Welcome to the webinar about assistive technology supports for math. This session will identify AT supports that can be used to facilitate access to the common core state standards and Ohio's New Learning Standards.
I'm Heather Bridgman and and I'm an assistive technology consultant with OCALI. My background is in the field of rehabilitation engineering and I have a teaching license in the area of high school math. I have been working in the field of AT for more than 20 years.
There are a great number of children who experience math deficits. In fact, math disabilities are as common as reading disabilities, but in our system of education, special education services are often based on reading disabilities. What many people don't realize is that math disabilities ARE learning disabilities.
Once a student is identified as having a learning disability, few are are provided substantial assessment and remediation for their arithmetic difficulties.
My purpose today is to share some math scaffolds and supports that can be used to accommodate some of these deficits.
Let's look at some of the different types of math-related challenges a person might encounter when trying to perform mathematic computations.
A catch-all term for math challenges is "dyscalculia". Dyscalculia refers to a wide range of learning disabilities involving math. There is no single type of math disability, and dyscalculia can affect an individual in different ways. The words popping up on your screen are some of the challenges that students face on a daily basis. These challenges impact their ability to advance through the mathematics curriculum.
Research with brain injury tells us that difficulties with arithmetic and and higher level abstract reasoning can be dissociated. This may indicate a need for AT supports to provide a student with basic math computations in order to allow that student the opportunity to perform abstract reasoning tasks.
Many who struggle with paying attention to operational signs, borrowing & carrying, and sequencing steps in equations, can go on to join honors level math classes where conceptual knowledge is praised.
*These students should not be tracked into lower level math classes in elementary years, when computation skills are given higher weight.
Some students struggle with written math symbol systems: The objective here is to connect informal math understanding with the formal procedures, language and symbolic notations. Students need experiences with physical manipulatives, which are concrete materials that can be moved and re-arranged - to learn how they can be translated to abstract symbols. Think about students with physical difficulties - they may not have been given these opportunities to interact with concrete objects but finding alternate ways to allow for physical manipulation is important to this area of development.
Math Language is another area that causes trouble for some: confusion about terminology, difficulty following verbal explanations, and weak verbal skills impact a student's ability to learn steps in complex calculations.
Visual-Spatial-Motor Organization results in a person having trouble interpreting what the eye sees. It is important to provide many opportunities to manipulate concrete objects in order to anchor verbal instructions. The goal in this case is to construct a strong VERBAL representation for quantities and relationships rather than relying on visual-spatial mental representations. It may seem contrary to your "gut" feeling, but for students with visual-spatial-motor organization challenges, it is best to avoid pictures and graphics to convey information and focus instead on verbal representations anchored with concrete materials.
Some kids with these challenges are very bright; and find themselves being identified as "not trying", "having a math phobia", "not paying attention", etc.
So let's talk for just a minute about accommodations versus modifications. Accommodations do not change what the child is expected to master.
This presentation will focus on math tools that can be used as ACCOMMODATIONS to access the GENERAL EDUCATION math curriculum or to provide universal design for learning opportunities that might be applied across the board to all students.
This webinar will focus on AT supports and tools for curriculum access rather than teaching strategies. However we would like to take this opportunity to mention the work of Dr. Riccomini. Dr. Ricomini from Penn State has identified some great teaching strategies that are helpful for students with math challenges. Dr. Riccomini has done work for several state support teams in Ohio and you can view his archived presentations through the SST 14 website.
So let's talk just a bit about the differences between assistive technology and instructional technology. It's true that many times AT (or assistive technology) can be used as instructional technology and instructional technology can also be used at AT. But there are some distinct variances between the two and we would like to take a look at these differences.
First, AT is usually intended for use with a specific child whereas instructional technology is intended to benefit all students.
Assistive technology is intended to increase an individual's FUNCTIONAL PERFORMANCEin order to gain access to the general education curriculum while instructional technology is used to TEACH general education ideas and concepts to the entire class.
AT is often used to COMPENSATE for a skill deficit and to provide a scaffold for skill development and instructional technology is used to provide OPTIONAL methods and modes of learning.
Assistive technology is NECESSARY for the student to function and access the curriculum but instructional technology is generally NOT REQUIRED or necessary for task completion.
Finally - assistive technology will be a part of a student's IEP process meaning that it was considered, carefully selected and a plan for it's use to achieve educational goals is indicated in the IEP. Use of instructional technology is not part of the IEP process.
I hope this information helps clear up the differences between assistive technology and instructional technology. That said, many different types of math supports, hardware and software may be considered assistive technology or instructional technology depending on how it is being used.
Much of the math curriculum relies on reading. Including an understanding of the content vocabulary, making sense of the problems and visually tracking the written words of a problem.
If reading is the primary barrier for your student, there are many low-tech, mid-tech and high-tech supports that can assist with these challenges.
There are Text-to-speech software programs that will read the text out-loud and highlight the words as it reads. This software is now built-in to the standard operating system of iOS devices and both the Mac and Windows operating systems.
Many of the more sophisticated text-to-speech programs such as Kurzweil, Solo and Read & Write Gold to name a few, allow for embedded digital notes and hyperlinks to expand background knowledge.
Low-tech and electronic highlighters and filters are available to focus on the important information in an article or reading passage.
Picture supported reading is another scaffolding tool that can be used to help reading comprehension.
And talking dictionaries can be used to provide definitions of content words.
Similarly, access to the math curriculum requires a means of written output. If writing is your student's primary barrier to accessing the math curriculum, consider some of these tools.
There are low tech tools such as adapted paper, writing templates and pencil grips. Mid-tech and high-tech examples of assistive technology writing tools might include a portable word processor, accessibility options, alternative keyboards, word prediction or voice recognition.
These are just a few examples of tools to help scaffold and support reading and writing. The importance of these literacy supports is paramount to success in math; but to cover this topic appropriately - we would need much more time. So the remainder of this presentation is going to focus on specific math tools that might be used tomake the mathcurriculum more accessible.
This video, from the Ottawa Network for Education gives a nice overview of some of the AT tools that could be used for access to the math curriculum.
As we present several different AT tools to support access to the mathematics curriculum, it is important to begin with an assessment of the student's needs being sure to include the tasks he or she is trying to accomplish and the environment in which the student is working. Use this information to make informed decisions about potential AT solutions. Collect data along the way to remember whether the identified AT is working or not.
This slide and the one following it, show the domains of math concepts and the grade bands in which they are typically taught. The math handout that accompanies this presentation summarizes the tools we will discuss, hyperlinks for specific resources and the common core state standards that can be addressed with the use of each assistive technology math tool.
Visit the document archive on the OCALI website to view this handout. At this time, I will briefly exist this presentation and show you where that document can be found.
So I'm just going to go to the OCALI website, and you'll see on the main page here, there's a button that says "Document Archive". If I click that button, you will see many different presentations that OCALI staff members have submitted and placed up here. Right now the first one on the list is "AT, Math and the Common Core State Standards". That is the handout that accompanies this presentation.
Ok - Physical manipulatives are concrete materials that can be moved and re-arranged to learn how they can be translated to abstract symbols.
Students who struggle with understanding the language of math - symbols, quantities and actions may benefit from concrete representations of these abstract concepts.
The following slides will demonstrate a few examples of physical manipulatives.
Stern blocks are often used to show physical representations of numbers and the relationships between numbers.
Cuisenaire rods offer hands-on visual confirmation of math concepts for addition, division, and fractions.
The Barculator is a ruler with fraction bars that can be placed in the center section to demonstrate fraction relationships.
Similar to the barclator we saw in the previous slide, is the pieculator which is a colorful and tactile teaching tool that demonstrates fraction relationships using concrete models.
Pattern blocks can be used for a variety of tasks such as sorting and creating patterns in the elementary grades. They are also useful for exploring transformations, symmetry and congruency.
In upper grades, pattern blocks can be used to add and subtract factions and learn about angles. They are also useful for creating tessellations.
The MathLine from Onion Mountain is a wooden number line with the numbers 1-31. Each plastic ring can be separated independently.
This is great for students with physical disabilities or students with low vision. It has suction cups which allow it to be firmly attached to a flat surface such as a student's desk. The MathLine can be used for counting, exploring size and quantity, addition / subtraction and calendar skills.
So many of you might be thinking - well hey - those are just instructional tools. And you're right - these are things that are commonly seen in math instruction. But think back to our discussion about AT versus instructional technology. For those students who struggle with the language of math, using physical manipulatives might be something that is required in order for them to make progress adequate toward the general curriculum, it's not just a nice warm, fuzzy complement to the daily instruction.
Virtual manipulatives are a computer-based representation of physical manipulatives. They are interactive and can be moved, rotated, stacked, etc. so that the student can interact with them in a similar way as one would use physical manipulatives.
A student with significant physical challenges may not be able to move around the physical manipulatives shown previously. However, since virtual manipulatives are computer-based, a student who uses alternative methods of computer access can use those identified means to interact with these tools.
The National Library of Virtual Manipulatives has an extensive library of interactive tools. You can see that the resources are divided into grade bands and subject areas. The use of the manipulatives are free if you have internet access - and for those who would like to use the tools where Internet access is not available, a CD can be purchased for $45.
And I'm going to take just a minute here to show you what this website looks like. And don't worry about the URL's that are coming up on your screen because all of those are included in the handout that accompanies this presentation.
So when you come to the National Library of Virtual Manipulatives, this is what it looks like and each one of these boxes are links to many different activities regarding the subject area and grade level. So lets's just take a look at geometry for grades six through eight. And look - these are all different interactive virtual manipulative activities that can be - that the student can interact with. I'll just click on the first one to kinda' give you an idea what it looks like. This activity is called "Attribute Trains" and the idea is to determine a pattern of attributes that's going on here. So I'm seeing 1, 2, 3, 2, 3, 2... I'm seeing red, green, blue, red, green, blue, so I believe the pattern here is red, green, blue and so I would do is simply drag the shapes into the proper sequence - red, green, blue. And if I were incorrect, it would shoot them back out, but it looks like I've gotten the appropriate pattern here. I'll make a mistake here to show you what it looks like, OH, it pops it back out and gives you another chance and when I finish my pattern, it tells me that I am correct and I can go on to the next problem. So that's just an example of some of the interactive activities that are available and you can see there's a wide variety of activities in all of the grade bands and all of the different subject areas.
Ok, shown here is a screen shot from the IntelliTools Classroom Suite software. You can see that there are templates for basic addition and subtraction as well as fractions. Custom templates can be designed for higher grades and to highlight specific goals of Ohio's New Learning Standards.
The IntelliTools software and the Clicker software that we will show next, both offer an online sharing community where educators across the nation can share the activities they have designed, thereby reducing the work load for others. The handout that accompanies this presentation offers these links to the sharing communities.
The Clicker software offers word banks and on-screen grids related to math concepts. The math tools and symbols are somewhat limited, but they're certainly appropriate for lower level math problems. One of the neat things about this software its that it could be used with typically developing students but it is also switch-accessible. Making it a nice way to provide additional support while still using the tools a student's peers are using.
Large key calculators are a tool that could help some students. These are particularly useful for those who have physical challenges that cause them to bump nearby keys or for those with low vision concerns.
There are a wide variety of large-key calculators on the market. Some are sold by companies who specialize in products for individuals with blindness and low vision while others are available at your local office supply store. The large key version on the left side of this screen is often found at holiday times. I've even seen it recently at my local "Five-Below" store. (And if you're not familiar with what Five Below is, it's a type of dollar-store where all products are five dollars or less).
Talking calculators are useful for those who may understand the problem-solving process, but have difficulties mixing up numbers or operands. These calculators offer both auditory and visual feedback and typically headphones can be added so the auditory feedback can be provided privately. This is also a useful tool for students who are english language learners.
There is no specific mention of calculator use in the common core state standards, but once basic addition, subtraction, multiplication and division have been mastered, it may benefit those who typically have the challenges previously mentioned.
This is just a sample of a few different styles of talking calculators. Some come with earpieces, and others do not, but it's an important feature for the school environment. There are also some smaller pocket-sized versions available as well.
On-screen calculators are a computer-based representation of a calculator. They are helpful for individuals who have physical access challenges that make using a traditional calculator difficult, but have an optimized method of computer access. This may include alternative mouse pointers, keyboards or even switches.
There are a wide variety of on-screen calculators available from basic addition and subtraction to high-level graphing. On-screen calculators can typically be resized which is helpful for students with low vision and some offer auditory feedback as well.
Because they are software on a computer; a person who uses alternate access such as a joystick or switch can utilize them.
Here are a couple of on-screen calculators that are available free of charge from the website shown. There are also on-screen calculators built in to the Mac and Window operating systems and mobile devices.
Creating graphs allows students to make visual representation of equations and to make real-word connections.
Most students learn how to use graphing calculators at some point in their high school career, but prior to that, most learn how to graph using paper and pencil. For students with handwriting challenges, use of a graphing calculator might allow them to participate in graphing activities when creating pencil graphs is challenging.
There are a wide variety of graphing calculators available - and here are a few examples. The TI-83 is a basic model - that my kids used this in middle school. There are also more sophisticated models such as the TI-Nspire. This calculator offers more advanced features such as the ability to overlay math equations and drawings on real-world images. This allows students to model math around real-word examples. (In every grade after grade 3, it is a requirement of the Common Core State Standards to make applications to real-word concepts.
The use of graphing calculators also makes word problems visual.
Just like basic calculators, there is no specific mention of graphing calculators in the Common Core State Standards either; but the features of modeling real-world mathematics via imported images as seen with the TI-Nspire graphing calculator could be used to meet these goals.
There are also some apps for graphing such as the one shown here, simply called - "Graphing Calculator"
It costs only $1.99 through the iTunes store and has many of the features of traditional graphing calculators. It is a full-functioning scientific calculator. It allows the student to plot multiple equations on the same graph, evaluate the graphs at x & y values, find coordinates for intersections, roots, minimums and maximums and it also allows for graphing of piece-wise functions. This app also offers a custom keyboard to assist with entering equations and the results can be easily shared through email.
The audio graphing calculator is a very specific tool to support higher level graphing needs for students with low vision or blindness.
The audio graphing software makes graphs accessible to those who are visually impaired or blind by providing speech, sound and tactile feedback about the graphics.
It has voicing capabilities that will read each of the menu items as well as the mathematical functions entered and their resultants.
When plotting graphs, audio tones give feedback about the shape of a line. Keyboard equivalents can be used to perform all graphing calculator functions including the ability to determine zero's of the plot, line intercepts and other functions. Printed output can be obtained for sighted teachers or students as well as tactile graphs that can be sent to a braille embosser.
Let's take a look at what I think is one of the most unique features of this software which is the audio tone support provided for graphing.
That's a pretty neat way to provide feedback about shapes of graphs, isn't it?
While we're on the topic of feedback for individuals who are blind or have low vision, let's look at this promising new development to the field of mobile technology.
This is a video about haptic feedback - it's a haptic feedback app for Androids developed by Vanderbilt University grad students and it provides vibration and tactile feedback about math concepts and images.
Ok, the next set of AT tools that we will share is software for basic math processing such as addition, subtraction and division. These tools are useful for anyone who is using a computer to perform most of their math computations, such as students who are not using traditional paper and pencil but have access to a computer through the keyboard, mouse, alternative input devices or switches.
One of the features that is especially helpful in this case is the ability to line up math problems in columns. This is particularly difficult in most word processing programs, but the next few software tools help in this regard.
The first one I'd like to mention is called MathPad.
MathPad is a blank sketch pad that allows the student or teacher to create electronic math worksheets. And there are some pre-made worksheets available as well.
One of the neat features is that it allows for vertical alignment of numbers and even smaller numbers to indicate carrying and borrowing.
Now MathPad is older software that's been around for a long time but even though, it can still be purchased through IntelliTools - Cambium Learning. However, it works only through Windows 7 and Mac OS 9. Mac OS 9 was replaced by newer versions back in 2002 so it's been quite a while, but I mention this software because it is not uncommon to find school computers with older operating systems and this is a software title that was purchased commonly in Ohio, so it may be available at your school.
MathPad Plus -is similar to MathPad, but it includes fractions, decimals and word problems. You can select to view fraction pies, rods, or decimal grids.
MathPad and MathPad plus offer auditory feedback and are accessible through the IntelliKeys keyboard, switches and a standard keyboard or alternative input devices.
These programs help with organization by aligning the problems and prompting the user for the next step of the answer with a blank box. The program also presents one problem at a time to help focus and reduce frustration.
Now if you need something a little more current - Here is an app that does a lot of the same things as MathPad. It is called, Panther Math Paper and it costs $19.99.
Because Panther MathPaper allows for vertical orientation of numbers, it allows the user to solve math problems without the use of a pencil. There are built-in keyboard shortcuts to quickly move the cursor around the page and keyboard hold-time adjustment settings are available to prevent accidental hits. While solving problems, the predictive cursor jumps ahead to the next logical spot.
This may not sound like a lot, but trust me - having the ability to line up problems and quick access to mathematical symbols is a real benefit to those who are attempting to line up an solve math problems electronically.
Here is another app that I recently became aware of. It is called ModMath and it's free! It is very similar to Panther MathPaper, but it uses a calculator-like interface to input numbers and symbols. This app is geared toward students with dysgraphia rather than more complex motor challenges.
Alternating columns and rows can be highlighted for better visual discrimination. It allows a student to work with fractions, carrying, borrowing, and canceling, but not roots, exponents, and simple algebra (which are things that are available in Panther MathPaper).
The previous software programs are great for basic level math needs such as addition, subtraction, multiplication, division and even beginning level algebra, but the next set of tools are mostly helpful for higher level math needs such as integrals, exponential equations, factors, derivatives and more.
And one of the big benefits of using this type of software is that it allows the math problems to be grouped and organized electronically as one might traditionally do on paper.
Equation editor is a free add-on toolbar that is included in Microsoft Word. It allows you to create higher-level math equations in standard form such as the one pictured here. Once the equation is created using the special symbol buttons, it is entered into a Word document.
The Equation Editor is available in Microsoft Word for Mac version 2011 and earlier versions of Microsoft Word for Windows, but on the Windows side, with the 2010 edition of Microsoft Word, they have discontinued equation editor but built in their own supports for writing equations and symbols. These can be found in the "symbols" group of the toolbar.
MathType is a more sophisticated version of Equation Editor. It offers the ability to invoke functions with keystroke shortcuts and customize the toolbar for commonly used equations.
The software comes with over 500 math symbols and templates whereas Equation Editor only offers 275.
One of the other significant features of MathType is that there is a built-in translator to DBT - or the Duxbury Braille Translator. If you are creating math materials for Braille production, it is important to translate the mathematical symbols properly and this software makes it easier to do so.
For those of you who need voice output, a free add-on is available to allow these equations to be spoken out loud. Most text-to-speech programs will not speak math equations properly. However, the free player called, "MathPlayer" is only available on Windows 7 and Windows XP and it only works with Internet Explorer version 9. That said, if you need spoken output, it is possible within these constraints.
There are other options out there for creating electronic math equations and graphs. Scientific Notebook is one of them. This software allows you to graph computations and mathematical expressions in real time - and with a mouse click, you can evaluate, simplify, plot and solve equations right in your document.
However, it uses its own word processor unlike MathType which imports directly to Microsoft Word. But with Scientific Notebook, equations can be exported as .rtf format in order to share the work with colleagues and teachers.
One of the math domains of the common core state standards at the high school level is modeling geometric figures. The next two tools allow for both 2-dimensional and 3-dimensional modeling of equations with real-time graphing.
This is beneficial for any student who struggles with handwriting and also those who benefit from visual representations of constants and variables and how they might affect a complex graph.
This software is called FX Graph by Efofex. As you can see from the images it looks a lot like the graphs one might produce on paper. It offers the ability to create many different types of 2-dimensional graphs and it allows for use of data tables to create these graphs. What I like about this software is that it was very intuitive to use. A person can start creating graphs within the first few minutes of using this software. This is an add-on to Microsoft Word or Pages and allows you to insert these graphs into your word processor. FX graph is part of a suite of titles from Efofex, but FX Graph is the only one available for both Mac and Windows.
These are some images from the Geometer's sketchpad software. Don't worry, there is no audio, just animations. This is an interactive modeling software that allows a student to visualize math concepts in real-time. It can be used for a wide variety of 2-dimensional and 3-dimensional modeling activities from grades 3 all the way up to college-level.
And there is an app version of Geometer's Sketchpad called "Sketchpad Explorer". And this is free.
By dragging, manipulating and animating graphs, the student can visualize and understand fundamental concepts related to elementary math, geometry, algebra, trigonometry, calculus and more. This app also allows you to interact with any document created in Geometer's Sketchpad and through the Sketch Exchange community.
SketchUp is another tool for 3-dimensional modeling.
Many students with autism have strengths in the area of visual and spatial orientations. In fact, it is often said that individuals with autism think in pictures. SketchUp was designed as a tool in mathematics to help with diagraming and modeling. In this example we see how an individual with autism struggled for 2 hours to draw a simple floor plan, but with SketchUp - a sophisticated drawing was created in half the amount of time that the written drawing took.
SketchUp could also be used by students to show their understanding of 3D shapes.
Ok, so moving on to voice input - most voice input programs have difficulty with typing specific math symbols. However, some students rely on voice recognition as their primary means of computer access. This next slide will show a solution to this problem.
In this video, we see MathTalk in action - this is a software application program that combines Dragon Naturally Speaking - a popular voice input program - with Scientific Notebook - a sophisticated math processing software that was mentioned previously. Notice how the person dictating needs to differentiate between letters such as x and y in the math equation and text for writing. You will see her using the international alphabet of alpha, bravo and charlie for a, b and c to dictate math equations. Let's take a look.
Ok - I'm going to stop the video there... but I think this gives a nice overview of the type of math symbols and computations that can be created using voice input with the MathTalk software.
Math Talk is a software program that works in conjunction with Dragon Naturally Speaking and Scientific Notebook to allow voice input for any math problem from prealgebra, algebra, trigonometery, calculus and statistics all the way through grad level and Ph.D level math courses. This program does require Dragon Naturally Speaking to function and as far as I can tell, it only runs in the Windows operating system.
Multimedia learning supports such as math videos, animations or games can be especially useful if a student is lacking background knowledge or if he or she just needs repetition of math concepts. With videos, the student can rewind and fast-forward to learn at their own pace. There are applications to every common core standard in every grade level.
Khan Academy is a vast collection of short math videos and interactive exercises. In addition to providing re-teaching opportunities and the privilege of moving ahead or rewinding to learn at one's own pace, the Kahn Academy also offers interesting background videos such as one about Euclid as the father of geometry. It's often helpful to understand how and why these math concepts came about to help students relate to the concepts.
Khan Academy also has an extensive section that maps their exercises to the common core standards. Each section is supplemented with videos to further explain the topics if a student is stuck. And this can be found at www.khanacademy.org/commoncore but keep in mind that all of the URL's mentioned can be found in the accompanying handout.
There are tons of websites out there for practicing math facts, but let's look at Math Playground. It's a little different because it offers interactive games that are aligned to the Common Core State Standards.
This is limited to grades 1 through 6, but there are multiple interactive games for each domain and grade band of the Common Core State Standards.
In this example, we have selected grade six and you can see several examples for practicing the concept of ratios and proportional relationships.
Now some students will require specialty tools to access the mathematics curriculum. So here are some tools that might help students with low vision, physical disabilities and learning disabilities.
First we have the pouring cup by Enabling Devices and this allows the student to measure and pour using a single switch. This would be useful for many different math activities involving volume and measuring.
This is a talking tape measure sold by Maxiaids. It also comes in a spanish speaking version and measures in both inches and centimeters.
And next we have a talking measuring cup. It measures volume, weight and density. And this tool is currently available through Hammacher Schlemmer.
The Total Tools Audio Ruler by Crayola talks when it walks across paper. It uses disappearing ink that fades away in a few minutes but that disappearing ink shows the user what's being measured. This device can measure in increments from 1/8 inch all the way up to 1 foot and it can be purchased from Amazon.
The Coinulator is a nice alternative to a traditional calculator. It allows the student to press the coin and dollar buttons to add money and it can also speak the amount entered.
And the last adapted math tool that we are going to share with you today is the MoneyCalc. This device is similar to the Coinulator in that allows a student to add using dollar bill and coin buttons. However, it also offers a traditional number pad as well to begin to make connections to traditional computations. The display lines up the digits in either a horizontal or vertical display and includes dollar signs in the computations.
So this concludes our webinar about assistive technology math tools to support access to the general education curriculum. There is a handout that accompanies this presentation that outlines the AT math tools mentioned, who may benefit from their use and the Common Core State Standards domains and grade bands that apply to each tool. This handout can be found at www.ocali.org and then click on the document archive.
Thank you for joining us today!
Discover assistive technology (AT) solutions for “dyscalculia” or learning disabilities involving mathematics. AT may provide a solution for math computation difficulties that support abstract reasoning tasks for some students. Explore AT solutions to many math difficulties including computation and visual-spatial-motor organization.