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Trial registered on ANZCTR
Registration number
ACTRN12616000573459
Ethics application status
Approved
Date submitted
21/04/2016
Date registered
3/05/2016
Date last updated
21/04/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Impact on writing alphabet symbols using an orthographic handwriting programme (The Secret Code), for children with handwriting difficulties, in year one or two of primary school.
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Scientific title
Impact on writing alphabet symbols using an orthographic handwriting programme (The Secret Code), for children with handwriting difficulties, in year one or two of primary school.
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Secondary ID [1]
289058
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Children in year one or two, who have no known neurological diagnosis but have difficulty with learning to write.
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Condition category
Condition code
Other
298594
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0
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Research that is not of generic health relevance and not applicable to specific health categories listed above
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Phase A - Samples of the child's writing is taken from class to measure and as well the child will visit the researcher (experienced occupational therapist) where they will be recorded writing the alphabet and a sentence. This will occur over a minimum of 3 weeks and no more than 6 weeks, to determine a stable baseline of the child's writing performance from in class handwriting instruction.
Phase B - The intervention being tested, is the 'Secret Code', a novel orthographic handwriting programme, to help children in year one or two, who are having difficulty learning to write. The children will visit the researcher (experienced occupational therapist), for an individual one-on-one session, twice a week for ten weeks, for forty five minute sessions. The "Secret Code' intervention includes -
Teaching the children the eight shape components that alphabet letters are constructed from and ensure they understand direction, orientation and the colour and name of each of these shapes
The children then learn how each alphabet letter is constructed with these stroke component shapes. Because many children with difficulty learning to write have memory problems, this step utilises memory strategies such as association, stories and colour.
Once this step has been achieved the children learn how these shape components are placed on the dotted third lined paper and this is a crucial step that ensures legibility of their writing.
From here children learn the concepts necessary to write a legible sentence such as the spaces necessary between letters in words, spaces between words and punctuation.
Slowly the programme layers on new learning to help children learn how to write longer text.
The first steps mentioned are what will be taught in the research study. There is no technology used, just teaching and using writing instruments.
Second Phase A - This phase is similar to the first Phase A and will begin six weeks after the conclusion of the Phase B (intervention phase) and will occur over three weeks. During this phase, like with the first Phase A, a minimum of six samples of the child's writing will be collected and recorded, Samples will be taken from in class writing activities and also the researcher will observe the children writing the alphabet and a sentence, This phase is to determine if the child's handwriting performance post the intervention phase has been maintained or changed in anyway when they have returned to classroom teaching alone.
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Intervention code [1]
294563
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Treatment: Other
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To determine the impact of an orthographic handwriting program (the Secret Code) on the ability of children with handwriting difficulties in Year One or Two at primary school, to write the letters of the alphabet.
The outcome will be assessed using the PRPP (Perceive, Recall, Plan Perform) Task Analysis Stage One and Stage two from the researcher (experienced occupational therapist) observing the child writing the alphabet and from handwritten work completed in class.
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Assessment method [1]
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Timepoint [1]
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The child will be assessed weekly throughout the ten week intervention programme.
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Primary outcome [2]
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To determine the impact of an orthographic handwriting program (the Secret Code) on the ability of children with handwriting difficulties in Year One or Two at primary school, to write a sentence.
The outcome will be assessed using the PRPP (Perceive, Recall, Plan Perform) Task Analysis Stage One and Stage two from the researcher (experienced occupational therapist) observing the child writing a sentence and from handwritten work completed in class.
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Assessment method [2]
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Timepoint [2]
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The child will be assessed weekly throughout the ten week intervention programme.
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Secondary outcome [1]
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To measure ability to write letters or the alphabet and a sentence post intervention.
The outcome will be assessed using the PRPP (Perceive, Recall, Plan Perform) Task Analysis Stage One and Stage two from the researcher (experienced occupational therapist) observing the child writing the alphabet and from handwritten work completed in class.
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Assessment method [1]
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Timepoint [1]
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Six samples of the child's writing from in class and from observation by the researcher (experienced occupational therapist) will be assessed over a three week period in Second Phase A (six weeks after the conclusion of Phase B - intervention phase).
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Eligibility
Key inclusion criteria
Once consent has been received from the parents for their child to participate in the study, the child will be screened to determine if they fit the criteria for eligibility to be included in the research. The eligibility for the inclusion in the study is
Attend regular primary schools and be in grade one or two.
Have no known neurological deficits or diagnosis such physical impairment, vision impaired, hearing impaired, speech impaired, intellectual delay or autism.
Score 60% or less on the Stage One of the Mastery of the PRPP assessment of writing the alphabet.
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Minimum age
6
Years
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Maximum age
8
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
If the child does not meet the inclusion criteria -
not in the correct age bracket
have a diagnosis (as listed in the inclusion criteria)
unable to speak fluent English
score above 60 % on the Stage One of the Mastery of the PRPP assessment of writing the alphabet.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
This study is a pilot study, utilising a non-concurrent, Single System Research Design (SSRD). For this reason, any children that meat the selection criteria can participate if they and their parents / guardian, provide their consent.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Children will be recruited and included in the study as they are referred, until the total number of ten children has been reached.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
The study will be using an ABA format -
Phase A - establishing a baseline of performance of handwriting from classroom instruction alone
Phase B - a ten week intervention phase
Second A phase - after a six week break from the conclusion of the intervention phase (phase B), Phase A will be repeated to determine how the child's handwriting has changed (or not changed) or the skills have been maintained or not maintained after the intervention has ceased.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Data Analysis
Data from PRPP Stage One and Stage Two task analyses will be calculated as a percentage of task mastery, graphed and entered into SPSS (Version 22). 6 separate graphs depicting obtained scores will be generated including: PRPP Stage One Total Score, PRPP Stage Two Total score: PRPP Perceive Quadrant Score, PRPP Recall Quadrant Scores, PRPP Plan Quadrant Score and PRPP Perform Quadrant Score. Each data point observed on the graphs represents an analysis of handwriting task mastery in relation to the expected outcome. The data will be checked for serial dependency. Data analysis will then be carried out in the following step-wise fashion: visual analysis, semi-statistical analysis and finally, statistical analysis which will be used to confirm visual analysis (Ottenbacher, 1986). Significance level will be set at 0.05.
Analysis will examine the changes within and between the phases and will include:
*descriptive statistics of the sample
*graphing scores generated by each variable’s data collection point across the three phases;
*visual analysis of the changes in mean, variability, trend and slope of the data within and between phases (Kazdin, 2011).
*semi-statistical analysis of differences between the phases using the two standard deviation band method (Ottenbacher), 1987)
*follow-up statistical analysis of the differences between the phases (Kazdin, 2011; Ottenbacher, 1987).
*Inter-rater agreement of the independent ratings will be obtained on one third of the data by an occupational therapist trained in the assessment protocol. Intra-rater reliability will be established on one third of the data by reviewing the scoring via video analysis.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
23/05/2016
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Actual
23/05/2016
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Date of last participant enrolment
Anticipated
22/08/2016
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Actual
12/09/2016
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Date of last data collection
Anticipated
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Actual
7/12/2016
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Sample size
Target
10
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Accrual to date
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Final
10
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment postcode(s) [1]
13166
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6003 - Highgate
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Recruitment postcode(s) [2]
13199
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6010 - Claremont
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Kathryn Mathwin
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Address [1]
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Kathryn Mathwin Occupational Therapy
5 Princess Rd
Claremont
Western Australia 6010
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Kathryn Mathwin
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Address
Kathryn Mathwin Occupational Therapy
5 Princess Rd
Claremont
Western Australia 6010
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
292261
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Country [1]
292261
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294884
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The University of Sydney
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Ethics committee address [1]
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The University of Sydney NSW 2006 Australia
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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24/03/2016
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Approval date [1]
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04/05/2016
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Ethics approval number [1]
294884
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Summary
Brief summary
‘The Secret Code’ is a novel occupational therapy handwriting programme. It follows the principals of orthographic development, which has been associated with creating significant and lasting change, for children who have challenges learning to write the letters of the alphabet. Handwriting difficulty is the most common reason for referral to occupational therapists who service young school age children. Currently, occupational therapy intervention is most often based on a motor learning perspective, using specific task training, practise and fine motor training. Evidence indicating the successful generalization of handwriting skills learned in therapy is scarce. With 10-34% of children in schools identified as failing to develop proficient handwriting, further research into this area to determine successful ways to help these children, is essential. This study aims to provide evidence to support further research into inclusion of orthographic processing in the traditional handwriting intervention.
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Trial website
Nil
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Trial related presentations / publications
Nil
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Public notes
Nil
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Contacts
Principal investigator
Name
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Dr Christine Chapparo
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Address
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Senior Lecturer
University of Sydney
Faculty of Health Sciences
NSW 2006
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Country
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Australia
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Phone
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+ 61 2 9351 9206
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Kathryn Mathwin
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Address
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Kathryn Mathwin Occupational Therapy
5 Princess Rd
Claremont
Western Australia 6010
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Country
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Australia
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Phone
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+61 428 187 983
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Christine Chapparo
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Address
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Senior Lecturer
University of Sydney
Faculty of Health Sciences
NSW 2006
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Country
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Australia
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Phone
65332
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+ 61 2 9351 9206
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Fax
65332
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Email
65332
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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