72 | pISSN: 1858-3598 eISSN: 2502-5791
Jurnal Ners
Vol. 15, No. 2, Special Issue 2020
http://dx.doi.org/10.20473/jn.v15i2.19011
This is an Open Access article distributed
under the terms of the Creative Commons
Attribution 4.0 International License
Original Research
Improving the Fine Motor Skills with Embroidery among Children with an Intellectual
Disability
Syiddatul Budury 1, Khamida Khamida1, Siti Nurjanah1 and Triana Jamaliah Jalaluddin2
1 Nursing and Midwifery Faculty, NahdlatulUlama University Surabaya, East Java, Indonesia
2 Student of Bachelor Nursing, Nursing and Midwifery Faculty, NahdlatulUlama University, Indonesia
ABSTRACT
Introduction: Children with intelletual disability experience delays infine
motor skills compared to normal children, if the child's fine motor skills
are not trained and developed, it will affect to the child's growth and
development. One of occupational therapies to improve their finemotor
skills is through embroidery. The purpose of this study was to analyze the
effect of embroidery to the fine motor development of children with
moderate mental retardation at the special school, Bangkalan Indonesia.
Methods: The design was pre experimental research with one pre test-
post test design group, population of all children with moderate mental
retardationas many as 13 children. The research instrument use
dwasobservation sheet.
Results: Data analysisby Wilcoxon Signed Ranks Test.The embroidery
therapy using cross stitch technique. It was held every Monday and
Thursday for eight week, took an hour each session
Conclusion: The results of the study showed that most children after had
embroidery had enough finemotor skills (84.6%) and the statistical test
value was obtained p<α (0.002<0.05). The students improved their fine
motor ability such as how they coloring, scissoring, grasping, and holding
up a paper. The conclusion of this study is that there was an effect of
embroidery therapy on fine motor skills in children with intellectual
disability.
ARTICLE HISTORY
Received: Feb 27, 2020
Accepted: April 1, 2020
KEYWORDS
intellectual disability; fine motor skills;
embroidery
CONTACT
Syiddatul Budury
syiddatbr@unusa.ac.id
Nursing and Midwifery Faculty,
NahdlatulUlama University Surabaya,
East Java, Indonesia
Cite this as: Budury, S., Khamida, K., Nurjanah, S., & Jalaluddin, T. J. (2020). Improving the Fine Motor Skills with
Embroidery among Children with an Intellectual Disability. Jurnal Ners, Special Issues, 72-74.
doi:http://dx.doi.org/10.20473/jn.v15i2.19011
INTRODUCTION
Children are the next generation and the important
potential of any nation. They need a good and healthy
environment for optimal growth and development.
The values that we impart to children will have a great
effect on society. This does not only refer to normal
children but also to children with an intellectual
disability. The United Nations Development Program
estimates that globally over 200 million children have
an intellectual disability (APA - American Psychiatric
Association, 2015) and that 80% of all people with
disabilities live in a low income country.
Intellectually disabled children or children with
mental retardation are ways to refer to children who
experience a physical, mental-intellectual, social and
emotional delay with a significant effect on their
growth and development processes (KPPPA, 2015).
Children who have an intellectual disability
experience delays and limitations concerning their
adaptive behavior and intellectual functioning
(Armatas, 2009). According to DSM-5, their
intelligence range is 20 – 70 (Shogren & Turnbull,
2010). In reference to their adaptive behaviors, they
have problems in terms of their gross motor and fine
motor development, in addition to their speech and
social skills. The fine motor abilities of children have
an important role, namely to train the small muscles
such as the hand and finger movements. The
coordination of the fingers, hands and arms plays a
vital role in activities such as eating, dressing,
grasping and the use of utensils and tools (Suchiporn
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JURNAL NERS
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Lersilp, Supawadee Putthinoi, 2016). The
development of the small muscles facilitates the
proper coordination needed to perform daily
activities. A mentally retarded child needs moderate
training in accordance with their physical,
psychological and intelligence condition. Children
with mental retardation encounter barriers to their
development and growth in the sensory and motor
areas, including both gross motor and fine motor
skills. The fine motor skills of intellectually disabled
children are developing and so there needs to be
training to develop the proper coordination
(Training, The, & Retarded, 2001).
The National Institute for Mentally Handicapped
has developed activities to improve the fine motor
skills of intellectual disabled children such as turning
a door knob, stacking objects, pasting paper,
assembling objects, separating rolls of material,
wrapping objects, cutting with scissors, drawing,
painting and sewing (Handicap, 2001). Embroidery is
occupational therapy that contains of cutting scissors,
drawing, and sewing. Embroidery is similar to the
plastilinography technique used for promoting fine
motor skills (Maria Lapshina, 2019). It can train
children with mild and moderate intellectual
disability to concentrate, enhancing the strength of
their muscles when pulling threads. It enhances their
fingers when forming patterns through embroidery.
Indirectly, embroidery can make the stiff muscles
supple. Embroidery can not only improve the fine
motor skills but it can also improve their intellectual
functioning including imaginative thinking, logic,
accuracy and perseverance (Sadovnika, 2019).
MATERIALS AND METHODS
The research design that was used in this study was
pre-experimental with a one group pretest-posttest
design. The population consisted of intellectually
disabled children at a special school in Bangkalan
with 24 students. The sample totaled 13children who
were 12 – 14 years old with a moderate intellectual
disability taken through simple random sampling.
The criteria in this study were that they were boys
and girls with a moderate intellectual disability who
are able to follow instructions and who went to school
regularly. The informed consent form was signed by
their parents who accompanied them while the
children were at school.
The design was pre-experimental with one pre-
post group. The data collection used an observation
sheet based on the Madras Developmental
Programming System modified and developed by
Purna (Purna, 2015). The observation sheet consisted
of 5 aspects: drawing, folding, gripping, cutting,
squeezing and sticking. The embroidery took place at
the school and it was held twice a week for 2 months.
Each session took 60 minutes. The embroidery
method used the cross-stitch technique. What they
sewed was three letters from the alphabet. The data
was analyzed using the Wilcoxon Signed Rank test.
This research passed the ethical clearance held by
Unusa Ethical Board
RESULTS
Table 1 showed that most of the respondents were
girls and that most of them were 14 years old. From
Table 2, it can be seen that before being given the
embroidery intervention, most of the children had
moderate fine motor skills (8 children: 61.5%). A
small number of children had good fine motor
development (3 children: 23.1%). After being given
the embroidery intervention, the level of fine motor
development overall was good (11children: 84.6).
Before the intervention, more than half of the
respondents had fine motor skills in the moderate
category of 8 (61.5%) but there was a decrease after
the intervention to 2 (15.4%). There was an increase
in the number of respondents with fine motoric skills
in the good category by 11 people (84.6%). There was
a significant difference in the fine motor skills before
and after the intervention with a value of p = 0.002.
DISCUSSION
When the embroidery is in process, the children with
an intellectual disability are learning how to use their
hands and fingers to sew, install a thread, strike and
catch the yarn. They are then using the cross-stitch
technique to do the embroidery itself. It helps their
fine motor skills to improve, especially the 5 aspects
of drawing, folding, gripping, cutting, squeezing and
sticking. The results show that embroidery has a
significant effect when it comes to improving the fine
motor skills of children with an intellectual disability.
This result relates to what Boopathi and Umarani
found in that facilitating a fine motor activities
program can promote fine motor skills (K Ramesh
Boopathi, 2019). The playing activity enables the
children with a mild and moderate intellectual
disability to develop their self-help skills such as
dressing, eating and playing. These skills are
coordinated by the maturation of the central nervous
system and specific motor experiences (Vidoni,
McCarley, Edwards, & Boyd, 2009). Embroidery is a
Table 1. Distribution of the Frequency of the Variables
Variable N %
Gender
Boys 6 46.2
Girls 7 53.8
Age
12 years old 3 23.1
13 years old 4 30.7
14 years old 6 46.2
Table 2. Distribution of the Fine Motor Skill Level Before
and After Embroidery
Fine Motor
Skill Level
Pre % Post %
p-
value
Less 2 15.4 0 0 0.02
Moderate 8 61.5 2 15.4
Good 3 23.1 11 84.6
S. BUDURY ET AL.
74 | pISSN: 1858-3598 eISSN: 2502-5791
form of occupational therapy using hand muscle
strength activity sets. It requires coordination
between visual attention on the object and hand-eye
coordination. Embroidery not only improved the
intellectually disabled children’s activities such as
grasping and wearing clothes but it also improved
their concentration ability and writing and coloring
skills.(Islamiyah & Widyana, 2017) Fine motor skills,
learning ability, and communication skills all have a
relationship to the functioning of the cerebellum that
is closely related to learning and social behavior
(chen Yu, 2013).
As we can see, fine motor skills are needed as
much by intellectually disabled children as they are
needed by normal children. If they do not gain any
strength in terms of their fine motor skills, the
children’s activities and independency will be lacking.
They will depend on us to do some of their daily task
because their inability. That is why we do need to
improve their fine motor skills. In addition, this study
had the limitation of generalizing to a large
population. Future research should involve a larger
number of subjects.
CONCLUSION
The objective of this study was to improve the
children’s fine motor skills using embroidery. It has
been found that there is an effect from embroidery on
the improvement of the fine motor skills of
intellectually disabled children. Children gradually
respond to the stimulus and learn to develop their
fine motor skills. The intervention condition can also
apply in the contexts of coloring, scissoring, grasping
and writing
CONFLICT OF INTEREST
The authors declare that there are no conflicts of
interest.
ACKNOWLEDGEMENT
Thank you to all of the students with an intellectual
disability who participated in this research.
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