((A.4...l.). .. . :44 iv»... a: .v1» 4. a.btsrl t .al.:. .v' V‘s-01"]: nl‘ ,- t0 r.vL:. .qu‘.l€.¢ . v.-nv..‘l.c 4|..sb‘4..tV|v.31 . ulfiv4,.an.g Em... gins . . . . I. .Q 495! V. 5. 2..- s llllllllllllllllllllllllllllllllll This is to certify that the thesis entitled The Relationship Between Balance And Fundamental Motor Skill Performance Of Children Who Are Deaf presented by Paul G. Behen has been accepted towards fulfillment of the requirements for Master's degree in Education Major professor Date [0/319 /72— 0-7639 MS U is an Affirmative Action/Equal Opportunity Institution LIBRARY Michigan State University }O~.* “‘4. PLACE IN RETURN BOX to remove this checkout from your record. TO AVOID FINES return on or before date due. DATE DUE DATE DUE DATE DUE I #fi lfil ill MSU Is An Affirmative ActionlEquel Opportunity Institution . cmmwa'fid THE RELATIONSHIP BETWEEN BALANCE AND FUNDAMENTAL MOTOR SKILL PERFORMANCE OF CHILDREN WHO ARE DEAF BY Paul Gregory Behen A THESIS Submitted to Michigan State University in partial iuliillment oi the requirements for the degree of MASTER OF ARTS Department of Physical Education and Exercise Science 1992 ABSTRACT THE RELATIONSHIP BETWEEN BALANCE AND FUNDAMENTAL MOTOR SKILL PERFORMANCE OF CHILDREN WHO ARE DEAF BY Paul Gregory Behen The purpose of this study was to investigate the relationship between the balance and fundamental motor skill performances of children who are deaf. The sample included 56 girls and 50 boys aged 4 to 12 years. Static balance was measured using a stark stand test, and dynamic balance was measured using a heel-toe beam-walk test. The Developmental Sequences of Fundamental Motor Skills Inventory (Seeieldt & Haubenstn’cker, 1974) was used to assess the subjects: performances on mnning, galloping, hopping, skipping, jumping, catching, throwing, striking, punting, and kicking. Chi-square analyses revealed that: (a) static balance was related to the performances of each of the ten fundamental motor skills that were assessed, and (b) dynamic balance was only related to the hop, skip, and throw. These results suggest that instmctional activities for children who are deaf should be designed to improve both balance and fundamental motor skills. ACKNOWLEDGEMENTS I would like to acknowledge the following people for their support, encouragement, and guidance: My Thesis Committee, Dr. David Stewart, Dr. John Haubenstricker, and, especially, Dr. Gail Dummer, for being such a driving force in the corrpletion of this thesis, and in my career as a physical education teacher for students with physical and mental impairments. The teachers, administrators and. especially, students from both schools, for their willingness to participate in this study. My parents, Nancy and Patrick Behen, for a lifetime of support. My sister, Jennifer Behen, for being the reason why I have become a teacher in this field. My friend, Rick Cohn, for his support and encouragement while finishing this thesis. TABLE OF CONTENTS LIST OF TABLES ............................................................................................... LIST OF FIGURES .............................................................................................. CHAPTER I. INTRODUCTION ........................................................................................ Need for the Study ................................................................................. Purpose of the Study .............................................................................. Hypotheses ........................................................................................... Overview of Research Methods ............................................................... Delimitations ........................................................................................... Limitations .............................................................................................. Definitions .............................................................................................. II. REVIEW OF LITERATURE ......................................................................... Balance Skills of Children and Youth ........................................................ Development of Balancing Ability ............................................................. Age and Gender Differences in Balancing Abiiity ....................................... Fundamental Motor Skills of Children and Youth ....................................... Relationship Between Balance and Fundamental Motor Skills .................... Balance Skills of Deaf Children ................................................................. Fundamental Motor Skills of Deaf Children ................................................ Relationship of Balance to Fundamental Motor Skills of the Deaf ................ Summary ................................................................................................ Ill; METHODS ................................................................................................ Subjects ................................................................................................ Instrumentation ...................................................................................... Tests of Balance and Fundamental Motor Skills ......................................... Static Balance ......................................................................................... Dynarric Balance .................................................................................... Page vii viii c-L (J'IUIrbODOOUN 20 20 22 22 22 22 Fundamental Motor Skills ..................................................................... Running ........................................................................................... Galloping .......................................................................................... Hopping ........................................................................................... Skipping .......................................................................................... Jumping ........................................................................................... Throwing .......................................................................................... Kicking ............................................................................................. Punfing ............................................................................................ Catching .......................................................................................... Striking ............................................................................................ Data Reduction ....................................................................................... Static Balance ...................................................................................... Dynamic Balance ................................................................................. Fundamental Motor Skills ..................................................................... Procedures ............................................................................................ Data Analyses ......................................................................................... Hypothesis Testing .............................................................................. Hypothesis 1 .................................................................................... Hypothesis 2........... ......................................................................... Hypothesis 3 .................................................................................... Hypothesis 4 .................................................................................... Hypothesis 5 .................................................................................... Hypothesis 6 .................................................................................... N. RESULTS ................................................................................................. Age and Balancing Ability ........................................................................ Gender and Balancing Abiflty ................................................................... Fundamental Motor Skills and Static Balance ............................................ Fundamental Motor Skills and Dynamic Balance ........................................ Gender and Fundamental Motor Skills ...................................................... Agmmo? Skills ........................................................... V. DISCUSSION ............................................................................................ VI. SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS .......................... Summary ................................................................................................ Conclusions ........................................................................................... Recommendations ................................................................................. APPENDICES A. B. HUMAN SUBJECTS APPROVAL ................................................................ DIAGRAM OF TESTING FACILITY ................................................................ . DEVELOPMENTAL SEQUENCES OF FUNDAMENTAL MOTOR SKILLS NVENTORY ............................................................................................... . SUBJECT INFORMATION ........................................................................... BALANCE AND FUNDAMENTAL MOTOR SKILLS SCORES ........................ 22 23 23 23 23 23 24 24 24 24 24 24 24 25 25 27 29 29 29 29 ‘29 29 29 30 31 31 33 33 37 4O 41 43 47 47 47 48 49 51 52 62 65 F. FREQUENCIES OF FUNDAMENTAL MOTOR SKILLS PERFORMANCES BY AGE AND GENDER ................................................................................ 68 G. RESULTS OF CHI-SQUARE ANALYSES USING MODIFIED BALANCE SCALE ...................................................................................................... 80 LIST OF REFERENCES ...................................................................................... 83 Table 1. Table 2. Table 3. Table 4. Table 5. Table 6. Table 7. Table 8. Table 9. Table 10. Table11. Table 12. Table 13. LIST OF TABLES Age of achievement for balancing tasks .............................................. Research on abilities of deaf people ................................................... Distribution of subjects by age, gender, and school ............................ Cause of hearing loss ........................................................................ Age at onset of hearing loss .............................................................. Frequencies of balance performances isted by age ............................ Frequencies of balance performances listed by gender ....................... Frequencies of fundamental motor skill performances by static balancers and nonbalancers ................................................. Frequencies of fundamental motor skill periorrnances by dynamic balancers and nonbalancers ............................................. Percentages of deaf children who achieve most mature level of fundamental motor skill ...................................................................... Frequencies of fundamental motor skills performances by males and females ........................................................................ Frequencies of fundamental motor skills perionnances by age ............. Frequencies of fundamental motor skills performances by dynamic balancers and nonbalancers (modfied balance scale) ............. 14 21 21 21 32 33 35 38 42 68 70 81 Figure 1. Figure 2. LIST OF FIGURES Ages at which 60% of children attain fundamental motor skills .............. Stages of development of hopping .................................................... viii 12 26 CHAPTER I INTRODUCTION The first five years of life generally are regarded as the period wring which the fundamental motor skill patterns emerge (Wickstrom, 1975). Some of the fundamental motor skills include the locomotor skills of ninning, skipping, hopping, galloping, and jumping, and the object control skills of catching, striking, throwing, kicking. and punting. The ability to balance has also been shown to develop before the age of five years (Frankenburg & Dodds, 1967; Keogh, 1969). A broad base of balance and fundamental motor skill provides the foundation for later participation in the games, dance, and sport activities of our culture. Succesle involvement in leisure and sport activities can lead to a lifetime of physical, social, and emotional well-being. The opportunity for some deaf people1 to attain the maximum benefits of sport and physical activity may be limited. Deaf children have displayed difficulties in both fundamental motor skill acquisition and balance ability. Research has shown that deaf children display delays in the acquisition of mature levels of fundamental motor skills (Butterfield, 1987; Dumrner, Haubenstricker, a Stewart, 1999). Butterfield (1987) found that in the skills of kicking, jumping, catching, and hopping, deaf children displayed fewer mature patterns than expected for children of equal chronological age. Dumrner, Haubenstricker, and Stewart (1989) found that deaf youngsters demonstrated deficiencies in hopping, leaping, horizontal jumping. skipping. striking, bouncing. catching, kicking. and throwing. In general, researchers have found that deaf children displayed balance deficiencies as compared to their hearing counterparts (Long, 1932; Boyd, 1967; Lindsey a O’Neal, 1976). 1The author is aware of the importance of using “people first" language. However, for ease in reading this manuscript, “people who are deaf“ will be referred to as “deaf people.“ The inability to acquire mature levels of fundamental motor skills at earlier ages may be due to the inability to balance. Only one study has linked the inability to balance with the inability to acquire mature levels of fundamental motor skills for deaf children. This study by Butterfield. (1987) showed that, for a selection of 10 fundamental motor skills, the higher the level of performance, the greater the score in balance. It is imperative that this relationship be examined so that early attempts can be made to improve the balance and fundamental motor skills of deaf people. Need for the Study Only one study has examined the relationship between the ability to balance and the ability to perform fundamental motor skills for deaf children (Butterfield, 1987). In this study by Butterfield, a direct relationship was found between balance and fundamental motor skill performance. However, the skills of punting and galloping, two fundamental motor skills important to the success in specific games and spons, were not examined. Also, the Scale of Infra-Gross Motor Abilities (SIGMA) (Loovis 8. Erving, 1979), which was the assessment tool used to examine the level of fundamental motor skill performance, does not provide an adequate assessment of mature skill for some test items, in that the highest performance level possible for some skills falls short of a truly mature movement pattern. Further knowledge of the relationship between the performance of balance and fundamental motor skills for deaf children would allow physical education teachers to more effectively enhance balance and motor skill acquisition. If it is true that balance ability has an effect on the performance l9vels of fundamental motor skills for deaf people. then teachers and researchers should begin to focus their efforts on ways to most effectively enhance both balancing ability and fundamental motor skill acquisition. lf practitioners are to be expected to base lnstmctlonal content on empirical evidence, then this relationship must be investigated. Purpose of the Study The purposes of this study were to: (a) examine the balance characteristics and fundamental motor skill performance characteristics of deaf children aged 4 through 12 years, including the influence of gender and age on such characteristics; and (b) determine if balance relates to the level of performance of the fundamental motor skills of throwing, catching, striking, kicking, punting, mnning, jumping, skipping. gall0ping, and hopping of deaf children. Hypotheses It was the intent of this study to examine the following hypotheses: (1) There is a positive relationship between age and the ability to balance. As age increases. the ability to balance for deaf children also increases. (2) There is no difference in the ability to balance between males and We. (3) There is a positive relationship between fundamental motor skill performance and static balance performance for deaf children. (4) There is a positive relationship between fundamental motor skill performance and dynamic balance performance for deaf children. (5) There is a positive relationship between age and the ability to perform the fundamental motor skills for deaf children. As age increases, the ability to acquire mature levels of fundamental motor skill increases. (6) There is no dfference between males and females in the ability to perform the fundamental motor skills for deaf children. In addition, descriptive data were obtained relative to degree of hearing loss, age at onset of hearing loss, and cause of hearing loss. Overview of Research Methods This is a cross-sectional, descriptive study designed to obtain data on the balance and fundamental motor skill performance of deaf children. Data from the study originally conducted by Dummer, Haubenstricker, and Stewart (1989) were used. The independent variable in this analysis was balance performance, with level (1, 2, 3, 4, or 5) of fundamental motor skill performance the dependent variable. The subjects in this study were grouped according to their balancing ability. Subjects were categorized as balancers if they could maintain a stork stand for ten seconds (static balance) or if they could perform 10 heel-toe steps on a balance beam (dynamic balance). \ The fundamental motor skills of running, hopping, jumping, skipping, galloping, throwing, catching, striking, kicking, and punting were assessed using the Developmental Sequences of Fundamental Motor Skills Inventory (DSFMSI) (Haubenstricker 8 Safews; Sapp, 1980; Seefeidt 8 Haubenstricker, 1974; Seefeidt 8 Haubenstricker, 1976a; Seefeldt 8 Haubenstricker, 1976b: Seefeldt 8 Haubenstricker, 1976c: Seefeldt, Reuschlein, 8 Vogel, 1972), a qualitative assessment instmment. Videotaped performances of each of the students were analyzed. Students’ scores were rated according to the quality of performance they displayed, with 1 representing an immature skill level, and 3, 4, or 5 (dependng on the skill) representing a mature skill level. if, for example, they displayed behavior meeting the criteria for a Stage 31hrow, they would be given a “3" for their performance. Once balance performances and fundamental motor skill performances had been assessed, a chi-square analysis was performed to determine whether a relationship existed between balance and the performance of each fundamental motor skill. This research plan is described in detail in Chapter ill of this study. Delimitations The population for this study was delimited to deaf children who attended two schools for deaf students, one in the United States (School A) and one in Canada (School B). The population of students was delimited further due to parental consent. Only those students given permission to participate by their parents were subjects for this study. We study was further delimited by the ”mm..-- . _.m-,,,c-—.J" test battery designed to measure balance. The only measures of balance videotaped were the stork stand on the preferred foot with eyes open and the balance beam walk. Limitations The investigator wasflaware of the folpw;ngpfliei_wefine$es in the study. ( 1) The effects of the facilities used for the testing sessions on the test of balance and performance of the fundamental motor skills of the subjects is unknown. This IS especially true for ‘/ Hue—un— m—-- a._‘ m\w _ _,,._.—.-r Eva—M .- ”- -Wfi ‘ W‘va’ the performances of the skills of kicking and throwing due to the limited space (20 -30 meters) available for the throwior distance and kick for distance results. Subjects may not have exerted themselves fully because they felt confined by the finite space available. The quality of the performances/mung Deenaffected. Conversely, the wall may have acted as a motivator. SoWegsmay ””9519”? to hit the wall, exerting themselves fully. (2) Neither the tests of balance nor of fundamental motor skills had been standardized for deaf people. Although students were instructed using their preferred mode of communication, it is unknown whether instructions were fully understood. However, subjects were given additional demonstrations and instnictions if it was clear that they misunderstood the original directions. Definitions Fundamental Motor Skills - The fundamental motor skills are the locomotor skills of mnning, skipping, hopping, jumping, and galloping, and the object control skills of catching, throwing, kicking, striking, and punting. Static Balance - In this study static balance was measured using a stork stand test. Subjects stood on one foot, placing hands on hips, and the ankle of the resting foot near the knee. Subjects were timed to see how long they could maintain this stance. The clock was started when the ankle of the resting foot was placed near the knee. The clock was stopped when the resting foot moved out of position, or when the support foot was moved from its original position. Dynamic Balance - Dynamic balance was assessed using a balance beam walt. Subjects waked the length of a 3.04 m beam using heel-toe steps. The number of steps taken across the beam before the subject stepped off or stopped walking heel-toe were counted. CHAPTER II REVIEW OF LITERATURE The research topics examined in this review of literature include the balancing ability of both deaf and hearing children, and the influence of age and gender on their ability to balance; the performance of fundamental motor skills of both deaf and hearing children, and the influence of age and gender on the ability to perform the fundamental motor skills; and the influence of balance ability on performances of fundamental motor skills. Balance Skills of Children and Youth The ability to balance can conceptually be broken down into two types, static and dynamic. Static balance, as defined by Seashore (1947), is the maintenance of a specified body position in which the antagonistic muscles are so engaged that there is minimal local or general body sway. Dynamic balance, as defined by Bass (1939), is the ability to keep one's emilibrium while changing from one balanced position to another or through a series of positions taken successively. Iderlification of the two types of balance was derived from several studies in which the results of several balance tests were subjected to correlational and factor analytic statistical techniques. The tests used for the two different types of balance are unique. Tests of static balance, include the balance board, the balancometer, the stabiiometer, and the stick balance. Tests of dynamic balance include the balance beam test, rail waiting test, leap test, and stepping stone test (Drowatsky 8 Zuccato, 1967; Herrpel 8 Fleishman, 1955). Correlations between the two types of tests were low, and factor analyses found that factor loadings differed. In this review, the findings of Bayley (1935, 1969), Frankenburg 8 Dodds (1967), McCaskill and Wellman (1938), and Keogh (1969) will be highlighted to describe the development of balancing abilities. Other studies will be summarized to describe age and gender differences in the ability to balance. [1 | IIBI . EI'I'I An individual's progress in achieving various balancing tasks are listed in Table 1 and described here. Generally, children can stand briefly on one foot by their second birthday (Bayley, 1969) and they can maintain that position for 5 seconds by 38 months. At 54 months the duration is extended to 10 seconds (Frankenburg 8 Dodds, 1967). Usually, children at 23 months can walk following a line on the floor, with their feet placed on either side of the line. Only at 27 months can they walk the line backwards with footsteps astride (Bayley, 1969). Walking forward heel-toe is more difficult and is only partially achieved by 43 months (Frankenburg 8 Dodds, 1967). Keogh (1969) discovered that 65% of boys and 87% of girls could walk heel-toe for ten steps at age 5. Other studies have shown that standing and walking on a walking board or balance beam occurs at 28 months and 38 months, respectively (Bayley, 1935). The two tasks that have been most often used to measure the balance capabilities of children are walking on a beam and maintaining a balanced position on a stabilorneter. The studies that have examined these dynamic and static balance measures will be described here. Heath (1949) and Goetzinger (1961) studied boys and girls ages 8-14 years with normal hearing. The balance beam was used to measure balance in both of these studies. The beam width and the test procedures were the same in both studies. In each study, subjects walked three different beams: 10.16 cm, 5.08 cm, and 2.54 cm in width, respectively. Each subject was given three attempts on each of the beams. The number of meters walked along each of the beams in each of the trials were calculated. Table 1 E l E l . | l E l . I | Bdandng Task Age in Morths ' Study Stand on one foot: Momentarily 22-23 Bayley,1969 1 second 30 Frankenburg 8 Dodds,1967 5 seconds 38 Frakermig 8 Dodds,1967 10 seconds 54 Frankenburg 8 Dodds,1967 Wak a line on the floor: Forward: astride 23 Bayley,1969 Backward: astride 27 Bayley,1969 . Circular path: forward 37 McCaskiI 8Wetren1938 Heel-toe: Fomard 43 Frankenburg 8 Dodds,1967 Badtwaid 56 Frarkerburg 8 Dodds,1967 Stand on waldng board: Triesto stand 18 Bayley,1969 Both feet for a few seconds 24 Bayley,1969 Walk on a walking board: Attenus steps 28 Bayley,1935 Atterrpts steps partway 38 Bayley,1935 10 The results were similar in both studies. Boys and girls had a similar pattern of improvement with age. The overall pattern of change was uneven from year to year, with smaller mean increases from ages 8 to 9 and 10 to 11. The mean differences between boys and girls were small in these studies: however, the boys scored slightly higher in both studies. Keogh's (1965) study measured the ability of boys and girls ages 5 to 11 years to hop on one feet a distance of fifty feet, maimain a stork stand on balance beam, and walk heel—toe on a balance beam. Keogh found a gradual improvement across ages. The findings in this study were similar to those by Heath (1949) and Goetzinger (1961), in that the mean differences between boys and girls were small. In Keogh's study, however, the girls scored slightly better than the boys. DeOreo and Wade (1971) studied 150 boys and g'rls ages 3-5 years. The tests of balance inchded a forward beam walr using beams of varying widths, a backward beam walk, and ability to balance on a stabilometer. While findings from this study indicated that there was a gradual improvement with age, there were no significant differences between the scores of the boys and girls except in the measure of static balance. The mean scores showed the g'rls superior to boys on nearly all test items of static balance. Other studies have shown that there is a gender difference in static balance. Morris. Williams, Atwater, and Wilrnore (1982) found that on the stark stand test of static balance, 6 year old girls performed significantly better than 6 year old boys. In summary, the studies reviewed indicate that, in general, balance performances in'prove with increasing age from 3 to 14 years, however the changes are gradual, and year to year performance differences are usually small and insignificant (DeOreo and Wade, 1971 ; Keogh, 1965). When balance performance is looked at across a wide range of ages and tasks, there is little or no difference between boys and girls in balance performance. if the nature of the task is considered, however, there is a tendency for girls to demonstrate better performance than boys on static balance tasks (DeOreo and Wade, 1971 ; Morris et al., 1982). 11 Fundamental Motor Skills of Children and Youth Data collected by Seefeldt and Haubenstricker (1982) provide normative findings on the performance of the fundamental motor skills of children. Approximately 150 children performing the various fundamental motor skills were examined. The results of this study showed developmental sequences for the locomotor skills of mnning, hopping, skipping, galloping, and jumping, and the object control skills of catching, throwing, kicking, punting, and striking. Figure 1 displays the ages at which 60% of children in this mixed-longitudinal sample were able to perform the nine fundamental motor skills. The numbers on each bar of the illustration correspond to developmental stages; 1 denotes the least mature stage, and 3, 4, or 5 denotes the most mature stage for each skill. Several trends are suggested from the data illustrated in Figure 1. In terms of gender, boys tend to attain each stage of overhand throwing and kicking earlier than girls; whereas, gins tend to attain each stage of hopping and skian earlier than boys. The difference between boys and girls is most marked for overhand throwing. The attainment of specific stages, especially Stages 2 and 3 of the fundamental motor skills of ninning, jumping, catching, and striking shows much similarity between boys and girls. There is more variation between boys and girls at the ages in which the final or mature stages are attained. Girls attain the final two stages of catching earlier than boys, but attain the earlier stages at the same age as boys. In contrast, the difference between boys and girls for attaining the mature form of the standing long jump is small. In terms of age, development of the fundamental motor skills progresses rapidly during early childhood and continues into middle childhood with respect to several skills. Most fundamental motor skills ordnarlly develop by age 6 or 7, although the mature patterns of some skills do not develop until later. The data illustrated in Figure 1 show the ages at which 60% of children attain specific developmental levels for fundamental motor skills. SELECTED FUNDAMENTAL MOTOR SKILLS THROW ING KICKING RUNNING JUI‘IPING CATCHING STRIKING I-DPPINO SKIPPING 12 ----- ears .=... GIRLS I ----------- 2 ----- 3 ----- 4----s I333333883:333828883388833383I833843833333833833835 l ----------- 2 --------- 3 ----------------- 4 Iassassgsaassgass2assasss:s:=saa=s$s=ssssaxsss4 l--2 ----- 3 ------ 4 133.28.33.838888-8883384 l ----------- 2 ------------ 3 ---------------------- 4 I ------ 2 ----- 3 --------- 4----s Is388332-8333383asa4sssasss i--2 ----- 3 ------------------- 4 I33.3233333383333832888383883888883884 l ----- 2 ------- 3 ----------- 4 188883238888883888.838388i4 kfim$é&é&&%%RW%&WWMo CHRONOLOOICAL AGE m mourns figural. Ages at which 60% of children attain levels of fundamental motor skills (Seefeldt 8 Haubenstricker, 1982). Relationship Between the Performances of Balance and Fundamental Motor Skill The role of balancing ability on the perfomiance of fundamental motor skills was examined by Ukich and Ulrich (1985). In their study, Ulrich and Ulrich administered a test 01 15 terns measuring balancing ability and developmental level of gross motor skills in 33 girls and 39 boys 13 aged 3-5 years. The balance tasks included all eight items from the balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency (Bruininks, 1978). The performance of several of the fundamental gross motor skills were assessed using stage descriptions developed by Seefeldt and Haubenstricker (Haubenstricker 8 Seefeldt, 1976; Sapp, 1980; Seefeldt and Haubenstricker, 1974; Seefeldt 8 Haubenstricker, 1976a; Seefeldt 8 Haubenstricker, 1976b; Seefeldt 8 Haubenstricker, 19760; Seefeldt, Reuschlein, and Vogel, 1972). Findngs revealed a significant linear relationship between age and ability to balance, but no difference was found with respect to gender and the ability to balance. However, a significant gender difference was found for four of the movement skills. Mean values indicated that boys were more advanced in throwing, kicking, and striking, and girls were more proficient in skipping. Results indicate, that when age was factored out, balance was found to be significantly related to the level of performance of fundamental motor skills. The stages of hopping on the preferred and nonpreferred foot. jumping, and striking were significantly related to balancing ability. Balance Skills of Deaf Children There have been several studies of balance as it relates to deaf children and youth (Long, 1932; Marsh .1936; Myklebust .1946; Boyd ,1967; Vance .1968; Grimsley .1972; Case, Dawson, Schartner 8 Donaway .1973; Lindsey 8 O'Neal .1976; Brunt 8 Broadhead, 1982; Potter and Silvennan ,1984; and Butterfield .1987). The results of these studies suggest that hearing people balance better than deaf people. The information relative to the studies that examine the balance abilities of deaf children is summarized in Table 2. The relationship of age to balance, and gender to balance. are highlighted in the following paragraphs. In terms of gender, the early studies conducted by Long (1932), Morsh (1936), and Myklebust (1946), found that boys aged 5-21 yielded better balance performances than girls of the same ages. in these studies, both static and dynan'fc balance measures were used (Balance 14 Table 2 B I I I I .I. . l I I I Researcher n Ages Test Results Deaf/Hearing Age Long, 1932 174 8—1 8 Balancing Hearing>Deaf - M-f 00 Board F-74 Morsh, 1936 132 - Dunlap Hearing>Deaf OId>Young M-146 Balancing F-156 Board Myklebust, 1946 203 5-21 Heath - OId>Young Mai 05 Railwalklng Rm Test Boyd, 1967 180 8-10 Oseretsky Hearing>Deaf - M-180 Scale Vance, 1968 88 5-12 Stork stand Hearing>Deaf - Grimsley. 1972 60 12-15 Dyna- Deaf aided by visual cues>hearing M-30 balometer Fdo Case at al., 1973 60 16-18 iowa-Brace Hearing>Deaf - M-60 Test Lindsey 8 O’Neal, 108 8 Oseretsky Hearing>Deaf - 1976 M-58 Test F-50 Brunt 8 Broadhead, 154 7-14 Bruininks- Hearing>Deaf OId>Young 1982 M-85 Oseretsky F-69 Potter 91 al., 1984 34 5-9 SCSIT Hearing>Deaf 15 board, Heath Rail-Walking Test). in the more recent studies conducted by Lindsey and O'Neal (1976), Brunt and Broadhead (1982), and Potter and Silvennan (1984), no significant gender differences were found for the ability to balance for subjects 5-14 years of age. The instruments used in these studies (Bruininks-Oseretsky Test of Motor Proficiency, Southern California Sensory Integration Test) also measured both static and dynamic balance . The more recent findings of insignificant differences between gender groups and the ability to balance for deaf people by Lindsey and O'Neal (1976), Brunt and Broadhead (1982), and Potter and Silvennan (1984) are consistent with those of researchers who examined this same relationship for people who could hear. Heath (1949), Goetzinger (1961), and Keogh (1965) found no significant difference between gender groups and the ability to balance. Only DeOreo and Wade (1971) and Morris, \Mlliams, Atwater, and Wilmore (1982) have found differences between genders in the abilities to balance. In these isolated cases, girls were superior to boys in the ability of static balance. In summary, in terms of age and it's relationship to balance, findings have consistently shown that balance improves with age. This result would seem obvious in light of the fact that with age comes practice and experience. Almost all of the studies affirm the positive correlation between age and balance. Marsh (1936), Myklebust (1946), ant and Broadhead (1982), and Butterfield (1987) found this to be tme. In fact. the results from Butterfield (1987) yielded mean performances that increased with age for both static and dynamic balance. These findings are consistent with studies of Heath (1949), Goetzinger (1961) and Keogh (1965) which were designed to measure the balancing abilities of people who could hear. How9ver, no positive conclusion can be drawn with respect to gender differences and balance, since the results of the studies are not completely consistent. Fundamental Motor Skills of the Deal The only published studies that have been revealed on the fundamental motor skills of deaf children were reported by Butterfield (Butterfield, 1986; Butterfield, 1987; Butterfield 8 Ersing, 16 1986) and Dummer, Haubenstricker 8 Stewart (1989). Butterfield (Butterfield,1986; Butterfield, 1987; Butterfield 8 Ersing, 1986) studied 132 children who were deaf between the ages of 3 and 14 years. The subjects were individually evaluated on the 11 gross motor items of the Ohio State University Scale of lntra Gross Motor Assessment (OSU SIGMA) (Loovis 8 Ersing, 1979). Using this scale, the fundamental motor skills were rated qualitatively from Level 1 (least mature) to Level 4 (most mature). For each skill, the 4 respective levels reflected sequential motor development, and a score of 1, 2 ,3 or 4 was awarded for the predominant motor behavior. Butterfield concluded that for the skills of kicking, jun'ping, catching, and hopping, the deaf displayed fewer mature patterns than expected for chronological age. Butterfield also concluded that cause of deafness did not affect the development of basic gross motor patterns. Chi-square analyses indicated no gender differences in performances of the fundamental motor skills. Dummer, Haubenstricker, and Stewart (1989) also studied the acquisition of fundamental motor patterns by deaf students. Like Butterfield (1986), they used a qualitative assessment tool, the Test of Gross Motor Development (T GMD) (Ulrich, 1985). Id {9.93.99.33.91 performances of 210 deaf youngsters, ages 3-22 years. Skilled performance on the TGMD is represented by attainment of all the criteria for a particular motor skill. Normative data is provided for the age at which 60% of nonhandicapped children attain all criteria for each locomotor and object-control skill. It was found that only on the skills of running, galloping, and sliding did the deaf students perform as well as their counterparts from the normative sample. Deaf youngsters demonstrated deficiencies in the other locomotor skills assessed by the TGMD: hopping. leaping, horizontal jumping, and skipping; and in each of the five object control skills: striking, bouncing. catching, kicking, and throwing. It was also noted that although the deaf subjects did not achieve mature skill levels on most skills by the same ages as the normative san'ple, their performance levels improved with increasing chronological age. In summary, Butterfield (Butterfield,1986; Butterfield, 1987; Butterfield 8 Ersing, 1986) found delays in the acquisition of catching, junping, kicking, and hopping. Dummer, Haubenstricker, and Stewart (1989) also found delays in the acquisition of skipping, striking. throwing. bouncing, 17 and leaping. The differences in the results of the studies could be attributed in part to the different assessment instruments used. Both tests used in these studies measured qualitative perfomiance attributes. However, the Test of Gross Motor Development (TGM D)(Ulrich, 1985) criteria for mature levels for some of the skills, throwing, in particular, are more stringent than the OSU SIGMA. Also, the skills of leaping and bouncing were assessed using the TGMD, but were not assessed by Butterfield. Relationship of Balance to Fundamental Motor Skill of the Deaf Although there have been numerous studies dealing with balance and motor ability, there has only been one study that has assessed the fundamental motor patterns as they related to balance of deaf people. This study resulted from the research done by Butterfield (1987). The primary purpose of the study undertaken by Butterfield (1987) was to describe the fundamental motor and static and dynamic balance characteristics of hearing impaired children ages 3 through 14. The Ohio State University Scale of lntra Gross Motor Assessment was used to assess qualitative performance differences. The Bmininks-Oseretsky Test of Motor Proficiency (Bruininks, 1978) was used to assess balance. The basic design for this study was a cross-sectional, correlation design whereby a set of predictor variables (age, sex, hearing loss. static balance. and dynamic balance) were correlated with level of fundamental motor skill performance (Level 1, 2. 3, 4, of the OSU SIGMA), the criterion variable. Data from the fundamental motor skill and balance assessments were subjected to linear discrininant analysis. From this analysis, stmcture coefficients were interpreted for the significant discriminant functions. Only stnlcture coefficients with a value greater than .30 were used in the interpretation. Butterfield (1987) found that the 132 children studied exhibited delays in the acquisition of mature skill levels in catching. kicking, junping, and hopping. but had achieved mature skill levels in other fundamental motor skills. Also, for al 10 skills, age. static balance, and dynanic balance gave meaning to the funch'on. For all 10 skills, the higher the SIGMA level, the older the child was 18 likely to be, and the greater her or his performance score in dynamic and static balance. Thus, a direct relationship between static and dynamic balance and motor skill development was discovered. Butterfield failed to identify any significant differences between males and females for any of the fundamental motor skills or balance tasks. Also, a significant difference among age levels favored the older groups. consistent with earlier findings. Butterfield (1987) found a direct relationship between static and dynamic balance and fundamental motor skill performance. Butterfield also found delays in the acquisition of the skills of catching, kicking, jumping. and hopping. Unfortunately, the skills of punting and galloping, two fundamental motor skills important to the success in specific games and sports, were not examined. Also. the Scale of Infra-Gross Motor Abilities (SIGMA) which was the assessment tool used to examine level of fundamental motor skill performance does not provide an adequate assessment of mature skill levels for some test items, in that the highest performance level possible for some skills falls short of a truly mature movement pattern. Summary In summary, as age increases, the ability to balance for both deaf and hearing children also increases. The majority of the studies that have examined the relationship between the ability to balance and gender have shown that no differences exist between males and females in terms of balance ability for hearing people. When experiments have controlled for IO and hearing loss. no difference in balance ability has been found between deaf males and females. Although age and gender are related to balance ability for deaf people as they are for hearing people, much research has shown deaf people to display deficient balance ability when compared to hearing people. The fundamental motor skill performances of boys and girls have been found to improve with age for both hearing and deal individuals. In terms of gender. hearing boys tend to attain each stage of overhand throwing and kicking earlier than hearing girls; whereas, hearing girls tend to attain each stage of skipping and hopping earlier than hearing boys. In the only study that has 19 examined the relationship between gender and fundamental motor skill for deaf people, no differences were found for boys and girls for any of the fundamental motor skills. Deaf people have been shown to be delayed in attaining mature levels of several of the fundamental motor skills as compared to hearing people. A Only one study has examined the fundamental motor patterns as they relate to balance of deaf people, although a more thorough understanding of the relationship between the ability to balance and perform fundamental motor skills may help to enhance the skills of deaf people (Butterfield, 1987). In this study, static and dynamic balance were found to be related to the performance of fundamental motor skills for deaf people. CHAPTER III METHODS This study used data collected by Dummer, Haubenstricker, and Stewart (1989). This investigator assisted in the collection of data for the Dummer et al. study. The performance of fundamental motor skills and balance skills of 210 deaf children were assessed. The subjects were students from two schools for deaf students, one in the United States (School A) and one in Canada (School B) who met the following criteria: a primary diagnosis of deafness (hearing loss of greater than 55 decibels); absence of significant motor, vision, behavioral, or teaming impairments; and parental consent. Additional data on degree of hearing loss, etiology of deafness, and age of onset of hearing impairment of these subjects were provided by school records. The sample of 210 children and youth included 93 girls and 117 boys aged 3-22 years. Subjects Ths subjects for this study were students from the larger group examined by Dummer et al. who met the additional criterion of chronological age of 4-12 years. See Table 3 for the distribution of subjects by age, gender, and school. The actual sample of 106 children included 56 girls and 50 boys aged 4-12 years. Degree of hearing loss could only be determined for 86 subjects, whose better ear average was 99.17 decibels. For 18 subjects the degree of hearing loss could not be assessed by an audological examination, and for 2 subjects the degree of hearing loss was not available in school records. The cause of deafness was unknown in 50% of the cases. genetic in 25%, meningitis in 11%, rubella in 8%. cytomegalovirus in 3%, and other causes (e.g., Waardenburg syndrome. anoxia, prematurity) in 4% (See Table 4). Age at onset was prelingual for 83%, postlingual for 9%, and unknown for 8% (See Table 5). 20 Table 3 21 School A (United States) School B (Canada) __Am F M F M 'LOIEL— 4 2 2 0 1 5 5 2 1 2 7 1 2 6 1 0 3 5 9 7 0 3 5 2 10 8 3 1 7 3 14 9 3 2 5 4 14 1 0 1 1 6 5 1 3 1 1 1 3 4 5 13 12 1 2 9 4 16 Total 14 15 41 36 106 Table 4 Causenltlearinuoss Cause :8 n Unknown 5 0 5 3 Genetic 25 2 6 Meningitis 11 1 2 Rubella 8 8 Other 4 4 Cytomegalovirus 3 3 Table 5 WW Acaatcnset Y: n Prelingual 8 3 8 8 Postlingual 9 1 0 unknown 8 8 22 Instrumentation The information in this section first describes the tests used to collect data and then presents the assessment instmments used to reduce the performances of balance and fundamental motor skill for data analyses. Staticbalame To test static balance, students performed a timed stork stand on the preferred foot with eyes open. The subjects stood on a flat, orange marker approximately 20 cm in diameter that was placed on the floor. Subjects stood on one foot, placing their hands on their hips and the ankle of their resting foot near their knee. A stopwatch was started when the ankle of the resting foot was placed near the knee and the stopwatch was stepped when the resting foot moved out of position. or when the support foot was moved from its original position. Students who could balance for longer than 10 seconds were motioned to stop their performance. Each subject was given two trials. All performances were videotaped to allow for further scrutiny. Whose Dynamic balance was assessed using a balance beam. The beam was trade of wood and measured 3.04 m long, 3.81 cm wide, and 15.24 cm high. A step was placed adjacent to the end of the beam. The top of the step was flush with the top of the beam. This allowed the subjects to take their first step \m'thout having to step up onto the beam. Subjects walked the length of the balance beam using heel-toe steps. The number of steps taken across the beam before the subject stepped off or stopped walking heel-toe were counted. Subjects could place their am in a way best suited to them. Each subject was g'ven two trials. All performances were videotaped for further examination. EundamentaLmotolesills Subjects participated in locomotor and object-control activities to determine level of fundamental motor skill performance. Perfomiances of the following skills were examined: 23 running, galloping, hopping, skipping, throwing, kicking. punting, catching, striking, and jumping. Running, galloping, hopping, and skipping were administered in an area designated for locomotor skills. Throwing. kicking, punting, catching, and striking were administered in an area designated for object-control skills. Jumping was administered in the area designated for balance assessment. All performances were videotaped. See Appendix B for a diagram of the testing facility. Banning. Subjects ran a 13.7 m dash. Cones were used to delineate the course. Subjects started behind a designated line. Subjects were cued to start by the action of the test administrator who stood near the finish line. Subjects started to mn when the hand of the test administrator was lowered. A brightly colored glove was worn so that subjects could view the start easily. Subjects ran as fast as they could through the course of cones. The entire performance from starting line to finish was videotaped. Each subject ran through the course two times. Galloping. Subjects galloped through a straight course approximately 13.7 m long. Subjects galloped, leading with their left leg, from starting line to finish line. Subjects then turned around and galloped, leading with their right leg, to the starting line. Each subject galloped through the course two times. flogging. Subjects hopped through a straight course approximately 8 m long. The subjects hopped to a designated line on their left foot. Subjects would turn around when they reached the designated line and hop back to the starting line on their right foot. Each subject hopped through the course two times. Skinning. Subjects skipped through a straight course approximately 13.7 m long. Each subject skipped to the finish line, stopped, and then turned around and skipped back to the starting line. Each subject skipped through the course two times. Wm. Subjects performed a standing long jurrp at the station designated for balance assessment. A starting line was taped onto a standard gym mat approximately 6 cm from the end of the mat and ninning parallel with the end of the mat. Subjects placed toes up to the line and jumped as far as they could along the length of the mat. Each subject performed three jumps. 24 mm. Each subject threw a ball the size of a softball. The subjects threw the ball as far as they could. The subjects stood in a designated area and threw the ball toward a wall on the opposite end of the gym. Each subject threw three balls. Mug. Subjects kicked a 20 cm playground ball off a fee. The subjects kicked the ball in the direction of the wall on the opposite side of the gym. Subjects were allowed to take preparatory steps before kicking the ball. Each subject kicked three balls. Bunting. Subjects punted a 20 cm playground ball. The subjects punted the ball in the direction of the wall on the opposite side of the gym. Each subject punted three balls. Canning. Subjects caught a 15 cm ball. The subjects were thrown a ball by the test administrator while standing in a designated area. Subjects were allowed to move their feet to catch the ball. Each subject attempted to catch three balls. Striking. Subjects attempted to hit a 20 cm ball. Subjects used a bat to hit the balls toward the opposite wall. Subjects were positioned adjacent to home plate. The test administrator threw underhand pitches to the subjects from a distance 013-5 m. Each subject attempted to strike three balls. Data Reduction Staticbalance The subjects best performance on the stork stand (i.e.. the performance that lasted the longest amount of time) was used for data analyses. The performances were qualitatively examined to detennine if the form displayed was appropriate. Excessive movement of the support foot would indicate the end of the performance. Placement of the non-support foot on the floor also indicated the end of the performance. The score for performance on the stork stand was then used to place the subject into one of two groups. A score of less than 10 seconds placed a subject into a group labeled “static nonbalancers". A score of 10 seconds or more placed a subject into a group labeled ”static balancers". Grouping the subjects as either ”static balancers” or “static nonbalancers“ allowed for chi-square analyses. 25 mm The subject's best performance on the balance beam (i.e., the greatest number of steps taken along the beam) was used for data analysis. The score for performance on the balance beam was then used to place the subject into one of two groups. A score of less than 10 steps would place a subject into a group labeled ”dynamic nonbalancers.“ A score of 10 steps or more placed the subject into a group labeled "dynamic balancers." The balance scale limitations of 10 seconds for static balance. and 10 steps for dynamic balance, were not chosen arbitrarily. Because the data was collected on videotape before this study was initiated. no change in the procedures for testing could be made. At the time of testing, subjects were told to stop balancing shortly after the 10 second mark. The time limit of 10 seconds was then used accordingly in this study. Also, because the length of the balance beam was 10 feet long, allowing some subjects (those with large feet) to take a maximum of 10 steps, 10 steps was chosen as the cut off line between dynamic balancers and nonbalancers. Neither tests of balance have been examined for reliability. This investigator timed and recorded all of the performances on the stark stand and balance beam from the videotape footage. The beginning or ending of a performance was not recorded on the videotape in only a few instances (na8) due to an error in filming the original performance. A referral was made back to the data collected at the time of recording in these instances. The score for the performance collected at the time of videotaping, that is, the number of seconds in static balance; the hunter of steps taken across the balance beam, was used for analysis. Wills To determine level of fundamental motor skill performance the Developmental Sequences of Fundamental Motor Skills Inventory (DSFMSI) (Haubenstricker 8 Seefeldt, 1976; Sapp, 1980; Seefeldt 8 Haubenstricker,1974; Seefeldt 8 Haubenstricker, 1976a; Seefeldt 8 Haubenstricker, 1976b; Seefeldt 8 Haubenstricker, 19760; Seefeldt, Reuschlein, 8 Vogel, 1972) (Appendix C) 26 was used. This test is a qualitative, criterion-referenced assessment tool. It detennines the quality of performance of the fundamental motor skills of mnning, hopping. jumping. skipping, galloping. throwing, catching, striking, kicking, and punting. This developmentally-based test divides each skill into sequential performance stages. The lowest stage, Stage 1, refers to the least mature stage, and the highest stage, Stage 3, 4, or 5 (depending on the skill), refers to the most mature stage. Each stage is defined by performance criteria stated in behavioral form. For example, in the skill of hopping, one who displays a Stage1hop would have an erect body, arms held at shoulder height. and the nonsupport leg held in front of the body with the thigh parallel to the floor. A person whose hop was labeled Stage 4 would display a substantially greater amount of body lean. arm opposition with swing leg, hands held at waist level or below, and the thigh of the nonsupport leg held vertically with the foot behind the support leg. Figure 2 illustrates the criteria for each stage for the skill of hopping. Stalls Damnation 1 Thigh of nonsupport leg held anterior to body and parallel to surface, haids held near shoulder heigli, Ittle dstance actieved 2 Thigh of nonsuport leg held lower in front in a diagonal position with foot nearbuttocks, trurft incinesforward, bilateral armforce 3 Thigh of nonsupport leg is vertical with knee flexion of 90 degrees or Iess,tn.irf