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Performances of orthodox and liberal Jewish children in third grade on praxis subtests of the SIPT: a cross cultural study

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Performances of orthodox and liberal Jewish children in third grade on praxis subtests of the SIPT: a cross cultural study

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Content PERFORMANCES OF ORTHODOX AND LIBERAL JEWISH CHILDREN IN THIRD GRADE ON PRAXIS SUBTESTS OF THE SIPT: A CROSS CULTURAL STUDY. by Cindy L. Sobel A Thesis Presented to the FACULTY OF THE GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree MASTER OF ARTS (Occupational Therapy) December 1994 UNIVERSITY O F S O U T H E R N CALIFORNIA T H I G R A D U A T E S C H O O L U N IV E R S IT Y PA R K L O S A N G E L E S . C A L IF O R N IA 9 0 0 0 7 This thesis, written by Cindy L. Sobel under the direction of A,fir Thesis Committee, and approved by all its members, has been pre sented to and accepted by the Dean of The Graduate School, in partial fulfillment of the requirements for the degree of Master of Arts in Occupational Therapy Deem Date THESIS COMMITTEE Dedication page: To Miriam. To my thesis advisor for all her patience, understanding, guidance, dedication and scholarship. There are not enough words to express my gratitude to you for all the time you spent meeting with me and the constant attention you gave to editing and developing this thesis. To the children and families I have been privileged to work with and learn from over the course of my career. To the memory of all those who perished at the hands of their oppressors and all the great contributions that were lost to this world. Acknowledgenents Many people have contributed to various stages through which this study has passed. I would like to express my sincerest appreciation to Dr. L. Diane Parham, Dr. Bruce Phillips, and Dr. Ruth Zemke, all of whom have contributed to the development of this thesis. Without their kind guidance, patience, and insights this thesis would never have been completed. In addition, I would like to thank Rabbi Daniel Landes for providing me with contacts in the Jewish community, sources from his vast library, and constant support throughout this entire process and Sheryl Robbin Landes for her support. Dr. Ron Reynolds of the BJE, for his interest and support for helping me gain access to the Jewish Day Schools and find subjects for this study. Kim Secura, and Robin Turner, for answering my constant questions at the USC office and on the phone. Dr. Michael Carlson for his statistical expertise. The Fine, Baichman-Kass, Steinschriber, Porter-Zasada, and Hassan families. Scott Sobel, Sara Neiman, Deborah Littman, Marilyn Lowenstein and Marilyn Rich. Linda Fineholtz for her time and objectivity, Jay & Nadine Kaplan-wildmann and Josh Narrowe for programming and maintaining the computer, Paul Hamburg at the Simon Wiesenthal Center, the MCH grant people, my colleagues at Therapy West, & my teachers at the Ayres clinic. Rabbi Krause, Rabbi Stewart, Mrs. Deckel, and Mrs. Fasman of Yeshiva Rav Isacsohn, Dr. David Ackerman of the Pressman Hebrew Academy, and of course all the participants and their parents. A special thanks to: Roberta Murray, Rosa, Patti, and Raphaella, Gina, Leah, Tzippora, and Stella for providing Miriam with a loving, caring environment throughout this project. To sweet Miriam: Thank-you for your independence and understanding during this process. I can only hope that if you feel you missed out on spending time with Ima, that you will come to understand how important this was for me to complete. I ask your forgiveness and knowledge that, G-d willing, there will be another tomorrow for us to be together. To Drs., Stephen Steitler, Shirley Perluss, Sai-ling Michael, and Tziona Melman, thank-you for helping me stay balanced and focused. Ultimately, my deepest gratitude is to Hashem for watching over me throughout this process. May we all be a little stronger for it. iii Table of Contents DEDICATIONS .............................................. ii ACKNOWLEDGEMENTS ......................................... iii LIST OF TABLES ........................................... vi THESIS ABSTRACT .......................................... vii Chapter 1. INTRODUCTION TO THE PROBLEM ...................... 1 Statement of the Problem .......................... 5 Statement of the Purpose .......................... 9 Assumptions ....................................... 9 Questions to be Answered ........................ 10 Hypotheses ........................................ 10 Scope and Delimitations ......................... 10 Limitations ....................................... 11 2. REVIEW OF THE LITERATURE ...................... 13 Praxis ............................................ 13 Subtests of Praxis ............................... 20 Description of Practic Subtests ................. 21 Development of the SIPT and Standardization .... 25 Reliability ....................................... 27 Validity .......................................... 28 Cultural Bias in Sensory Integration Test Performance ......... 33 Description of Orthodox and Liberal Jewish Family Lifestyles ............. 35 Orthodox Jewish Lifestyle ....................... 36 Daily Routines in the orthodox Jewish Home and School ........................ 41 Liberal Jewish Lifestyle ........................ 54 Historical Perspectives ......................... 55 Daily Routines in the Liberal Jewish Home and School ................................ 57 3. METHODOLOGY ....................................... 63 Research Design .................................. 63 Hypotheses ........................................ 63 Subjects .......................................... 64 Instruments ....................................... 67 iv Chapter Procedure ........................................ 69 Methodological Assumptions ...................... 75 Data Analysis .................................... 76 Limitations ...................................... 77 4. RESULTS .......................................... 7 8 Comparatbility of the Two Groups ............... 78 Comparison of Praxis Performance of the Two Groups ............................. 80 5. DISCUSSION, CONCLUSIONS, AND RECOMMENDATIONS ... 81 Conclusions ...................................... 87 Recommendations for Future Research ............. 89 Clinical Implications ........................... 90 REFERENCES ................................................. 91 APPENDIX ................................................... 97 V List of Tables Table 1. Between Group Differences in Gender ............. 79 2. Between Group Differences in Age ..................79 3. Descriptive Statistics and Wilcoxon Rank Sum Test on the Median Subtest Scores for Liberal and Orthodox Jewish Children on Postural Praxis (PPr), Bilateral Motor Coordination (BMC), Sequencing Praxis (SPr) and Oral Praxis (OPr) Subtests of the SIPT ..... 80 vi ♦ Thesis Abstract This study explored the possibility that cultural differences make a significant impact on children's performances on standardized tests. A comparison was made of the motor performance of third graders of two Jewish American subcultures in Los Angeles on four practic subtests of the Sensory Integration and Praxis Tests (SIPT). It was hypothesized that orthodox Jewish children would perform more poorly than their liberal Jewish counterparts due to seemingly limited opportunities for orthodox Jewish children to develop their motor abilities. Orthodox Jewish children lead a life with a greater emphasis on strict adherence to Jewish law and auditory/visual tasks (reading, reasoning, intellectual discourse) both in school and at home (Linzer, 1984). For the liberal Jewish child, although the child is culturally imbued with a rich sense of Judaism from the family, the emphasis of his or her world includes rigorous academic studies as well as physical play, and equal encouragement of boys and girls to develop academically and physically (Heilman, 1984). The results of this study were that there were no statistically significant differences between these two groups' performance on the four practic subtests. Although a strong case was built anticipating that there would be a difference between these two group's performance and that the orthodox boys would produce among the lowest test scores, the vii findings of this study revealed that there is no difference in practic abilities between orthodox and liberal Jewish children in Los Angeles. In short, this study does not support the stereotype that orthodox Jewish children are clumsy. Clinically, the implications of this study are that, because both groups performed similarly to the SIPT normative sample on praxis subtests, it is appropriate to use SIPT norms when scoring the results of praxis subtests of Jewish children in Los Angeles. Further, this recommendation could be strengthened if results were replicated with larger sample sizes. Results tentatively suggest that an orthodox Jewish background has no significant effect on the child's motor performance. viii INTRODUCTION TO THE PROBLEM Cultural differences may make a significant impact on children's performances on standardized tests. The proposed study investigated this issue by comparing the motor performance of third graders of two Jewish American subcultures within the united States. This study was motivated by a previous cross-cultural comparison by Saeki, Clark, and Azen (1985), who assessed whether cultural differences affect Japanese children's performances on eye-hand coordination subtests of the Southern California Sensory Integration Tests (SCSIT^ (Ayres, 1972). The authors found that Japanese children growing up in Japan and in the U.S. performed better than the standardization group of American children, and that the Japan-born children performed the best, as compared to Ayres' normative data and the Japanese American subjects. The authors attributed these differences, in part, to culture itself, which they defined as the patterns, beliefs, values, and behaviors shared by social groups (Saeki, et al., 1985). Saeki et al. (1985) concluded their paper by stating that, "The findings of this study suggest that future cross- cultural studies on the SCSIT are needed to assure valid decisions about whether or not dysfunction is present" (Saeki, et al., 1985, p.109). Since the study by Saeki et al. (1985) was conducted, the SCSIT has been updated and replaced by the Sensory Integration 1 and Praxis Tests (SUED (Ayres, 1989). No studies to date have examined cultural differences in performance on subtests of the SIPT. When administering an instrument to a population not belonging to the age or the cultural group upon which the test was originally standardized, one must be aware of the limitations and restrictions in its use; misdiagnosis and misinterpretation may be possible, otherwise. (Saeki, et al., 1985, p.2) Without considering the unique characteristics of the culture of the particular child being tested, the cultural values implicit in the population used to generate normative data will be imposed inappropriately. The population representing the culture of the child being tested might actually score significantly higher or lower than the average score of the published sensory integration test norms. If a child from the cultural group not represented in the norms scores higher than the published mean, the clinician might mistakenly conclude that there exists no difficulty with motor or other sensory integrative abilities. In actuality, in comparison to his or her own cultural group, this child may function far below the level of his cultural peers, and thus may have a functional problem which goes undetected due to inappropriate use of SIPT norms. Similarly, if a child has a profile with a significant delay according to the SIPT published norms, yet in comparison to his or her own cultural group demonstrates superior abilities, then reliance on published norms may erroneously 2 lead the clinician to deduce that a neurologic dysfunction exists. Within his or her own culture, this child may be functional, however appears to be dysfunctional according to normative test data. Therefore, a recommendation of therapy to address the child's weak areas based on these test results, by an evaluator unfamiliar with important details of this child's background and cultural group would be inaccurate and unnecessary. Such issues may apply when the SIPT are administered to an orthodox Jewish population, who have cultural elements in their lifestyle that may differ substantially from the original population on which the SIPT was standardized. This investigator's experience with orthodox and liberal Jewish children suggests that they may have different experiences and attitudes in relation to motor activities. For example, while working in Jerusalem at Hadassah Hospital, this researcher worked with a 9 year old, orthodox Jewish boy, who was referred for occupational therapy (OT) due to poor fine motor skills. When asked to assume an on all fours position, in an attempt to strengthen his postural musculature as a precursor to improving fine motor skills, he refused saying that this position made it look as if he were bowing down, as if to an idol, and that was forbidden in Judaism. The activity was adapted to accommodate his religious beliefs and values to more appropriately address an OT objective. In comparison, a secular Jewish boy, who was also referred for OT for the same 3 reasons, participated in this activity without reservation. Such experiential differences in relation to motor activity may result in differences in motor ability. This researcher's personal experience in observing differences in motor ability between orthodox and liberal Jewish children can be illustrated by the following example. Soccer is a very popular sport in Israel, and children's participation in soccer leagues is as common as American children participating in Little League. When asked to kick a soccer ball during therapy, each of the boys in the above example had a different motor response. The orthodox boy became very anxious, stiffening up his body, protruding his tongue as if concentrating very intently on how he would line up his body and with which foot he would kick the soccer ball. He shifted his weight continuously from one foot to the other as the ball approached, and finally used a chair as a form of external support to stabilize himself as he kicked the ball with his right foot. He swung his arms backwards, as if in a huge circle in an attempt to regain his balance after kicking the ball, and ultimately fell backwards to the floor. The boy who came from a liberal Jewish background, although referred to the clinic for the same reasons, did not exhibit nearly as much anticipatory effort prior to kicking the ball. He actually spent the few seconds prior to contacting the ball, just looking at it, crouched down a bit, and kicked the ball, also with his right foot using excessive 4 force, then remained standing. As a therapist, a question arose regarding each boy's motor abilities. Why was there such a different motor response from each of the boys in the above example? Compared with his liberal Jewish counterpart, was the orthodox Jewish boy exhibiting coordination difficulties because of a neurologic problem, or had his religious background limited his motor experiences to the extent that motor immaturity resulted? Does a child's religious, cultural background actually have an affect on the child's motor abilities? In order to ensure valid evaluation when using this instrument with children from a Jewish population comprising both orthodox and liberal Jewish children, it is important to conduct a cross-cultural SIPT test performance comparison between these two groups and compare the results of their performance. Selected SIPT subtests involving motor performance will be used because they isolate the child's ability to perceive, process, and demonstrate or recreate a single movement or sequence of movements, which according to Ayres's definition of praxis, includes both knowing what to do and how to do it (Fisher, Murray, & Bundy, 1991). Statement of the Problem The problem which was addressed in this study is whether or not culture is associated with test performance on the SIPT. The specific problem that was addressed is whether or 5 not there are statistically significant differences in the SIPT scores between orthodox and liberal Jewish children on their performance on four of the practic subtest of the SIPT. It is, however, beyond the scope of this study to compare and contrast the scores of all subtests comprising the SIPT. This study focused on one of the six behavioral domains of the SIPT, praxis, as measured by four praxis subtests. The four subtests are Postural Praxis (PPr), Bilateral Motor Coordination (BMC), Sequencing Praxis (SPr), and Oral Praxis (OPr). "These subtests mainly require use of a somatopractic element involved in general motor planning ability, including sequencing and projected or anticipatory movements" (Cermak, 1991, p.149). Praxis is defined as one's ability to willfully perform in and act on the environment. It is important to note that praxis is not solely a motor planning ability, but includes an individual's sensory processing and conceptual abilities as well as her or his neuromotor abilities (Cermak, 1991). Somatopraxis is defined as the ability to motor plan, associated specifically with the element of successful processing and discrimination of tactile information received from one's environment (Cermak, 1991). "The idea that development is influenced by the environment is about as old as the idea of development. The setting(s), customs, and psychology of caretakers not only regulate the healthy emergence of human potential, they also 6 shape the possibilities of disorder" (Super, 1983). Parents, or parent equivalents, serve as a medium through which children enter the Jewish world of faith, ideals, history, and community leadership. A child learns to find solutions to balance his inner needs and the outer reality in this intimate community of the family. (A detailed discussion of the context and manner in which Jewish values are transmitted in a Jewish family is discussed in the literature review section). This system also allows for a harmonious balance of authority and independence. The child also learns attitudes towards the use of one's body (tzniut or personal modesty), and the values that are given high priority within a Jewish home. Physical development is considered important yet almost incidental in order for one to be healthy, capable and purposeful within one's community and family. Developing one's individual physical abilities, i.e. for the purpose of athletic competition, is not valued highly in an orthodox Jewish community (Linzer, 1984; Matzner-Bekerman, 1984). In contrast to the view of the Jewish family with regard to transmitting values to children, is a stereotype of Jews as untrained, unskilled, inexpert, in a word, "klutzy". There is some evidence in the literature to support the stereotype of orthodox Jewish children's limited physical prowess (Mayo, 1988). Examples from literature as far back as a report from the Industrial Commission of 1901, "The Jew occupies a unique position in the clothing trade. His physical strength does 7 not fit him for manual labor. [A common belief of the time.]" (Commons, 1901, as quoted by Glazer, 1965). There is research evidence to support the role of environment and culture in affecting an individual's physical development (Saeki, 1985; Super, 1983). Therefore, not all fingers can point conclusively to neurologic dysfunction as the sole reason for a child who presents with signs of poor praxis. Based on this researcher's personal observations of children inside and outside of clinical settings, in America and Israel, and based on a review of the literature, it seems appropriate to hypothesize that a difference exists in the motor abilities of orthodox and liberal Jewish children. A difference in motor abilities between a child who spends most of his day sitting and studying text (the orthodox Jewish child) and the child who participates in a wide variety of activities (painting, arts, sports, swimming, crafts, dance, swinging) in addition to a demanding academic curriculum which includes a Judaic component, (the liberal Jewish child) may be significant. While the orthodox Jewish child may seem to come from a restricted environment, from an occupational therapy standpoint, within his or her own cultural group the child may be functioning well within normal limits. In comparison to his or her liberal Jewish counterpart, who may appear much more well rounded from an OT standpoint, the unique experiences and differences of each of 8 these Jewish subgroups within American society need to be respected by clinicians evaluating children for potential developmental delays. Statement of the Purpose The purpose of this study was to determine whether or not there are significant differences in practic abilities of orthodox and liberal Jewish children as measured by the PPr, BMC, SPr, and OPr subtests of the SIPT. If the differences in the test performances among the two cultural groups are statistically significant, then the results will more strongly suggest that an evaluator should consider cultural variations when using and interpreting the SIPT. In particular, results of this study suggest guidelines for interpretation of SIPT praxis subtests with orthodox and liberal Jewish American children (Chapter 5). Assumptions The following assumptions were made in this study: 1. That environmental factors (including religious observance) as well as genetic factors influence child development. 2. That cross-cultural differences in child development during infancy and early childhood differentially influence later behavior, including motor abilities. 3. That the PPr, BMC, SPr, and OPr subtests of the SIPT 9 are valid and reliable instruments for measuring praxis. 4. That children who attend orthodox Jewish day schools, are part of a family that lives a comparably orthodox Jewish lifestyle. 5. That children who attend a liberal Jewish day school, are part of a family that lives a comparably liberal Jewish lifestyle. Questions to be Answered The question that this study attempted to answer was as follows: 1. Are there statistically significant differences in the mean subtest scores of PPr, BMC, SPr, and OPr between orthodox and liberal Jewish children? Hypotheses The following null hypotheses were generated for the purposes of this study: 1. There will be no differences in the mean subtest scores on the PPr, BMC, SPr, and OPr between orthodox and liberal Jewish children. Scope and Delinitations This study was delimited by its: 1. Study of only four SIPT subtests (PPr, BMC, SPr, and OPr) which measure praxis, one of the major behavioral domains 10 addressed by the SIPT. Results can not be generalized to any other subtests included in the SIPT, or any other motor tests. 2. Focus on orthodox and liberal Jewish American chil dren. Results cannot be generalized to any other population. 3. Focus on orthodox and liberal Jewish third graders (aged 8-9 years old), residing in the greater Metropolitan Los Angeles Area. Results should not be generalized to orthodox and liberal Jewish children from any other age group or geographic area. Limitations Because of time and financial restrictions, orthodox and liberal Jewish children in this study were those residing in the greater Metropolitan Los Angeles Area without differentiating between Sephardic (Jews whose families came to the United States from Spain, Portugal, Greece, Morocco, Yemen, and northern Africa) and Ashkenazic (Jews whose families came from eastern and northern Europe including Czechoslovakia, Poland, Russia, Hungary, Romania, Austria, Germany, and England) Jews. This study was designed to tap into populations served through the Jewish Day School system in Los Angeles, with the help of Dr. Ron Reynolds, head of the division of Jewish Day Schools in greater Los Angeles at the Board of Jewish Education, and Dr. Bruce Phillips, a Jewish sociologist at Hebrew Union College. Because all subjects attended private schools, they were from relatively 11 socioeconomically advantaged families, and thus are not representative of the Jewish population at large. 12 Chapter 2 REVIEW OF THE LITERATURE The purpose of the review of the literature was to provide a synopsis of existing literature relevant to this study. This section is divided into three sections: praxis, subtests of praxis, and a brief overview of orthodox and liberal Jewish lifestyles. PRAXIS Much of the literature regarding praxis is linked to research of both adult onset apraxia and developmental dyspraxia (Ayres, 1972, 1985; Cermak, 1991). The term praxis is more than motor planning; praxis means "action based on will" and comes from the Greek work for "doing, acting, deed, practice" (Cermak, 1991, p.137). That praxis is composed of three primary elements (ideation, motor planning, and execution), is consistent throughout the literature (Ayres, 1972, 1985; Ayres, Mailloux, & Wendler, 1987; Cermak, 1991; Murphy & Gliner 1988; Parham, 1987). "Praxis includes both knowing what to do and how to do it" (Ayres, 1991, p.141). Ayres (1985) defines the three basic components of praxis as: Ideation, or formulating an idea of how one might interact with the objects in the environment; motor planning, or formulating an internal plan 13 of action; and execution, the final performance of the motor act. Ideation is a cognitive or thinking process. Before one can engage purposefully or adaptively with a physical object, large or small, one must first have the concept of possible object-person interaction and some idea as to what might take place during that interaction (Ayres, 1985). This is an essential skill underlying all use of objects. A child may have the coordination to use an object, yet lack the conceptual understanding of how to use the object to reach an intended goal. Ayres (1985) suggests that difficulties with ideation or conceptualization involve not easily anticipating the outcome of a task, and poorly visualizing body-environment interaction. This affects the child's ability to anticipate how an object can be used, or how it moves. The element of organization is also central to ideation (Ayres, 1985). Will the child initiate action within a therapeutic environment, playground, or playroom or is the child mainly a passive observer? Does the child attempt to construct pieces of eguipment together in an orderly manner, or are the child's attempts random? (Ayres, 1985; Parham, 1987). Parham (1987) points out that it is necessary, when evaluating a culturally different child, to consider the possibility that the child may have been taught to await direction or permission before actively playing in an unfamiliar environment in the presence of an unfamiliar adult. 14 According to Parham (1987), ideation can be difficult to assess. As there are no objective tests that exist to tap this construct, it is highly inferential. "One of the best ways to evaluate this ability is to observe the way the child plays spontaneously with toys and therapeutic equipment. It is particularly revealing to observe what is done with novel equipment that has never been seen before by the child. Initially, do not direct the child. The goal here is to gain insight into the extent to which the child can generate and organize ideas of what to do" (Parham, 1987, p.31). Questions regarding the child's ability to anticipate the potential for what to do with a certain piece of equipment are also valuable in an evaluation of ideation. For example, will a child attempt to ride or climb onto a rocking horse or not, or swing on a swing or randomly swipe at it? How does the child interact with objects in his or her environment? Observing a child randomly pushing separate pieces of equipment around the room, without any constructive relating of one piece to another, may indicate difficulty with ideation. Some children with poor ideation resort to more aggressive behaviors, at times throwing toys and objects, or not initiating any action unless explicitly directed (Parham, 1987). "Praxis is that neurological process by which cognition directs motor action; motor or action planning is that intermediary process which bridges ideation and motor execution to enable adaptive interaction with the physical 15 world" (Ayres, 1985, p.23). Motor planning is an internal plan of action that occurs before actual motor execution. It is structuring action. It requires conscious thinking. Elements must be adequately selected and organized in appropriate order (Ayres, 1985; Cermak, 1991; Parham, 1987). If one has to think about actions, one is probably engaged in motor planning. If one no longer has to think about them, the actions have probably become automatic and no longer require planning (Ayres, 1985). Because thinking is a cognitive process, if a child is thinking, motor planning is occurring. The bridging of the conceptual plan and the motor act is becoming actualized (Ayres, 1985; Parham, 1987). If a child has difficulty with motor planning, she or he probably also has difficulty with ideation (Ayres, 1985; Cermak, 1991). If execution is the result of an idea that has been created and thought through in one's own mind's eye, then the quality of that execution, the sequence, the timing, the flow of the process will reflect these previous stages (Ayres, 1985; Cermak, 1991; Parham, 1987). Sequencing and timing of actions are central to praxis. Sequencing is a composite of a series of movements that have been ordered into a smoothly executed, whole act. It requires many changes or transitions from one position to another or it may require remembering or knowing which movement comes after which (Ayres, 1985). Ayres (1985) notes that "while frequent reference is made to the left side of the brain in connections 16 with sequencing of action, timing of action has not generated many comments. Luria and Hutton (1977), however, stated that the premotor zone of the cerebral hemispheres (bilaterally) organize motor impulses in time" (p.32). Timing can be defined as, "the selection for maximum effect of the precise moment for beginning or doing something" (Webster, 1984, p. 1236). A timing disorder may be seen with the child who closes his or her hands in an effort to catch a ball a few seconds before it actually reaches him or her. Timing is important in the sequencing of actions during purposeful activity. Both timing and sequencing are important elements of praxis (Ayres, 1985, p.32). An example of timing and sequencing as elements of praxis can be observed in a game of jumprope, where each participant is required to jump into and continue jumping with the rhythm of the turning rope. One must perceive the right moment to jump under the turning rope and establish one's own rhythm to continue jumping without interrupting the flow of the rope, usually being turned by two other people, establishing a sequence of planned movements essential to the successful participation by this individual for this activity. This includes deciding when to stop by planning to jump out of the rope without interrupting the rhythm of the turning rope and before it next hits the ground. Execution is the observable motor aspect of praxis and it is only in the execution of a motor act that the qualities of ideation and motor planning can be observed. "This would be 17 true if one defines "execution" as that process which occurs primarily over the pyramidal system. It is somewhat misleading to refer to execution as the final process, for there is a continual spiral of ideation, sensory integration, planning, execution, sensory feedback, ideation, etc." (Ayres, 1985, p.32). Difficulty with executing a motor plan is often due to poor ideation or limited motor planning (Ayres, 1985; Parham, 1987). Ayres (1972, 1985, 1989) also emphasized the essential role that somatosensory processing plays in the development of praxis, specifically with regard to the role of the tactile system. The literature identifies two disorders of praxis: developmental dyspraxia and somatodyspraxia (Cermak, 1991). It is important to understand that somatodyspraxia is a subtype of developmental dyspraxia and not a separate type of disorder. "Developmental dyspraxia is defined as a difficulty in formulating the plan of action, and not primarily a problem in motor coordination (motor execution)" (Cermak, 1991, p.141). The child with developmental dyspraxia is able to motor plan, but this ability is impaired. She or he has difficulty performing motor skills, is clumsy, and needs more practice in order to learn motor tasks than do other children of the same age (Cermak, 1991). While "developmental disorder" denotes a neurologic problem (even if not a sensory integration (SI) problem), the term dyspraxia would not be used for a child who is "clumsy" due to different experiences, 18 because dyspraxia also implies a neurologic disorder. A more accurate description of the child would be that he or she has difficulty with motor skills (Dr. L. D. Parham, personal communication, 8/9/93). Somatodyspraxia refers to the subgroup of developmentally dyspraxic children whose dyspraxia is hypothesized to be due to poor somatosensory processing. "Ayres defined somatosensory-based dyspraxia, or somatodyspraxia, as a disorder of encoding a new, as opposed to a habitual, motor response strategy" (Cermak, 1991, p.141). This reflects the difficulty with which a child learns a new skill, however, once it is learned and performed as part of the child's daily life routine, the task can be performed with adequate skill. It is also important to note that the acquired skill itself remains specific to the particular task, because the person is generally not able to generalize this skill to other similar activities. A new part of any task must be learned as if it were a totally new task, including the quality, or required velocity, and force of movement (Cermak, 1991). Cermak (1991) also states that praxis involves the ability to organize behaviors and develop or choose appropriate motor strategies to accomplish a task. Therefore, the client with developmental dyspraxia is often disorganized in approaching a task, and has poor work habits. It can be concluded that "developmental dyspraxia and somatodyspraxia are essentially equivalent with regard to the motor 19 manifestations of the planning deficit” (Cermak, 1991, p.142). However, a critical component of somatodyspraxia is the presence of a disorder in tactile discrimination. Poor tactile discrimination is not necessarily a symptom of developmental dyspraxia (Cermak, 1991). Saeki and her associates were the first researchers in this arena to document that differences in culture will affect the outcome of a child's performance on sensory integration subtests of motor ability (Saeki et al., 1985). There is no other existing literature of this nature with regard to the cultural differences and their effects on motor performance on either the SCSIT or the SIPT. The proposed study will therefore add knowledge to how culture influences sensory integration subtest performance. Specifically, performance on praxis subtests will be examined between orthodox and liberal Jewish children. Subtests of Praxis The Postural Praxis (PPr), Bilateral Motor Coordination (BMC), Sequencing Praxis (SPr), and Oral Praxis (OPr) subtests were chosen for use in this study because they are among the highest loading subtests in the somatopractic factor (Ayres, 1989, p.202). Ayres & Marr (1991) refer to the PPr, BMC, SPr, and OPr as the strongest subtests of motor ability that identify this factor. Although a measure of the propensity to cross the body midline (Space Visualization and Contralateral 20 Hand Use (SVCU)) and one tactile subtest (Graphesthesia (GRA)) also loaded on the somatopractic factor in some analyses (Ayres, 1989), these scores were not used in this study because the purpose of this study was to focus on children's motor abilities, specifically praxis. The components of motor sequencing, motor memory, bilateral motor coordination, oral motor coordination, and overall body coordination, are the specific elements of praxis that this study attempted to tap by using these four subtests. Description of Practic Subtests This section presents guidelines for understanding what each of the four subtests that were used for this study entailed and the meaning of the different possible interpretations that the results of these subtests yield. Please refer to Appendix A for the test administration and scoring protocols of the PPr, BMC, SPr, and OPr subtests. Postural Praxis (PPr) involves the mirrored imitation of positions, primarily using the arms and hands, by the child as quickly as the child is able to after the examiner has assumed each posture of the 17 items individually. The child has 7 seconds in which to assume a mirrored position that the examiner is assuming. The child and examiner sit on armless chairs opposite each other during the single administration of all items. Arms and knees of both the child and examiner must 21 be visible and identifiable (not hidden by loose sleeves or a skirt) (Ayres, 1989). PPr taps a central practic ability common to all of the praxis subtests, but especially to Oral Praxis (OPr), and Sequencing Praxis (SPr). It evaluates a child's aptitude in planning and assuming different and unusual body postures. It requires visual interpretation of each demonstrated position, although no memory of that position is required (Ayres & Marr, 1991). A low score on Postural Praxis is often a major indicator of somatodyspraxia. However, a low score on Postural Praxis without a low score on another praxis subtest or on a somatosensory subtest probably should be questioned and possibly should not be diagnosed as reflecting dyspraxia. A child with a low Postural Praxis score, accompanied by some somatosensory deficit, will probably have trouble with skilled body-environment interaction (Ayres & Marr, 1991). In Bilateral Motor Coordination (BMC) the child is expected to imitate a series of movements after they have been demonstrated by the examiner. Each item consists of a motor pattern that is executed two or three times. The child and examiner sit in chairs without arms facing each other. In contrast to the administration of the PPr, the child is expected to imitate the examiner's motions after the demonstration of the item has been completed. Because this test follows PPr in which the child imitates postures, children are expected to be able to grasp the essential nature 22 of the task of BMC. Movements consist of touching the palms of the hands to the thighs or the feet to the floor, making an audible, but not loud, sound. Scoring is based on the degree of smoothness, reciprocity of movement, and sequencing (Ayres, 1989). To be interpreted as evidence of poor functional integration of the two sides of the body, a low Bilateral Motor Coordination score should be accompanied by low scores on Oral Praxis or other subtests involving bilateral integration such as Sequencing Praxis (Ayres & Marr, 1991). Bilateral Motor Coordination appears to have a somatic foundation, and is easily affected by somatodyspraxia. Bilateral Motor Coordination is also vulnerable to neuromotor incoordination and to unilateral dysfunction (Ayres & Marr, 1991). Sequencing Praxis (SPr) requires the child to repeat a series of hand or finger tapping movements after the examiner has finished demonstrating each item. There are three trial items and nine test items of sequenced motions. Each test item consists of five or six subitems. Within each item, the first subitem sequence of positions is relatively simple. Movements are added to each successive subitem, increasing the level of difficulty. The child and examiner sit facing each other across a child sized table. The examiner must remove all rings and jewelry that may make sounds when tapping the 23 table. If possible, the child's jewelry should also be removed (Ayres, 1989). SPr is often interpreted as measuring a quality that is central to praxis. It evaluates competency in perceiving, remembering, and executing a demonstrated sequence of unilateral and bilateral hand and finger positions (Ayres & Marr, 1991). A low Sequencing Praxis score may be interpreted as evidence of somatodyspraxia, or it may be interpreted as part of a bilateral integration and sequencing deficit, depending upon what other scores are low. The bilateral nature of the Sequencing Praxis task is as important to interpretation of the subtest as is the sequencing aspect (Ayres & Marr, 1991). Oral Praxis (OPr) requires the child to imitate a series of movements or positions of the lips, tongue, and mouth after the examiner has demonstrated each item. The examiner is expected to not wear brightly colored lipstick because of the possible distractions it would pose to the child. The child and examiner sit across the table from each other. All items are administered to all children (Ayres, 1989). OPr is, of all the praxis subtests, the most closely related to perception and interpretation of sensations from the body, especially tactile sensation. The SIPT does not test somatosensory perception in the oral area, and there is no guarantee that the somatosensory test of the arms and hands accurately represent the oral area. However, the validity 24 data do suggest that they are closely related. The validity data indicate that an oral praxis problem is frequently associated with a postural praxis problem. In such a case, the oral dyspraxia might be considered part of a more general practic ideation, planning, and execution problem. Poor functional integration of the two sides of the body and poor sequencing also may contribute to a low Oral Praxis score (Ayres & Marr, 1991). Development of the SIPT and Standardization: The subtests in the SIPT have evolved over several decades. Initially, a number of clinical procedures commonly employed to assess agnosia (an impaired ability to recognize familiar objects) and apraxia (an impaired ability to perform coordinated motor activities) in individuals with adult-onset brain damage were redesigned for use with children with minimal brain dysfunction or learning disabilities. Through statistical analyses, those procedures that provided the most useful clinical information, and that showed the highest factor loadings and the strongest capacity to discriminate between dysfunctional and normal children, were selected (Ayres, 1989). First appearing as several different individual tests, they were later published in combined form as the Southern California Sensory Integration Tests (SCSI1)(Ayres, 197 2a), and as the Southern California Postrotarv Nystagmus Test (Ayres, 1975). 25 The normative data analyses for the SIPT were conducted in three stages: (a) preliminary analyses, which examined age- and gender-related differences in SIPT performance, and determined the appropriate scoring and stopping rules for the SIPT tests; (b) computation of means and standard deviations, which included the examination of developmental trends and the normality of the score distribution for each of the 17 subtests in the SIPT; and (c) determination of major SIPT scores, based on the extent to which each of the various subscores for each subtest allowed discrimination between normal and dysfunctional children {Ayres & Marr, 1991). "Preliminary analyses indicated significant sex differences on all of the SIPT subtests except Manual Form Perception (MFP) and Postrotary Nystagmus. Therefore, separate norms were developed for boys and girls" (Ayres & Marr, 1991, p.207). The developmental curves for the tests indicated that the optimal age groupings for the normative data should cover 4-month intervals for children younger than 6 years of age, and 6-month intervals for children aged 6 and older. Therefore, separate norms were developed for boys and girls in each of 12 age groups. For each of these groups, SIPT scores generally fit a normal distribution curve. Means and standard deviations were computed for each normative subgroup, so that each child's score can be reported as an index of the degree to which the child's performance differs 26 from the average performance of children of the same age and gender (Ayres & Marr, 1991). The following section details the reliability and validity of the praxis subtests. Reliability Interrater reliability indicates the extent to which a child's test scores agree when his or her performance is evaluated, recorded, and scored by different examiners (Ayres & Marr, 1991). Most tests have some margin for human error. A high interrater reliability coefficient is an indication that the child's scores will be very similar when his or her performance is evaluated by different examiners. To evaluate interrater reliability, the SIPT was administered to 63 children from the age of 5 years 0 months to 8 years 11 months (50 boys, 13 girls, mean age = 7.26 years, SD = 1.04 years). This sample included 19 children with diagnosed reading disorders, 41 children with other learning disabilities, and 3 children with spina bifida. Eight examiners participated in the interrater reliability study, and each child's performance on the SIPT was evaluated, rated, and scored by two different examiners. The interrater reliability coefficient values for each of the four praxis subtests of interest in the present study were as follows: PPr =.96, (n=62), OPr =.94, (n=63), SPr =.99, (n=51), and BMC =.96, (n=48) (Ayres, 1989). Test-retest reliability indicates the extent to which test scores for an individual are consistent across different 27 administrations of the test over time (Ayres & Marr, 1991). Insofar as the constructs assessed by the SIPT are assumed to be fairly stable over time, a good measure of these constructs should have fairly high test-retest reliability. The test-retest reliability of the SIPT was evaluated in a sample of 41 dysfunctional children (24 boys, 17 girls, mean age = 6.5 years, SD 1.3 years) and 10 normal children (four boys, six girls, mean age = 6.8 years, SD = 1.4 years). Each child was tested twice with the SIPT, with an interval of 1 to 2 weeks between testings. To ensure that the reliability coefficients would not be inflated by age differences in test performance, all coefficients were computed using standard scores (derived from the age- and gender-appropriate norms for each child). As a group, the praxis subtests had the highest test- retest reliabilities, although the PPr, SPr, and BMC tests all indicated significant practice effects of the retest. The test-retest reliability coefficient values were as follows: OPr =.90 (n=49), PPr =.86 (n=49), SPr = .84 (n=47), and BMC =.82 (n=45). OPr had the highest test-retest reliability coefficient of all the SIPT subtests. Validity Validity is the most important aspect of a test. It is the extent to which the assessment tool actually measures what it claims to measure and that the content reflects what the 28 examiner is attempting to measure. "Test validity refers to the ability to draw meaningful inferences from test scores to meet an intended purpose" (Ayres & Marr, 1991, p.207). To ensure that validity estimates would not be inflated by age and gender differences in SIPT performance, all SIPT analyses were conducted using standard scores (i.e., each child's scores were represented in standard deviation units, computed using the age- and gender-appropriate norms for each child). Three types of validity-related evidence were addressed by Ayres (1989): construct-related, content-related, and criterion-related. Construct-Related validity is the validity established by the ability of the instrument to differentiate between groups known to behave differently on the variable or construct claimed to be measured by the instrument (Polit & Hungler, 1987, p.527). For example, will each of the four subtest of interest to this study discriminate between those children who do or do not have difficulty with motor abilities? Ayres (1989) used factor analytic studies to address this type of validity. "Factor analysis is a statistical technique that identifies groups of test scores that are correlated or covary" (Ayres & Marr, 1991, p.209). For example, it can be expected that motor planning and tactile discrimination tests define a factor and that if a child has a low score on one of 29 the subtests that identify this factor, then it is likely that the child will have low scores on all of them. Three factor analyses of SIPT scores clarified the nature of the constructs evaluated by the SIPT. Subjects of the three analyses were (l) the SIPT normative sample (n=l,997), (2) a group of dysfunctional children (n=125), and (3) a group of combined normal and dysfunctional children (o=293 (176 normal children, and 117 children with learning or sensory integrative deficits). Each of these factor analyses resulted in the identification of a somatopraxis factor. The term somatopraxis was derived from findings of a close association between somatosensory (tactile-proprioceptive) processing and motor planning (Ayres & Marr, 1991). All four subtests of interest in the present study loaded significantly on the somatopraxis factor in the factor analytic studies of the Combined Normal & Dysfunctional Sample, and the SIPT Normative Sample. For the factor analysis of Dysfunctional children the somatopractic factor was the fifth, of five factors, to emerge with significant loadings only on PPr and OPr (Ayres & Marr, 1991). Postural Praxis correlated positively with most of the other SIPT subtests, indicating high saturation of a common praxis element in this test. Correlations with Oral Praxis and Sequencing Praxis were particularly strong. Postural Praxis loaded substantially on somatopraxis factors for two of 30 the factor analytic studies, the SIPT Normative and the Dysfunctional Sample, however loaded moderately on the Combined Normal & Dysfunctional Sample (Ayres & Marr, 1991). Oral Praxis correlations and factor loadings demonstrated a major link with motor planning ability. Oral Praxis loaded strongly on somatopraxis factors on all three of the factor analytic studies, the SIPT Normative Sample, the Dysfunctional Sample, and the Combined Normal & Dysfunctional Sample (Ayres & Marr, 1991). Sequencing Praxis also was highly correlated with the subtests that define somatopraxis factors. Correlations with the other SIPT subtests suggest that Sequencing Praxis evaluates a central practic ability that subserves most aspects of praxis under evaluation by the SIPT. (Ayres & Marr, 1991). Bilateral Motor Coordination correlated strongly and positively with Sequencing Praxis and Oral Praxis. (Ayres & Marr, 1991). Criterion-Related Validity establishes validity by showing that the new instrument (in this case the SIPT) correlates well with an existing and accepted instrument which measures the same variable or construct (Polit & Hungler, 1987, p.528). One approach to criterion-related validity is to correlate test scores on alternate measures, of which some are presumed to assess similar abilities (convergent validity) and 31 others are presumed to assess different abilities (divergent validity). The pattern of correlations is then examined to determine whether or not the obtained results are consistent with these theoretical expectations. Both the SIPT and the Kaufman Assessment Battery for Children (K-ABC) were administered to a combined sample of normal children, children with learning disabilities, and children with sensory integrative disorders. The SIPT measures of sequential processing (especially Sequencing Praxis and Bilateral Motor Coordination) have high correlations with the K-ABC Sequential Processing scale, and have the highest correlations of any of the SIPT subtests with the Sequential Processing scale in the normal control group. The complex praxis subtests of the SIPT generally have the highest correlations with the K-ABC scales with overall correlations most similar for the normal and dysfunctional children, although the magnitude of the correlations differed across the two subsamples. Similarly, Ayres & Marr (1991) cite the work of Zivani, Poulsen, and O'Brien (1982) who administered both the Bruininks-Osteretsky Test of Motor Proficiency and the Southern California Sensory Integration Tests to 32 boys and 27 girls with learning disabilities, and concluded that the overall pattern of correlations between these two tests suggested that the two share a common practic-postural domain (Ayres & Marr, 1991). In short, Postural Praxis, Bilateral Motor Coordination, Sequencing Praxis, and Oral Praxis are all strong indicators 32 of what they purport to test, as indicated by results of construct validity and criterion-related validity studies. Cultural Bias in Sensory Integration Test Performance Culture impacts on how children perform on tests (Super, 1983). According to Saeki et al, (1985), "...differences in child development exist across cultures. Researchers have attributed these differences, in part, to culture itself, which they define as the patterns of beliefs, values, and behaviors shared by social groups. If developmental differences across cultural groups do exist, then such differences may affect the childrens' performances on the SCSIT" (Saeki, Clark, & Azen, 1985, p.109). Saeki et al. (1985) compared the scores of 82 Japanese children born in the U.S. and 98 Japanese children born in Japan with the U.S. normative data for the revised version of Motor Accuracy (MAC-R) and the SCSIT Design Copying (DC) test. Both of these tests assess fine motor function. Both Japanese groups performed significantly better than the Ayres normative group on DC and on MAC-R right hand performance; there was no significant difference, however, in MAC-R left-hand scores. For DC, there was also a significant interaction between age and culture, with the greatest cultural differences appearing at the oldest ages (7 to 10 years of age). One of the conclusions of this study was that the DC and MAC-R tests may be underselective of Japanese and Japanese- American children with dysfunction, in part due to the 33 cultural emphasis on fine motor skill acquisition. In the summary of the study, Saeki et al. (1985) state that, "performances by other ethnic groups on the SCSIT will probably differ from the performances of the normative sample, on which the SCSIT was standardized. The findings of this study suggest that future cross-cultural studies on the SCSIT are needed to assure valid decisions about whether or not dysfunction is present" (Saeki, et al., 1985). Sensitivity to cultural differences has emerged as a prominent issue in the Occupational Therapy literature (Evans, 1992, Fisher, Liu, Velozo, & Pan, 1992, Pope-Davis, Prieto, Whitaker, & Pope-Davis, 1993). It is necessary for an occupational therapist to acquire, understand and use information about a person's culture in the development and implementation of a treatment plan. There is no existing literature that specifically details the effects of childrens' culture on their test performance during the SIPT data collection and how the data might differ if this information were used in establishing the norms for the SIPT. The outcome of this study will contribute to the knowledge base that documents the effect of orthodox and liberal Jewish culture on children's performances of four practic subtests of the SIPT. Although individual evaluators may be sensitive to a child's culture, because the SIPT norms do not reflect cultural differences in performance, interpretation of the child's performance must be done cautiously. Although the 34 administration of the PPr, BMC, SPr, and OPr subtests to two subcultures of American Jewish children did not produce statistically significant results, an explanation for this outcome can point to the effect of environment and not specifically culture on a child's motor abilities. These findings could be considered associative with Saeki, et al's (1985) findings. For example, because the performance of the orthodox Jewish males was not statistically significantly different from the performance of the liberal Jewish males, because of the children's lifestyle and school environment, orthodox Jewish children are not necessarily predisposed to immature motor abilities, in Los Angeles. These values are reinforced by the community in which the child lives and although he or she may in fact have immature motor abilities he or she may also, and more importantly, be functioning appropriately within the norms for his or her culture group. Therefore, a conclusion, for this or any cultural group, that the child may have immature motor abilities solely as a result of a neurologic condition and a recommendation for therapy to address the child's motor immaturity would both be incorrect. Description of orthodox And Liberal Jewish Family Lifestyles Jewish families range on a continuum from those which define themselves primarily in terms of their host culture (for example, as American, French, British etc.) and only 35 marginally Jewish, to those for whom being Jewish is essential and central to their lives. While these latter Jews may be in America, France or Great Britain or some other host culture, they do not consider themselves to be part of it. Most Jewish families, however, are somewhere between these two extremes (Heilman, 1984). Orthodox Jewish Lifestyle Orthodox Judaism is defined as Judaism that adheres to the Torah and Talmud as interpreted in an authoritative rabbinic law code and applies their principles and regulations to modern living (Encyclopedia Judaica, 1988; Webster's 1984). Orthodox Jews come in a wide variety of types in America today. Chasidic Jews number their ranks; so do some right- wing anti-Zionists , left-wing profeminists, middle-of-the-road conventional modern orthodox, "born again" ba'alei teshuva, the sectarian yeshiva crowd, and so on. Twentieth-century American Jewry being what it is, the institutional frameworks in which most of the above would locate themselves are the institutions of Orthodox Jewry; and the self-label they would be likely to choose is Orthodox Jew" (Greenberg, 1983). Greenberg goes on to say that in her book, How To Run A Traditional Jewish Household (Simon & Shuster, 1983), she uses the term "traditional" and "Orthodox" almost interchangeably throughout her text, a style that will also be adopted for use in this section. Traditional is defined as "1: an inherited, established, or customary pattern of thought, action, or 36 behavior (as a religious practice or a social custom) 2: the handing down of information, beliefs, and customs by word of mouth or by example from one generation to another without written instruction1 ' (Webster's, 1984, p.1250). Despite the great diversity within traditional or Orthodox Judaism, the basics are essentially the same for all: an underlying belief that there is a personal God, Who revealed Himself in history, Who gave us the Torah, Who commanded— and commands— us to live in a certain way. That "special way" includes, among other things, observance of the Sabbath and the holidays, daily prayer, kosher food laws, a well-defined code of morality and sexual ethics, and a very high value placed on Torah learning and education of the young. It is these very things, these modes of behavior, that make the traditional Jewish household so overtly different from any other (Greenberg, 1983; Linzer, 1984). Other differences exist that may be more difficult to quantify, but nonetheless are persistent characteristics of the special ritual life of an Orthodox Jew. One is the strong commitment to community. Without the sturdy communal structures, Orthodox Jews understand that most of the observances, such as keeping kosher (kashrut), Torah education of children, Sabbath and holidays, daily prayer, a Jewish burial society, a mikveh (Jewish ritual bath), would be infinitely more difficulty to carry out (Greenberg, 198 3, Liebman, 1972). 37 Another typical feature of traditional Jewish households is the cohesiveness of the family unit. Much of "family time" is organized around the required observances, also a tremendous time of education and role modeling for the children. A typical Orthodox Jewish family is quite likely to celebrate together home rituals, synagogue life, and community events. Actively practicing control of one's temper, not gossiping, constantly assessing one's behavior and morality are all acts that can only be taught through example and constant discussion (Greenberg, 1983; Liebman, 1974; Linzer, 1984). The values and childrearing practices inherent in such a religious environment might affect a child's motor abilities. This fervent emphasis on auditory/visual tasks (sitting and learning, reading, reasoning, talking), rather than on a balance of physical, creative, and intellectual activities expresses a value within orthodox Judaism that is rooted in history. Knowledge gave an individual power and was also often used as both a physical and theological survival technique. Honing one's ability in philosophical discourse also represents an historic shift away from the Greeks, originators of the Olympic games which were held in the nude, whose emphasis was that of physical, external beauty and not on details of world religions (Encyclopedia Judaica, 1988). "Jews valued education, philosophy, and verbal and written expression over physical work" (Glazer, 1965, p.44). This became a survival technique when Jews lived in shtetls 38 (Jewish ghettos) in Europe. Verbal discourse was a safe way for Jews to engage each other in "battle". If Jews physically fought one another, it would become an open invitation to the enemies who lived around the Jews, in the host country, to also fight with and kill Jews. Therefore, Jews needed to develop reasoning abilities in order to disagree with each other yet not be wiped out (personal communication, B. Phillips, 3/17/93). The value of education and highly developed verbal skills is seen throughout Hasidic literature as well, because if a person, usually referring to a man, was worth something, he was a scholar, a teacher, someone who used his intellect (Buber, 1947; Ben-Amos & Mintz, 1970). The lowest form of humanity in a Jewish society was someone called a baal agalah, literally, a teamster; the owner of a wagon which indicated a wagon puller. It raises a clear image of a person who is akin to a donkey, and underscores the importance of intellectual achievement within this cultural group. An observer for the Industrial Commission writes in 1900, "In the lower schools, the Jewish children are the delight of their teachers for cleverness at their books, obedience, and general good conduct" (Glazer, 1965, p.111). This refers to the social characteristics of American Jewish immigrants who lived in crowded tenements, reinforcing their religious and cultural values, until they were able to advance economically, and move out into the suburbs of large cities such as Chicago, 39 New York, or Philadelphia. These values of education and obedience, respect for teachers and parents, are considered cornerstones of the traditional Jewish family. "The first impression of this particular world is that of the massive weight of authority, attested to by the mitzvot, the Halakhah, and the responsa, comprising the extensive legal system that institutionally coerces behavior and conscious ness" (Linzer, 1984, p.84). The entire thrust of the parents' obligations to their children is to help them to grow up and become persons in their own right. This includes instructing the child in practical matters of Jewish law, including how to swim (Kiddushin 30:30b). Teaching a child to swim can be seen as the parents' obligation to help a child not only physically save his/her own life, if necessary, but also to develop competence, a parable for the importance of learning a viable trade to be able to "keep one's head above water", in order to function and succeed in society (Linzer, 1984). Mitzvot are the biblical precepts which traditionally number 613. The Halakhah encompasses the entire system of Jewish law; the responsa comprise the question-and-answer literature that emerged in Jewish communities after the Second Commonwealth, after the erection of the second holy temple in Jerusalem, circa 2500 years ago. The recorded legal decisions were incorporated into the Halakhah. Today, Rabbis are recognized by the Jewish community to also have the authority to determine an issue of Halakhah for individuals. This form 40 of Rabbinic authority tends to bind a community to a certain Rabbi, and also gives authority to a certain group of Rabbis to determine community wide Halakhic issues (Linzer, 1984). However, the historic group cohesiveness of Jews, throughout the literature, has at its base the Jewish family (Bekerman-Matzner, 1984; Bubis, 1977; Glazer, 1965; Greenberg, 1983; Heilman, 1984; Hyman, 1989; Kraemer, 1989; Linzer, 1984; Rosenthal, 1970; Sanua, 1977; Schlesinger, 1971; Sklare, 1958, 1974; Twain, 1985; Zborowski & Herzog, 1967). "That the Jewish home is a home in the truest sense is a fact which no one will dispute. The family is knitted together by the strongest affections; its members show each other every due respect; and reverence for the elders is an inviolate law of the house" (Twain, 1985, p.68). Daily Routines in the Orthodox Jewish Home and School From the time a child in a traditional Jewish family opens her or his eyes, until he or she closes them, she or he is expected to and taught how to emulate and serve God exemplifying Torah principles. The family is the most important of primary groups. It is the central institution in the transmission of ethnic identity, cultural heritage, language and patterns of association (Heilman, 1984). For example kindness, mercy, giving someone the benefit of the doubt, charity, honesty, modesty, faith, respect, trust, decency are emphasized in one's behavior throughout the day. 41 The origins of traditional Jews' understanding of how and why to live this way cones from the word of God, at the beginning of time. Therefore, every word one utters and every action one does is supposed to be done for the purpose of reflecting one's gratitude to God for the life and lessons he gives us and for bringing an understanding of God's greatness to other people. The following section will detail the typical daily routines of a traditional Jewish household. The individual role of the parents, the way they model Jewish values to their children, the relationship between the parents and children and between siblings will be emphasized. This information is a compilation of a review of the literature, this researcher's personal observations and experiences in America and Israel, and discussions with community members. Upon rising early, between 5:30 and 6:00 a.m., in the morning, one says a prayer thanking God for returning one's soul, which was considered to be on loan to God while one slept. A blessing (brauckha) is said after one finishes using the bathroom, thanking God for the perfection and good running order of our bodies. Prior to eating or speaking to anyone, a man dresses quickly, saying blessings while he puts on his clothing, including the four cornered undergarment (called a tallit kattan, literally, a small tallis, a prayer shawl) with fringes (tzitzis), worn at all times. This tallit kattan is given to a young boy when he becomes toilet trained, somewhere around three. This serves to remind him of his constant 42 commitment to serving God in this lifetime, something that marks a rite of passage for young boys from being a baby to truly being a young boy. Grown men, often put on their kippah (a traditional head covering for a man, also known as a yarmulkah) the first thing in the morning. Young boys often need to be reminded, but are expected to remember to wear one all the time, by the time they reach first grade. Modest clothing (a full description of which follows in the section on an orthodox Jewish day school) is chosen, and a child is expected to dress him- or herself, by third grade. However an adult or older sibling is available to help, if necessary. Clothing is usually chosen the night before (except for shoes, which always seem to disappear), to prevent morning pandemonium as there may be anywhere between two and eight children attempting to get up and dressed in the morning at the same time. Before eating breakfast at school or at home, one says the appropriate blessing suited to the food one is eating (there are different blessings for foods that grow on trees, come from the ground, are made of grains, or that are considered bread), and appropriate blessings that are said after one eats each certain types of food, according to the same categories. By third grade, a child is expected to know these different blessings, with occasional prodding to say them and correcting from a parent or older sibling. Blessings over various types of food are said before and after any food is eaten at any time of the day. A teacher or other adult is 43 usually available to help a child when necessary. The food eaten is only of the highest kosher standard, and is eaten with the appropriate milchig (milk) or fleishic (meat) plates and silverware, depending upon what food one is eating at that time. The time to go to school, around 7:30 a.m. to 7:45 a.m., arrives quickly and an orthodox Jewish child gets there either by bus, walking or bicycle, but most usually by carpool. Older siblings, high school aged, may be sent out of town to study at yeshivot. This is usually done for boys. Girls usually stay at home and attend the local Bais Yaakov (House of Jacob, an established name for orthodox Jewish girls to study in high school). After dressing and before breakfast, the father usually goes to shul (synagogue) where he recites his morning prayers in a minyan (a quorum of at least ten men). A young third grader, boy or girl, may be brought to this minyan and expected to be able to at least pray 1/3 of the morning prayers independently. He or she would have learned this by being taught by a parent, a teacher (from the age of three) or an older sibling. If not done with a minyan, then the morning prayers are done at home, or at school with one's class with the help of one's Rebbe or teacher, as is usually the case with most orthodox third graders. 44 orthodox Jewish dav school The orthodox Jewish community has in recent years established large numbers of yeshivas and day schools (Cohen & Heilman, 1989). Because of the tendency for Orthodox Jews to cluster geographically, a Jewish day school for the children, certainly at an elementary school level, is a highly desirable institution, if not one of the essentials to meet the community's needs (Liebman, 1974). These institutions are there to perpetuate the ways of traditional Judaism by providing proper training and a suitable cultural environment for the transmission of a way of life (Heilman & Cohen, 1989). In the orthodox Jewish day school, the principal was a man, who has Rabbinical ordination (a degree from a recognized yeshiva, a school of higher Jewish philosophy and the study of Jewish law) or from an individual Rav (a term to denote an outstanding and recognized scholar in the Jewish community) whom the community he lives in recognizes as a Jewish scholar well versed in Jewish law, philosophy, and lifestyle matters. It was not clear whether or not he had any additional secular degree(s) (BA, BS, MA, MS, or Ph.D) in education or another subject. "The staff who teach Jewish studies in traditional yeshivas often come from the more insular sector of orthodoxy" (Cohen & Heilman, 1989), thereby providing the children with a role model who exemplifies the traditional texts. The children will refer to their teacher, if it is a man, as their "Rebbe" (a term of respect and endearment for a teacher in a 45 traditional Jewish day school who is directly responsible for teaching the children Jewish law and philosophy). As an orthodox Jewish man, the principal dressed in a dark suit, white shirt, a fairly conservative tie, formal shoes (not sneakers or boots) and wore a dark hat covering a dark kippah (also known as a yarmulkah, a head covering that traditionally observant Jewish men wear all the time); he did not shake hands with this female investigator, nor was it offered to do so as it is considered a more respectful and modest form of behavior for men over the age of 13 to avoid casually touching a woman and vice versa. It is considered acceptable if the woman is his wife, mother, daughter, or aunt, or if he is attending to her, as in the case of a doctor, dentist, or person assisting with saving her life. Similarly, the children had a dress code. Boys wore dark, non-jean, pants, white long or short-sleeved shirts (on fridays only) and non-stained, non-tattered shirts with collars the rest of the week (no tee-shirts), a kippah (yarmulkah), sneakers or shoes, no boots. A small percentage of the boys in the school have peyyis (or earlocks, curls of hair that grow in the place of sideburns, and are never cut), however none of these children participated in this study. Girls wore their hair in long braids or "modestly" groomed, with no high fashion haircuts with gel or mousse. They wore a uniform, as most orthodox Jewish day schools require in order to cut down on dressing competition (personal 46 communication, Rabbi D. Rue, Traditional Jewish day school teacher, March, 19 1993). The length of the girl's skirts were worn below the knee, with a shirt to match the uniform. The shirt had at least short- sleeves down to the elbow. Leg and footwear included stockings or knee socks, sneakers or shoes, only rain boots when necessary. No make-up or excessive jewelry was permitted. A simple necklace, possibly a ring, or a pair of earrings for pierced ears were considered acceptable adornment. The women teachers in the school were expected to wear modest clothing, at least knee length dresses or skirts that are attractive, but no tight fitting clothing (personal communication, Y. Fasman, January 19, 1994). Sleeves on shirts and dresses were at least down to and below the elbow. Stockings and modest shoes were acceptable leg and footwear for women. Bare legs, gym shoes, high heels, and cowboy boots are not acceptable and expected footwear for the women faculty. The teachers and administrators wore shaitlot (wigs) to cover their hair if they are married women, with simple make-up and not too much jewelry. Red is considered to be an immodest color to wear as the dominant color of an outfit, and blouses that are low cut in the front and the back are not modest or acceptable wear, nor are pants for women. Both the men and women teachers serve as significant role models to the children, in dress, behavior, and scholarship, and therefore dressed accordingly. 47 Only kosher food (food that is produced under the auspices of community-wide recognized and accepted Rabbinic authority and often has symbols, with the OU as the most common) under strict Rabbinic supervision was brought to school for lunches and snacks. There was no hot lunch program at this school. Girls and boys attended school in separate buildings in single sex classes from grade one and on. The boys' curricula are different from the girls' curricula with regard to the type of Jewish text learning each does. The school curricula is a mix of secular and Jewish studies; half a day of English and half Hebrew, including four hours on Sunday mornings, for boys only, devoted to Jewish text studies (lernen, yiddish for learning when describing classical text study). "More time spent in sacred literature means greater attachments to the people who choose to guide their lives by these books" (Cohen & Heilman, 1989, p.84). While the boys do not have art, music or gym classes during school, most of the boys appear to participate in organized sports after school, in Los Angeles. While the girls also attend school for the same hours as the boys, including four hours on Sunday mornings, their curriculum is substantially different. For example, while the boys are learning, the girls choose from a wide variety of options to fill their time, including sewing, Israeli dance, music, etc. 48 The length of the school day is from 8:00 a.m. to 4:00 p.m., with homework to be done at nighttime. Upon arriving home, a child is usually greeted by an adult, most commonly Ima (pronounced EEma, mommy in Hebrew). Some ultra orthodox Jewish families consider Hebrew to be the "holy tongue" and use it only for prayer, even in Israel. Therefore, English or Yiddish is spoken at home, and mommy is called mommy and not Eema, and the father is referred to as Tatti or papa, and not abba (Hebrew for father) for that reason. It is considered a cornerstone of the traditional Jewish family that someone, preferably the mother, is home for the children when they arrive home from school. The mother is considered the one who sets the mood for the home, and binds everyone in the family together (Greenberg, 1983; Matzner-Bekerman, 1984). Therefore, she prides herself, partly, on the great affection, care, and attention she provides for her children throughout their lives. Usually, the children wash their hands and sit down with Ima to tell her all about their day while they are having a snack. If it is cooked, it is homemade, of course. There is a strong chance, 8 out of 10, that the average orthodox Jewish family does not have a television set at home. Therefore, a child's attention is focused towards discussion of him or herself and his studies with his or her mother, and later father, while doing homework, usually at the dining room table. The mother usually sits with the child while she or he 49 is doing his or her homework, and is integrally involved in the child's learning, and the process of completing both his or her secular and religious subjects. It is also understood that if special assistance is needed for math, Hebrew grammar, etc., someone in the community is only a phone call away. This reflects the closely knit support structure of the community in which the child lives. After doing homework, the child is expected to do household chores that are his or hers alone to complete. This includes doing dishes, taking out garbage, taking care of the baby (because hopefully the child is one of at least five or six children and Ima always needs help with the smaller children), doing an errand, practicing an instrument, or studying Hebrew text with an older sibling, or tutor. Scouts (cub or girl) are not usual in the orthodox Jewish community. However, participation in orthodox youth groups, which usually meet on the sabbath are highly encouraged. When all the chores are done, and if there is still time before dinner, and there usually is, the child is permitted to play. Often one's siblings, both older and younger (with the older ones responsible for the younger ones), and usually friends from the block, who are also probably schoolmates, often get together to play. Imagination and creativity are the key ingredients to many games, and are encouraged in children's play. If children play inside, they are again encouraged to play in similar groupings, with board games, 50 books, and imagination as the key ingredients. This is to encourage a child to be self reliant, innovative, thoughtful, and a model to one's younger siblings. This is also to deemphasize materialism, as many large orthodox families cannot afford every toy on the market, and also encourage their children not to expect every toy on the market. There is often a high level of auditory and visual stimulation occurring simultaneously, coupled by constant movement of somebody prior to dinner. The phone is usually ringing, the baby needs attention, and someone usually needs help to find that missing piece of the game in order to be able to play. This mayhem may sound chaotic but it is also, usually, the mother's opportunity to teach cooperation, sharing, independence, and self-control to the children underfoot (personal communication, T. Union, October 9,1992). The third grader has davened (the Hebrew term for praying) mincha (the afternoon or midday prayers) at school, and will need to daven ma'ariv (the evening prayers) at home. Usually the father comes home sometime before dinner. The children are expected to run and greet their father with a pleasant face, warmth, and hugs and kisses. At dinnertime everyone has his or her own place at the table. It is understood that no one sits in Ima or Abba's chair, and that no one starts eating until everyone is seated at the table. It is expected that Abba will be able to be at home with his family, and that dinnertime is a time for everyone to talk 51 with each other about the day's events, especially what was learned about the Torah and the practice of mitzvahs (Mitzvahs are the 613 laws that orthodox Jewish people are expected to practice regularly.) According to orthodox Jewish philosophy, it is considered "a meal of clowns" if there are no words of Torah at the table where people are eating together. Therefore, it is an opportunity for the family to share teachings and Jewish ideology commonly held by the community at that time. Often, parents will try to explain as much as they can to their children regarding necessary disciplinary action, and not just yell at or hit the child. Everyone is usually given a chance to speak, and, as mentioned previously, appropriate blessings are said before and after any food is eaten. Time together at the dinner table is considered sacred because it is a time for family to connect and share time with each other, emphasizing the importance of togetherness (personal communication, T. Union, October 9, 1992). After dinner, there are more chores for everyone to do. Evening prayers must be said, lunch made for tomorrow, laundry to be folded, clothing to be picked out, and tzedukah (charity) to be put in the pushke (collection box marked for a certain organization that is in a person's home) before the end of the day. For the third grader, often, bedtime is around 8:30 p.m. Bedtime stories are usually read with Ima or Abba, and they are usually about a lesson to be learned from the weekly Torah portion, or illustrate a desirable character 52 trait of a person in Jewish history, or a story that winds up being a parable for teaching a desired principle, i.e. kindness, mercy, etc. Stories are considered to be the medium of choice for teaching young children Torah values because stories are a captivating way to illustrate a point to young children (personal communication, T. Union, October 9, 1992). Therefore, third grade Torah education is often filled with stories, and the books suitable for this age are stories that illustrate deeper, more complicated ideas that children will encounter as they grow up (charity, honesty, kindness, modesty, self-sacrifice, sharing, etc.). There is a special prayer that is said with children by their parents or older siblings, from the day they are born prior to going to sleep at night. It is called the Shema, and it is a prayer that a traditional Jew is required to say twice a day, once when he lies down and once upon waking. It is also the prayer that a traditional Jew is supposed to have on his or her lips as the last words he or she utters before he or she dies, because it proclaims a person's recognition of God as the only God and his greatness forever. Because one's soul returns to God for safe keeping while one sleeps, in the chance that one's soul is not returned, and therefore one does not awake, the person who devoted him or herself to a life of traditional Judaism would have proclaimed the majesty of God's greatness and oneness in this world before dying. The prayer 53 is said for that reason, and also as a request to God for protection while one sleeps. The orthodox Jewish third grader spends all day at home and at school learning about how to act as a person committed to Torah, mitzvot, and emulating God, as he is understood according to traditional Jewish values, principles, and theology. While the physical body is viewed as a vehicle for carrying out Torah values, development of specific motor and physical abilities in and of themselves are not meaningful within this culture group. Liberal Jewish Lifestyle Based on this researcher's experience and a review of the literature, in contrast to their orthodox Jewish counterparts, liberal Jews do not do the vast majority of what traditional Jews do that classifies them as traditional Jews (Heilman & Cohen, 1989; Liebman, 1974). Most liberal Jews do not keep kosher. Prayers are not said three times a day, by adults or children. Blessings are not said regularly before or after eating food most of the time, using the bathroom, or for any other reason. The food eaten in one's home may not be kosher, but there are wide variations on this. People may choose food that is not specifically kosher, as authorized by a recognized Rabbi, but also may not eat milk and meat together, which is considered traif (or not kosher). All different types of food are eaten on the same dishes (no separation of milk and meat 54 foods) with the same silverware. Liberal Jews identify with their Judaism not according to strict Jewish law (halachka) but in ways (according to Reconstructionist, Reform, or Conservative Jewish practice) that maybe a truer expression of one's own spirituality (Rosenthal, 1973). Historical Perspectives The period in America from 1880-1920, can be viewed as a time during which the sacred norms and organizations of Jewish Orthodoxy were challenged (Polsky, 1958). It saw a mass influx of strictly Orthodox Jews moving from East-European shtetls into America, taking over American values in the daily endeavor of American living (Polsky, 1958). Henceforth, it has been observed that today, Jews who are less traditional are probably 4th or 5th generation American Jews and more assimilated into American society than their more religious counterparts (personal communication, B. Phillips, March 17, 1993.) The latter are either more religious because they are 1st or 2nd generation American, and are therefore closer to living and adhering to the tradition, or are religious by choice, ba'alei tshuva (literally, those who return)(personal communication, B. Phillips, March 17,1993). Respondents in both Polsky's and Rosen's studies appear to emphasize that the degree of adherence to ritualistic observance is a valid measure of one's religiosity (Polsky, 1958; Rosen, 1958). The respondents were teenagers between the ages of 18-20, living 55 in suburbs of Michigan and Chicago, who were asked to discuss their attitudes and views of their own Jewish identity and observance. When asked if they considered observance of, for example, the sabbath, the Jewish holidays, and dietary laws (all of which are considered basic practices within religious Judaism), the majority of respondents responded positively to the inquiry, indicating that they could be traditional Jews. On the contrary, if one did not actively practice these Jewish rituals, one could still consider himself a Jew, but not a traditional Jew. Affluence, higher education, and intermarriage have emerged as factors that contribute most strongly to Jewish assimilation (Ellman, 1964; Goldstein & Goldscheider, 1974; Liebman, 1974; Polsky, 1958; Rosen, 1958; Sklare, 1958, 1974; Warner & Srole, 1958). "Intermarriage is an important indicator in regard to the degree of social integration achieved by the members of a minority group. (Milton Gordon sees it as one of the last rungs on the ladder to final integration and assimilation. We believe him to be sub stantially right.)" (Ellman, 1964, p.261). It is also important to add that while liberal Jews may not adhere to the code and letter of Jewish law, the level of creativity and the meaningful spiritual expression with which many Jews approach their celebration, and the less strict observance of the religion is not to be dismissed as unauthentic. Instead, this form of expression needs also to 56 be heeded with respect for the large numbers of Jews it includes today (Blau, 1965; Greenberg, 1983; Heilman, 1983; Rosenthal, 1974). Daily Routines in the Liberal Jewish Hone and School The philosophy in the liberal Jewish home is one emphasizing egalitarianism between men and women, rational behavior in resolving problems and finding solutions to situations. Flux, weaving tradition with modernity is the religious philosophy that characterizes the choreography of the liberal Jewish home (Rosenthal, 1973). The liberal Jewish home reflects Jewish culture combined with modern secular thinking (Heilman, 1983). Therefore, a television is considered a useful educational tool for children. Most first graders have grown up with Sesame Street, and a variety of other educational videos to stimulate music, language, learning the alphabet, numbers, shapes, and the positive example of cooperation amongst people who are from all over the world. Social action is prominent in the expression of one's Judaism as is tolerance of differences between people (Rosenthal, 1973). The use of non-sexist language, and behavior is also considered essential in the liberal Jewish home. It is highly likely that both parents work and that the father does not go to synagogue early in the morning, every 57 morning. Children are not expected to pray during school time, although some schools do include time to pray as part of the curricula. The fact that the children are attending a Jewish day school, suggests that both the children's parents are Jewish, or if only one is Jewish, that the children are being raised as Jews. According to the Bureau of Jewish Education, more children attend a liberal Jewish day school who come from single parent, divorced, or blended families more so than their orthodox counterparts (personal communication, R. Reynolds, director of school services at the Bureau of Jewish Education, May 5, 1993). The commitment of the family to the child(ren) receiving a Jewish education remains strong, in spite of the fact that an alternative family structure exists (Heilman, 1983; Mirsky, 1978; Rosenthal, 1973). When the children get dressed in the morning, a uniform may be required at school, but the dress of the adults in the home, reflects contemporary fashion and business attire, more than personal modesty. Men and women do not wear any sort of regular head covering, and hemlines, sleeve lengths, colors, shoes, and accessories are worn "to dress for success" rather than for the purpose of expressing personal modesty (personal communication, L. Fine, January 12, 1994). Third grade children who attend a liberal Jewish day school are usually the fourth or fifth generation of Americans descended from European immigrants (personal communication, B. 58 Phillips, September 1993). They also attend Jewish day school as more of a cultural expression of the family's commitment to Judaism than a religious one. The third grader learns the Hebrew alphabet, sings songs, and, has a multifaceted curriculum that balances secular with Jewish studies. In the liberal Jewish day school, the principal is either a man or a woman, and holds at least a master's degree in Jewish education or education, and may have a Ph. D. in education. She or he is not regarded as a Rebbe, and will not wear a head covering all the time. She or he certainly shakes hands with the opposite sex, as a matter of proper business practice and an expression of non-sexist behavior (personal communication, D. Ackerman, June 1993). She or he dresses in fashionable business clothing, which may include a shirt and tie for a man, and dress slacks for a woman. The children who attended liberal day school may or may not be required to wear a uniform. Girls are permitted to wear pants, leggings, or skirts and dresses. Almost any clothing is acceptable, with the exception of that which is dirty and tattered. Sneakers are permissible foot wear for both boys and girls and they may wear more trendy shoes i.e., clogs, cowboy boots, other types of boots, high fashion sneakers, as well as other shoes. The girls are also permitted to wear jewelry, including pierced earrings. The teachers, both men and women, are permitted to wear a wide range of acceptable clothing. Men can sneakers, cowboy 59 boots, sandals, with or without socks, jeans, or suits and ties. Women can wear red dresses, pants, short-sleeved shirts, sneakers, sandals, cowboy boots, and are not required to wear stockings. They can wear make-up, generally one or two earrings in one ear, and neither men nor women are expected to wear any type of head covering. These teachers also serve as role models for their students, however their appearance and style of dress included more contemporary fashion and is restricted by common sense rules of decency rather than communal religious standards. For example, women are not permitted to wear halter, see-through, or strapless tops, heavy perfume, excessive make-up, or jeans or pants with holes. With regard to food, the children may eat a hot lunch at the school, which will probably not follow the same kosher standards as those of their more traditional Jewish day school counterparts. The children are usually permitted to bring their own food from home, without any restrictions on the types of food they can bring, except for obviously non-kosher foods such as bacon, or meat and cheese sandwiches. Many modern Jewish day schools have emphasized their secular educational programs at least as much as their religious ones (Heilman, 1983). This trend described 10 years ago, is reflected in liberal Jewish Day Schools today. No separation of the sexes exists in any grade. There are no differences in the amount and type of Jewish text learning 60 between the boys and the girls. Because boys and girls are together in classes, they learn the same things. The school curricula usually involve a balanced mix of secular and Judaic studies, with an importance placed on art, music, and gym with financial support from the parents and the school for participation in organized sports after school. The length of the school day is usually from 8:45 a.m. to 3:15 p.m., a shorter day than the traditional day school, with homework to be done at afterwards. The third grade child typically watches television before and after school and is more likely than his or her orthodox counterpart to have an interactive computer and computer games available for his or her use. An abundance of toys, games, stickers, and commercial after school snacks are likely to welcome a child home, as is the housekeeper (or nanny or babysitter) who stays with the children until the parents get home from work. It is also probable that this child may have, on the average, one or two siblings, and live in a house with a yard and a swing set, and have a bicycle. Children are often encouraged to play with one's friends or siblings until dinnertime, unless there is homework to do, or a special lesson to attend (dance, gymnastics, music) after school or after dinner with a parent or parents. Bathtime and stories ensue after dinner, and time together as a family before bedtime, which ranges between 8:00 p.m. to 9:00 p.m. The family may eat together, depending on 61 each person's schedule for that day. The children have a usual place at the table and the parents are more flexible about where they sit. This seating flexibility is motivated by modern secular thinking rather than religious doctrine that reguires children not to sit at their parents' places at the table. The importance of feeling loved and connected to one's family are emphasized prior to and at bedtime, not service to God or performance of mitzvahs. Success in school is necessary for entrance to a "good" university and ultimately a good profession by which one can make a decent living. A child is encouraged to cultivate his or her spirituality through Jewish means by understanding the holidays and the basic tenentes of Jewish theology. Decency, kindness, and truth are emphasized without being sexist, unfair to others, or illogical and not for a religious purpose. For the Jewish child from a liberal Jewish family, although the child is culturally imbued with a rich sense of his or her Judaism, the emphasis of his or her world is on physical play, and egual encouragement of boys and girls to develop academically and physically. The breadth of their environmental opportunities (i.e. dance, movement, unrestricted attire, art, music, etc.) may allow for the manifestation of better overall motor abilities than their orthodox Jewish counterparts. 62 Chapter 3 Methodology This chapter presents the methods and procedures of this study. This includes sections on research design, hypothesis, subjects, instruments, procedures, methodological assumptions, data analysis, and limitations. Research Design The research design of this study was descriptive in nature, including a cross-cultural comparison. The mean subtest scores of children from two cultural groups on the Oral Praxis, Postural Praxis, Bilateral Motor Coordination, and Sequencing Praxis subtests were compared. These two cultural groups were: an orthodox Jewish American group, and a liberal Jewish American group. The orthodox and liberal Jewish children were tested by this researcher. The tests were all conducted in English, as English was the first language for all the participants. Hypothesis The following null hypothesis was tested in this study: Hoi: There are no differences in the mean subtest scores on the PPr, OPr, BMC, and SPr between Orthodox Jewish children, and Liberal Jewish children. 63 It was expected, in accord with the literature review, that Liberal Jewish children would score higher than Orthodox children. Subjects The subjects in this study were 13 orthodox Jewish children from one Jewish day school, and 13 liberal Jewish children from several liberal Jewish Day Schools in Los Angeles county. The sample was one of convenience. Only third graders were chosen for this study because it was felt that cultural differences related to schooling might be well established by this age. Jewish subjects were eight-year old third graders who, by third grade, are expected to be able to sit still and concentrate on the task at hand for at least 20-30 minutes at a time (Cohen & Heilman, 1989; Schiff, 1966). It can be expected according to Gesell (1949) and Bradekamp (1986) that third graders' bodily movements are more rhythmic and graceful, and that they enjoy being timed in a task. Girls' timing abilities are becoming smoother, as evidence of their ability to run into a moving rope and run out when beginning to fail (Gesell, 1949). Overall, third graders, are aware of their own posture and remember to sit upright. They also like to use a variety of movements and postures and can change his/her posture more adaptively. More symmetry can be 64 expected in the child's movements and he/she has a tendency to like to do things speedily (Gesell, 1949). The tendency for children to be more sedentary and more even in their task performance is evident, as is their ability to be more poised and self-dependent (Bradekamp, 1986). Therefore, it can be expected that a third grader can rise to the challenges presented in the ability of imitating unigue movements, reproducing rhythmic sequences, and integrated movements with the mouth and arms, as required by the practic subtests in this study. All Jewish subjects attended either an orthodox or liberal Jewish day school. Based on statistics from the Bureau of Jewish Education (BJE) it is estimated that there are 600,000 Jews living in Los Angeles, and 8,500 Jewish children from kindergarten through the 12th grade attending Jewish day schools ranging from the most liberal to the most orthodox curricula. All Los Angeles Jewish day schools are affiliated with the BJE, and approximately half of the enrolled children represent ages 5-8 years old (R. Reynolds, BJE, personal communication, 4/21/93). It is important to note that all Jewish day schools in Los Angeles county are under the auspices of the Bureau of Jewish Education (BJE), which has its own guidelines for education standards that the day schools must meet. Also any research to be conducted using students in the Los Angeles Jewish Day Schools must be approved by Dr. Ron Reynolds, 65 (Director of School Services, Bureau of Jewish Education) prior to any contact made with the principals or parents of students. Dr. Reynolds gave his wholehearted support to this project and provided this investigator with contacts and a personal letter of introduction to the school principals. Those children already receiving speech, occupational, or physical therapy to address a developmental delay, or taking medication (e.g., ritalin, due to a known diagnosis of attention deficit disorder, etc.) were excluded from the study. A limitation of the study was that a more rigorous process for screening out children with developmental conditions was not used. In this study, exclusion was only addressed in the Informed Consent form leaving the decision of participation, according to the criteria for participation established in the study, solely up to the parents. As it turned out, out of a original total n in each group of 14, two boys, one from each group, had to be dropped from each group of 14 children, because it was discovered after the data were collected that the above described conditions existed in each of these cases. It was disclosed to me by the classroom teacher that one of the orthodox boys was taking ritalin and had a known diagnosis of attention deficit disorder (ADD) and had previously been extensively tested. As an aside, he did perform average to above average in all of the subtests scores. 66 The boy who had to be discounted from the liberal sample was actually in second grade and not third grade, and was actively receiving speech therapy at the time of the data collection. Although he was 8 years 6 months at the time of the data collection, it could be indicative of some learning difficulties, that he was a year behind his same age peers. Instruments This section will include a brief description of the PPr, BMC, SPr, and OPr subtests. Please refer to Appendix A for the protocol sheets of these subtests. A discussion of reliability and validity of these tests can be found in Chapter 2. Postural Praxis (PPr) evaluates aptitude in planning and assuming different and unusual body postures. There are 17 different positions, each of which the child is required to assume and then hold for seven seconds. Hand and arm postures are most frequently used, but head, trunk, and finger positions are critical on some of the items. Although Postural Praxis requires visual interpretation of each demonstrated position, no memory of that position is required. The child receives a score of 0,1, or 2 on each item, depending upon both accuracy and speed of response. Bilateral Motor Coordination (BMC) requires the child to imitate smoothly executed movement sequences of hands (Items 1-10) and feet (Items 11-14) after they are demonstrated by 67 the examiner. Reciprocal movements of right and left extremities are stressed to assess integration of function of the two sides of the body. Each item is scored on a 0-1-2 scale, depending upon correctness and smoothness of movement. For the arm items, the test is discontinued after four consecutive items are incorrect (i.e., scored as 0). Administration of the feet items follows the completion or discontinuation of the arm items. The feet items are discontinued when two consecutive items are incorrect (i.e., scored as 0). Sequencing Praxis (SPr) evaluates competency in perceiving, remembering, and executing a demonstrated sequence of unilateral and bilateral hand and finger positions. The test consists of nine items, each with a number of subitems. Each of the six hand items requires a specific number of motions or changes of positions of either one or both hands. Each motion consists of tapping the table, the other hand, or the head with the palm or fist. The number of motions to be executed is increased from two or three on the first subitem to four or eight on the last subitem. Each subitem is scored as 0,1, or 2 for accuracy, and the total score is the sum of these subitem values. Each item is discontinued when two consecutive subitems have been scored as 0. When the first two subitems are scored as 0 on two consecutive hand items (Items 1 through 6), the hand items are discontinued. when the first two subitems of two 68 consecutive finger items are scored as 0, the test is discontinued. In the Oral Praxis (OPr) test, the child imitates the examiner's movements of the tongue, teeth, lips, cheeks, or jaw. Some items consist of a sequence of movements. Performance is scored on a 0-1-2 scale, depending upon accuracy of imitation. The total test score is the sum of the item scores. Procedure First, permission from the Human Subjects Protection committee at the University of Southern California was obtained. Dr. Ron Reynolds at the BJE, wrote a letter of introduction on my behalf. This letter was included as part of an information packet that was presented to the Jewish Day School principals in an effort to secure subjects for this study. A three page description of the study, the testing protocols, a copy of the Informed Consent form and a cover letter to the parents were also part of the packet (please refer to Appendixes A,B,C, & D). The beginning of the school year tends to be difficult for students in Jewish day schools because many Jewish holidays occur then. This year (1993- 1994), for example, school began September 1, and the Jewish holidays began September 15. For the month during which the holidays occur, there is an interruption with regard to the actual classroom hours spent focusing on third grade 69 curricula. Therefore, for the purposes of this study, it was planned that the testing would be administered to Jewish subjects four months into the school year, about mid- December, after the children have had time to be third graders and adjust to the demands of the new academic environment. The testing was actually administered between the last week in January and the first week in March, 1994. The arrangements for the actual data collection were arranged seemingly late in the school year, in large part due to amount of time it took to establish meetings with the schools administration. A significant interruption to setting up the data collection came during the beginning of December when the children have their winter break. This began Dec. 6 and school resumed on Dec. 20. Therefore, it was the case of both school administrators who suggested that the meetings prior to the data collection begin after the winter break. This turned out to be the course of events. After meeting with Rabbi Krause, the principal of Yeshiva Rav Isacsohn representing the orthodox student body, he agreed to allow his students to participate in this study saving, "I'm not quite certain that I understand exactly what you do or the nature of this study, but I do see that it could help someone else down the road. Please, go ahead and do it." He asked me to schedule a meeting with the heads of both the girls' (Mrs. Deckel and Fasman) and boys' (Rabbi Stewart) schools at Yeshiva Rav Isacsohn, which commenced a few days 70 after my initial meeting with Rabbi Krause. The project was met with overwhelming support from these administrators who were gracious and cooperative during the time I conducted the testing at their schools (which are across the street from each other). The heads of the schools took it upon themselves to discuss this project with the individual third grade teachers, and oversaw handing out and collecting the consent forms. The consent forms were handed out on a Monday and whatever number came back by Friday, at the end of that same week, determined how many children participated in the data collection. The consent forms were handed out twice, on Monday of two consecutive weeks, in an effort to secure more subjects and follow up on children who forgot or lost them. At the end of two weeks, there were a total of 4 girls, from a possible 53, and 10 boys from a possible 57 who had returned signed consent forms and were able to participate in this study from the orthodox Jewish Day School. Beginning with the girls at Yeshiva Rav Isacsohn, three girls were tested first, in two days, and the fourth, who had been absent frequently, was tested on the eighth and final day of testing at the Yeshiva. I was able to complete the testing with all ten boys in one week, two per day, for five days. I was afforded a room, mostly free of interruptions at both schools. All the testing was conducted solely during the children's lunch and recess times. Therefore, it took a total 71 of eight days to test the fourteen children, two per day for six days, and one per day for the first and last days. With regard to securing subjects from the liberal Jewish Day School, it was originally planned to approach the Stephen S. Wise Day School, and a meeting had been arranged with the director. This meeting was in part arranged through a personal contact of a faculty member at the school who teaches second grade. She felt from the start that securing subjects from the school would be next to impossible at best, and arranging a time and space would be more difficult than that. The meeting with the director was arranged for the morning of January 17, 1994 at 11:00 a.m. That meeting never took place that day or any time thereafter, due to the substantial damage that the Stephen S. Wise school, like so many other schools in the San Fernando Valley, sustained during the 6.6 earthquake on January 17, 1994. The earthquake also interrupted the handing out of the informed consent forms at the orthodox Jewish Day School for one week, yet resumed promptly on the morning of the 17th of January. This investigator was able to gain access to the second proposed liberal Jewish Day School, the Pressman Hebrew Academy at Temple Beth Am, beginning the morning of February 14, 1994. The educational director, Dr. David Ackerman, wholeheartedly supported this research endeavor, and personally saw to handing out and collecting the Informed Consent forms to the third grade class, of 15 students, 9 of 72 the parents consented to their child participating in the study. Dr. Ackerman and both the Hebrew and English third grade teachers, who split the class during the day, allowed the testing to be done continuously over two days, taking the child out of the classroom for a total of 20 minutes during which time the PPr, OPr, SPr, and BMC subtests were given. The other 5 children, a neighbor or friend of the investigator, who also attend liberal Jewish Day Schools, were contacted personally by the investigator, and the time and place for the testing was arranged between the child, the child's parent and the investigator. The data collection was conducted at different times with each group of children. This procedure could have contributed to the individual groups' performances. Each of the testing times was agreed upon between myself, the school administrators, and the individual classroom teachers. The orthodox children were tested only during their lunch and recess time, a 50 minute period, with a five minute leeway before and after that time, granted to me by the teachers. It could be concluded that the children were highly motivated to conclude the testing as quickly as possible for a few reasons. They wanted to; a) finish eating their lunch because they were hungry, b) be with their friends, and c) wanted to maximize their only opportunity during the day to engage in athletic activities, including playing football, or jumping rope. It is interesting to note that this investigator was told that a 73 few of the orthodox boys did not want to participate in this study specifically because they knew that it would be during their lunch/recess time and they did not want to miss their only opportunity during the day to play football. The data from the liberal Jewish day school was collected in two days, because the principal of the Pressman Academy asserted that, "it would be more time efficient to collect the data in as short a period of time as possible and it is only twenty minutes out of one day out of the entire year that these students would be taken out of their classroom instruction" (Private communication, D. Ackerman, 2/28/94). Dr. Ackerman was and continues to be enormously supportive of research. (The other) five of the thirteen children in the liberal sample who were personal contacts of this investigator were tested at home at prearranged times with their parents, between 4:30 - 7 p.m. These subjects were very focused on the task at hand, which was almost a surprise to this investigator, given the level of familiarity between the family, the children and this investigator, and the time of day. All of the participants were given a small token, silly/nutty putty, or legos, for their participation in the study. It was arranged with the classroom teachers and the investigator at the completion of the data collection, that an 74 educational toy, game or other suitable material was given to the class. All participants were receptive to this gesture. The data collection was done solely by this principal investigator who is certified by Sensory Integration International to administer and interpret the Sensory Integration and Praxis tests. Once the data were collected, the computer scored test sheets were completed and then sent to Western Psychological Services (WPS) where they were scored by computer. This is the procedure used for scoring all SIPT tests. Dr. Diane Parham wrote a letter on this researcher's behalf to WPS in an effort to acquire the testing materials at a less expensive rate. WPS in turn sold the required amount of testing materials to this investigator for a total of $200.00 plus tax. This amount included the scoring of the tests as well as the price of the individual subtest and transmittal sheets. There were a total of 300 sheets required for the original project proposal. This gesture is believed to demonstrate the support that WPS offer for research on the SIPT. Methodological Assumptions The following methodological assumptions were made in this study: l. The PPr, OPr, BMC, and SPr subtests are valid and reliable instruments to measure praxis. 75 2. Differences in performance of Ashkenazic and Sephardic children will be inconsequential. 3. Primary language used at home will not affect the child's motor performance. 4. Differences in family structure (e.g. single parent family vs. nuclear, vs. extended family) will not affect the child's motor performance. Data Analysis Prior to hypothesis testing, basic descriptive statistics (sample description and mean test scores) were generated separately for each group in the study. Score distributions were reviewed for normalcy and it was decided that even though the distribution was fairly normal, because of the small sample size non-parametric statistical procedures would be used to analyze the data. The statistical analysis were used to identify whether or not there were main effects for condition (orthodox vs. liberal; with expected higher scores for liberal) and gender (higher mean scores for females then males) . A Chi-Square test was used to evaluate groups differences in gender, and a Wilcoxon Rank Sum test was used to evaluate groups differences in age. The results are discussed in Chapter 4. The dependent variables are the four practic subtests, PPr, BMC, SPr, and OPr. The independent variables are the 76 condition, traditional or liberal, and the gender, male or female of the subjects to be included in this study. The non-parametric procedures were performed at the rv- = 0.05 significance level and was used throughout the statistical analysis of this study. The p values were considered one tailed for condition because it was expected that the liberal group would perform better than the orthodox group. Limitations The following limitations should be considered when interpreting and generalizing the data of this study: 1. The selection of the subjects was not at all random as it was limited to those who agreed to participate in this study. 2. Because of time and financial restrictions, the subjects were limited to those residing in Greater Metropolitan Los Angeles. 3. Because of time and financial restrictions, the amount of data collected for this study was limited to the number of subjects who had returned signed consent forms within a specified time frame. It was not possible to extend the dates for returning consent forms, or approach other schools with known populations suitable for this study, to gain their participation. 77 Chapter 4 RESULTS This chapter presents the results of the study according to the null hypothesis stated in the previous chapter. The data were collected from January through March 1994. Thirteen children who attended an orthodox Jewish Day School and thirteen children who attended a liberal Jewish Day School, or a total n of 26 children, participated in this study. Tables 1 & 2 present the results of the data analyses. Comparability of the Two Groups It was important to establish whether the groups were similar with respect to age and gender. This was necessary in order to show that group differences in age and gender were not likely to influence group scores. A 2 x 2 Chi-square test was used to analyze gender differences and a Wilcoxon Rank Sum test (Zar, 1984) was used to analyze age differences (see Tables 1 & 2). These calculations were performed by hand. 78 Table 1 Betweeen - Group Differences in Gender Gender Freauencv (%) ■£ males Liberal 7 (53% ) 9 (69%) 2.90 ^ value .09 females 6 (47%) 4 (31%) Between - Table 2 Group Differences in Age Aae in Months Liberal Orthodox Wi.Wo jt value (two-sided) X + SD 106.2+ 3.8 103-1± 4.5 207(144 . 10 Note. WL = summed ranks for Liberal group, W» = summed ranks for Orthodox group. Table 1 shows that there is no statistically significant difference between groups in the proportion of males to females ( = 2.90) (p > .05). Table 2 shows that there is no statistically significant difference in the median age between liberal and orthodox Jewish children in this study (p > .05). These results show that the two groups were not significantly different with respect to age and gender. 79 Comparison of Praxis Performance of the Two Groups In Table 3, descriptive statistics (the means, standard deviations, and ranges) for the two comparative groups' performance on the four practic subtests of the SIPT are presented. Due to the small sample size, non-parametric statistical procedures were then used to analyze the data. A Wilcoxon Rank Sum test was used to individually calculate the results of the two groups' performances on each of the four practic subtests. Table 3 Descriptive Statistics and Wilcoxon Rank Sum Test on the Median Subtests Scores for Liberal and Orthodox Jewish Children on Postural Praxis (PPr), Bilateral Motor Coordination (BMC), Sequencing Praxis (SPr), and Oral Praxis (opr) Subtests of the SIPT Mean± Standard Deviation Subtest (Range) Liberal Orthodox , Wo p (one-sided) (n=13) (n=l3) PPr .39+ 1.30 .42 + 1.08 174.5, 176.5 p = .96 (-2.37, 2.22) (-2.64, 1.68) BMC .99+ .65 .87+ .73 182, 169 p = .98 (-.57, 1.70) (-.37, 1.87) SPr .68± .86 .39+ .83 201.5, 149.5 p = .18 (-1.22, 1.95) (-1.86, 1.72) OPr .24± 1.39 .85+ .73 161.5, 189.5 p = .47 (-1.99, 1.86) (-.38, 1.86) It was established that there were no statistically significant differences in the median subtest scores between the two groups in this study (p > .05). 80 Chapter 5 DISCUSSION, CONCLUSIONS, AND RECOMMENDATIONS The findings of this study are discussed in accordance with the research question generated in Chapter 1. Group .Differences on Praxis Tests The research question of the study was: Are there statistically significant differences in the mean subtest scores of PPr, BMC, SPr, and OPr between orthodox and liberal Jewish children? The study demonstrated that there were no statistically significant differences in the median practic subtest scores between orthodox and liberal Jewish third grade children (p > .05). The lack of difference is probably best interpreted as a result of self-selection and environmental interaction. According to Dr. Bruce Phillips, a renowned Jewish sociologist at Hebrew Union College, the orthodox Jews who live in greater metropolitan Los Angeles, are a self selecting group for openness to cultural influences outside the orthodox community (personal communication, B. Phillips, 3/17/94). The majority of these individuals came from the east coast, primarily New York, and stayed in Los Angeles. While these people may have moved out here for economic reasons and opportunities, they chose to stay and live. 81 Had they wanted to stay in a large deliberately isolated, parochial setting, they would have stayed in New York (i.e. Munsey, or Crown Heights) or a comparable community in Montreal, Canada. However, because they moved to Los Angeles, it would be correct to say that these orthodox Jews are open to living in an orthodox community but one in which their children could be exposed to other influences. Another explanation, the phrase for which was coined by Dr. Diane Parham (personal communication, D. Parham, 3/16/94), with which Dr. Phillips agrees (personal communication, B. Phillips, 3/17/94), is that of the "California effect". It is warmer for most of the year in Southern California than in those above mentioned east coast communities, highly conducive to being outdoors, and participating in sports. The influence of the environment is further seen in that it is an acceptable form of footwear for orthodox children to wear sneakers in school, as opposed to their east coast counterparts who wear black shoes, for boys, and non-sneaker shoes for girls (personal communication, B. Phillips, 3/17/94). These groups may also have been influenced by the fact that LA has a predominant health, athletic/sports minded culture and that Jews who live here participate in that culture. Although wanting to be and seeming like "everyone else" (the greater community), Jews have a vested interest in maintaining their national and cultural identity. This idea was central to Ginzberg (penname Ahat Ha'am), a pivotal Jewish philosopher 82 regarding national Jewish identity. He asserted that while the essential activity of a nation is to express its individuality in thought and action to demonstrate the distinctive character of spirit, otherwise called its individuality, it is equally as important to express universal human values in the terms of its own distinctive spirit. "This conception of the nation as a basically cultural group, and of the relation between the individual nation and the human family is what redeems Jewish nationalism from the charge of tribal narrowness" (Simon, 1960, p.121). The performance of these two "different" groups of Jewish children illustrates the point that Ginzberg raises; the orthodox children's motor skills in Los Angeles are not affected by their religious lifestyle. Another interpretation of why no differences were found is that the orthodox children in this study might have taken the testing more seriously than the liberal students. Within the orthodox community there exists a level of respect between children/students and adults and between adults that carries over into interpersonal interactions. It is expected that people treat each other respectfully. This manifested itself over and over again during the data collection at the school. The staff and administrators referred to each other by their surnames (Rabbi, Dr., Mr., Mrs., Ms.) and referred to these people in this manner when speaking to the children as well, modeling this respect. Between adults, this respect 83 manifested itself from the orthodox school administration to this investigator in terms of the punctuality of the meetings, and focused attention that was given to the details that were required of the staff (i.e., hand out and collect consent forms). The children referred to this investigator as Mrs. Sobel, only. A measure of respect from children to adults is demonstrated by children standing up when an adult, especially a teacher, Rabbi, or parent enters the room. This was done for this investigator by both boys and girls during the data collection. This respect carried over to the type of conversation that was conducted between this investigator and the individual children during the testing time. Although detailed at times in their inquiries regarding the nature of the testing and their performance, the children were very task oriented and did not offer any personal information about themselves or speak tangentially. The orthodox children were also polite and did seek immediate feedback on their performance as did their liberal counterparts. Another pointed difference that illustrates this point was reflected in the information that was included in the cover letters sent home to the parents with the Informed Consent forms. Each of the day school principals asked for different details to be included in the letters. At the orthodox school, personal information about this investigator was emphasized and academic credentials were regarded as 84 nobody's business (i.e., requesting this investigator's marital status, number of children, but not that this study was part of a master's thesis or any previous work history). It seems that this more personal information helped to reinforce this investigator's identity and credibility as part of the orthodox community. However, it was requested that the opposite information be emphasized (i.e. from which university and for what academic degree is this study) for the cover letter to be sent home with the consent forms to the liberal Jewish day school families. In both instances, the opposite information was deemed as unnecessary, or not important for the parents to know. In contrast to the orthodox Jewish day school, the liberal Jewish day school imparted a unique flavor of its own. Most striking was the level of familiarity with which the staff, and administrators addressed, and spoke with each other, as if to convey as sense of kidding although efficient in the process. This rapport may have been a more open reaction to the many stressful environmental factors that befell the school and Los Angeles at the time of this study (the earthquake, the school physically moving buildings, the main secretary losing her home in the quake, etc.). However, the principal was much more relaxed in meeting times with this investigator, yet did take it upon himself personally to see to handing out and collecting the Informed Consent forms to the third grade parents. 85 The interactions with the children manifested the most striking difference which was possibly due to the time of day during which the children were tested. Because the liberal children were tested during classroom instruction time, it could be hypothesized that they were relieved to be out of class, and possibly as equally unmotivated to return, although that was not the case. The children did however, speak much more freely about themselves, their personal lives, families, and were willing to share a lot of personal information with this investigator during the testing time. It was established that most of the orthodox boys participated in organized sports outside of school, and during recess time. As a matter of fact, the basketball team from the orthodox day school is considered one of the best in the league (personal communication, R. Stewart, January 19, 1994). Thus, the orthodox sample in this study may have had unique opportunities to develop their praxis abilities. Of note, most of the girls in the combined sample were actively taking music or dance lessons, which could also have contributed to the lack of difference in the groups' performance. It was interesting to note that SPr approached significance (p =.18) in differentiating the two groups. SPr is a subtest that measures the integration of bilateral coordination and the ability to plan and execute sequential movements with the hands and fingers. The total accuracy score indicates the average accuracy with which the 86 child was able to reproduce the sequences of movements that were demonstrated by the examiner on all hands and finger items. There are separate accuracy scores for the finger and hand items, in addition to the total accuracy score. Possibly because the accuracy with which the child replicates the movements is so strictly graded, there is a higher potential for even a slight difference in performance to be noted. This could be especially true between the subjects in this study who appear to perform very similarly on the other three practic subtests, but perform more disparately on SPr. This difference, which approaches statistical significance, may be attributed to cultural influences. However, it is also possible that the differences were most pronounced in this rigorous subtest because of factors such as time of day and circumstances under which the testing was conducted. It is interesting to note that SPr is the praxis test that loaded most heavily on praxis factors in Ayres's research (Ayres, 1989). This may make SPr more sensitive to group differences if they exist. Perhaps significant differences between groups would have been found in the present study had larger sample sizes been available. Conclusions This study was designed to investigate cultural influence on a child's practic ability as measured by the PPr, BMC, SPr, and OPr subtests of the SIPT. The rationale for this study 87 was seeded both by a previous study of this nature, evaluating the effect that cultural influences have on the child's development of eye-hand coordination (Saeki, et al., 1982), and this researcher's experience in 1986 working with children referred for occupational therapy in Israel. The PPr, BMC, SPr, and OPr were administered to thirteen Orthodox Jewish children and thirteen liberal Jewish children in two Jewish Day Schools in Greater Metropolitan Los Angeles. The findings of the study are summarized as follows: 1. The results of a 2 x 2 Chi-Square test indicate that the groups were similar with respect to gender ( =2.90) (p > .05). 2. The results of a multiple Wilcoxon Rank Sum test indicate that the groups were similar with respect to age (in months) (p > .05). 3. The results of the multiple Wilcoxon Rank Sum tests indicate that there is no statistically significant difference in the median subtest scores between orthodox and liberal Jewish children on the PPr, BMC, SPr, and OPr subtests of the SIPT (p > .05). Although a strong case was built anticipating that there would be a difference between these two groups' performance and that the orthodox boys would produce among the lowest test scores, the findings of this study revealed that there was no difference in practic abilities between orthodox and liberal Jewish children in Los Angeles. In short, this study does not 88 support the stereotype that orthodox Jewish children are clumsy. Recommendations for Future Research Some issues have emerged during this study, and it is recommended that further investigation be made in the future. 1. Replication of this study sampling Jewish children who represent an Orthodox and Liberal group in much more disparate communities. For example, a researcher might compare the performance of children who live in Munsey or Crown Heights, New York both insulated Orthodox Jewish communities, with the performance of children who attend a liberal Jewish Day School (i.e. a Zalman Schecter school) on the upper West side of Manhattan. 2. Replication of this study by securing an overall larger sample size, closer to 30 in each sample group. 3. More systematically screening out potential subjects who may in fact be under therapeutic treatment (including use of medication, e.g. Ritalin). 4. Replication of this study in comparable communities in Israel, i.e. Mea Shearim or B'nai Brak to represent the Orthodox group and children in Tel Aviv to represent the Liberal group to better represent a more diverse Jewish population. 89 5. Longitudinal study with subjects over 13 years of age, allowing the opportunity to study the development of praxis and its relationship to occupational choice. 6. Future cross-cultural studies, as Saeki, et al recommended fAJOT. 1985) in the original study that motivated this one, on the SIPT are needed to assure valid decisions about whether or not dysfunction is present when evaluating children from a specific cultural group. Clinical Implications The results of the study of Jewish children who attend two different Jewish day schools in Los Angeles, reveal that both groups perform similarly to the SIPT normative sample on praxis tests. Therefore, it is appropriate to use SIPT norms when scoring the results of praxis subtests of Jewish children in Los Angeles. This recommendation could be strengthened if results were replicated with larger sample sizes. Results tentatively suggest that an orthodox Jewish background has no significant effect on the child's performance. 90 References Ayres, A. J. (1989). SIPT Sensory Integration and Praxis Tests. California: Western Psychological Services. Ayres, A.J. (1985). 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Massachusetts: Merriam-Webster, Inc. Publishers. 96 Appendix Appendix A: Test formats for the OPr, PPr, BMC, and SPr as they appear in the SIPT manual and were used to administer and score these tests with each of the subjects. Appendix B: Individual cover letters that were sent to the heads of each of the Jewish Day Schools. Appendix C: Individual cover letters that were sent home to the parents of each of the three groups of children included in this study. Appendix D: Informed Consent Form 97 Annemrfi v A WpS TEST REPORT “ n ttfH S «r>«n * 1?(D> W rtihut I w m i i • LM A flffttl C*bfdrmi fCQR SENSORY INTEGRATION A N D PRAXIS TESTS (SIPT) 5. POSTURAL PRAXIS (PPr) Protocol Sheet A Joan Ayres. Ph D DIRECTIONS: Sil Oiiprisui* lire child lm ! ncni "Vuu make your at m i end hinds do the same thing that mine do. Saa how loal you can do it ' Assume murra image nl illuslralion Aftei child iimlales "This hand is over my aai, this hand is on lop ol it, and I'm loaning to lha aid*. It's as though you wete looking in a m inor." Assume neulral position Hem 1 "Now do this one Do it quickly " Hold each posilmn until (he child correctly imitates it. or lor 1 seconds In all cases scoie 0 il Ihe pasture was inconect or completed altei 7 seconds Scoie I il ihe correct posluie was assumed in 4 7 seconds, or the poslure devialed as descnbed in Ihe scoring cn le iii Score 2 if the correct posture was assumed within 3 seconds If Ihe position changed tiequenlly. the accurate position must be maintained (or 2 ol the first 3 seconds lo receive a scoie ol 1 oilier wise, score Ihe position at 7 seconds Do nol penalire fm iKmminored response However Ihe In si nme this occurs uncoui/ l^ lu ld lo assume a innrorerf position If unsure of Hie child s score, you may d itw any deviations over Ihe illuslialiiqs on Ih or later scoring Alsn note the response lime in these cases Hnwevei all such maiks must be eraseiT R EO U M EO TRAMMHTM. NUMKH )© ©oooo©© ®®®®®®® ©®®®®®© ®©0©©0® ®®®®®®® ®®®®®®® 0®®®®00 ®®®®®0® 0000000 • Administer ail items • Hold each postuie until child correctly imitates or tor 7 seconj TRIAL feeder) 7 seconds seconds, or arm or less or forward ® Incorr Do nol score abducte t in 3 seconds CHILD S NAME Arm abducted re than AS*, forward 4 5 * ar more, 1 or more fingers touch ahouldar Anna cn fingeii n ol palma ol hold 0 Incorrect or exceeded 7 seconds 0 Correct in 4 7 seconds, or arms crossed, lingers only either hand on sides of head ® Correct in 3 seconds_________ Tips * f thumb •»d fingai(a) ol ••e h hand farm opening, can a n pupils 0 Incorrect or exceeded 7 seconds 0 Correct in 4 - 7 seconds, or 2 open ings but cannot see 1 or 2 pupils © Correct in 3 seconds _________ Fingeri curve •v tr opposite ihouldtr. no fingernails viaibfe except thumb © Incorrect or exceeded 7 seconds © Correct in 4 7 seconds, or 1 or more fingernails visible but all 5 above sternal end of clavicle © Correct in 3 seconds_________ Arms crowed, hands covet cinler st apposite patella 0 Incorrect or exceeded 7 seconds © Correct in 4-7 seconds, or entire hands on distal half of thighs © Correct in 3 seconds CONTINUE ON BACK V ?60fllS | Ctw-tfii * 1904 !9Hr> lgaatrv WtSIERN rSYO*Anr,k:AL srrtvicts Not In b r r*n>ixJtrr*r1 *'< wliofe or hi VvKtwuf w itH ait nl lA^ftiein fSytlnatogtf-Al SffviCP* AH nqftii tdsetvdd 3 4 5 6 7 9 9 n U S A 7M71 T J I 98 Administer all items Hold each posture until child correctly imitates or foi 7 seconds Elbow * cupp'd by o p p o iil' handi © Incorrect or exceeded 7 seconds ©Correct in 4 7 seconds, or only I elbow cupped 7. ® Correct in 3 seconds W rm s c ru s t'd , palmar u n f jc ' of 2 Irn g 'rlip s of *ach hand touch @ Incorrect or exceeded 7 seconds ©Correct in 4 ■ 7 seconds, or only 1 finger either hand touches fingers of other hand © Correct in 3 seconds ___ Arm bthind Itg. grasps Other Itg batwaan knaa and ankla © Incorrect or exceeded 7 seconds © Correct in 4 -7 seconds, or hand touches but does not grasp other leg © Correct in 3 seconds__________ One hand an f id* ol head, olhar hand on hip. haad and trunk leaning © Incorrect or exceeded 7 seconds © Correct in 4 ■ 7 seconds, or head or trunk alone leaning or hand on thigh, buttock, or above waist © Correct in 3 seconds__________ 10 W n ili/a r m iro n e d , all 5 fingart aach hand t conlrdjalaral lag betwagn © Incorrect or exceedei © Correct in 4- 7 secoi but not all 5 fini touch © Correct in 3 13 Thumb* and indax finger* lorm tinkad ih ap at © Incorrect or exceeded 7 seconds © Correct in 4-7 seconds, or other or additional fingers and ttiumbs form linked shapes rect in 3 seconds Arm i fold'd, knuckles and lingai* not visible medial to arm* © Incorrect or exceeded 7 seconds ©Correct in 4-7 seconds, or knuck les or fingers of either hand visible medial to arms © Correct in 3 seconds___________ im encircle* •ad, hand Hat on da of haad. othar palm overlap* first hand, haad tilt* 14. Thumb and indax fingertip! touch exceeded 7 seconds tin'4 7 seconds, or head I or only fingers overlap S nd i in 3 seconds © Incorrect or exceeded 7 seconds © Correct in 4-7 seconds, or middle finger(s) substituted tor index finger(s) Q Correct in 3 seconds___________ Thumb and liltla fingai hoakad. not all joint* naad (lax. palmar approach 16. Hand* graip opposite lag between a n k l' and hnaa, flaaian of 2 linear* aach hand. 10 finger* visible 17. © Incorrect or exceeded 7 seconds © Coirect in 4 - 7 seconds, or dorsal approach © Correct m 3 seconds__________ © Incorrect or exceeded 7 seconds © Correct in 4-7 seconds, or fewer than 10 fingers visible or touch not grasp © Correct in 3 seconds____________ Palm af 1 hand an dorsum of othar, palm* down, ring and litll* finger* intarpoead © Incorrect or exceeded 7 seconds © Correct in 4-7 seconds, or 1 or 3 fingers or utnar side interposed © Correct in 3 seconds D O N O T W R IT E H E R E 99 W pS TEST REPORT tiii» rn h » ii« it |c ii S#*«cn * U*JI LM C »H *IN« m ) SENSORY INTEGRATION A N D PRAXIS TESTS (SIPT) 6. BILATERAL MOTOR COORDINATION (BMC) Protocol Sheet A Jean Ayres Pl> 0 DIRECTIONS FOR ARMS ITEMS Sit lacing Ihe child Tml Hern "Watch my handi mom Whan thay a i* through moiling, you do thi ii m i thing (Demoniliate I IT h il'i correct.i Be lure to move imoathly liho ih ii (nrnve child i hands) When I begin with Ih it hind lleft). you begin with tb it hand (child's nghl) W hin I begin with this hind Inght). you begin with this hand (child s left)" If insufficient mnnbei ol movements "Do it is many timet is I did i t " Item I "W itch me do another om. (Oemonsliale I Now you do it. " Uo nnl penalire the clnlil tor starting with Ihe wiring hand but lemind the child on Inst (but only on hi-til wrung hand use f ill >/' Ihe T rr]p cm res ponding lo the child s item score II) - tnijjriecl. nnnreciprocal. dysiliytlmnr. segimited iiir.nmpleie 1 - apiuominalely cunect oi slightly irregular. / y ijnrecl and well cnnidiiiatedl Discontinue when four rnnsecultve items ate stored as 0 then give leet 1 DIRECTIONS FOR fEFT ITEMS Du nut give feel items to 4 yeai aids Tnal^jem H o ^ w V lp d n the some thing w ith our leet Watch me (Uemtmstiate) You do it " Scoie each item a!h<L i. or 2 ^ 1 lot tire anus Hems Discontinue when Iwn consecutive items are scmed as 0 M O U M U ntMMMmW M IM M II ARMS Discontinue when 4 consecutive items ate seated 0 and go on to leet items ooooooo ©©©©©©® ®®®®©®@ ®®©©©©© ®©®©®©® ®®®®®®® 0000000 ®®®®®®® ©®®®©®® cmVds Ν А М Е ” FEET ,Q Do nol administer to 4-year-olds Discontinue when 2 consecutive items are scored as 0 i TRIAL 1 : L. R . L, R 14 seconds) 1. R . L, R . L |4 seconds) ufTYA © 2 I. R, L. R (4 seconds) ^ A t ) © 3. Both, clap clap. both, clap clap (4 secondslN v \ (® © © 4. LR, LR. LR (3 seconds) ( —sy® © © 5. Both, both both. both, both bolh (fc'«fop2s) j © © © 6 . \r Crossed RL, RL, R L 13 seconds) © © © 7. LL. RR, LL, RR 14 seconds) ® © © 8. RR, U , R R . LL (4 seconds) © © © 9. L, RR, L. R R (4 seconds) © 0 © 10. R. LL, R, LL (4 seconds) © © © Ml TRIAL 1 1 : L, R. L. R <2 seconds) 11. R, L, R , L 12 seconds) © © © 12. LL, RR, LL, RR (3 seconds) © © © 13. R. LL, R , LL (2 seconds) © © © 14. L. RR. L. RR (2 seconds) © © © O B S E R V A TIO N S /ns t^ytaMidl— t S 198 4 t9 8 5 198B by W ESTERN PSYCHOLOGICAL SERVICES Nctl It^ bw tli-i'Cnlu* 0 < * w » h i* c m in p * il vmITwmji wriltwn p n n tn v o ri ol A « llW n P tythoA 'gtc** ServtCdt AH Fig*irs !»?<•'.ed 3 4 5 6 / 0 9 Pstnitd m U S A ' 6 4 2 ? J?« 100 W PS TEST REPORT *W t*R H * tJW ' V t> iv h'* Hu'fvrl • l« Clht**w i U7^ SENSORY INTEGRATION A N D PRAXIS TESTS (SIPT) 11. SEQUENCING PRAXIS (SPr) Protocol Sheet A Jenn Ayrns PhD and Zoe K M ailkrua.M A DIRECTIONS: Sit oppnsle thild Trral I am gaing lo mow* my hands Whan I tla p moving, you da iha aama thing II I u ta this hand (hold on laid, you u ia th it hand Ito jc li child's light) II I uaa this hand (hold up nghll. you u ia this ona (touch child s lei I) If I ua* both hands (hold up boThl. you u ta both handl (touch bath ol cluld 5 hands) Now do this tl mermen position 01 number ol taps on Inal I. say "Watch me again," and repeat trial Demonstrate lest items only mice II child begins any item beluie you brush 'W a il until I finish, than you do i t " Repeat riemonstiatiun fill in the 0 1 or ? rnclf ronpspijnditig to the child s score no each suhitem II ~ Eiecuted with wrong hand position or movement or too lew m ton many muhmu I - Started with wrong hand pnsihon or movement but stalled over anil com pleled/oiiecttj < = Completed with ecu tec. l harul positions in co re d sequence and collect number ol rhgboni and laps Use ol m coiitct hand does not allect scene Discontinue each Hern when two consecutive subitems are incurred (scored aYTNUtnd go o iU o rflfsl item Orsconlmue test when suhnems a and b ot IWD consecutive items are scu ie O s 0 Do nol administer linger items lllerns 7 91 to 4 year olds M O I R M O I M M M m M M D H I I I 5) @ ® ( 5 ) ®0® OOOCDOOO ©®©®©©© ®©©®®@© ©0©®©©® ©®©®©©0 ®®®®®®® 0000000 ®®®®®®® ®©©©©©® CHtlD'S NAME Discontinue each item wlien 2 consecutive subitems Discontinue hand itpm when subitems a and b ol / consecut go on lo next item are scored ns 0, and go on to item 7 n TRIALS Item 2 e. Clap Clap © © © Clap Clap P . O ® o 2 Clap Clap op op © o Clap Clap 1 p I cl C l ! Clap © Clap Clap op 0 , 0 Clap Clap © O © c 0 i n ® © © © © © o. n. op op © © © op op Clap © © © op 0 , 0 Clap Clap © 0 © op OP | CMP Clap Clap 0 , 0 @ ® © ® CONTINUE ON BACK W ?60B( I I ) L t m r p l't IS S -I 1 1 8 8 1 1 0 8 hy W tS tth M P S V C IK A O G IC A l S F8W C C 5 Nr*t L e t t v rp|if ,’rtiirwii m U O HIJ C v p a n A I I IKHJI w iiiltn p c r m n s m o1 Pjyt(»ntog«:*l S *T V C M A lln g lilir p tfr v a il 3 4 T ) 0 t ft 9 P lH tla d ih U S A 17t (©©©©« 101 hem 3 Mirror positions .'fc- ® O © C. -« N . * © © © © © © =*3- © © © h .gi-- t © © © ci . ei P7? 1 „ „ „ ■ 1 l « L | @ © © Item 5 Mirror positions L#!r ^ © © © b A , . ^ a © © © b. / / - n © © © c. L*.:k/£ , ^ "i © © © c. ‘ a/ L A. © © © d. E ^JI _ E V , liLl © © © J ¥ ■ n * & a & a © © © e. , ^ "1 <© 0 © l N V 1 ^ ”■■i r^- © © t. E ' i 1 a © >©—© & ■ T- ® © Item 4 a . , 0 I 0 ® © © [_ . ,1*) | © © © i r o T T . i T .] ® © © d. .ft .ft Clap 1 [. 0 f) j , ft ; c,*r ’ © © © Item 6 nsitions , & © O © FINGER ITEFI • D n not administer lo 4-year olds • Finger codes are 1 = thumb, 2 = index. 3 4 - ring. 5 = little N • Discontinue each item when 2 consecitiv^pMems are scored as 0 and go on to next iteln J • Discontinue lest when subitems a and J consecutive items are scored a s 0 Item 7 ® © © © © © © © © © © ® © © ® R 1 5 5 1 5 ® © © Item 8 a. R 1 2 I © © ® © © ® © © ® © © ® © © © ® © © 102 WPS TEST REPORT tttoA^lTCflOfetiCli * IJQJt • in Anfftn (ihMMI KOn SENSORY INTEGRATION A N D PRAXIS TESTS (SIPT) 12. ORAL PRAXIS (OPr) Protocol Sheet A Jo,m Ayios Pit D DIRECTIONS: Sil opposite (lull) Hem 1 "Watch my m outh and do this " Scoie response II child's lespanse is not well eaecuted (does not leceive score of 21 "Try la do this |u sl I do it" anti demonstrate again Hem 2 "Wail until I finish before you do theae. Do it as many times as I do il." (Refer ID scoring criteria m Manual I Administer all items Give no vetbal description etcepl on Item 12 To get child s attention Itelutt items "Watch m e" Before each item, make sure child is watching yom face If child watches any portion ol item, item is not leadimmsleied II child does nol watch or begins erecution before demonstration completed "W ail u n til I fin ish , than you do it" and lepeat demonstration Fill in Ihe 0 l eu? circle corresponding lo Ihe child's Hem scoie () - Unable lo peilm iii action 1 ~ FseciiletJ w ilh prior rpialily or adequately w ith siilhcienl nurubei ol muveinenls tiul w ith poor sequencing. oi begun incoiteclly but then collected 2 - T w itte d well with good sequencing Nonnniiuied oi reversed iespouse is slilf consideied collect if oilier criteria are met (ercept Items 13 and 141 M O U M U D TMNMNTTM. MMMtK T ) © 0 ( r ) ( ii} ( o ) ( o i 00Q000O ©©©©©©© ®®©®@®® ®®0®©©© ®®®®©®® ®®®©®®® 0000000 ®®®®®®® ©0©®©®® CHU.D'SNAME • Administer all items / / ^ / J /U/t i , / , / s / / / * 1 Stick out tongue (Commend child on performance) ® © 0 2. Click teeth 3x (1 sec) (Reinforce need to complete sufficient number 0 of actions.) © © 3 Pucker tips with obvious protrusion ® © © 4. With lips together, puff out cheeks. ® © © © 5. Smack lips ® © 6. With mouth open so that lips do not touch, cover teeth with lips. © © © 7. Make "p k f with audible but not voice sound 2k (2 secs) ® © © 8. Stick out tongue, retract, close mouth: 3 K (3 secs) ® © © 9 Put tongue in right cheek, then put tongue in left cheek: 2x (2 secs) ® © © 0. Move jew to right side, then move jaw to left side: 2x (2 secs) © O © 1 Put longue in left cheek ® © © 12 Pul tongue i n your cheek Push briefly Say: "Now hold it there." © Push on child's longue. © © 13 Start longue midline upper lip. move tongue to right and lick lips all the © way around © © 14 Start tongue midfine upper lip, move tongue to left and lick tips all the way around (Must be opposite Item © 13) © ® 15 Touch tongue to upper lip. then to lower lip: 2x (2 secs) © © © 16. Pucker (or purse) lips to right side of face, then to left side: 2x (2 sacs) ® © © 17 Site lower lip, then bite upper lip 2x (2 secs) ® © © 18. Stick out lower tip, close lips: 2x (2 secs) © ® © 19. Protrude jaw foiward with open mouth, then retract jaw closing lips: ® 2 K (2 secs) © © I t s ® J f a t i P i g i C I \ m e g M 260BI12) (r a tr y i^ ti r 19H fl 1 hy W t S * l R * P S Y C H O lO G lC A l SERVICE S hkfll Id f^lidrnhia * il H I wlKli* < W ill P»H wHtVMfl WMUHI f»»N rH r4!IIO M O * We*tftrr A >609 32 I 103 Appendix B December 16, 1993 Rabbi Yaakov Krause Yeshiva Rav Isacsohn/Torath Emeth Academy 540 N. La Brea Avenue Los Angeles, Ca. 90036 Dear Rabbi Krause: I am a graduate student completing the requirements for the Master's degree in Occupational Therapy at the University of Southern California (USC). My husband and I are orthodox Jews, and we presently have one precious three year-old daughter. I am conducting cross-cultural research on motor coordination skills of third graders. It is essential for the success of this study that Orthodox Jewish children in Los Angeles participate in this study. I will need to test 30 orthodox third graders, preferably an equal number of boys and girls. It will take about 15 minutes to perform the subtests with each child. I would like to conduct the testing with the children in a small, quiet classroom on the school premises at a time that will be convenient to you, the teachers, and your students. All participants will be provided with a consent form, an example of which is attached to this letter. Each student will be given a series of four subtests that assess motor skills. These will consist of four subtests requiring the child to reproduce facial gestures, postures using the hands and arms, sequences of hand movements, and combinations of arm and leg movements that I will demonstrate. The child will either be seated next to or across from me, as the sole examiner. I will also score the results of these tests. I have enclosed copies of a description of this research project, the informed consent form, and the four test protocols. I will be contacting you shortly by phone to set up a time to meet with you to discuss the possibility of your school's participation in this study. Thank you for your time and attention to this matter. Sincerely, Cindy L. Sobel, OTR 104 January 31, 1994 Dr. David Ackerman Principal, The Pressman Academy 1027 S. La Cienega Blvd. Los Angeles, Ca. 900 3 5 Dear Dr. Ackerman, Thank-you for meeting with me briefly to discuss my research proposal last Thursday, January 27, 1994. I very much appreciate your support and understanding of research and the potential difficulties involved in acquiring subjects. I hope that you have had time to look over the information that I gave to you. I realized that there are a few rather important details that I may have either overlooked or need to clarify in our next meeting. I will contact you by the end of this week to arrange another meeting to discuss the possibility of your third graders' participating in my study. I hope that it meets with your approval and I look forward to discussing any questions that you have at our next meeting. Thank-you again for your time. Sincerely, Cindy Sobel 105 February 16, 1994 Dear Dr. Ackerman, Thank-you very much for squeezing our brief meeting into your very busy schedule and, as a result, agreeing to allow your third graders to participate in my study. Enclosed, you will find the cover letters to the parents and two copies of consent forms to be sent home with the third graders over the long weekend. Hopefully, they will all be returned by Tuesday, Wednesday the latest, and testing will commence on Wednesday, 2/2 3/94. I will ask that the consent forms be returned either to you or the classroom teacher, only, as you see fit. I will also come back to check on how many forms have been returned on Tuesday afternoon, 2/22/94. Thank-you again for your time and participation in this project. I look forward to presenting, and discussing with you the results of this endeavor. Sincerely, Cindy Sobel 106 Appendix C January 17, 1994 Dear Parents, Your child is being asked to participate in a study to document the range of motor performance of Jewish third graders on four motor subtests in the greater Los Angeles area. I would like to provide you with a bit of background information about myself, as the principal investigator of this study. My name is Cindy Sobel and I am an observant Jewish woman. I am married, presently with one daughter, and work as a pediatric occupational therapist in a private group in Culver City. I will be the person to administer these four tests with your child, which are totally non-invasive and will take no more than 10 minutes to complete. These four subtests will only be administered once with each child, individually. Specifically, your child will be asked in imitate movements and body positions that I will demonstrate. After receiving confirmation from Rabbi Krause to commence with this study, I met with Rabbi Stewart, Mrs. Deckel, and Mrs. Fasman, all of whom agreed to the undertaking of this study. Testing will be conducted on the school premises under the guise of Rabbi Stewart, Mrs. Deckel, or Mrs. Fasman, and will be conducted during your child's lunchtime so as not to reaove him or her from any classroom time. Enclosed, you will find two copies of the Informed Consent form that both you and your child will need to sign in order to participate in this study. One copy needs to be returned with your child to the classroom teacher for my use, and one copy is for your files. Upon receiving the first 15 returned forms (15 boys, and 15 girls), the testing will commence. Upon the completion of the study, which I expect to be soon after Pesach, I will send a letter to all participants of the study notifying you of the conclusions. I will also meet with Rabbi Krause, Rabbi Stewart, Mrs. Fasman, and Mrs. Deckel to discuss these findings. If you have any questions regarding your child's involvement in this study, I can be reached at the phone number on the consent form, and will be happy to make an appointment with you to address any of your concerns. Thank-you for your consideration and participation in this project. Sincerely, Cindy Sobel 107 February 16, 1994 Dear Parents, Your child is being asked to participate in a study to document the range of motor performance of Jewish third graders on four motor subtests in the greater Los Angeles area. This study in being done to fulfill part of the requirements for a Master's degree in Occupational Therapy (OT) from the University of Southern California (USC). This study has already been approved by the USC department of Occupational Therapy and by the University research committee and I hope that it will meet with your approval, as well. A bit of background information about myself: I have worked as an Occupational Therapist for eleven years in New York, Boston, Israel and California and presently work as part of a private pediatric therapy group in Culver City. I will be the person to administer these four tests with your child, which are totally non-invasive and will take no more than 15 minutes to complete. These four subtests will only be administered once with each child, individually. Specifically, your child will be asked to imitate movements and body positions that I will demonstrate. I have discussed this study at length with Dr. Ackerman and secured his approval to proceed with this project. Testing will be conducted on the school premises under Dr. Ackerman's guise and will not interfere with your child's educational program. Enclosed, you will find two copies of the Informed Consent form that you will need to sign in order for your child to participate in this study. One copy needs to be returned with your child to the classroom teacher for my use, and one copy is for your files. Upon receiving the signed forms by Tuesday, February 22, 1994 the testing will commence. Upon the completion of the study, which I expect to be soon after Pesach, I will send a letter to all participants of the study notifying you of the conclusions. I will also meet with Dr. Ackerman to discuss these findings. If you have any questions regarding your child's involvement in this study, I can be reached at the phone number on the consent form, and will be happy to make an appointment with you to address any of your concerns. Thank-you for your consideration and participation in this project. Sincerely, Cindy Sobel 108 March 2, 1994 Dear Parents, Your child is being asked to participate in a study to document the range of motor performance of Jewish third graders on four motor subtests in the greater Los Angeles area. This study is being done to fulfill part of the requirements for a Master's degree in Occupational Therapy (OT) from the University of Southern California (USC). This study has already been approved by the USC department of Occupational Therapy and by the University research committee and I hope that it will meet with your approval, as well. A bit of background information about myself: I have worked as an Occupational Therapist for eleven years in New York, Boston, Israel and California and presently work as part of a private pediatric therapy group in Culver City. I will be the person to administer these four tests with your child, which are totally non-invasive and will take no more than 15 minutes to complete. Specifically, your child will be asked to imitate movements and body positions that I will demonstrate. These four subtests will only be administered once with each child, individually. Enclosed, you will find two copies of the Informed Consent form, one of which you will need to sign in order for your child to participate in this study. The other copy is for your files. Upon the completion of the study, which I expect to be soon after Pesach, I will send a letter to all participants of the study notifying you of the conclusions. If you have any questions regarding your child's involvement in this study, I can be reached at the phone number on the consent form, and will be happy to make an appointment with you to address any of your concerns. Thank-you for your consideration and participation in this project. Sincerely, Cindy Sobel 109 Appendix D INFORMED CONSENT TITLE OF PROJECT: Performances of Orthodox and Liberal Jewish Children In Third Grade On Praxis Subtests of the SIPT. PRINCIPAL INVESTIGATOR: Cindy Sobel DEPARTMENT: Occupational Therapy 24-HOUR TELEPHONE NUMBER: (310) 859-0828 PURPOSE OF STUDY: You are invited to participate in a study of motor skills among orthodox and liberal Jewish third graders. We hope to learn whether or not children from different Jewish backgrounds perform differently on tests of motor performance, you were invited as a possible participant in this study because your child is a third grader attending either an orthodox of liberal Jewish day school in greater Metropolitan Los Angeles. PROCEDURE: If you decide to participate, the investigator, Cindy Sobel, will give each child a series of four tests that assess motor skills. They will consist of four tests requiring the child to reproduce facial gestures, postures using the hands, and arms, sequences of hand movements, and combinations of arm and leg movements. The child will either be seated next to or across from Cindy Sobel, who will demonstrate each movement for the child. Testing will take approximately 15 minutes with each child. The tests will be administered with each child individually and only once. RISKS: No invasive procedures will be used. Risks involved with this study are that the child may become bored during the 15 minute testing session and feel restless. Additionally, the 15 minutes of testing may inconveniently remove the child from other activities that he or she might have been doing. BENEFITS: The individual child is not expected to benefit from participation in this study. However, the benefit of participating in this study is that knowledge regarding the range of motor skills of Jewish third graders may help therapists who assess children to more fairly evaluate children from different Jewish backgrounds. 110 CONFIDENTIALITY STATEMENT: Any information that is obtained in connection with this study and that can be identified with you will remain confidential. OFFER TO ANSWER QUESTIONS: If you have any questions relating to the study, please feel free to ask them at any time. You will be given a copy of this form to keep. COERCION AND WITHDRAWAL STATEMENT: Your decision whether or not to participate will not interfere in any way with your child's schooling. If you decide to participate, you are free to withdraw your consent and to discontinue participation at any time. INJURY STATEMENT: If your child requires medical treatment as a result of injury sustained during participation in this study, the financial responsibility for such care will be yours. AGREEMENT: YOUR SIGNATURE INDICATES THAT YOU HAVE DECIDED TO PARTICIPATE HAVING READ THE INFORMATION PROVIDED ABOVE. Signature of student Date Signature of parent of guardian Date 111 LOS ANGELES COUNTY-USC MEDICAL CENTER INFORMED CONSENT HUMAN RIGHTS IN MEDICAL STUDIES California law requires that you must be informed about: 1. The nature and purpose of the study. 2. The procedures in the study and any drug or device to be used. 3. Discomforts and risks to be expected from the study. 4. Benefits to be expected from the study. 5. Alternative procedures, drugs or devices that might be helpful and their risks and benefits. 6. Availability of medical treatment should complications occur. 7. The opportunity to ask questions about the study or the procedure. 8. The opportunity to withdraw at any time without affecting your future care at this institution. 9. A copy of the written consent form for the study. 10. The opportunity to consent freely to the study without the use of coercion. 11. Statement regarding liability for physical injury, if applicable. If you have any questions or concerns regarding these rights or the character of the study, please feel free to discuss them with the persons(s) conducting the study. 112 INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. 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Asset Metadata

Creator Sobel, Cindy Lorraine (author)

Core Title Performances of orthodox and liberal Jewish children in third grade on praxis subtests of the SIPT: a cross cultural study

School Graduate School

Degree Master of Arts

Degree Program Occupational Therapy

Degree Conferral Date 1994-12

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag education, elementary,education, tests and measurements,OAI-PMH Harvest,sociology, ethnic and racial studies

Language English

Contributor Digitized by ProQuest (provenance)

Advisor Parham, Linda Diane (committee chair), Phillips, Bruce (committee member), Zemke, Ruth (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c18-5011

Unique identifier UC11357748

Identifier 1376516.pdf (filename),usctheses-c18-5011 (legacy record id)

Legacy Identifier 1376516-0.pdf

Dmrecord 5011

Document Type Thesis

Rights Sobel, Cindy Lorraine

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA