without deafness. *International Journal of Pediatric Otorhinolaryngology*, Volume 73, No. 11, (November, 2009), p. 1539-1544, ISSN 0165-

predictor of adolescent physical activity. *Journal of Adolescence Health*, Volume 44,

of bimanual percussion in 12- to 24-month-old children. *Infant Behavior and* 

motoric disorders in the pupils with sensory impairment.

**5. References** 

5876.

za defektologiju, Sveučilište u Zagrebu

vestibular function as well as motor performance (Crowe & Horak, 1988).

the sample of the children with sensory impairments, the presence of balance dysfunction was noticed in 49.4% of the total sample, and in the sample of the children attending mainstream schools, it was 48%. Opposite to our hypothetic view and to previous research, we did not find any significant presence of balance disorders in the pupils with hearing impairment. Children with visual impairment have the problem of maintaining balance because of the lack of visual information, which are very important for maintaining the position of the body. The feature that is characteristic is the frequency of the phenomenon of dyscoordination, and that in the category of visually impaired children (65.07%), which is significantly greater also in relation to the pupils with a typical developmental course (37.3%, and to the sample of the pupils with hearing impairment (36.99%). Regarding the immense influence and the active role of visual information in movement control, the correction of errors and the entire coordination, such a result is not surprising. When we discuss the relationship between motor skill performance in children with and without sensor impairment, an important difference between these two groups of children can be seen in the relationship between gender and distribution of symptoms of delayed neuromaturation. Opposite to the research results of Nikolić and Ilić-Stošović (2009), that confirmed a relationship between gender and symptoms of delayed neuromaturation in children with typical development, it was not found in our research. The answer for this difference can be found in the relationship between experience and motor development. Although, all children in our sample attended special schools because of their increased need for individual and adaptive education, it is possible that lack of experience needed for development of neuromaturation (e.g. specific game) brought equalization in this area of motor skill performances between boys and girls. Additional research is needed in this area. Issues that need to be addressed include the association of education model (inclusive vs. special) and development of motor skill performance.

Assuming all presented studies related to the relationship between age and balance skill, age is a very important factor in balance skill for children with and without sensor impairment, but only if we consider type and difficultness of tasks. If we accept the opinion that it appears that postural control is more highly dependent upon visual input than on somatosensory (An et al., 2009), than we can conclude that we did not find strong evidence for a relationship between age and balance skill, but we did find a strong relationship between visual input and this motor performance skill. It is necessary, for further research to examine how different task demands (with and without visual input) influence balance skill in children with typical development. It is also necessary to examine how children with sensor impairment develop their motor skill performance and how the specifics in that development influence to scores measured at balance skill testing. Houwen et al. (2009) state that motor skill performance may be a function of age and experience.

A significant representation of isolated motor disturbances in the pupils with sensory impairments must concern and require the earliest possible intervention. The therapy approach to the disorders in motor development implies above all a properly established diagnosis, on the basis of which the kind and the form of the treatment to be applied will be determined. A timely treatment within the re-education, directed to the delaying in neuromaturation, disharmonic lateralization, balance and coordination disorders, may give favourable results. Also, it is very important to improve motor skill performance of children with sensory impairments, because it might contribute positively to their sports participation.

the sample of the children with sensory impairments, the presence of balance dysfunction was noticed in 49.4% of the total sample, and in the sample of the children attending mainstream schools, it was 48%. Opposite to our hypothetic view and to previous research, we did not find any significant presence of balance disorders in the pupils with hearing impairment. Children with visual impairment have the problem of maintaining balance because of the lack of visual information, which are very important for maintaining the position of the body. The feature that is characteristic is the frequency of the phenomenon of dyscoordination, and that in the category of visually impaired children (65.07%), which is significantly greater also in relation to the pupils with a typical developmental course (37.3%, and to the sample of the pupils with hearing impairment (36.99%). Regarding the immense influence and the active role of visual information in movement control, the correction of errors and the entire coordination, such a result is not surprising. When we discuss the relationship between motor skill performance in children with and without sensor impairment, an important difference between these two groups of children can be seen in the relationship between gender and distribution of symptoms of delayed neuromaturation. Opposite to the research results of Nikolić and Ilić-Stošović (2009), that confirmed a relationship between gender and symptoms of delayed neuromaturation in children with typical development, it was not found in our research. The answer for this difference can be found in the relationship between experience and motor development. Although, all children in our sample attended special schools because of their increased need for individual and adaptive education, it is possible that lack of experience needed for development of neuromaturation (e.g. specific game) brought equalization in this area of motor skill performances between boys and girls. Additional research is needed in this area. Issues that need to be addressed include the association of education model (inclusive vs.

Assuming all presented studies related to the relationship between age and balance skill, age is a very important factor in balance skill for children with and without sensor impairment, but only if we consider type and difficultness of tasks. If we accept the opinion that it appears that postural control is more highly dependent upon visual input than on somatosensory (An et al., 2009), than we can conclude that we did not find strong evidence for a relationship between age and balance skill, but we did find a strong relationship between visual input and this motor performance skill. It is necessary, for further research to examine how different task demands (with and without visual input) influence balance skill in children with typical development. It is also necessary to examine how children with sensor impairment develop their motor skill performance and how the specifics in that development influence to scores measured at balance skill testing. Houwen et al. (2009) state

A significant representation of isolated motor disturbances in the pupils with sensory impairments must concern and require the earliest possible intervention. The therapy approach to the disorders in motor development implies above all a properly established diagnosis, on the basis of which the kind and the form of the treatment to be applied will be determined. A timely treatment within the re-education, directed to the delaying in neuromaturation, disharmonic lateralization, balance and coordination disorders, may give favourable results. Also, it is very important to improve motor skill performance of children with sensory impairments, because it might contribute positively to their sports participation.

special) and development of motor skill performance.

that motor skill performance may be a function of age and experience.

The construction and the application of screening protocol which contain the evaluation of neuromaturation maturity (symptom of synkinesia, diadochokinesia and motoric impersistence), the evaluation of lateralization, balance, coordination (general motoric skills), enabled differentiated diagnostic criteria for establishing the level and the quality of motoric functioning, as well as of the prevalence and the form of the manifestation of motoric disorders in the pupils with sensory impairment.

Interventions for motor deficits in children with hearing impairments must consider vestibular function as well as motor performance (Crowe & Horak, 1988).

However, this research has some limitations. First, in this research, correlation between type of hearing impairment (conductive or perceptual), as much as level of hearing loss, was not considered in the aim of establishing a relationship between motor skill performance. Second, correlation between congenital and other type of hearing loss or visual impairment was not considered in the aim of establishing a relationship between prevalence and distribution of motor skill performance. In that way, further research should consider this. Next, opportunities for movement experience of both groups of children with sensor impairment are very important factors that influence quality of motor skill performance. Restricted opportunities for movement and deprivation of practice have been shown to interfere with children's abilities to perform motor skills at adequate level (Gallahue & Ozmun, 2002, as cited in Houwen et al., 2009). In literature it is expressed that an adequate environment that reinforces positive environmental interactions is important for stimulating motor skill practice in children with visual impairment (Schneekloth, 1989, as cited in Houwen et al., 2009). There is no reason to believe that there is an opposite rule for children with hearing impairment. So, stronger evidence for a correlation between motor skill performance in children with sensor impairment could be found if further research considers it. Lastly, we examined only motor skill performance in children with sensor impairment educated in special schools. So, when we discuss our results, we must consider that our participants had such a level of sensor impairment what needed education in special circumstances. It might be possible that distribution and prevalence of symptoms of delayed motor skill performance would be different if we correlated motor skill performance in children with sensor impairment educated in mainstream schools and children educated in special schools. Unfortunately, this was not possible as, in the period that we did our research, inclusive education was not an option in the Republic of Serbia.
