Journal of ICSAR 
ISSN (print): 2548-8619; ISSN (online): 2548-8600 
Volume 8 Number 1; DOI: http://dx.doi.org/10.17977/um005v8i1p59 

59 

 

Psychomotor Therapy Program of Eye-Hand Coordination Game to 
Address Hand Flapping Behavior in Children with Autism 

  
Retno Triswandari1*, Budi Susetyo2, Mamad Widya2, Ardisal1 

 

1Universitas Negeri Padang, Padang, Indonesia 
2Universitas Pendidikan Indonesia, Bandung, Indonesia 

*E-mail: retnortw@fip.unp.ac.id, budisusetyo@upi.edu, mamadwidya@upi.edu, 
ardisalarnev@fip.unp.ac.id  

 
Abstract: This study aims to find out the extent of psychomotoric therapy program of 
eye-hand coordination games addressing the hand flapping behavior in children with 
autism. This study was motivated by the frequent emergence of hand flapping behavior 
in children during learning or playing, while verbal instructions given by the teacher are 
insufficient to raise children’s awareness. This study was conducted on MB subject, an 
autistic student of an SDLB. This research used Single Subject Research (SSR), A-B-A 
design. The results of the study answered the problem formulation proposed because there 
was an increase in the value of the mean level of children’s motor skills, including the 
baseline-1 phase (A-1) by 0%, the intervention phase (B) by 33%, and the baseline-2 
phase (A-2) by 75%, and a decrease in the value of the mean level of intensity/number of 
hand flapping behaviors, including the baseline-1 phase (A-1) by 187 times, the 
intervention phase (B) by 154, and the baseline-2 phase (A-2) by 119 times. Based on 
these results, it can be concluded that the psychomotor therapy program of eye-hand 
coordination games can address hand flapping behavior in MB, children with autism. 
 
Keywords: Psychomotor Therapy; Hand Flapping Behavior; Children with Autism. 
 

INTRODUCTION  
Education through physical activities has been carried out by many teachers in 

schools, including in general schools, special schools, as well as schools with inclusive 
education settings. Physical activity is used as a tool or a medium to fulfill the needs of 
students with special needs or better known as Children with Special Needs (CSN), 
especially those with social-emotional or behavior issues who require assistance. Houben 
(2014, p.18) stated that: 

 “at school children with social-emotional problems or behavior problems often need 
specific assistance and help to function adequately. Psychomotor Therapy (PMT) can offer 
this help, by providing bodily experiences and offering movement and play situations in 
which the child can practice new behavior. As such, PMT suite the child’s world of 
experience very well.”  

According to this viewpoint, psychomotor therapy can provide solutions for children 
with socio-emotional or behavioral problems at school by providing body experiences as 
well as movement and play situations in which children can practice new behaviors. The 
behavior of children with special needs not only is caused by the impact of the obstacles they 
face but also occurs because their desires/ willingness are not fulfilled. This situation is due 
to their inability to convey something because of a high level of anxiety or extreme joy. 
Behavioral issues in children with special needs can interfere with the learning process and 
interactions with peers and adults in the school setting. Of course, this must be minimized to 
the point where it is no longer bothersome. Many efforts can be made to deal with behavior, 
including learning processes/therapy such as psychomotor therapy.   

This psychomotor program assists students in forming new behaviors through the use 
of bodily experiences and movement in play situations. Psychomotor therapy programs can 
also be used to address the stereotyped behavioral barriers that exist in autistic children. One 

http://issn.pdii.lipi.go.id/issn.cgi?daftar&&&&&2548-8600
mailto:retnortw@fip.unp.ac.id
mailto:budisusetyo@upi.edu
mailto:mamadwidya@upi.edu
mailto:ardisalarnev@fip.unp.ac.id


60 Journal of ICSAR; Volume 8, Number 1, January 2024, 59-64 

 

of the barriers to stereotyped behavior is hand-flapping behavior. According to the findings 
of Pratiwi’s (2016) research in inclusive school settings, hand-flapping behavior decreases 
after children receive psychomotor therapy intervention programs. Hand flapping is a form 
of self-stimulatory (stimming) behavior, also known as stereotypical behavior, which is a 
form of repetitive and non-functional motor behavior disorder that can interfere with daily 
activities or result in bodily injury and can occur continuously. Hand-flapping behavior in 
autistic children varies and can occur under certain conditions, such as when they are nervous 
or anxious, excessively happy, silent, or not engaged in an activity.  

As we are aware, autistic children, also known as children with autism syndrome 
disorder, are those characterized by disruptions and delays in cognitive, language, behavior, 
and social interactions (Wulandari, Gunarhadi, & Widyastono, 2022; Irdamurni, et al., 
2021). These children experience obstacle in social communication, social interaction and 
behavior (Homdijah, Euis & Ehan, 2021). Autism is excessive mobility. When children 
cannot sit still, behave the way the want and are easily distracted in one activity (Irdamurni, 
et al 2021). With this disorder children are unable to form social relationships an 
communicate well or normally, even children do not have eye contact with other people. 
Children show failure to foster interpersonal relationships characterized by a lack of 
response to people around them (Jaleha & Mirnawati, 2019).  

A preliminary study in the form of observation activities has been carried out by the 
researcher on the hand-flapping behavior of autistic children who attend the Special School 
(SLB) of Pelita Adinda Birahmatika, Bandung City.  It revealed that teachers have made 
efforts to overcome this behavior in children by giving verbal instructions when hand 
flapping occurs. These verbal instructions are for example, "Put your hands down, Dear!" 
and "Come on, don't flap your hands!"  This effort is quite appropriate because it raises 
children's awareness that this behavior is improper, making them lower their hands and stop 
waving them. However, children's awareness of the habit of hand-flapping did not last long. 
They resumed hand-flapping a few moments later. Based on this, the researcher believes that 
there is a need for innovation in dealing with hand-flapping behavior in autistic children at 
school. 

Several types of therapy can also be applied with autistic children to address 
developmental barriers experienced, including also to deal with behaviors, such as excessive 
and deficit behaviors, in the hope that they can be replaced with new behaviors that are in 
accordance with existing norms and prevailing in society. The researcher, however, has a 
tendency to use psychomotor therapy programs to deal with this hand-flapping behavior. 
This is supported by the findings of Abduljabar's (2010), which revealed that the orientation 
of physical education implementation in special schools needs to shift from sports-based 
implementation to psychomotor-therapy-based teaching. Thereafter, the psychomotor 
therapy program was implemented in eye-hand coordination games such as hitting balloons, 
throwing and catching balls, throwing balls into containers and throwing targets. The games 
utilize media in the form of balloons, small basketballs, and small balls.  

Based on the description above, the researcher feels the need to formulate a 
psychomotor therapy program for eye-hand coordination games to deal with hand-flapping 
behavior in autistic children. In the program there is a task, in the form of eye-hand 
coordination games which are also a tool to improve the motor skills of children with autism 
in motion enrichment, namely in the gross motion section in the form of manipulative skills 
consisting of hitting objects, receiving (catching objects) and throwing objects. If children’s 
motor skill increase, it is expected to reduce the intensity or amount of hand flapping 
behavior in children with autism. 
 



Triswandari et al, Psychomotor Therapy Program of Eye-Hand Coordination … 61  

 

METHOD  
This research was conducted on the subject of MB, an autistic child who is a student 

of the Special School (SLB) of Pelita Adinda Birahmatika, Bandung City. This study aims 
to develop and implement a psychomotor therapy program for hand-eye coordination games. 
The study used an experimental method, conducted with Single Subject Research (SSR) with 
an A-B-A research design (Sunanto et al., 2005). Fraenkel, et al (2013) Explain that SSR 
refers to a research design developed to document changes in the behaviour of subjects 
naturally. The independent variable in this study was a psychomotor therapy program of eye-
hand coordination games while the dependent variable was the hand-flapping behavior of an 
autistic child. 

Making a program for handling children with special needs is divided into two ways, 
based on the results of the assessment of observations in the field and based on the 
assumption that all children with special needs have not been able to (Susetyo, 2020). This 
study uses the second method, name by assuming that all autistic children have not been able 
to handle their hand flapping behavior. Furthermore, the program is complied or developed. 
Before being tested on the subject, validation was carried out first both on the program and 
the instrument. The validated program was then tested on the research subjects. Therefore, 
the method used in this research is the experimental method. The experimental method 
described by Sugiyono (2011), is a research method used to seek the effect of certain 
treatments on others under controlled conditions.  
 
RESULT AND DISCUSSION 

The results of the research findings in the field present: 1) Child Profile, 2) 
Psychomotor Therapy Program Formulation of Eye-hand Coordination Games, and 3) 
Implementation of Psychomotor Therapy Program.  
Discussion of the Child Profile 

The following is the profile of MB, who is the research subject. The description below 
was obtained from the results of research that has been done: 
 
Table 1. Results of Baseline 1 (A1), Intervention (B), Baseline-2 (A2) R & N Subject 

Measurements 
Ability Findings Needs Handling/ Implication 

1. Able to follow instructions 
while studying or playing 

2. Upper and lower limbs do 
not experience stiffness 

3. The senses of hearing and 
vision do not experience 
problems, as evidenced by 
the frequent reflexes of 
turning to sound source 
direction 

When 
learning/playing, the 
child often shows 
hand-flapping 
behavior, such as 
flapping/waving 
hands 
simultaneously and 
repeatedly. 

Learning activities 
while playing that can 
reduce the intensity of 
hand-flapping 
behavior by 
flapping/waving hands 
simultaneously and 
repeatedly 

Psychomotor program of 
eye-hand coordination 
games, which can 
improve children’s 
motor skills in 
manipulative skills such 
as hitting objects, 
receiving (catching) 
objects, and throwing 
objects. 

 
Discussion of the Psychomotor Therapy Program Formula of Eye-Hand Coordination 
Games 

The psychomotor therapy program used in this study was designed in the form of hand-
eye coordination games. The games serve as a tool for improving the child's motor skills. 
The motor skills developed in this study are movement skills, which is one of the targets of 
motor development, namely movement enrichment. There are two types of motion 
enrichment, including gross motion and fine motion. The gross motion refers to a person's 



62 Journal of ICSAR; Volume 8, Number 1, January 2024, 59-64 

 

ability to move dominantly with large muscles. Motor skills in this study are classified as 
gross movement skills in children, which are divided into three categories: locomotor, non-
locomotor, and manipulative. There are three indicators of manipulative movement skills, 
including the movement of hitting an object, receiving (catching) an object, and throwing an 
object. The three indicators are applied to the form of eye-hand coordination games, 
including hitting balloons, throwing and catching balls, throwing balls into containers, and 
throwing targets. The motor skills of the child in these four games were then assessed using 
a motor skills test. 

The hand-flapping behavior is part of the repetitive and non-functional self-stimulatory 
(stimming) behavior that occurs in autistic children. Behavioral barriers, along with social 
interaction and communication, are among the developmental challenges faced by autistic 
children. Some behaviors are excessive, while others are lacking/deficient. Hand flapping 
behavior includes excessive behavior and can interfere with children's activities if the 
amount/intensity is high. In this study, the observed hand-flapping behavior was 
flapping/wagging both hands simultaneously. The intensity of the hand-flapping behavior 
was observed during the program and then recorded in a behavior recording format.  

Before the implementation was tested, the instrument of the psychomotor therapy 
program for eye-hand coordination games that had been prepared was tested for validation, 
which involved 3 experts. The validity results were then calculated using the CVR formula 
and show the results of the CVR index = 1. The magnitude of the CVR index indicated that 
the instrument compiled was valid. 

Furthermore, the instrument also passed a reliability test using an inter-reader 
reliability test. The inter-reader reliability test was used because the test used was in the form 
of performance of children's motor skills. The results of the inter-reader reliability test 
showed a correlation coefficient of 0.57. The results of the correlation coefficient indicate 
that the test instrument was reliable because it reaches at least a correlation coefficient of 
0.50.  
The Implementation of Psychomotor Therapy Program  

The researcher focused on data processing solely on one type of game, which was data 
on the child’s motor skills and data on the intensity/number of hand-flapping behavior in the 
game of hitting the balloon. It was done because the game of hitting the balloon was the first 
indicator and became a pre-requisite on the aspect of manipulative skills, namely the 
movement of hitting an object. 

Based on the data that has been analyzed and presented in the form of tables and graphs 
using the A-B-A design, it can be seen that the implementation of the psychomotor therapy 
program of eye-hand coordination games can handle the hand-flapping behavior of the 
subject of MB in this study. The research data is described as follows:  

1. The Child’s Motor Skills in Game of Hitting the Balloon 
Based on the results of data analysis on the subject of MB, there was an increase in 

motor skills in the aspect of manipulative skills, particularly the movement of hitting 
objects in the game of hitting the balloon. This is evidenced by the data mean level at 
baseline-1 phase (A-1) of 0%, intervention phase (B) of 33%, and baseline-2 phase (A-2) 
of 75%. 

These scores indicate an increase in the child’s motor skills before and after being 
given intervention in the psychomotor therapy program of eye-hand coordination games. 
Before the program was implemented, namely in the baseline-1 phase, the child's motor 
skills were not visible. The child's movements were only stuck to hand flapping. After 
being given treatment/intervention, the average motor ability of the child increases so that 
the child can perform the task of hitting the balloon. 



Triswandari et al, Psychomotor Therapy Program of Eye-Hand Coordination … 63  

 

2. Intensity/Number of the Child’s Hand Flapping Behavior 
Based on data analysis that has been performed on the subject of MB, it can be seen 

that the intensity/number of hand-flapping behavior has decreased in the game of hitting 
the balloon. This is evidenced by data on the mean level in the baseline-1 (A-1) phase of 
187 times, intervention (B) of 154 times, and baseline-2 (A-2) of 119 times. 

These scores indicate a decrease in the intensity/number of the child’s hand-
flapping behavior before and after being given a psychomotor therapy program through 
the game of hitting the balloon.    

 
According to the findings of this study, it was found that the subject of MB who 

received psychomotor therapy programs had the hand-flapping behavior managed. Hand-
flapping behavior is one of the obstacles experienced by individuals with autism. The 
causative factor is thought to have something to do with the increase in the function of 
monoamines and catecholamines (epinephrine, norepinephrine, and dopamine) in the brain 
which are neurotransmitters involved in motor function. As explained by Hout, (2010 p. 12), 
frontal lobe and basal ganglia disorders affect the representation of action, motor, and 
working plans, resulting in impaired motor regulation. 

 
CONCLUSION 

Based on the results of data processing and analysis, it can be concluded that 
psychomotor therapy program of eye-hand coordination games can handle autistic children’s 
hand flapping behaviour towards subject MB. Researchers limit hand flapping behaviour 
which is the target behaviour only in the movement of flapping or flapping both hands 
simultaneously and limit the processing of data on the results of children’s motor skills to 
only one type of game, data on the game of hitting balloons only. It because the game is the 
first indicator or prerequisite in the aspect of manipulative movement skills, namely the 
motion of hitting objects. This Single Subject Research (SSR) stud also answers the 
formulation of the research problem, because there is an increase in the mean level in 
children’s motor skills and a decrease in the mean level in the intensity or number of 
children’s hand flapping behavior. 

The results of this study also revealed that while undergoing a psychomotor therapy 
program, children began to learn to structure the movement tasks that they were required to 
perform. These results are supported by Houben's (2014, p. 18) arguments that the use of 
psychomotor therapy at school can provide solutions for children with socio-emotional or 
behavioral problems by providing body experiences and movement and play situations in 
which children can practice new behaviors. Research can provide suggestions based on 
research findings as follows: The research can take data on psychomotor therapy programs 
for eye-hand coordination games in group settings in team games with the condition of 
research subjects who both have behavioral problems.  
 
ACKNOWLEDGEMENT 

I would like to acknowledge and give my warmest thanks to my supervisor Mr. Budi 
Susetyo and Mr. Mamad Widya who made this project possible. His advice carried me 
through all the stages of writing my project. I would like to give special thanks to my family 
as a whole for their continuous support and understanding when undertaking my research 
and writing my project. All your prayer for me was what sustained me this far. And finally, 
I would like to thank God, for letting me through all the project. All praises to Allah. 

 
 



64 Journal of ICSAR; Volume 8, Number 1, January 2024, 59-64 

 

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http://journal2.um.ac.id/index.php/icsar/article/view/22511/8407