Four-Card Object Assembly

These tasks require cards similar to the ones used in the “two-dimensional” version of the Kohs method; namely, cards with two types of squares pictured on them, which are either painted with only one color or divided diagonally into two parts of two different colors. The cards used in the tasks in this chapter are black and white, but they can be red and white, and blue and yellow (similar to Kohs blocks). If the leader constructed a house using black and white cards first, the next time he or she might change the colors of the cards to make it look like a new task. In all tasks of this type a leader uses the cards to put together a model and children then copy it, but first they jointly analyze the cards and the model.

In Task 1, “Find Using the Model,” the child adds the cards according to the model (see Fig. 15.1).

In Task 2, “Take a Look and Tell,” the child answers questions about the model; for example, “What part is colored on figure number three?” (upper left); “And what about figure number four?” etc. (see Fig. 15.1).

In Task 3, “A House,” a set of cards (cards number one through six) and a picture of the house are laid out in front of the child (see Fig. 15.2). The child is given the following instruction: “Look at the house and show me the cards you need to build the house just like it. Now build the house.” The instruction helps direct the child's attention to the analysis of the model and prevents a trial-and-error approach to the task.

In Task 4, “A House and a Pine Tree,” the child is instructed to choose the cards for the house and build it and then to choose the cards for the pine tree and make it (see Fig. 15.2). So as not to repeat Task 3, the leader changes the color of the house.

In Task 5, “Rotating the Cards,” four cards divided diagonally are laid out in front of the child (see Fig. 15.3). The child is then given another diagonally divided card and asked, “Can this one be similar to the first card? Put it on the table in such a way that they look the same. Now try matching it up with the second card. What did you do with the card?” (I rotated it).

The child then works in a similar way with the third and the fourth cards. This strategy helps lead the child to the conclusion that any of the four versions of these cards can be obtained by rotating one card.

After that the child is given the following instructions: “Let us draw the four cards. Here is a square. We connect the opposite corners of it and color one of the halves” (The psychologist marks the two corners and the child connects them with the line).

In Task 6, “Guess the Card,” the same four cards are laid out in front of the child (see Fig. 15.3). The psychologist instructs the student, “I thought of a card and I want you to find it. Its upper left corner is red. Now find me another card. This card's lower left corner is red. Now find a card that has a red lower right corner.”

In Task 7, “Think of a Card,” the child and the psychologist sit next to each other, and the same four cards are put in front of them. The child is given these instructions: “Think of a card, describe it for me, and I will try to find it. (The verbal description of cards is practiced similarly to how it was done in the previous task.)

Here are the instructions for Task 8, “Make a Flower”: “Make a flower like this one. Tell me where the red corners will be” (for the first card they should be in the lower left corner, for the second card.…, etc.; see Fig. 15.4).

In Tasks 9–12, “Construct a Figure,” children construct a butterfly, a sand watch, a little bow for a girl's braids, and a window. If a student starts having difficulties, he or she is asked to point out where the colored corner is on the model (see Fig. 15.5). The psychologist monitors the number of tasks and the repetitions, which depend on the child's tiredness and how well he or she has mastered the material. Tasks that involve competition or in which children are asked to think of their own figure are very effective in helping them master the material.

In Task 13, “Draw a Figure,” the child is asked, “Can you remember the figures that you constructed today?” (The child then goes over them). “Can you draw the figures that you liked?” (The child is given a piece of paper with four squared frames that each are divided into four parts by horizontal and vertical lines). If the student experiences difficulties remembering or drawing the pictures, the model is used to help the child (see Fig. 15.5).

In Task 14, “Make a Diamond,” the cards are laid out in front of the child and positioned in such a way that they look like a diamond (with the corner down as opposed to one of the sides down, as in prior tasks). The model of the figure is also presented to the child (see Fig. 15.6). The following instruction is given: “You already know how to construct figures really well. Try to make a figure like this (pointing to the model). Did you notice how the cards are positioned?”

In Tasks 15–16, “Make a Bow and a Boat,” the child is asked to make a bow and a boat. If necessary the psychologist can help the child recognize a bow (a bow for a girl and a bow tie for a man) and a white boat with sails and highlight the outlines of one or each of the four cards for them (see Fig. 15.7).

Eight- to Ten-Cards Object Assembly

For all tasks in this section the child is given a model and cards similar to the “two-dimensional” Kohs cards.

In Task 1, “Candy,” the psychologist tells the child, “Did you recognize what this figure looks like? How many cards do you think you will need to make a figure like this? How many cards of the same color? How many two-colored cards? Choose the color and put the ‘candy’ together please” (see Fig. 15.8)

In Task 2, “Chocolate Candy,” the instruction for the child is, “This candy is a chocolate candy. Let us put it together. How many and what type of cards do you need? Choose them and make the candy” (see Fig. 15.9).

In Tasks 3–4, “A Boat and a Fish,” those figures are constructed in a similar way (see Fig. 15.10).

In Task 5, “Drawing a Figure from the Model,” the child is instructed as follows: “Which figure did you like the most? Let us copy it.” After that the child is given an empty frame consisting of 8 or 10 pieces.

Use of Lego Dakta

To complete these tasks you will need either a Lego Dakta set or something similar (one that uses plastic bricks for mosaics; see Fig. 15.11).

In Task 1, the child sorts the figures from the Dakta set by shape according to the sample shown in Figure 15.11.

In Task 2, the game “Remember,” this instruction is given: “Which one of the figures do you like most of all?” (The child points to the figure and names it). “Pick all the similar figures” (see Fig. 15.11).

The teacher or another child then picks all the figures of any other shape. The figures are turned upside down, and everyone plays the memory game in which each player turns two figures face up. If they are the same the player keeps them and continues to turn the figures face up. If the two figures are different, the player turns them back over and ends his or her turn. The player who collects the most pairs of figures wins. Another version of the same game is for every player to choose a “favorite” figure, and at the end the player who collects the highest number of favorite figures wins.

In Task 3, “Find the Missing Piece,” the child is shown a card from the Lego set and is asked to finish assembling “a pine tree,” a pattern, or “a boat”; in other words, the child needs to find one piece missing from each figure (see Fig. 15.12).

The child is then given this instruction: “Now let us put together one more pattern. Take the figure (brick) that has a red lower left corner. Now, underneath it put the figure that has a red upper left corner. Did you guess what pattern we are making? Please, finish it. Are you finishing the right or the left half?”

In Task 4, “Let Us Build a House,” The child is shown a card (see Fig. 15.13) and told, “This is a house. It has three floors and three rooms on each floor. The house would look nicer if the figures of the same color occupy the same floor; for example, all the greens are on the first floor. Build the first floor. What color will be on the second floor? What about the third? You built a very nice house. What is the color of the figures that live above the green ones? What is the form of the figures to the right of the middle room? What is the form of the figures to the left?”

The instruction for Task 5, “Snake,” is “Let us make a snake. What kind of head does it have? Put this piece in the upper left corner of the panel. Now let us make its body and its tail. Put the next piece in. It has to be different from the previous one either by color or by shape. For example, any red figure can be used after the red triangle except for a triangle. But if you choose the same shape, it has to be a different color from the previous one. There are two players in this game and they take turns. The player who makes a mistake loses the turn.” This task is good for developing not only visual-spatial functions but also executive functions.

In Task 6, “Steam Engine,” the child is shown a model and pieces from Lego Dakta set (see Fig. 15.14) and is told, “Make a steam engine. Start with the chimney. Keep adding pieces and tell me where you are putting them (under, over, to the right, etc).” After that the child is given a piece of graph paper (with large rules) and asked to draw a steam engine.

In Task 7, “Using a Smaller Size Model,” the child is given a picture to serve as a model and all the pieces necessary to construct an object (see Fig. 15.15). The instruction to the child is, “Let us figure out what is pictured here (a pine tree, the sun, a fence, and a gate). Let us build the gate. What kind of blocks will you need for the lower part? What about the upper part? Put them on the panel.”

The other elements of the picture are put together in a similar way. Thus the child is learning the strategy of reading the elements of a model in an orderly fashion.

“White and Black Squares” Method

In this method, the child is given a frame with nine white squares and nine black panels with handles. The child completes patterns by either putting in or removing these panels from the frame. The size of the panels (11 × 11 cm) and the presence of the handles make it easier for children with motor difficulties to complete the task (this method was originally created by the Finnish psychologist, M. Saarela; for more details see Pylaeva & Akutina, Reference Pylaeva and Akhutina2000 R, or Chapter 14).

In Task 1, “Getting to Know the Material,” the child is given the following instruction: “Take all the panels off and count all the squares. Find the central square, then an upper row, a lower row, and a row to the right and a row to the left. How many squares are there in each of these rows? Find the upper left square, the upper right square etc. Put the black square in the middle. Now put it in the upper left corner” (see Fig. 15.16).

In Task 2, “Build a Figure,” the child is shown a model on cards that are smaller than the frame and asked to make figures one after the other (see Fig. 15.17).

In Task 3, “Building by Memory,” the instruction is, “Remember the figures you built and build them again by memory” (see Fig. 15. 17).

In Task 4, “Make Letters,” the child is given a model and asked whether he or she recognizes the letter. After that the child is asked to make the letter using the blocks. Then the child is shown several models in sequence and puts these letters together (see Fig. 15.18). The child can be asked, “What word can you make out of these letters?”

In Task 5, “Making Letters by Memory,” the child is given this instruction: “Remember the letters you made and make them again in the same order. What was the first letter you made? What was the second?” etc.

In Task 6, “Drawing by Memory,” the child is given a piece of graph paper with the following instruction: “Let us draw these letters. First draw the frame.” (If the child starts to experience problems, the psychologist marks the key points of the frame, and the child draws it and divides it into parts with the psychologist's help.) “Now draw this letter. Choose the pencil of your favorite color. Which squares are you going to color? Now use a different color to draw another letter, but first prepare the frame.”

In Task 7, “Building Familiar Figures,” the child is given a sequence of samples and asked what these samples look like (stairs, white and black crosses; see Fig. 15.19). The instruction for this assignment is, “Make a staircase. Tell me, where did you put the black squares?” (in the lower left corner, etc.). The other two objects are constructed in a similar way with verbal explanations. After finishing the third figure the leader can ask: “What has to be done to make a part of chess board out of this figure?”

In Task 8, “Figure Quiz” (dictation of figures), the child is given a card, and he or she gives the psychologist instructions on what needs to be done to build the figure on the card; for example, put the black square in the lower left corner, etc. (see Fig. 15.20). Other samples can be used for this task as well. The psychologist can “make mistakes” while completing the task.

In Task 9, “Figures Identification and Memorization,” three cards with sample figures are laid out in front of the child (see Fig. 15.21). The psychologist copies the middle figure on the panel and says to the child, “Show me the figure I made. Look at it closely. Now make it yourself.” After that the psychologist shows and asks the child to recall from memory first Figure 1 and then Figure 3. One figure can be made and the other one drawn.

In Task 10, “Practicing Visual Measurements,” the child is given two sample cards (see Fig. 15.22) and asked, “Name the letters that are pictured on the cards” (“T” capital and “t” regular). “Make the big letter. You've done it and it was easy for you. Now try making the small one.” In case of difficulties the child is given the following hint: “See where the border for the panels is.”

In Task 11, “Making Shifted Figures,” the child is given a sequence of samples and asked what these samples look like (a pyramid, a well, a target, and a mill; see Fig. 15.23). The child builds the figures using the sample and then repeats it from memory. It is possible to practice these tasks further in a graphic format.

We used the complex of construction tasks presented here for developing visual-spatial functions not only in preschool and first-grade students (see Chapter 14) but also in 8- to 14-year-old children with pronounced delays in the development of spatial functions. In the next chapter we describe the use of these methods to prepare children with cerebral palsy to use computer games aimed at developing spatial functions.

Figure 15.1. Four-card task assembly, Tasks 1 and 2.

Figure 15.2. Four-card task assembly, Tasks 3 and 4.

Figure 15.3. Four-card task assembly, Tasks 5–7.

Figure 15.4. Four-card task assembly, Task 8.

Figure 15.5. Four-card task assembly, Tasks 9–13.

Figure 15.6. Four-card task assembly, Task 14.

Figure 15.7. Four-card task assembly, Tasks 15 and 16.

Figure 15.8. Eight- to ten-cards object assembly, Task 1.

Figure 15.9. Eight- to ten-cards object assembly, Task 2.

Figure 15.10. Eight- to ten-cards object assembly, Tasks 3–5.

Figure 15.11. Lego Dakta, Tasks 1 and 2.

Figure 15.12. Lego Dakta, Task 3.

Figure 15.13. Lego Dakta, Task 4.

Figure 15.14. Lego Dakta, Task 6.

Figure 15.15. Lego Dakta, Task 7.

Figure 15.16. “White and Black Squares” construction method, Task 1.

Figure 15.17. “White and Black Squares” construction method, Tasks 2 and 3.

Figure 15.18. “White and Black Squares” construction method, Task 4–6.

Figure 15.19. “White and Black Squares” construction method, Task 7.

Figure 15.20. “White and Black Squares” construction method, Task 8.

Figure 15.21. “White and Black Squares” construction method, Task 9.

Figure 15.22. “White and Black Squares” construction method, Task 10.

Figure 15.23. “White and Black Squares” construction method, Task 11.

Method

All study participants were undergoing treatment at the Gorki Leninskie Remediation Institute and were diagnosed with cerebral palsy. Fifty-one children aged 8–14 participated in the experiment. After the clinical assessment and preliminary discussion, the children were divided in pairs based on similar assessment results. One child from each pair was assigned to the experimental group and the other one to the control group. Six of the 51 children left the study prematurely, so that complete data were collected on 23 children in the experimental group and 22 children in the control group. Both groups included children with diplegia, left-side and right-side hemiparesis, and mixed (spastic/ataxic) form of CP (in the experimental group the number of children with these abnormalities were 13–2–1–1; in the control group, 14–6–1–1, respectively). Three children in the experimental group (but none in the control group) had the hyperkinetic form of CP. Additionally, there were two wheelchair- bound children in the experimental group and none in the control group.

Children from both groups underwent the standard rehabilitation course (medication management, physical therapy, etc.) at the facility. In addition, children in the experimental group participated in the interventions using experimental methods, which took place in twice-weekly to three times a week sessions over a 5-week period; each session lasted from a half-hour to an hour. The children from the control group were invited to play computer games during the same period of time. Children's spatial functions were tested before the beginning of the experiment and after its completion using computerized methods and tests that we developed and included as part of the neuropsychological assessment. Full neuropsychological assessment and testing using Raven's matrices were conducted only once at the beginning of the experimental course.

We created the course of remedial-developmental education based on Vygotsky-Lurian methodology. It started with preparatory games and assignments. After Lesson Five, computer games were added to the set. The number of supportive lessons depended on how successful children were in completing the program. In total children had between 15 to 30 half-hour supportive sessions. The number of computer assignments also depended on how fast children were able to learn the games; the average number was eight. All tests and remedial interventions were conducted individually in a separate room.

Supportive tasks. The goal of these assignments was to strengthen spatial concepts and to develop verbal regulation of spatial actions; in other words, to develop spatial and executive functions necessary for solving spatial problems. During the completion of these tasks the concepts of “top,” “bottom,” “forward,” “backward,” “to the right,” and “to the left” from the child's point of view were either introduced or practiced. Combinations of several of these concepts were also introduced or practiced; for example, upper right corner, etc. The movement commands (“forward,” “stop,” “turn right”) were learned separately.

All games were arranged in order of gradually increasing demands on spatial functions and regulatory speech function. The educational material was freely modified to maintain children's interest in the tasks. The set included the following games: “Construct the Figure” (with figures made from cards, Lego pieces, and wooden panels used in the “Black Squares” method; see Chapter 15); “The Flight of the Balloon” (see Task 1 in Chapter 17); “Postman” (both games use a metal board); graphic dictations; and “Teacher and Robot.” Each game-task allowed for a wide range of movements.

For example, in the “Construct the Figure” task the children did the following actions:

1. Frame and sample analysis, constructing figures using samples and from memory

2. Searching for the sample of smaller size

3. Constructing a figure using the smaller size sample

4. Outlining the contour of the figure and coloring the figure

5. Constructing the figure from the smaller size pieces

6. Drawing the frame and the smaller size sample on the graph paper

In addition, the children completed a set of pencil-and-paper tasks of varying levels of complexity on recognition, copying, and recall (using a sample or by memory) of different spatial structures (the separate tasks and sets of tasks presented earlier).

Computer development games. An IBM-PC computer was used in this part of the study. The assignments were designed using the software package, Superscape. Children sat in front of the 40 × 30 cm monitor at a comfortable distance (about 40 cm) away. Movements in virtual space (forward, backward, turning right and left) were conducted by the trainer as directed by the subject. All movements were conducted at the same slow speed and would end once the command to stop was received from the child. Actual copies of the mazes (see the later discussion) were made using plastic magnetic chips (to build walls) that were placed on a 40 × 40 cm metal surface.

The idea behind the computer methods was to model the same spatial tasks (mazes) using different means so that generalization of spatial skills would occur. Children were presented with the following three tasks:

1. navigate in a computer-generated two-dimensional labyrinth

2. create a toy copy of the labyrinth and navigate it

3. use the virtual three-dimensional labyrinth and the toy copy for navigation. (A labyrinth with the same structure was used in all three tasks.)

The goal was to reach a tree inside a maze (the tree was either in a virtual format [two- or three dimensional] or made of wood). The lesson started with the two-dimensional computer game: the child moved a “ladybug” toward a tree that was visible, giving the trainer commands (“forward,” “stop,” “turn right”) based on their (the child and the trainer) common point of view. In the second task the child built a model of the maze using plastic strips with magnets inside them and moved the toy toward the exit. In moving the “ladybug,” the “turn right” command was interpreted as a turn in the direction of its right front leg. This was done so that the commands in all three types of tasks were the same, eliminating multiple interpretations.

In the third task the children practiced movements and reaching a goal in virtual space, using the real model for support. In this task the “point of view” of the player was moved in the virtual environment horizontally below the edge of the labyrinth's walls. The walls of the labyrinth blocked the small tree, and it was visible only from the close proximal point. The structures of the labyrinth, which were similar for all three tasks, gradually increased in complexity as the remedial interventions progressed (the examples of the two-dimensional labyrinths are presented in Fig. 16.1).

An additional fourth task was offered to those students who completed the entire course of the “labyrinth” assignments. It consisted of the six different versions of a virtual park with an object (a small weathervane) hidden in a ditch that could only be seen from a close distance. The “map” of the park was available for all six versions, and the place where the object was hidden was marked. Also marked were locations of two landmarks that were large enough to be visible from any spot in the park. Starting from some arbitrary point the student was supposed to find the hidden object (for a more detailed description of this method, see Akhutina, Foreman, et al., Reference Akhutina, Foreman, Matikka, Narhi, Pylaeva and Krichevets2003; Akhutina & Krichevets, 2002 R).

Assessment of Spatial Functions’ Dynamics

To assess the effectiveness of the remedial interventions we used two computer tests that we designed for this purpose and neuropsychological trials that did not require graphic activity. Before the remedial interventions we used Raven's matrices to compare children in the experimental and control groups.

The following computer methods were used for the assessment:

Computer version of Kohs Blocks: In the right half of the screen the subject was shown a configuration consisting of three kinds of squares: all white, all red, and squares divided diagonally into red and the white parts. The same squares were presented in the left part of the screen, but in a different configuration. The goal of the assignment was to re-create the configuration shown on the right in the left part of the screen. The subjects could give the following commands: “up,” “to the right,” “to the left,” “down,” “turn,” and “change the figure.” A 22.5-degree turn to either side was conducted after each command. The tasks were divided into four categories based on complexity, which depended on whether the following were present:

1. The borders of the squares coincided/did not coincide with the borders of the colored fields.

2. The sides of the squares were parallel to the sides of the screen or were positioned at a 45-degree angle to the screen (“diamond” position).

The results were assessed using five scales that measured the quality of the subject's reproduction of the general Gestalt, ability to orient the main parts in relation to the screen, the presence of space between the squares, etc. The child could receive scores from zero (correct) to two (completely incorrect) on each scale.

Computer tasks on constructive praxis. Children were shown images of two clowns that were symmetrical along the vertical axis of the screen. The subject was asked to memorize the image and its “reflection.” After one minute the left image was removed, and in the lower left part of the screen the pieces of the image were displayed (the arms, the body, the legs, and the head). The arms and the legs were displayed in two positions (created by the positioning of hands and soles). The same commands as in the previous task were used to move the figures (see Fig. 16.2 for the test results for one of the subjects). The results were also assessed using five scales to evaluate how well the subject reproduced the general Gestalt, ability to orient the main parts of the body, the angles of different parts of the clown, ability to orient the arms and the legs, and the distance between the elements that were supposed to be connected. The scores on each scale were from zero to two. The assessment of the results was conducted by a group of experts who did not know to which group (control or experimental) the subject belonged.

Neuropsychological trials included the following methods:

Benton's test on line orientation (Benton, Hamsher, Varney, & Spreen, Reference Benton, Hamsher, Varney and Spreen1983). This test was used to assess visual-spatial perception. The children were presented with five angled lines and asked to find the line with the same angle as the line on the control card. The number of incorrect segments determined the penalty score. Single scores were then added up to receive an overall score.

Subtest “Arrows.” This subtest from the neuropsychological battery for children, NEPSY (Korkman, Kirk, & Kemp, Reference Korkman, Kirk and Kemp1998), was also used to assess the orientation of the lines. Each task consisted of a picture of eight arrows and a target. The subject was asked to identify the arrow that was aimed at the target (there were two on each form).

“Paths.” The test, which was created at the Institute of Pre-school Education AO USSR and also included in NEPSY, measures visual-spatial relationship perception and ability to use the diagrams of the routes. The number of correct answers is recorded (maximum 10).

Results

Both groups had similar gender (52% males in experimental group and 55% in control group) and age composition (identical means of 9.7 and standard deviation of 1.6). No significant differences in scores between the groups were noted in the Raven's matrices.

The data on spatial trials before and after the remediation course were normalized based on pre-intervention data so that it could be used in the statistical analysis. No differences between the groups in regard to spatial functions were identified before the remedial training.

Correlation analysis showed significant negative correlation between the state of spatial functions before the remedial course and improvements in this measurement in both groups through the course of the experiment (r = −0.51; p < 0.001). To control for this, we included the variable, pre-training score, in the later analysis as a covariate. The dispersion diagram is presented in Fig. 16.3.

To analyze the efficacy of the treatment, we used the dispersion analysis (ANOVA), with the dependent variable, “improvement in testing summary indicator”; the independent variable, “experimental/control group”; and the covariant described earlier. Both groups demonstrated improvement: t-criteria for the control group showed t = 5.71, df = 21, p < 0.001; for the experimental group, t = 8.65, df = 22, p < 0.001. However, for the experimental group the progress was more significant (ANOVA, F = 5.35, p = 0.0026).

Discussion

This experiment showed that spatial functions in children with difficulties in motor area could be improved by using the battery of tasks described in this chapter. The results coincide with earlier observations that the navigational experience in virtual reality in both children and adults is particularly effective for the development of spatial functions (Foreman, Stanton, Wilson, & Duffy, Reference Foreman, Stanton, Wilson and Duffy2003; Foreman, Stirk, Pohl, Mandelkow, Lehnung, Herzog, & Leplow, Reference Foreman, Stirk, Pohl, Mandelkow, Lehnung, Herzog and Leplow2000; McComas et al., Reference McComas, Pivik and Laflamme1998; Stanton et al., Reference Stanton, Wilson, Foreman and Sharkey1996).

Unlike the pilot study (where the children with underdeveloped spatial and regulatory functions were not successful in mastering computer navigation games), in the main experiment progress was noted in all children; it was especially pronounced in children with a low baseline level (indicated by a high negative correlation between the baseline and the improvement). With the aid of additional supportive tasks all children managed to internalize spatial concepts and to operate successfully in the new environment. Their success attests to the advantages of interactive education and the effectiveness of methods created on the basis of Vygotsky-Lurian methodology.

In both the pilot and the main experiment all students underwent the standard rehabilitation process, and therefore improvement of the indicator tested was noted in both groups; however, it was significantly higher in the experimental group. This fact clearly attests to the usefulness of this remedial course.

We only have limited data on the improvement in the students’ general level of functioning after the completion of the remedial course. However, anecdotal evidence we obtained from teachers, nurses, and parents attests to the positive influence of the training on the children's successes at school. The extent of the positive influence of spatial functions training on general life skills and mastering of the school program deserves separate consideration.

Figure 16.1. Examples of two-dimensional mazes: simple maze (left) and medium difficulty maze (right).

Figure 16.2. The sample (right) and results (left) of the computer task on constructive praxis: “the clown” before (upper picture) and after (lower picture) the remedial course.

Figure 16.3. Dispersion diagram for the test results: horizontal axis – pre-training score, vertical axis – difference between pre- and post-training scores. O – experimental group, ▼ – control group.

Task 1: Orienting on a Piece of Notebook Paper

A child is asked to find the middle point (center) on a piece of notebook paper and to draw a balloon. The child is then given the following assignment: “The balloon flies upward. Draw a line to where it flew and draw a balloon above, in the upper part of the paper.” The psychologist emphasizes the keywords (in italics) by his or her voice. The child then practices drawing lines and balloons in other directions: the balloon “flies” to the upper left corner, upper right corner, etc. (see Fig. 17.1). At the next session the child is asked to draw a butterfly or a leaf and perform similar actions.

The next step is to transition to a more complex picture. “Draw some grass at the bottom, a mushroom in the lower left corner, a cloud in the upper part of the paper, and the sun in the upper right corner.”

Task 2: A Maze

First, the child helps hedgehogs find the way to the apples by showing the path with his or her finger. After that the child draws the path with a pencil and corrects mistakes if necessary (using an eraser). Then he or she outlines the path with a colored pencil, giving instructions to the hedgehogs: Go up, down, turn right, turn left (see Fig. 17.2). These commands to the hedgehog are also the commands to the child, which he or she can use later in externally directed as well as internal speech.

To more fully establish this skill – naming directions for the actions – other labyrinths or routes with right-angle turns are used. Special attention is given to the step in which a child combines his or her actions and verbal commands directed at a different character, “robot,” or self as a driver.

Task 3: Getting Used to Graph Paper

The child is asked to find the center point and outline one square on a piece of graph paper. After that, he or she outlines a square in the bottom, left and right parts, and the upper left corner, etc.

Then the child practices movements in different directions (see Fig. 17.3a). First he or she “plants carrots” by drawing lines from the marked points down one, two, etc., squares; then “grows flowers” by drawing lines up from the marked points and “hammers nails” by drawing lines to the left and to the right. The child then learns how to indicate the length and the direction of a movement with a number and an arrow pointing in the direction of the movement. He or she is asked “to read” the following: 2→ (i.e., two squares to the right). These tasks prepare children for a graphic dictation.

The graphic dictations are presented to the child during the next several lessons (see Fig. 17.3b). They gradually become more complicated, although all the programs are talked through:

1. Draw a pattern following the verbal commands of psychologist; for example, “One square up, two squares to the right…(the child repeats the commands in a whisper).

2. Continue a pattern based on a sample (the child dictates to him- or herself).

3. Complete a pattern according to the given written plan (the child reads and executes the plan).

4. Analyze a sample and create a program (the level of difficulty for this task can vary).

Task 4: Graphic Dictations (“Gnomes Invite Quests”)

These tasks are taken from the handbook on preparing children for school, School Is Soon: Traveling with Bim and Bom to “Math” Country (Akhutina, Manelis, Pylaeva, & Khotyleva, Reference Akhutina, Manelis, Pylaeva and Khotyleva1999/2006 R).

The first graphic dictation is performed using a plan that is verbalized by an adult (the child not only sees the plan but also hears it step by step). Every completed step is marked by a colored marker. The children perform the next several tasks on their own, dictating to themselves out loud or silently. Completed steps are marked in the plan (see Fig. 17.4).

Task 5: Copying the Drawings Along the Squares

Before starting work on these tasks children complete assignments on dividing squares in half by drawing vertical, horizontal, or diagonal lines, and they practice making squares out of two or four parts.

In the first task adult helps the child analyze the drawing of the sunshade. Together they discuss the direction of the movement and the number of squares. After that the child completes the task. The children do the second task on their own (see Fig. 17.5).

Task 6: Different Versions of Drawing Using Squares

It is recommended that children learn different ways of completing this task (see Fig. 17.6):

1. The adult dictates and the child completes the drawing using verbal instructions.

2. The child completes the drawing based on the visual sample.

3. The child analyzes the drawing, creates a plan, and dictates it to another child or an adult.

Task 7: The Dotted Structures

These tasks are used for practicing spatial functions as well as developing programming and control functions (see School of Attention; Pylaeva & Akhutina, Reference Pylaeva and Akhutina1997/2008 R).

When practicing spatial functions the adult asks the child to do the following:

1. Outline the circles on the mugs, count their number, and discuss their location;

2. Identify mugs and spoons with similar patterns, and draw a path from a mug to a spoon.

3. Compare mugs and plates with one and two circles to determine whether they are decorated in the same way.

4. Decorate the plates repeating the design on the cups (see Fig. 17.7).

Task 8: Bim and Bom Conduct “Scientific Research” on Numbers

In this task we discuss the composition of numbers; children outline the numbers and construct them independently from clay or real dough.

To overcome mirroring it is helpful to put the numbers in a row and to mark the beginning of every number so that children can “discover,” for example, that only number “6” is turned to the right and away from number “5” (see Fig. 17.8).

The task of completing the picture is difficult. At first children should write the numbers using a pencil so that mistakes can be corrected.

Task 9: Recognize and Complete a Letter

Working with letters facilitates development of visual-spatial functions. One of the methods used for this purpose is to make a letter by putting its parts together. Children are asked to figure out what letters can be constructed from sticks and what letters need round parts. The simpler letters are constructed from sticks of different sizes.

From the very beginning it is extremely important to establish spatial positions of letters and their parts to prevent mirror-type mistakes. Usually we start with capital letters. Symmetrical letters, such as A, Н, I, M, O, Q, Т, U, V, W, Х, Y, typically do not cause problems. Mirror-type mistakes (left–right) are most often noted in 12 letters that are turned to the right (В, C, D, Е, F, G, К, L, N, P, R, S) and in 2 letters that are turned to the left (J, Z).

In this task the vowels and the consonants that can be used to guess the coded words are presented at the top. A child together with an adult decides what part is missing in a particular set of letters; in this example, the letters miss the left part. The child then chooses his or her favorite colored marker and, guessing each letter, completes it and reads the whole word. After completing several of these tasks by adding right, bottom, and top parts of the letters, the child starts coding the words him- or herself for the teacher or other children to guess (see Fig 17.9).

Task 10: Roman Numerals

Working with Roman numerals provides practice in number composition and understanding the meaning of the position of sign I to the left or to the right of V or X (before or after V or X). The adult tells the child about Roman numerals using the text and the picture. Roman numerals are shown using fingers and sticks. Particular attention is paid to numbers 5 and 10 and the numbers next to them on both sides. After that the numbers are outlined and related to Arabic numerals (see Fig. 17.10).

Task 11: Tasks on Visual-Spatial Cognition

A child together with an adult examines the carpet, naming the parts that are missing (“upper right corner and upper left corner”). Then the child highlights the word “left,” colors it, and uses a blue marker to color all the patterns that are turned to the left. After that the child finds the same design on the pieces and colors it as well. Next, he or she determines which one of the pieces matches the upper left corner and draws a line from that piece to the corner; the child then finds the piece that belongs in the lower left corner. The child colors the word “right” and corresponding patterns in red, and then they are connected with lines as well. In the central part the child first colors the pattern turned to the left and to the right in the corresponding colors (blue and red); then he or she colors the patterns that are turned upward (toward the sun) in yellow and those turned downward (toward the grass) in green. In the second part of the task the child solves logic problems based on the concepts of “left–right” and “up–down” (see Fig. 17.11).

Task 12: Understanding Reversible Grammar Constructions with Prepositions

This task is an example of working with quasi-spatial functions (for details, see Chapter 13). The adult tells the child that an animal is hiding in the barn (see Fig. 17.12):

This material can also be used to practice prepositional constructions. The adult says: “I put an apple on the barrel on the box. Find it. Then I moved the apple. Can you guess where to?”

As psychologists working in classrooms we interact with teachers very closely. In the next two chapters we describe this collaboration.

Figure 17.1. Task 1.

Figure 17.2. Task 2.

Figure 17.3. Task 3.

Figure 17.4. Task 4.

Figure 17.5. Task 5.

Figure 17.6. Task 6.

Figure 17.7. Task 7.

Figure 17.8. Task 8.

Figure 17.9. Task 9.

Figure 17.10. Task 10.

Figure 17.11. Task 11.

Figure 17.12. Task 12.

Assessment and Observations of Egor

Egor's neuropsychological assessment revealed deficiencies in right-hemisphere functions as evidenced by spatial and visual difficulties, fragmentation errors, and difficulties in automation of motor, especially visual-motor, skills. He also experienced a decrease in functioning of the “energetic” unit of the higher mental functions, which enables a necessary level of activity and helps maintain a working state (Luria, Reference Luria1973).

The teacher's observations of his behavior in class showed that initially Egor did not want to learn or even be at school, and he did not want to interact with peers. However, when he became engaged in group work in class, he showed a sufficient level of general development, extensive vocabulary, and well-developed speech. At the same time he was disorganized and unable to focus on the task at hand, which, combined with his lack of study skills, caused frequent refusals to complete tasks, irritability, and extremely fast exhaustion.

After several lessons in his RDE class, Egor's negative behavioral reactions subsided. He became more active in class, showed interest in creative oral assignments, and connected with several teachers and students at school.

Completion of written tasks, however, remained unattainable for this student. Because of the difficulties he experienced in becoming engaged in assignments and his slow speed of task completion, Egor often got nervous, would rush through the assignment, and would cross out what he had written. Often he would end up in tears, and it would take him a long time to calm down. He would make comments about being different from other kids, not knowing how to do anything, and never being able to learn. His ability to work fluctuated in the course of even one class, let alone a week or a month. However, gradually his ability to work increased, which was closely connected with his increased motivation to communicate meaningfully and to engage in cognitive activity as well as a greater awareness of his own successes.

Let us look at his work during Russian-language classes. In the initial sessions the difference between his oral and written work was obvious. He had good knowledge of the spelling rules and could skillfully explain the orthograms; however, he could not manage writing. Figure 19.1 shows a sample of his writing.

1. The sentence he attempted to copy was: Na korable s nami bylo dva malьchika.

2. The sentence he wrote: nakoroble s naimI bAla DVam malьchьchka.

3. Word-for-word translation: On ship with us were two boys.

The analysis of his writing problems revealed that they all were easily explained by right-hemispheric deficiencies in processing visual and visual-spatial information:

1. Difficulties in orienting on a piece of notebook paper and finding the beginning of a line

2. Difficulties following the line

3. Variations in letters’ size and slant and the space between letters

4. Lack of connection between the elements of letters and disproportion of their size

5. Difficulties remembering graphic and motor images of letters and confusing letters that looked similar (for example, K – H – N)

6. Persistent “mirror” type errors when writing letters

7. Practicing writing very frequent words did not lead to formation of stable ideograms (he made mistakes in words like “homework” or names of the months that he wrote at least three times a day during the entire month – see Fig. 3.5 for one more example of his writing)

8. Changing or missing vowels, even when they were accented (bylo – bala; park – prk)

9. Inability to follow the correct order of letters

10. Tendency for phonetic (transcription) writing (regularization errors, as in English “come” – cum; “comb” – koum; cf. Temple, Reference Temple1997)

11. Writing two to three words (e.g., a verb and a noun with a preposition) together, because he did not have a holistic image of words, which would have helped him recognize a mistake

In addition, when the student became fatigued we would start seeing perseverations of letters and syllables and contamination of words; that is, the merging of two words in one (24 February – 24 февраля – “24 ферваа”; На ели лежит – “На елижит”). It is worth noting that he performed much better on more complicated creative tasks that were more emotionally significant for him than on simple tasks.

Methods of Remedial Work Used with Egor

According to the Vygotsky–Lurian neuropsychological approach, the main strategy of remedial interventions is to “grow” a weak component using the support of strong components in the process of specially organized joint activity.

Egor had two weak links: maintaining the ability to work and visual-spatial organization of the writing process. The other functions (programming and control in particular) were affected secondarily to these two main dysfunctions.

To increase his ability to work it was necessary both to increase his motivation and interest in completing tasks and to divide and thus decrease the size of each task and, whenever possible, simplify the process of completing each task. Egor's spatial difficulties were addressed during the individual remedial sessions with a psychologist, in which his teacher also participated.

Considering his difficulty in orienting on a piece of notebook paper, the teacher marked the margins and initially even the working line (line below the letters). In the fourth grade the teacher returned to use of a notebook with a particular rule pattern and lines that usually stopped being used at the end of first grade. The teacher gave clear instructions on where to start writing and checked to see whether Egor was able to follow them. The program of practicing writing included the sequential repetition of the primary orthographic rules and the practice of graphic skills.

In the first 2 months the teacher followed the “one difficulty at a time” rule. For example, if the goal of the task was to learn a grammar rule, then the graphic work that Egor had to do was minimal. It included, for example, inserting letters and words, sentence completion, or doing only certain parts of regular exercises. If the focus was on practicing graphic skills, then the assignments consisted of writing letters accompanied by a mnemonic symbol to help remember them. For example, while completing the task, Egor wrote a letter “b” and an arrow pointed upward next to it (b↑) to help him remember the correct orientation of the letter (for “p” it was p↓). The teacher also provided verbal mnemonic means to remember a letter; for example, “b is a back with a big belly”; “p is a part of pants.”

Parallel to the teacher's activity, the psychologist conducted a “scientific analysis” of the letters during her lessons (for details, see Task 9 in Chapter 17). Egor was able to notice that only seven letters went outside the line: two above (б, в) and five below (like р, y); in addition, two letters, ц and щ, had small “tails” (the boy compared the elements of the two letters y and ц that were outside the line). To overcome mirror-type errors, the psychologist identified the letters that look forward (я, y) or back (c, p).

Extensive work on spatial issues was also conducted during math lessons where just writing numbers in columns and keeping them all the same size initially presented an irresolvable difficulty for this student. To eliminate these problems a large piece of fabric with pockets was hung next to the blackboard. While students were solving math problems in their notebooks, Egor was solving them using this “device” by inserting numbers in the pockets, which represented squares in the notebook paper. That allowed him to solve complicated addition and subtraction problems; it also helped eliminate his fear of math problems, thus preparing a foundation for writing them down and solving them in his notebook where the space for solving the problems was marked using a red pen. Later such markings were no longer necessary.

The spatial organization of actions was practiced during reading lessons as well. To overcome his chronic mistakes of reading from right to left, he was allowed to follow the line with the finger or use a special ruler that had the following form: |_____.

In addition, Egor was required to regularly read the tables of syllables and one-syllable words with his classmates. The same table was used at the beginning of every reading lesson for the duration of one month. The children worked in pairs reading columns or rows and recorded the time and the mistakes made. In the pairs, the students switched roles, with each one wanting to give his or her partner a more complicated task and to read without any mistakes him- or herself. Because the goal of this exercise was to recognize the visual images of syllables and words, it was focused on optimization of both analytical (reading of syllables/words) and holistic (global) reading. Two rows (of eight that were used) from one of the tables are shown here (they were changed to be close to English orthography):

These methods enabled Egor to catch up and complete the third-grade school program. However, certain spatial difficulties remained. For example, he completed the final math test for the third quarter without any mistakes, but lacking confidence, he asked the teacher about the subtraction problem: “Should I subtract this number from that number?”

Today Egor is a student at a theater college.

Figure 19.1. A sample of writing by Egor, a third grader.