Identifying ambidexterity accurately is crucial for suitable treatment

 

U.B.B University, Romania, 2014

Abstract

My research deals with 1% of the population who is defined as ambidextrous ("mixed handed") and are often not evaluated professionally. They are characterized by low writing pace and slow information retrieval as well as slow sequence memorizing. Their slow functioning relatively to the norm creates an increasing gap in their academic achievements. Identifying the source of the problem is usually not identified, appropriate and focused intervention is not given and thus the problem remains and is not taken care of. Thus, students are not provided with practical tools that should help them deal with their difficulties.

This evidence relates to my argument that finding the source of the problem in childhood (or earlier age) will prevent mental health problems into adolescence. That is to say, that using other diagnostic tools is necessary because in many cases the diagnostic questionnaire does not clearly expose the ambidexterity phenomenon and the children might get trapped into a subsequent regressive vicious cycle of their school behavior.

The study will raise awareness of the importance of brain dominance among Moreover, . pedagogical evaluators, occupational therapists and psychologistsintervention program, which enables uniquea spreading the knowledge of improvement of basic required skills by applying a 10 minutes daily practice. Furthermore, raising professional's awareness that learning disabilities in general and ambidexterity specifically are not chronicle diseases but the result of a "different brain" which functions relatively slowly in certain domains and requires more practice.

Key Concepts: Ambidexterity, Learning disabilities: Writing skill, Information Retrieval, Brain plasticity, Training.

Introduction

The concept of handedness comes from the observation that most humans exhibit a preference for one hand over the other, with 90% of the population showing a rightward preference (Corballis, 2003). The question thus arises as to whether this asymmetrical hand use is reflected at the level of sensor-motor organization and in terms of neural control.

As for motor functioning and dexterity (Mori Iteya, Gabbard, 2006), it has been discovered that significantly dexterous children have better coordination whereas ambidextrous children have lower physical abilities and coordination, due to inefficient electric brain activity. Evidence supports this “hand-specialization hypothesis” as one of the possible origins of handedness. Children with inconsistent hand preference show inferior coordination compared to those of the same age with a definite handedness (Mori Iteya, Gabbard, 2006). It has also been observed that these differences may persist until adulthood.

Moreover, it was found that information transfer is done more efficiently among dexterous children. Recent evidence presents a link between mixed handedness and more efficient inter hemispheric communication when compared to either right- or left-handedness (Davidson, Tremblay, 2013). In addition, the examination of the hemispheric differences found a significant correlation between neurophysiology and handedness. Furthermore, it identified a small subgroup of mixed-handed participants displaying the expected characteristics of individuals who are typically less lateralized

than normal (Davidson & Tremblay, 2013). Interestingly, it is in this subgroup where significant differences were found at the neurophysiological level. That is to say that the maturity of dominant hemisphere is connected to effective electric transfer between the hemispheres which supports normal learning activities.

Further to this, there was an increase in incidences which were associated with faster interhemispheric transfer time. Thus, the findings support the notion that mixed-handedness is associated with faster and more efficient transcallosal communications (Davidson & Tremblay, 2013) .

Research depicts aspects of handedness as a proxy for how the brain functions, yet it is not a perfect measurement. It is possible that ambidextrous have an atypical brain lateralization and that the brain circuitry and function is likely to differ from the normal pattern seen in right-handed individuals (Rodriguez, 2010).

Traditionally, being left handed has been seen as a problem, and a number of books have been written to assist parents and teachers of children who are left handed (Geoffrey, Platt, Shafizadeh, Gordon and Revolta, 2012). One theory about the earliest human communities claims that before a child could contribute by, for example, hunting, he had to master the manufacture of tools and their accurate use to catch prey (Lillehammer,2010). The ambidextrous child would theoretically take longer to develop the same coordination milestones as their left and right-handed counterparts. Hence, I posit that handedness reduces the period of dependence of human children, who would thus be able to contribute to the community at a much earlier age.

Nevertheless, researchers are not sure what is behind this link, though they suggest ls and those who have a between ambidextrous individua brainthat differences in the dominant hand may play a role (Rodriguez, 2010). In fact, scientists are not sure why some people can use both hands equally well (with no dominant hand), a skill also known as mixed-handedness.

Extant literature describes the connection between left- handedness, ambidexterity, training and stuttering. From the late 1920s until the 1950s, researchers published articles and books connecting the etiology of stuttering to encourage forcing natural left-handers to write routinely and perform other tasks with their right hand. Based on

their clinical studies, these practitioners concluded that stutterers displayed weak laterality (Kushner, 2011).

Causes

Little is known about what makes people mixed-handed, but it is known that handedness is linked to the hemispheres in the brain (Vlachos, 2013). Nevertheless, it is also recognized that environmental influences clearly play a role in the handedness phenotype (Vlachos, 2013). Generally, there are both genetic and environmental theories. Nowadays, it is commonly accepted that human handedness is predominantly determined by gene(s). Therefore, there are basically two ways in which someone can become an ambidextrous person: through birth or through may be a "warning ambidextrous g bornbein In addition,training (Yancoseck, 2010). may ambidextrous damage, and individuals who are naturally brain sign" of potentialbe more prone to developing learning disorders or mental health issues (Knecht, 2000). This is likely not a causal relationship, but a connection between how the brain of an ambidextrous person develops.

It has been proposed that left and/or non-right handedness (NRH) is over-represented in children with a history of preterm birth because such births are associated with a greater incidence of injury to the brain (Domellöf, Johansson and Rönnqvist, 2011). The relation between NRH and such complications is explained by perinatal hypoxia, mainly affecting the left motor cortex.

One main line of explanation proposes that the development of handedness is biologically rooted and that asymmetries in the neonatal nervous system are reflected in early expressions of postural and motor asymmetries (Domellöf, Johansson, and Rönnqvist, 2011).

Another cause is associated with one of the learning disabilities: a weakness in form and diagonalline crossing". I hold that this is the basic ability to act at -"middleto cross the imaginary middle-line of the body. It is well known that the human brain acts in cross checking that expresses the integration between the hemispheres in the brain. This cross checking process evolves until 4-4.5 years old through flipping, the two sides of the body is between cooperationcreeping, sitting and walking. The necessary for completing body activities. Because the ambidexterity phenomenon is

defined as brain asymmetry that reflects imbalance in synchronization between brain hemispheres (Yancoseck, 2010). I got to the assumed that the main cause of learning disabilities among ambidextrous population is weakness in "middle-line crossing". Therefore, the requirement intervention program should include activities that will improve the cooperation between the hemispheres.

 

The symptoms / of the phenomenoncharacteristics ©

of ambidextrous students. achievements academicThe literature relates widely to the It has been suggested that they tend to have more emotional and mental problems, as well as linguistic and academic difficulties in comparison to their peers. It is clear that their different brain structure plays a central role (Knech, 2013). It is possible that the right linguistic hemisphere of ambidextrous people does not function as it does in their counterparts' brain. Recent studies show that ambidextrous people tend to have inferior functions in verbal and non-verbal tasks, and in mathematics or reading tasks . will have problems at school or develop ADHDand they (Rodriguez, 2010)

I hypothesize (in accordance with my professional experience) that in some cases ADHD development is a result of the learning disabilities these students have. According to my professional experience, if the difficulty is not properly identified and the object is not able to cope it, an "Emotional Failure" is activated. If the object does not understand this emotional source, a "Defense Mechanism" which then a I have difficulties with paying " or "I hate schoolis operated, e.g. " set"-"Fixed mindt an I hold that identifying the ambidextrous students can preven. "attention

Ambidexterity

Imbalance in synchronization between brain hemispheres (Yancoseck, 2010)

Weakness in "middle-line crossing."

Difficulties in fine motor skills

Influance on

writing

drawing

cutting

Slowtransfer between the hemispheres

Influence on

information retrieval

naming skill

Verbal fluency

Spatial-visual perception

"Emotional Failure" and its consequences (as will be shown in the following diagram).

 

improveIt is known that the popular treatment is providing medical aid in order to Thus, the learner cannot do without the pills and nobody academic achievements.understands why learning improvement does not occur. I believe that finding the source can prevent unnecessary distress. The student with learning disability has to cope with various challenges. Therefore, our responsibility as therapists, is to relieve s which will diagnosis and suitable intervention program through accurate the burdenFollowing the presentation of the ambidextrous characteristics, . match the findingsand a )1999 Alevriadou,& Poderi, Sakadami, s,Grouio(intellectual disability developing deficits in motor functioning such as developmental tendency for risk ofcoordination disorder portrays itself. Critical views

On the other hand, studies found that the rates of developmental and mental health problems were based on the results of questionnaires which were given to the children, parents and teachers, and not on professional assessments. Additionally, the researchers do not specifically suggest that mixed-handedness directly causes problems of language and behavior, rather that differences in the brain could be related to both. The limitations to these studies mean that the results should be seen as

1.If the difficulty is not properly identificed

2.The object is not able to cope it

3.

"Emotional Failure" is activated

4. a "Defense Mechanism"is created

5. Operating under a "Fixed Mind-Set"

very preliminary, and therefore should not be a cause of concern for parents (Rodriguez, Kaakinen and Moilanen, 2010). One possible reason for the apparently contradictory findings in these studies may be the different ways of identifying handedness. Thus, I hold that using other diagnostic tools is necessary because in many cases the diagnostic questionnaire does not clearly expose the ambidexterity phenomenon and the children might get trapped into a subsequent regressive vicious cycle of their school behavior.

Learning disabilities It has been long ago theorized that learning difficulties in atypical brain development an individual's future achievements and can have broad represent serious obstacles to There is currently no and Cohen Kadosh, 2013). (Krause societal significancegenerally accepted definition of learning disabilities. In my research, the focus is on the frequent characteristics among the ambidextrous students (as will be shown in the following diagram). .

Writing skill

The writing skill is one of the most complicated human activities that includes perceptionThe and motor aspects (Hammill & Poplin, 1978). perceptioncognitive, -and bi lateralityand motor aspects of the writing skill include the integration between the ability to use the hands effectively. e.i.. laterality

As is well known, successful writing depends on intact function of the hemispheres. The left hemisphere is involved in analysis, logical sequencing and pace of verbal language, whereas the right hemisphere is in charge of directions and visual perception. Moreover, "left thinking" is based on words and "right thinking" is based Thus, the writing skill requires integrative action on pictures and visual awareness. Cermak, 1992). (Tseng & between the two hemispheres

Due to various disabilities related to writing (visual perception, form perception, visual-motor coordination, motor memory, sensor-motor frequencies, pencil holding, pencil pressure, tonus, fine motor etc.), I posit that ambidextrous students receive less attention. As mentioned, the writing process requires integration of several skills. Thus, it is necessary to identify the specific source and to build suitable programs particularly for students who have not established a dominant hand. In this type of cases each hemisphere acts alone and there is no synchronization between them, and the writing skill evolves as a result of cooperation between the hand and the eye. t report eye and hand) do not receive orders from (and do noWhen these authorities ((Modlinger, 1981). back to) the same hemisphere, the writing skill can be damageTherefore, treatment might need to focus on activities in order to improve the "middle-line crossing."

Retrieval Information Theories regarding children with dyslexia find that most of them show fewer correct responses and spontaneous recalls, more "don't know" (DK) and TOT (tip-of-the-tongue) responses, and a less accurate feeling of knowing (FOK) judgments (Faust,Dimitrovsky & Shacht, 2003). A naming task experiment was administered to explore the source of the naming deficits of children with dyslexia. The children failed to retrieve a target word and gave less valid and more invalid partial phonological information.

One of the models which deals with the process of word production (Levelt, 1999) i.e. the ability to reach the lexical area, is a process during which the knowledge about the word is retrieved from memory in order to map verbal concepts within a “speaking plan”. The speech created by words begins with the desire to produce the word. The first stage is the lexical choosing, i.e. retrieval of the right word that bares the intentioned lexical-semantic representation. The second stage is the retrieval of the

phonological pattern (phonology coding), which allows to create the phonetic program – the final stage of speech production (Faust, Dimitrovsky & Shacht, 2003). According to this model of Levelt (1999) each mistake in the search for the word can reveal something about disability in the basic linguistic system.

As mentioned, ambidextrous children are twice as likely to perform poorly at school as right-handed children (Rodriguez, 2010), and are twice as likely to have language difficulties. According to Levelt’s (1999) model each mistake in the word search can indicate a disability in the basic linguistic system. Thus, I hypothesize that the naming problem of ambidextrous children is a type of linguistic problem that arises due to their difficulty in finding the suitable word, i.e. accessing the phonological word forms after the suitable abstract lexical representation has been successfully accessed. accuracyhasizes the significance of The naming field discussed in many studies empand speed of word retrieval (Danckle, 1979). The terms Dysnomia or ‘deficit in word finding’ or ‘deficit in word retrieval’ describe difficulties in the ability to read words and to remember the names of object, as well as the letters representing the sound. is Therefore, Wiig & Semel (1976) defined Dysnomia as a verbal fluency deficit that manifested in low speed and accuracy of verbal associations, and the word form low on language expression is manifested in Dysnomia deficit. The influence of the availability of alternative words, lexicon and the tendency to change the location of the syllable in the word.

Brain plasticity

Neurological Brain Plasticity is defined as the ability of the central nerve system to change as a result of several conditions: a) normal development due to the organism’s age; b) acquisition of new skills in childhood and in adulthood; c) damage to the central nerve system; d) sensory neglect (Papanicolaou et al, 2001). Recent theories regarding that reorganization of brain mechanisms of either somatosensory or linguistic functions or both was obtained after training (Joseph R., 1999).

The brain neurons plasticity occurs in two ways: a) Experience Expectant – it belongs to the critic period. The brain creates a pattern that needs experience in permanent developmental time for effective and optimal function as the vision system or an elastic process which depends -linguistic development. b) Experience Dependent

11

earning and neural pattern, thus this pattern connects to l availableon experience and memory which occur at every age (Joseph R., 1999). in organizational change in expressed It can be concluded that the brain plasticity isthe region that is responsible for function or through transfer to another hemisphere during long or short periods as a result of local damage or training. It is known that the linguistic region is genetically bilateral and when the activity occurs in the left hemisphere there is a deficit in ability in the right hemisphere for getting the linguistic functions. In cases of injuries, it might merge with the right hemisphere function.

Training

The trainings are sessions meant to improve performance by a series of repetitious exercises. The within-session improvements in performance (i.e., improvements shown across the training session on day 1) are in line with the notion of a "fast learning" phase that has been described in motor and perceptual skill learning in adults (Korman et al., 2003) and recently in children.

The goal of cognitive training is to improve a targeted cognitive function (working memory, attention, language and visual processing), if possible to the optimal degree. Nevertheless, the outcome may be different between individuals (Cohen Kadosh, 2013). Moreover, recent studies in the field of numerical cognition have shown similar long-term effects after arithmetic training (Snowball et al., 2013). It is important to mention that cognitive training alone has been shown to induce a certain amount of change at both performance and the neural levels. is carried out gnitive training takes place when the intervention trainingSuccessful cothe sensitive periods of brain plasticity. It is potentially possible to change or during even redirect atypical brain functioning, thereby possibly promoting structural reorganization (Krause, Cohen Kadosh, 2013). Discussion

Extant literature portrays Ambidexterity as an innate phenomenon (Mori, Iteya, Gabbard. 2006) which reflects imbalance in synchronization between brain hemispheres. The concept of handedness comes from the observation that most humans exhibit a preference for one hand over the other, with 90% of the population showing a rightward preference (Corballis, 2003). The question therefore arises as to

whether this asymmetrical hand use is reflected at the level of sensory-motor organization and in terms of neural control (Davidson, 2013). The emergence of handedness has been explained by physiological and pathological models (Vlachos, 2013). According to the theoretical account of pathological left-handedness syndrome, a subgroup of left-handers suffers from a condition that involves an early injury and which encroaches upon the critical speech zones of the frontotemporal/frontoparietal cortex (Satz et al., 1998). Thus, any brain injury in early life, before, during and after birth affects the lateralization process causing atypical handedness (left or mixed handedness), although mechanisms are not fully understood. e ambidextrous of th achievements academicThe literature relates widely to the students. It has been claimed that they tend to have more emotional and mental problems, and also linguistic and academic difficulties in comparison to their peers. It is clear that their different brain structure plays a central role (Knech, 2013). In addition, ambidextrous children had poor performance in language skills and have weaker speaking ability than their peers.

On the other hand, there are studies which found that the rates of developmental and mental health problems were based on the results of questionnaires which were given Thus, I hold .ssessmentsnot on professional ato children, parents and teachers, and using other diagnostic tools is necessary because in many cases the diagnostic thatquestionnaire does not clearly expose the ambidexterity phenomenon and the children might get trapped into a subsequent regressive vicious cycle of their school behavior. Additionally, therapists who meet young children (4-9 years old) tend to focus on the dominant hand choice and on the frequent tasks in school. As mentioned, adults rence to the source of refe reported about their difficulties in later age and there is notheir problems. Furthermore, therapists are not aware of the implication of .ambidexterity in academic functions

As mentioned, current treatment among practitioners is to observe activity in daily tasks of the children who tend to use both hands and to choose for them the hand which is actives in more tasks. I posit that these trainings are likely to cause damages like stuttering. That is to say that stuttering could be traced to ambidexterity in some

of the individuals as a result of training ((Kushner, 2011) which would create a condition known in psychology as a ‘misplaced sinister’ and may well affect speech.

I hypothesize that since ambidexterity is diagnosed by observation or by questionnaires which were given to the children, parents and teachers , many children who have not been diagnosed by professional therapists will be harmed. This means that if the source of their difficulties is ambidexterity and it will not be discovered, it will be impossible to give them suitable treatment. This fact supports the common practice among therapists. That is to say that they particularly examine the child's relatives and provide the child with skills which can help with the school's requirements, for example, writing and cutting. It is well known that learning difficulties continue until adultness although the writing pace is improved. According to my professional experience, among the learning disabilities ambidextrous students often suffer from low automation, low naming retrieval and slow oral fluency.

Since it is such a central issue and since the source of the problem is usually not identified, the focused intervention is often not suitable. Thus, the problem remains and there isn't significant improvement.

These conclusions prove the necessity of identifying the ambidextrous population accurately in order to create a suitable intervention program that would minimize the gap in their academic achievements. Therefore, Research hypotheses are: a) Identifying properly ambidextrous children could prevent wrong approach of their learning disabilities. b) Diagnosing accurate ambidextrous children might avoid their coming into a subsequent regressive vicious cycle of their school behavior.

In my research, it may contribute to raising professionals’ awareness for learning disabilities in general and ambidexterity specifically. This information led people to understand that low pace writing is not a chronic disease and that because of our flexible brain it may be improved through routine training. Therefore, it may prevent a permanent writing disability, as written expression is an essential linguistic skill, which enables data processing in one's brain and should therefore be developed.

It is known that the mainstream view among researchers is to describe the cause for the phenomenon but there is lack of studies regarding the treatment. Therefore, my study spreading the knowledge of the intervention program, which enables improvement of basic required skills (writing pace, information retrieval, oral fluency) by applying a 10 minutes daily practice. Furthermore, raising professional's awareness that learning disabilities in general and ambidexterity specifically are not

chronicle diseases but the result of a "different brain" which functions relatively slowly in certain domains and requires more practice. Additionally, the study will raise awareness of the importance of brain dominance among pedagogical evaluators, occupational therapists and psychologists. References

Corballis M.C. (2003). “From mouth to hand: Gesture, speech, and the evolution of right-handedness.” Behavioral and Brain Sciences, 26, 199–208.

Danckle, M.B. (1979). “Childhood learning disabilities.” In R. H. Valenstien. (Eds.) Clinical Neuropsychology (pp.535-576). Oxford Press: New York.

Davidson T, Tremblay F. (2013). “Hemispheric Differences in Corticospinal Excitability and in Transcallosal Inhibition in Relation to Degree of Handedness.” PLoS ONE 8(7): University of California, Merced.

Faust, Miriam, Dimitrovsky, Lilly & Shacht, Tamar. (2003) “Naming Difficulties in Children with Dyslexia Application of the Tip-of-the-Tongue Paradigm.” Journal of Learning Disabilities, 36(3) 203-215.

Gffrey, Platt, Shafizadeh, Gordon and Revolta, (2012). Children and handedness: making the right choices. Nova Publisher, Authored Book Grouios G , Sakadami N, Poderi2and A. Alevriadou (1999) Excess of non-right handedness among individuals with intellectual disability: experimental evidence and possible explanations Journal of Intellectual Disability Research, Volume 43, Issue 4, pages 306–313,

Hammill, D. & Poplin, M. (1978). “Problems in writing.” In: Hamill, D. & Bartel, N. (Eds.) Teaching Children with Learning and Behavior Disorders. Allyn & Bacon: Boston.

Joseph R. (1999) “Environmental influences on neural plasticity, the limbic system, emotional development and attachment: A review.” Child Psychiatry and Human Development, 29(3), 189-208. Knecht Stefan. (2013), Department of Neurology, University of Münster, Albert-brain Oxford journal. (10) 136 48129 Münster-Strasse 33, D-Schweitzer

Korman, M., Raz,N., Flash, T.,& Karni, A. (2003). “Multiple shifts in the representation of motor sequence during the acquisition of skilled performance.” Proceeding of National Academy of Science, 100(21), 12492-12497.

Krause Beatrix, Cohen Kadosh Roi (2013) Can transcranial electrical stimulation improve learning difficulties in atypical brain development? A future possibility for

cognitive training Developmental Cognitive Neuroscience,Volume 6, October 2013, Pages 176–194

Kushner, Howard I. (2011). “Retraining left-handers and the etiology of stuttering": es of Body, Brain and The rise and fall of an intriguing theory, Laterality.” Asymmetri1999, 11 June , -, Pages 1998 Volume 377, Issue 9782 The Lancet, ,CognitionPublished by Elsevier Ltd

Levelt, Willem J.M. (1999). “Models of word production.” Trends in Cognitive Science, 3(6), 223–232.

Lillehammer Grete (2010), Archaeology of Children

Modlinger, Ilana. (1981). Disorders of Writing Language: Diagnosis and Remedial Teaching. Pohalim Library: Tel Aviv.

Mori Shiro, Misaki Iteya, Carl Gabbard. (2006). “Hand preference consistency and eye- hand coordination in young children during a motor task.” Perceptual and Motor Skills, 102, 29-34.

Papanicolaou AC, Simos PG, Breier JI, Wheless JW, Mancias P, Baumgartner JE, Maggio WW, Gormley W, Constantine JEC, Butler II (2001). Brain plasticity for sensory and linguistic functions, J of Child Neurology , Vol 16, 241-252

Rodriguez A, Kaakinen M, Moilanen I et al. (2010). “Mixed-Handedness Is Linked to Mental Health Problems in Children and Adolescents.” Imperial college London, Science Teacher, 77(3), 15-18

Satz, P., Orsini, D., Saslow, E., and Henry, R. (1985). “The pathological left-handedness syndrome.” Brain and Cognition, 4, 27-46.

Snowball, A., Tachtsidis, I., Popescu, T., Thompson, J., Delazer, M., Zamarian, L., Zhu, T., Cohen Kadosh, R. (2013). “Long-term enhancement of brain function and cognition using cognitive training and brain stimulation.” Current Biology, in press.

Tseng, M.H., & Cermak, S. (1992). “The influence of Ergonomic Factors and Perceptual-Motor Abilities on Handwriting Performance.” American Journal of Occupational Therapy, 47(10), 919-926.

Vlachos, F, Avramidis, E ,G. Dedousis, E. Katsigianni, I. Ntalla, M. Giannakopoulou, M. Chalmpe. (2013). "Incidence and Gender Differences for Handedness among Greek Adolescents and Its Association with Familial History and Brain Injury", Psychology & Behavioral Sciences, Vol, 1 (No1), pp 6-10, Ellinika Grammata: Athens

Wiig, E.H. & Semel E.M. (1976). Learning Disabilities in Children and Adolescents. Columbus OH: Charies E. Merril.

ctoral induced hand dominance transfer." Do-Yancosek, Kathleen E. (2010). "InjuryPaper 18. Dissertations. Doctoral Kentucky of University Dissertations.

U.B.B University, Romania, 2015

Article

An Intervention Program for Improving Writing and Information Retrieval among Students with Ambidexterity

By: Yael Sender, Ph.D candidate

Supervisor: Prof. Dr. Dorel Ungreanu

Abstract

This research deals with 1% of the population who is defined as ambidextrous ("mixed handed"). Ambidextrous are characterized by slow writing pace, information retrieval and sequence memorizing. Their slow functioning compared to the norm creates an increasing gap in their academic achievements. This study refers to a unique intervention program called ATP (ambidexterity training program), which was developed by the researcher in order to enable the improvement of basic required skills in ambidextrous students. The intervention program included drawing, meant to strengthen the middle-line crossing, writing sequences of the Hebrew alphabet (for older students also English alphabet) and number sequences in order to improve the verbal fluency, and copying a paragraph (30 words) in order to improve writing pace. The current study examined the effect of the ATP on ambidextrous students (7-16) who had been characterize with these slow skills through routine training, and it established effects on perception, cognitive impact, motor abilities and behavior among the learning disabled (LD) participants.

Key Concepts: Ambidexterity, Writing skill, Information Retrieval, Brain plasticity, Training.

Introduction

Ambidexterity is addressed as an innate phenomenon (Mori, Iteya & Gabbard, 2006) which reflects imbalance in synchronization between brain hemispheres (Yancoseck, 2010). An ambidextrous person is someone who is able to use his or her right and left hands equally well, especially in the case of tasks that require fine manipulation or detail (Rodriguez, 2010). Studies show that ambidexterity is a "warning sign" for potential brain damage and tendency towards learning disabilities and organizational problems.

The concept of handedness comes from the observation that most humans exhibit a preference for one hand over the other, with 90% of the population showing a rightward preference (Corballis, 2003). Evidence supports this “hand-specialization hypothesis” as one of the possible origins of handedness. Children with inconsistent hand preference show inferior coordination compared to those of the same age with a definite handedness (Mori, Iteya & Gabbard, 2006). It has also been observed that these differences may persist until adulthood.

Moreover, it has been found that information transfer is done more efficiently among dexterous children. Recent evidence presents a link between mixed handedness and more efficient inter hemispheric communication when compared to either right- or left-handedness (Davidson & Tremblay, 2013). In addition, the examination of the hemispheric differences found a significant correlation between neurophysiology and handedness. Meaning, the maturity of dominant hemisphere is connected to effective electric transfer between the hemispheres which supports normal learning activities.

Research depicts aspects of handedness as a proxy for how the brain functions, yet it is not a perfect measurement. It is possible that ambidextrous people have an atypical brain lateralization, and that the brain circuitry and function is likely to differ from the normal pattern seen in right-handed individuals (Rodriguez, 2010).

One of the characteristics of learning disabilities is a weakness in "middle-line crossing". It is well known that the human brain acts in cross checking that expresses the integration between the hemispheres in the brain. This cross checking process evolves until age 4-4.5 through flipping, creeping, sitting and walking. The cooperation between the two sides of the body is necessary for completing physical activities. Thus, it depicts aspects of handedness as a proxy for how the brain

16

functions (Rodriguez, 2010). The ambidexterity phenomenon is defined as brain asymmetry that reflects imbalance in synchronization between brain hemispheres (Yancoseck, 2010) and results in learning disabilities. The main cause of learning disabilities among the ambidextrous is weakness in "middle-line crossing". Therefore, the required intervention program should include activities that improve the cooperation between the hemispheres.

Diagram no. 1: The impact of "middle-line crossing" weakness on ambidexterity

Writing Skills ©

The literature widely suggests that the skill of writing is one of the most complicated human activities, as it includes cognitive, perception and motor aspects (Hammill & Poplin, 1978). In this type of cases, each hemisphere acts separately and there is no synchronization between them. As a result, the writing skill, which depends on hand-eye cooperation, is impaired in ambidextrous children. When the eye and hand do not receive orders from (and do not report back to) the same hemisphere, the writing skill might be damaged (Modlinger, 1981). Therefore, treatment may need to focus on improving the "middle-line crossing" (Ding, 2004).

Information Retrieval

Hulme et al. (1991) claim that speed of speech is a measure of how quickly words can be encoded and rehearsed within the phonological loop. Another component referred to is the use of long-term memory representations of the phonological forms of the words that have to be recalled. In arithmetical skills the discussion regarded the ability to store number facts, as poorer fact retrieval also correlated with slower counting and weak access to lexical items.

Training

Previous studies have shown that the goal of cognitive training is to improve a targeted cognitive function (working memory, attention, language and visual processing), if possible to the optimal degree, but also that the outcome may be different between individuals (Cohen Kadosh, 2013). As is turns out, the goal of most interventions for LD population is a shift in neural activation from the right brain hemisphere to the left. Nonetheless, among LD learners this shift may be impaired, and they may overcome this impairment through lessening the dependency on the weak hemisphere or the less active hemisphere (Horowitz et al., 2014).

As noted in recent studies, an intervention program based on training led to an improvement in working memory and speed of processing (Horowitz et al., 2014). Training influences executive-function pathways in the brain as a result of greater activity of the error-detection system.

Ambidexterity

Imbalance in synchronization between brain hemispheres (Yancoseck, 2010)

Weakness in "middle-line crossing"

Difficulties in fine motor skills

Influences

writing

drawing

cutting

Slowtransfer between hemispheres

Influences

information retrieval

naming skill

verbal fluency

spatial-visual perception

It is important to mention that cognitive training alone has been shown to induce a certain amount of change in task performance and in the neural levels (Krafnick et al., 2011). Successful cognitive training takes place when the intervention training is carried out during the sensitive periods of brain plasticity (Papanicolaou et al., 2001). It can be concluded that brain plasticity is expressed in organizational change in the region responsible for function, or through transfer to another hemisphere during long or short periods as a result of local damage or training.

Gap in knowledge: In the diagnosis domain there is a gap in the outcomes of the assessment tools (McManus Test, Oldfield questionnaires and the Card Test, Galifret-Zazzo, 1966) and little awareness to the fact that the writing hand is not the dominant hand despite its dominance in various activities. In the cognitive domain, there is no report about a connection between ambidexterity and difficulties in information retrieval.

1. Methodology

The research paradigm

The research uses “mixed methods”, an approach which combines quantitative and qualitative research methods in the same study (Venkatesh, Brown & Bala, 2012). Since the writing speed, oral fluency, pace of speech, low automation and naming ability have quantitative outcomes, quantitative research is appropriate. The interview part allows the researcher to understand the experience of the students and the significance that they attribute to the intervention program.

Research population: 30 Ambidextrous students, ages 7-16 from 3 different schools: 10 students (14-16) from Boarding school, 8 young students (8-11) from Democratic school and 12 young students (7-11) from Elementary school; 19 male and 11 female. 22 participants write with their right hand and 8 write with their left hand.

The research tools

1. Three valid and reliable tests meant to identify 30 ambidextrous students: Oldfield questionnaire (1970), McManus Test (1988) and The Cards Test (1966).

2. Four valid and reliable tests meant for checking the initial performance in four skills: Naming test (Kave, 2005), Fluency, Automation (Ben Dror-Shani, 2006) and Writing Pace (DST, 2011). 3. The implementation of an intervention program (ATP) meant to improve the four weak skills and to prevent negative approach due to learning disabilities. 4. Mid-checking (after 18 meetings) of the impact of the intervention program and post-checking at the end of the program. 5. 25 In-depth interviews for reporting the student's difficulties before identifying the source of the difficulty, and the student's perceptions at the end of the intervention program.

The ATP (Ambidexterity Training Program)

This unique program was developed by the researcher and is based on personal professional experience.

The goal of the program was to improve four skills – writing pace, verbal fluency, naming and aoutomation retrieval – by a 15 minute routine training, conducted twice a week (34 meetings in total). Another goal was preventing permanent slow writing pace and information retrieval and improving oral fluency.

The program was executed using the following activities:

1. Drawing for 3-5 minutes, meant to improve middle-line crossing and the motor abilities.

2. Writing sequences, i.e. Hebrew alphabet (for older students also English alphabet) and number sequences, for 3-5 minutes, meant to improve verbal fluency.

3. Copying a paragraph (30 words) for 3-5 minutes, meant to improve writing pace.

2. Findings

There was significant improvement among all participants in writing pace and verbal fluency skills, and less improvement only in the naming skill and information retrieval. The intervention program contributed in the following measures:

Diagram no. 2: Sum changes of the skills before the intervention program and after it (pre- and post-intervention).

Writing pace: The findings indicate that there was a high rate improvement, from 90% deficiency in the pre-intervention stage to 10% in the mid-intervention stage, and 0% in the post-intervention stage. There was an increase in writing pace rate (words per minute) in norm range level: from 0% in the pre-intervention stage to 13% in the mid-intervention stage, and to 50% in the post-intervention stage. These changes were significant (χ2=78.84, p<0.01).

Verbal fluency: the findings indicate that there was a significant decrease in the rate of the verbal fluency (words per minute) in the following levels: Very very under norm (deficiency): from 57% in pre-intervention stage to 0% in the middle stage and post-intervention stage. Very under norm (difficulty(: from 33% in pre-intervention stage to 20% in the middle stage, and to 7% in the post-intervention stage. There was a significant increase of verbal fluency (words per minute) in the middle stage compared to the pre-intervention stage. Additionally, there was significant increase of verbal fluency (words per minute) in the post-intervention stage compared to the middle stage and as compared to the pre-intervention stage. The verbal fluency increased from 15 words per minute in the pre-intervention stage to 21 words per minute in the middle stage, and to 25 words per minute in the post-intervention stage

(F=76.31, p<0.01).

Naming retrieval: the findings indicate that there was a significant decrease in the rate of naming retrieval (no. of words) in the following levels: Very very under norm (deficiency): from 27% in the pre-intervention program stage to 0% after the intervention program. Very under norm (difficulty): from 47% in pre-intervention program stage to 7% after the intervention program. There was significant increase of naming retrieval (no. of words) in the post-intervention stage compared to the pre-intervention stage (t=-8.09, p<0.01).

The automaton process: the findings indicate that there was a significant decrease in the rate of the automation of letter (words per minute) in very very under norm, (deficiency), from 80% in the pre-intervention stage to 10% in the post-intervention stage.

There was significant decrease in the required time for letter retrieval (words per minute) in the post-intervention stage compared to the pre-intervention stage. Meaning, the letter retrieval time decreased from 43 minutes in the initial stage to 34 minutes in the final stage (t=7.99, p<0.01) (Table 8).

According to the in-depth interviews, there were significant changes in the perception, cognitive impact, behavior and motor abilities of the participants. In addition, the data offers some insights concerning the relationships between training and the improvement of weak cognitive skills, and an accurate identification of the source of difficulty. According to the data collected most participants were diagnosed yet did not know how to improve their weak skills. A 16 year old participant is recorded to have said: If I had known the source of my writing difficulties at a young age I could have practiced my writing skill and my understanding would have improved." Participants reported that the improvement increased their confidence in their academic abilities and brought significant change in their motor abilities. Likewise, their ability to concentrate improved due to the writing exercises during the lesson compared to their past performance.

3. Discussion

The findings show that the incidences of improvement in a sample of ambidextrous students occurred in favor of the intervention program, conducted during 34 meetings (twice a week), and included training of drawing, copying and sequences. The increased writing pace, verbal frequency, naming retrieval and automation relate to the theory about cognitive training for children with developmental reading disabilities (Wolf et al., 2000). Furthermore, the data in this study correlates with earlier studies which emphasized how a child's cognitive potential can be increased and may even cross the limits that were at first imposed by the learning difficulties.

As previously mentioned, all participants showed improvement in all the skills except for automation. In other words, the deficiency in the third following skills: writing pace, verbal fluency and naming, disappeared in all 30 participants. Furthermore, their performance increased to norm or to over the norm. Only in information retrieval did several participants maintain deficiency, and most of them improved from "deficiency" to "difficult": 90% of participants showed deficiency in the writing pace and 50% had norm pace after the intervention program. The improvement in writing pace and fluency was significant (<0.01) compared to the improvement in naming skill and automation retrieval.

4. Conclusion
The results demonstrate different effects of the ATP on the skills which were examined, and on the processing pace in all students with ambidexterity. The findings suggest that the intervention program can lead to improvement by creating new neural connections, made possible due to brain plasticity. It appears that consistent practice during regular meetings can lead to significant improvement; during the first 18 meetings of the intervention program there had been significant improvement in the writing pace and verbal fluency, whereas the other skills, which required deeper processing, improved after a longer period (34 meetings). The naming skill and the information retrieval skill involve deep processing, therefore require longer training.
The improvement in automation retrieval was limited to "very under norm" and "under norm", as none of the participants achieved performance within the range of the norm. I posit that these findings strengthen the research claim regarding the connection between ambidexterity and difficulties in information retrieval. A possible conclusion is that practice could improve these skills, yet it could never change or fix it. The learning disabled who has this retrieval deficiency is required to cope with it throughout his or her academic life.
Observing the gap between the improvement pace in the four skills (writing and fluency compared to naming and automation retrieval), it could be concluded that a training program which includes motor activity task (like drawing, copying and sequence writing) might lead to faster changes in the brain compared to verbal activity (like naming retrieval and automation) or visual tasks. Activity skills which were required in the intervention program included motor activity, causing the working memory to work faster. Naming retrieval and automation are deep processes which require longer training in order to improve. There is evidence that the motor cortex and spinal cord control the remarkable ability to change structure and function through endurance training (Adkins et al., 2006). Furthermore, the claim that the writing skill requires various cognitive processes, such as working memory, knowledge in long-term memory, or metacognitive processes such as self-regulation and metacognitive knowledge (MacArthur, Graham et al., 2008) can explain the improvement of the writing pace and the fluency as a result of intensive training and combining kinesthetic tasks.

5. Contribution to knowledge
The main contribution of this study is the unique intervention program, which enables the improvement of several basic inferior skills which are necessary to the learning processes. Furthermore, it could prevent permanent writing disability and emotional difficulties which accompany learning disabilities, turning helpless learners into active and capable ones. Furthermore, it might help learners avoid being trapped in a subsequent vicious cycle in their school behavior and change their perception of self. It is important to mention that the ATP is universal, as it can be practiced in every country, culture and language. It can help prevent feelings of failure and exeption. It may also raise awareness among professionals to the fact that the writing hand is not necessarily the dominant hand in other activities. It is reasonable to suppose that this program can help teachers and health professionals to identify children who are particularly at risk of developing certain difficulties, and expose them to an opportunity to change their brain regions.
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