Overall Assessment

Strengths

• Clear rationale: The background correctly identifies that most interhemispheric research is neuroimaging-based, and behavioral normative data in Indian school-aged children is lacking.
• Well-structured tasks: Tactile Intermanual Transfer and Bimanual Tapping are validated paradigms with established literature support.
• Appropriate design: A cross-sectional observational design is suitable for normative data collection.
• Good references: Vancouver style used correctly; references are relevant and recent enough.
• Ethical framework: Consent forms, voluntary participation, and confidentiality are addressed.

Issues That Must Be Fixed Before Publication

1. Missing Co-Investigator Details (Critical)

2. "Study Instrument" Section is Empty

3. Bimanual Coordination Task is Missing

4. Consent Form Issues

• The Informed Consent Form (Annexure 2) has no signature line for the parent/guardian — only Date and Place fields. A signature block is mandatory.
• The statement says "no personal identifying information will be collected," but the proforma collects name, date of birth, school, address, and parent phone number. This is a direct contradiction that will be flagged by the ethics committee.

5. Language Justification for Consent Forms is Weak

6. Transfer Index Formula Limitation

7. Sample Size Justification Needs a Cited Source

8. Convenience Sampling Limitation Not Acknowledged

9. Missing Reliability Plan for Assessors

Summary Table

Recommendation

What Has Been Fixed (Compared to the Previous Version)

Remaining Issues That Still Need to Be Addressed

1. Consent Form Still Has No Signature Line (Critical)

2. Confidentiality Contradiction Still Present

3. Sample Size Reference Still Missing

4. Edinburgh Handedness Inventory — Inconsistency in Proforma

5. Bimanual Coordination — No Overall Composite Score Method

6. IEC Approval Number Placeholder in Kannada PIS

7. Inter-rater Reliability Plan Still Absent

Overall Verdict

Can This Study Get Published?

Factors Working IN FAVOR of Publication

1. Genuine Research Gap

2. Non-invasive, Low-cost Methods

3. Three-task Battery Covering Both Callosal Regions

4. Appropriate Design for the Aim

5. Adequate Sample Size

Factors Working AGAINST Publication

1. Convenience Sampling

2. No Validated, Standardized Tools

• What is the test-retest reliability?
• What is the inter-rater reliability?
• Have these cut-off values (e.g., TI ≥ 80% = normal) been validated in children?

3. Cut-off Values Have No Empirical Basis in the Proposal

4. Bimanual Coordination Composite Score Problem

5. Undergraduate-led Study

6. SPSS Version Not Specified

Realistic Publication Targets

Bottom Line

1. "These tasks are not validated instruments"

What to write in your paper

• Fabri et al. (2001) — already in your reference list (Ref 6) — used tactile transfer to assess posterior callosal function. Cite this as the basis.
• Milner & Taylor (1972) — classic paper on tactile transfer in commissurotomy patients. Add this reference.

• Swinnen (2002) — already in your reference list (Ref 8) — established bimanual tapping as a measure of interhemispheric motor integration.
• Njiokiktjien et al. (1997) — already in your reference list (Ref 9) — used bimanual tapping specifically in schoolchildren.

• Gooijers & Swinnen (2014) — already in your reference list (Ref 3) — describes bimanual coordination tasks linked to corpus callosum.

"The task protocols used in the present study were adapted from established paradigms in the interhemispheric and bimanual coordination literature [Refs 3, 6, 8, 9] and modified for use in a pediatric clinical setting."

2. "What is the test-retest reliability?"

What to do

"To assess test-retest reliability, a randomly selected subgroup of 20 participants will be re-assessed within 7–10 days of the initial assessment under identical conditions. Intraclass Correlation Coefficient (ICC 2,1) will be calculated for all continuous task outcomes. An ICC ≥ 0.75 will be considered acceptable reliability."

3. "What is the inter-rater reliability?"

What to do

"Inter-rater reliability will be assessed by having two trained examiners independently score a subset of 20 participants simultaneously. Cohen's Kappa will be calculated for ordinal scores (bimanual coordination Task III, Condition 1). ICC will be calculated for continuous percentage scores. Prior to data collection, both examiners will undergo a standardized training session using a written protocol and practice trials."

4. "Have the cut-off values been validated?"

Option A — Remove the cut-off interpretation tables (Recommended)

"As no validated normative reference values currently exist for this population, performance will be described using descriptive statistics (mean ± SD) stratified by age group. The data generated by this study will serve as preliminary reference values for future clinical use."

Option B — Cite the source of your cut-offs

Summary: What to Add to Your Protocol

What Your Literature Table Has Proven

Task I — Tactile Intermanual Transfer

Task II — Bimanual Tapping

Handedness Assessment (Edinburgh Handedness Inventory)

What Is Still Not Covered

Task III — Bimanual Coordination

How to Use This Table in Your Paper

"The validity and reliability of the task-based measures used in the present study are supported by existing literature. Tactile intermanual transfer accuracy has been shown to directly reflect posterior corpus callosum integrity, with controls achieving 99% accuracy versus 30% in callosotomy patients (Fabri et al., 2001), and high inter-rater reliability has been confirmed in children (Marsico & Meier, 2023). Bimanual tapping demonstrates developmental validity with age-related improvement consistent with corpus callosal myelination (Njiokiktjien et al., 1997) and a test-retest reliability of r = .91 (Woods et al., 2015). Handedness was assessed using the Edinburgh Handedness Inventory, which has an internal consistency of α = 0.94 and stable test-retest scores across 18 months (Veale, 2014; Ransil & Schachter, 1994)."

Revised Publishability Assessment

Current Status of Your Study

What Publication Depends On Now

Things OUTSIDE the proposal that matter most:

Realistic Probability Estimate

The Three Things That Will Most Determine Outcome

Bottom Line

PHASE 1 — After IEC Submission (Waiting Period)

Step 1: Wait for IEC Response

• Typical waiting time at SDUAHER: 4–8 weeks
• The committee may respond with one of three outcomes:
  • Approved — proceed directly
  • Approved with modifications — make the changes they ask, resubmit, then proceed
  • Rejected — revise the proposal significantly and resubmit

Step 2: If Modifications Are Requested

• Respond to every comment point by point in writing
• Make only the changes they ask — do not change other parts of the proposal
• Resubmit within the deadline they give you
• You will then receive the Ethical Clearance Certificate with a number and date
• Keep this certificate — you will need the IEC number for your published paper

PHASE 2 — Before Data Collection Starts

Step 3: Obtain School Permission Letters

• Write a formal letter to the principal of each school
• Get it signed by your HOD and forwarded through SDUAHER
• Attach a copy of your IEC clearance certificate
• Get written permission from each school principal before entering

Step 4: Prepare Your Materials

• 10 familiar objects for tactile transfer (key, coin, scissors, comb, pen, rubber, button, clip, spoon, ring) — use the same set for every child
• Blindfold (clean, standard)
• Metronome app set at 60 BPM — test it before each session
• Digital stopwatch
• Tapping counter
• Pegboard or small objects for Task III Condition 2
• Printed proforma sheets for every participant
• Printed consent forms in English and Kannada

Step 5: Train Your Co-Assessor

• Both you and your co-assessor read the full protocol together
• Practice the entire assessment on 5 pilot children (not part of the main study)
• Calculate inter-rater reliability on these 5 pilot children
• Agree on exactly how to score ambiguous responses before the main study begins
• Document that this training happened — write the date and names

PHASE 3 — Data Collection

Step 6: Screen Participants

• Check age (6–12 years, confirmed by school record)
• Administer Edinburgh Handedness Inventory
• Calculate LQ — exclude if LQ is between -20 and +20 (mixed handed)
• Check inclusion and exclusion criteria
• Mark proforma: Eligible = Yes / No

Step 7: Obtain Consent and Assent

• Give parent/guardian the information sheet (English or Kannada)
• Allow time to read — answer questions
• Obtain written signed consent from parent/guardian
• Obtain verbal assent from the child
• Only then proceed with assessment

Step 8: Conduct the Three Tasks in Order

1. Task I — Tactile Intermanual Transfer
2. Task II — Bimanual Tapping
3. Task III — Bimanual Coordination

Step 9: Reliability Sub-Study (Do This Alongside Main Study)

• From your first 30 participants, randomly select 20
• Re-assess these 20 children within 7–10 days under identical conditions
• Have your co-assessor independently score Task III Condition 1 simultaneously
• Keep these reliability data separately — you will analyze them later

Step 10: Target 120–150 Participants

• Aim for roughly equal numbers across age groups: 6–8 yrs, 9–10 yrs, 11–12 yrs
• Aim for roughly equal gender distribution
• Track recruitment numbers weekly — if one school is not cooperating, add another school early rather than at the end

PHASE 4 — Data Entry and Analysis

Step 11: Data Entry

• Enter all proforma data into Excel or SPSS within 24 hours of each session
• Double-check every entry — data entry errors are a common source of problems
• Create a separate column for every variable:
  • Age, Gender, Grade, School, LQ score, Handedness category
  • Task I: Right hand %, Left hand %, Transfer Index
  • Task II: In-phase %, Anti-phase %, Gap score
  • Task III: Condition 1 score, Condition 2 %, Condition 3 breakdown frequency

Step 12: Run the Analysis in SPSS

PHASE 5 — Writing the Manuscript

Step 13: Structure Your Paper

Step 14: Choose Your Target Journal

1. Indian Journal of Physiotherapy and Occupational Therapy — national, indexed, suitable for this level
2. Journal of Clinical and Diagnostic Research (JCDR) — widely indexed, accepts observational studies
3. Physiotherapy Research International — international, if data is strong
4. Hong Kong Physiotherapy Journal — open access, international, physiotherapy focus

Step 15: Format and Submit

• Read the journal's Author Guidelines carefully before writing — every journal has different word limits, reference styles, and table formats
• Register on the journal's submission portal
• Upload: manuscript, title page, author details, ethics certificate, cover letter
• Write a cover letter stating: title, why it fits the journal, that it is not submitted elsewhere

PHASE 6 — After Submission

Step 16: Peer Review Response

• Typical review time: 6–12 weeks
• Three possible responses:
  • Accept — rare on first submission
  • Major/Minor revisions — most common, respond to every reviewer comment systematically
  • Reject — reformat for next journal and resubmit

Step 17: Revision and Resubmission

• If revisions are requested, respond within the deadline (usually 4–8 weeks)
• Write a point-by-point response letter addressing every reviewer comment
• Changes in the manuscript should be highlighted
• Resubmit

Step 18: Acceptance and Publication

• Once accepted, you receive a DOI (Digital Object Identifier)
• The paper goes to proofing — check carefully
• Published online — this is your citation

Timeline Summary

BEFORE YOU GO TO THE SCHOOL

What to Carry Every Day

DAY-BEFORE PREPARATION

• Count your tactile objects — confirm all 10 are present
• Charge your phone and test the metronome at 60 BPM
• Print enough proforma sheets for the next day
• Prepare consent forms in the language the parent reads

AT THE SCHOOL — STEP BY STEP

STEP 1: Set Up Your Assessment Space

• Request a quiet room or corner away from classroom noise
• Arrange one table and two chairs facing each other
• Place your materials within reach but out of the child's sight
• The room should have consistent lighting — not too dark

STEP 2: Identify Eligible Children

• Ask for children aged 6–12 years
• Ask teacher if any child has a known neurological condition, learning disability, or physical disability of the upper limb — note these for exclusion screening
• Call children one at a time

STEP 3: Send Consent Form Home (Day Before or Same Morning)

• Give the consent form + information sheet to the child to take to parents the day before your visit
• Or arrive early and distribute to parents who drop children at school
• Collect signed consent forms before assessing any child
• Do not assess any child without a signed consent form

STEP 4: Screen Each Child (5 minutes per child)

• Name, age, date of birth, gender, grade, school, parent phone number, address

LQ = [(ΣR − ΣL) ÷ (ΣR + ΣL)] × 100

• LQ between -20 and +20 → Mixed handed → EXCLUDE
• LQ +21 to +100 → Right handed → include
• LQ -21 to -100 → Left handed → include

• Any neurological diagnosis? → Exclude if yes
• Any upper limb injury or pain today? → Exclude if yes
• Normal or corrected vision and hearing? → Include if yes
• Can follow verbal instructions? → Include if yes

STEP 5: TASK I — Tactile Intermanual Transfer (10–12 minutes)

• Child sits comfortably at the table
• Apply blindfold or ask child to close eyes firmly
• Confirm child cannot see anything
• Place your bag of 10 objects under the table or behind you

• Place Object 1 into the child's RIGHT hand
• Say: "Feel this object carefully. What is it?"
• Child explores with fingers — no looking
• Record: C (correct) or X (incorrect) on proforma
• Remove object, place next object
• Repeat for all 10 objects
• Calculate: Right Hand % = (Correct ÷ 10) × 100

• Same 10 objects, now into LEFT hand one at a time
• Same instruction: "Feel this. What is it?"
• Record C or X for each
• Calculate: Left Hand % = (Correct ÷ 10) × 100

• Place Object 1 into RIGHT hand — child explores it for 5 seconds
• Without naming it, transfer the same object to the LEFT hand
• Say: "Now feel with your left hand — is this the same object or different? What is it?"
• Record C or X
• Repeat: start with LEFT hand, identify with RIGHT hand
• Calculate: Transfer Accuracy % = (Correct ÷ total) × 100

TI = (IMT correct ÷ IMA correct) × 100

STEP 6: TASK II — Bimanual Tapping (8–10 minutes)

• Child sits upright, both forearms flat on the table
• Both index fingers positioned on the table surface
• Open the metronome app — set to 60 BPM
• Let child hear a few beats before starting

• Say: "When the beat plays, tap BOTH fingers at the same time, every beat."
• Do a practice round of 5 beats
• Start metronome — run for 30 seconds (= 30 beats)
• Count simultaneous taps (both fingers hit at same beat)
• Record: number of simultaneous taps
• Calculate: In-phase % = (simultaneous taps ÷ 30) × 100

• Say: "Now tap one finger at a time — right, left, right, left — one tap per beat, alternating."
• Practice round of 5 beats
• Start metronome — run for 30 seconds
• Count correct alternating taps
• Calculate: Anti-phase % = (correct alternate taps ÷ 30) × 100

Gap = In-phase % − Anti-phase %

STEP 7: TASK III — Bimanual Coordination (8–10 minutes)

• Child sits at table, both hands free, eyes open
• No blindfold

• Give child paper and pen
• Say: "With your right hand draw circles continuously. At the same time, with your left hand draw straight lines up and down. Do both together for 30 seconds."
• Demonstrate once yourself
• Start stopwatch — observe for 30 seconds
• Score:
  • 2 — both movements stayed independent throughout
  • 1 — minor breakdown (one hand briefly copied the other)
  • 0 — complete assimilation (one hand fully copied the other)

• Place pegboard or 20 small objects in the center of the table
• Say: "Right hand picks up an object and places it to your right side. Left hand picks up a different object and places it to your left side. Do both at the same time, as many times as you can in 30 seconds."
• Start stopwatch
• Count total correct simultaneous placements
• Calculate: Coordination % = (correct placements ÷ 30) × 100

• Set metronome to 60 BPM
• Say: "Right hand taps TWO times per beat. Left hand taps ONE time per beat. Try to keep both going at the same time for 30 seconds."
• Demonstrate the asymmetric rhythm first
• Start — observe for 30 seconds
• Count number of times the child loses the rhythm or both hands fall into the same pattern (breakdowns)

STEP 8: Thank the Child and Dismiss

• Remove all materials
• Tell the child: "You did very well. Thank you."
• Call the next eligible child

RECORDING AND TRACKING

Daily After Each Session

• Check every proforma is complete — no blank fields
• Enter data into your Excel sheet that evening
• Do not leave data entry for the weekend — errors increase

Your Excel Sheet Should Have One Row Per Child:

Track Your Numbers Weekly:

RELIABILITY DATA COLLECTION (Do Alongside Main Study)

• Re-assess them within 7–10 days — same room, same assessor, same objects
• On the same visit, have your co-assessor independently score Task III Condition 1 while you score it simultaneously
• Keep these in a separate sheet labeled "Reliability Sub-study"

COMMON PROBLEMS AND SOLUTIONS

TIME MANAGEMENT

• Fix the consent form signature block and the confidentiality contradiction before IEC submission
• Find one reference for Task III bimanual coordination protocol
• During data collection, do the reliability sub-study — it will make a real difference at peer review
• Frame your findings as preliminary normative data, not definitive standards