2.9. The MoFis-I Kit

Stimulation of fine motor skills in hospitalized children took place using the MoFis-I Kit, an intervention program designed to improve the fine and grapho-motor skills of children aged between four and six years through 15 specific activities. The psycho-educational play activities of the kit were studied in order to achieve three objectives: (a) to improve the functions of the hand, in particular manual dexterity, digital dexterity, in-hand manipulation, and visual–motor coordination, considered essential to the performance and to the participation in daily life activities and foundational for the development of grapho-motor competence; (b) to develop manipulation skills related to autonomy and learning activities; and (c) to increase manipulation strength and endurance during fine motor activities.

The 15 activities can be carried out with a set of tools and implements that are inexpensive, easy-to-find (staples, elastic bands, plasticine, plastic bottles, pencils etc.), and transportable. Instruction for assembling the related material are given in detail to facilitate the administration both by occupational therapists or by other health personnel like, for example, psychologists, nurses, educators, hospital school teachers, volunteers, and parents. All psycho-educational play activities can last even just a few minutes, are presented in order of progressive difficulty, and are attractive and funny. At each stimulation session with the kit, the child must carry out three different activities, each of which trains different fine motor skills: activities for manual dexterity, activities for digital dexterity, and activities for visual-motor coordination.

The duration of the daily stimulation depended on the health and fatigue conditions of the children. For children hospitalized in the cancer ward, the administration took place on a daily basis and mostly in bed. The duration of the intervention was a maximum of 10 min because after this time, the children’s resistance diminished significantly. It was not always possible to administer the three activities during the same session.

For the children of the day hospital, the administration was scheduled once/twice a week, based on the medical examinations the child had planned. For the children of the day hospital, the kit was performed in the area dedicated to the school, although the activities often had to be interrupted by doctors and nurses when children had to undergo routine medical visits. For these children, the intervention program had a variable duration from 10 to 50 min.

In the present study, the psycho-educational play activities were conducted mainly under the supervision of an occupational therapist and two psychologists present at the DH and in the ward.