In order for children to develop a concept of direction, it seems necessary for them to act. Children with cerebral palsy who are more restricted in their motor development than children without disabilities should have difficulty in acquiring the concept of direction. The purpose of the present study was to examine the effect of action on the development of the concept of direction in children and youths with cerebral palsy. Subjects were 55 children and youths with cerebral palsy from 4 to 22 years old. They were rated on action with the items of the movable level and Dohsa level. Other characteristics of the subjects that were measured included age, sex, speech impediment, and level of intelligence. In the first task, the subjects were required to use their finger to indicate 6 directions (up, down, right, left, forward, and back) in the following 3 conditions: the direction that they were facing while in a sitting posture (Condition 1-A); the direction of a doll that stood face to face with the subject (Condition 2-A); and the direction of a doll that stood facing the same way as the subject (Condition 3-A). In the second task, the subjects were required to indicate 4 directions (up, down, right, left) in the following 3 conditions: the direction that they were facing while lying on the floor (Condition 1-B); the direction of a doll that lay on a table with its feet toward the subject (Condition 2-B); and the direction of a doll that lay on the table with its head toward the subject (Condition 3-B). The results showed that age, Dohsa level, and intelligence level affected the development of the concept of direction. When the scores on each item were analyzed, it was found that the 4- to 6-year-old children (Group A1) scored lower than the 10-to 12-year-old children (Group A3), the 13- to 15-year-old youths (Group A4), and the 18- to 20-year-old youths (Group A6). The Dohsa level of the subject-sitting condition (Condition 1-A) and doll-standing conditions (Conditions 2-A and 3-A) showed that the subjects who were bedridden scored lower than those who were able to stand and to walk. Those scoring in the normal range on intelligence had higher scores than those scoring low on intelligence measure. It was also showed that scores on the tasks that requires subjects to indicate directions relative to themselves were higher than scores on the tasks that required them to indicate directions with respect to the doll. The discussion suggested that development of the concept of direction is facilitated by means of a multiplier effect of the length of living experiences and the actions by which children and youth with cerebral palsy actively intend to effect their environment through their body mevements.
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