Middle East Journal of Family Medicine

Arzu Yukselen* Ph.D, Ozcan Dogan* Ph.D, Figen Turan Ph.D *, Zeynep Cetin*Ph.D, Mehmet Ungan Asscoiate Professor**

*Hacettepe University Department of Child Development and Education, Professional of Child Development and Education, 06100-Ankara, TURKEY
**Middle East Technical University Medical Centre and Faculty of Education, Department of Elementary Education, 06530- Ankara, TURKEY

Correspondence to:
Zeynep Çetin,Ph.D
Hacettepe University Department of Child Development and Education
06100 Samanpazari -Ankara/ TURKEY
Tel: 90-312-3051837
Fax: 90-312-3053053
E-Mail: zcetin@hacettepe.edu.tr

ABSTRACT

Purpose: The purpose of this study is to test the effects of physical training in motor skills in mentally retarded children. Throughout this process various types of motor skills are used.

Methods: Twelve mentally retarded children aged between 3-6 years participated in this study between March and June 2006. This study was performed in a pretest-training-posttest design. Children were trained and than scored on 11 fundamental movement skills based on the motor development part of the Portage Early Childhood Education Program Control Lists by a single observer. An exercise program was recruited for those children and they participated in this program during 26 sessions.

Results: Statistically significant differences were found in walking, running, jumping, balance, trampoline, rope-ribbon tests and obstacle set skills in pre- and post-test results (p<0.01).
Conclusion: In this sample and setting, training of the fundamental movement skills support motor development of mentally retarded children.

Key words: motor development, motor skills, mentally retarded children.

Whether mentally retarded or normally developed children, it's widely believed that fundamental movement skills and habitual physical activity are related in childhood ^{(1, 2, 3, 4, 5)}. Second year children relate to their environment and by the end of the second year, they have become skilled in the rudimentary movement skills that are developed during infancy⁽⁶⁾. Preschool and kindergarten children are developing their fundamental movement skills in a wide variety of stability, locomotor and manipulative movements. The development of fundamental movement skills is basic to the motor development of children. A wide variety of movement experiences provide them information on which to base their perceptions of themselves and the world about them. Motor development of the children is related to neurodevelopment^(7,8). Mentally retarded children generally have decreased motor developmental reflexes, increased basic reflexes, delayed upper level balance and balance reaction and slow down of the mental reactions⁽⁸⁾. Insufficient physical activity and problem in body awareness are effective in the motor development of the mentally retarded children^(9,10,11). There is still no consensus in the literature on the methods that should be used to assess the physical activity or the definition of fundamental movement skills in young children. The aim of the current study was to determine the effects of physical training in motor skills in preschool mentally retarded children.

12 mentally retarded 12 children aged between 3-6 years (7 girls, 5 boys) who are the students of a special government Education School in Ankara were included in this study between March 2006 and June 2006. Informed written consent was obtained from the parent of each child. Fundamental movement skills were measured by using 11 tasks based on the motor development part of the Portage Early Childhood Education Program Control Lists^(12,13). Tests were done before and after treatment. The test involved a set of 11 tasks: walking, running, jumping, cushion, ball, balance, obstacle set, bicycle, stairs, trampoline and rope -ribbon. Walking and running parts were composed of 6 items, jumping and stairs 4 items cushion 10 items, ball 11 items, balance 9 items, obstacle set 5 items, bicycle and trampoline 3 items, and rope-ribbon 11 items. Then children participated into the 26 session's gymnasium education program which was recruited for their individual and motor skill needs. Group gymnasium session included 3 parts:

a. Warm-up movements (5-10 minutes): Movement fascinating activities, functional activities.
b. Group activities (20-30 minutes): Group activities were composed of 11 stations from easy to difficult motor movements, as described below.
c. All class activities (5 minutes): This 26 session's education program was applied to the children in groups twice a week. Portage Early Childhood Education Program. Control list motor development part was used pre and post education programs⁽¹³⁾.

The program was composed of walking, running, jumping, cushion, ball, balance, obstacle set, bicycle, stairs, and trampoline and rope-ribbon stations. Each skill and station was composed of a series of motor skills designed from easy to difficult:

Walking;
1. Forward walking with rhythm tools,
2. Backward walking,
3. Side walking,
4. Forward and backward walking with walking bands, doormat and etc.,
5. Forward and backward walking across the balls,
6. Walking between various types of walking bands

Running;
1. Forward running in slow and fast speeds with rhythm tools,
2. Backward running in slow and fast speeds,
3. Side running,
4. Running with walking bands, doormats etc.,
5. Forward and backward running between balls,
6. Running between various types of walking bands.

Jumping;
1. Jumping with both legs,
2.Standing on one foot,
3. Jumping from higher place to the floor (20 cm),
4. Jumping from the foot-ankle height rope,

Cushion;
1. Creep,
2. Crawl,
3. Jump,
4. Roll,
5. Stand-forward,
6. Glide-side,
7. Crab walking,
8. Wheel barrow walking,
9. Duck walking,
10. Somersault,

Ball;
1. Reciprocal forward ball rolling,
2. Backward ball-rolling,
3. Ball sliding-both hands,
4. Ball sliding -one hand,
5. Kicking the ball-standing,
6. Kicking the ball-moving,
7. Throwing the ball,
8. Catching the ball,
9. Throwing the ball to the target,
10. Jumping the ball while standing on knees,

Balance;
1. Walking between two lines,
2. Walking on the single line,
3.Walking on the balance board (forward-backward),
4. Walking on the balance board while looking forward,
5. Walking on the balance board with the ball,
6. Lift the leg forward on the balance board,
7. Lift the leg backward on the balance board,
8. Creep on the balance board in the prone position,
9. Walking at the bottom on the balance board,

Obstacle set;
1. Passing between the wall and bar,
2. Passing over the obstacle,
3. Passing below the obstacle,
4. Creep under the obstacle in the prone position,
5. Passing through the obstacle,

Bicycle;
1. Moving by pushing feet without using pedals,
2. Putting feet on to the pedals,
3. Moving by pushing pedals,

Stairs;
1.Walking through the stair gaps (fast),
2. Walking through the stair bars,
3. Descending stairs,
4. Ascending stairs,

Trampoline;
1. Vertical jump while supporting with both hands,
2.Vertical jump while supporting with one hand,
3. Vertical jump without support,

Rope-ribbon;
1.Turning the rope in front (left to right),
2.Turning the rope in front (right to left),
3.Turning the rope in front (left to right),
4.Turning the rope in front (right to left)

Each task was shown and demonstrated and each child was tested and scored individually. Single trained observer gave 1 point if the test was not performed or 2 points if the test was performed with help and 3 points if the test was performed correctly.

Data Analysis
Wilcoxon statistical analysis system was used to compare movement skills levels before and after the program. Significance level was set at p<0.05.

Statistically significant differences were found in walking, running, jumping, balance, trampoline, rope-ribbon tests and obstacle set skills in pre and post test results (p<0.01). Nine of ten cushion movement skill scores were significantly different between pre and post test results (p<0.05). Only in the second item (crawling) there was no statistically significant difference found (p=0.83). In the statistical analysis of ball skill test results, significant differences were found in 10 out of 11 tests (p<0.01). Bicycle skills were significantly different between pre and post test results (p<0.01) except in the first movement (moving by pushing feet without using pedals) (p=0.083). In stair tests 3 out of 4 items were found significantly different in pre and post test results (p<0.05) except in the 4th item (stair climbing) (p=0.059) (Table 1).

The present study suggests that training of mentally retarded children in functional movements is beneficial for the development of fundamental movement skills⁽¹⁴⁾. Children who spend time in motor activities as described by their educators, tended to have higher results after the education program.

Our results tend to support the results expressed by Halle⁽⁶⁾. They found a statistically significant increase in physical activity and skills in minimally mentally retarded children aged between 6-11 years. However our observation marked some differences in stair climbing and moving by pushing feet without using pedals on bicycles before and after the education program. In the study of Centers et al, both normal and mentally retarded children were taken to the motor skills educational program for 5 months, 4 days per week during 40 minute sessions⁽¹⁵⁾. They found a statistically significant increase in motor skills of both groups. When we compare these results with ours, the duration of training in educational program in their study was seen to be longer.

Our findings are also similar to those of Johnson et al⁽¹⁶⁾ who had taken 15 mentally retarded children into the physical activity program. They found improvement both in physical and social skills.
Our observations tend to support the view expressed by Botha, that exercise programs improved the motor skills of mentally retarded children⁽¹¹⁾.

It is possible that gender differences might exist at the end of the education program based on the fundamental movement skills^(1,3,4). Girls performed more successfully in balance and boys performed better in running and jumping tasks. This result has been demonstrated previously in preschool children^(3,17). However we did not analyze gender differences in the main analyses because of the small number of the study group. It can be more beneficial to analyze the gender differences. and future studies are needed in a larger group of mentally retarded children.

It can be said that organization of gymnasium programs, proper to the motor development levels of mentally retarded children can improve fundamental movement skills of these special children. At the same time it's possible to say that these results can positively affect the body awareness and self confidence of mentally retarded children.

The present study showed that group exercise programs had positive effects on the improvement of motor skills.