Motorische schrijfproblemen bij kinderen [evidence statement]

2 Etiologie van schrijven en schrijfproblemen (bij kinderen)

Schrijven is nog steeds het meest gebruikte schriftelijke communicatiemiddel. Bij het leren schrijven op school wordt niet alleen de motorische vaardigheid, maar ook de koppeling met taal en lezen geleerd. De relatie tussen schrijven als motorische handeling en als uiting van taal is zeer relevant en wordt in dit statement als eerste besproken. Daarna verschuift het accent naar schrijven als motorische vaardigheid. De invloed van algemene aspecten die van belang zijn voor het leren (bijvoorbeeld aandacht of motivatie van het kind) worden niet beschreven; deze aspecten vallen buiten het kader van dit statement. De invloed van deze algemene aspecten zijn wél opgenomen in het hoofdstuk klinisch redeneren en zijn verwerkt in het stroomdiagram, omdat ze uiteraard een rol spelen in de interpretatie van diagnostische bevindingen en bij de interventie zelf. 
De zoektocht in de literatuur heeft veel informatie opgeleverd vanuit het psychologisch en motorisch perspectief. Alleen studies waarin (ook) de motorische aspecten van het schrijven als vaardigheid aan bod kwamen, zijn geïncludeerd. Studies die waren gericht op kinderen met comorbiditeit zijn geëxcludeerd (bijvoorbeeld kinderen met leer- of gedragstoornissen, neuromusculaire of andere aandoeningen, hyperlaxiteit). Er zijn alleen studies opgenomen met conclusies die uitgingen van originele data. Aan de hand van 2 reviews (Graham & Weintraub, 1996; Rosenblum et al., 2003b) is de algemene schrijfontwikkeling beschreven vanaf groep 1 (voorbereidend schrijven; bijvoorbeeld de ontwikkeling voorafgaand aan het daadwerkelijke schrijven).
De internationale verschillen in het schrijfonderwijs zijn groot. Zo starten kinderen in de Verenigde Staten van Amerika – een land waar veel onderzoek op dit gebied is gedaan – met het leren schrijven van blokletters en pas in groep 5 met het leren schrijven van het verbonden schrift. In Scandinavië leren kinderen een vorm van het cursieve verbonden schrift aan, zonder boven- en onderlussen. De resultaten uit buitenlandse studies zijn niet zonder meer van toepassing op de Nederlandse situatie. Ook in ons eigen land is er een grote variatie aan onderwijsmethoden op het gebied van het schrijfonderwijs: soms wordt gestart met het leren schrijven van losse letters, die wel al passen in het verbonden schrift, maar pas later aan elkaar worden geschreven. Soms bestaat het schrijfonderwijs in de eerste maanden van groep 3 uit voorbereidende schrijfoefeningen en worden nog geen letters geoefend. Bovendien wordt in het Nederlandse basisonderwijs gebruik gemaakt van circa 15 schrijfmethoden.

De projectgroep heeft de volgende onderzoeksvragen geformuleerd met betrekking tot de etiologie van het (leren) schrijven en de kenmerken van slechte schrijvers:

  • Wat is de relevantie van een adequaat handschrift?
  • Wat is de relatie tussen cognitieve processen (het schrijven als taalkundige activiteit) en motorische processen (het schrijven als motorische handeling)?
  • Hoe verloopt de normale ontwikkeling van het schrijven?
  • Waarin verschillen goede en slechte schrijvers?
  • Welke stoornissen in functie en beperkingen in vaardigheden staan in relatie tot slechte schrijvers? 
  • Wat is de relatie tussen visuomotorische vaardigheden en schrijfproblemen?
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