Efficacy of an Intervention to Teach Zippering: A Two-Group Control Study

Abstract

Date Presented 03/27/20

This pilot research compared the efficacy of a standard teaching zippering vest to a specially designed teaching zippering vest with a related story in the acquisition of zippering skills among 28 preschoolers. The study used a two-group (control/comparison) pre–post test experimental design. Results indicate that both groups developed their skills further with added practice; however, children in the comparison group did statistically significantly better than those in the control group.

Primary Author and Speaker: Fern Silverman

Additional Authors and Speakers: Carrie Knight, Anna Grasso, Stephanie DeFazio, Gina Inglese, Sophie Swallow, Jessica Lesnoy

Most children learn to zip without formal instruction; the ability to pull up a zipper emerges around age 3 if the shank is connected, with independence achieved by 5 years (CHOC, 2014). Using these milestones as benchmarks, this pilot study compares the effectiveness of a standard teaching zippering vest presented with general verbal prompts to a specially designed teaching zippering vest presented with a related story and vocabulary in the acquisition of zippering skills among typically developing preschoolers.

DESIGN/METHODS: This experimental study used a two group (control/comparison) pre-post test design; participants were 28 typically developing 3- and 4-year-old children at a preschool. IRB approval and parent permission were obtained. During eligibility screening, the inability to zipper independently was determined by parent report and by three zippering attempts. Typical development was confirmed with the DAYC-2. All screenings and interventions were finished within 3 weeks, minimizing normal development’s impact on results.

Each eligible child received 3 zippering sessions by OT and SLP faculty and graduate students and were allowed three zippering attempts per session. For the control group, the 3 supervised practice sessions used a standard practice zippering vest and six pre-determined general verbal cues (such as “Try again,” and “Use both hands.”) For the comparison group, the 3 sessions used a modified teaching vest, targeted vocabulary and a related story. The modified teaching vest had an image of a plant shoot on the zipper, with leaves at the top, roots at the bottom, and a leaf-shaped zipper pull.

ANALYSIS: Each individual session was video recorded. Inter-reliability was obtained via 2 separate researchers analyzing the video data in terms of the child’s success with a 7 step sequence of the task of zippering, and then comparing and aligning their results. Both inter- and intra- rater reliability was established at >98%.

Data coding used a nominal measure of 2,1, or 0. A 2 indicated success, 1 indicated partial-success, and 0 indicated inability or refusal.

All data was entered into a spreadsheet and then into SPSS for analysis. Independent T-tests were used to compare the measures between the two groups of participants.

RESULTS: 14 preschoolers participated in each cohort; 4 were excluded due to concerns on the DAYC-2 or absences. Aggregate data of the pre-trial zippering ability demonstrate no initial difference between the two participant groups (t (26) = -.267, p = .330). The aggregate data of three session interventions showed a difference between groups; 1^st session set, t (26) = -1.973, p = .074, mean difference (MD) = -.904, standard error (SE) = .459; 2^nd session set, t(26) = -2.148, p = .041, MD = -1.00, SE = .465; 3^rd session set, t(26) = -1.264, p = .009, MD = -623, SE = .414. These results suggest that a modified practice zippering vest with added visual and language cues (Batu, 2014) aided preschoolers in developing their zippering skills in both 3 and 4 year olds. Both groups developed their skills further with added practice; however, the children in the comparison group did statistically significantly better than those in the control group, beginning with the second set of interventions.

Study limitations include a small number of participants, an unknown degree of parental influence on teaching zippering at home, or the long-term effects of these three sessions. Further studies could address these issues.

CONCLUSION: Through carefully designed vests and related stories with targeted vocabulary, zippering skills can be taught. This research demonstrates that OT’s offer specialized skills and knowledge that can work in partnership with SLP’s to create innovative treatments to better service clients.

References

Children’s Hospital of Orange County (CHOC) (2014). Developmental Milestones: Dressing Skills [PDF file]. Retrieved from https://www.choc.org/wp/wp-content/uploads/2014/11/Rehab-Developmental-dressing-skills.

Batu, S. (2014). Effects of Teaching Simultaneous Prompting through Visual Supports to Parents of Children with Developmental Disabilities. Education and Training in Autism and Developmental Disabilities, 49 (4) 505-516. http://www.jstor.org/stable/24582347