Handwriting development, competency, and intervention

Gender Differences in Students' Self-Awareness of Their Handwriting Performance

Introduction

Self-awareness has been found to be an important factor in individuals' performance in daily activities. Yet, to date, the relationship between this factor and handwriting performance has not been examined. The purpose of this study was to compare the handwriting self-awareness (that is, self-knowledge and on-line awareness) and performance of girls and boys, and to examine the relationship between self-awareness and handwriting performance.

Method

Participants included 86 middle-school students (aged 12–14) enrolled in general education in Israel. A handwriting evaluation assessment was administered along with self-knowledge and on-line awareness questionnaires.

Results

Gender differences were found in relation to students' self-awareness of their handwriting performance. In comparison with girls, boys perceived their handwriting to be faster, even though their actual handwriting performance was slower. Regarding legibility, only boys showed a significant correlation between self-knowledge and performance, while both genders demonstrated significant correlations between on-line awareness and performance.

Conclusion

It appears that students aged 12–14 are only moderately aware of their handwriting performance, yet there are gender differences in relation to this awareness. These findings may assist educators and therapists in teaching, evaluating, and developing interventions to improve handwriting performance.

Development of the writing readiness inventory tool in context (WRITIC)

This article describes the development of the Writing Readiness Inventory Tool in Context (WRITIC), a measurement evaluating writing readiness in Dutch kindergarten children (5 and 6 years old). Content validity was established through 10 expert evaluations in three rounds. Construct validity was established with 251 children following regular education. To identify scale constructs, factor analysis was performed. Discriminative validity was established by examining contrast groups with good (n = 142) and poor (n = 109) performers in paper-and-pencil tasks. Content validity was high with 94.4% agreement among the experts. Two reliable factors were found in the performance of paper-and-pencil tasks with Cronbach's alphas of 0.82 and 0.69 respectively. The contrast groups differed significantly in two WRITIC subdomains: "Sustained attention" and "Task performance". Our findings indicated that the WRITIC is feasible for use in the classroom.

Visuomotor Control in Continuous Response Time Tasks across Different Age Groups

The goal was to examine whether visuomotor control and choice response time shared age-related developmental trajectories, and if prior computer experience played an important role in control processes. Children (6–7, 8–9, 10–11 yr.), younger adults (24 yr.) and older adults (76 yr.) performed the cursor pointing and choice response time (CRT) tasks with a computer mouse. Participants moved the mouse cursor back and forth to click two targets on the screen as fast and accurately as possible. In the CRT, based on visual stimuli, participants moved and clicked one of the three targets on the screen as fast and accurately as possible; the time between stimulus onset and clicking the correct target was recorded as the choice response time. Visuomotor performance increased with age to younger adulthood but was worse in the older adult group. CRT performance was also positively related to age among the groups of children, with scores leveling off in the young adult group. Computer experience was statistically significantly related only to visuomotor control, but not to CRT. Optimal CRT performance required only sub-optimal visuomotor control. Cognitive and sensory age declines may be related to the poorer CRT performance in the oldest age group.

Content and Construct Validity of Here’s How I Write (HHIW): A Child’s Self-Assessment and Goal Setting Tool

OBJECTIVE. We examined content and construct validity of Here’s How I Write: A Child’s Self-Assessment and Goal Setting Tool, to assess children’s perception of their handwriting and set child-directed goals.

METHOD. In Study 1, a content validity study, 6 occupational therapists and 2 educators assessed the need for this type of measure and examined the proposed items. Thirty-four occupational therapists and educators then completed an online survey examining the items. Study 2, a construct validity study, compared the self-ratings of 20 children with poor handwriting and 20 children with good handwriting in Grades 2–5 with their teachers’ ratings.

RESULTS. Results supported test content and indicated freedom from culture and gender bias. The assessment discriminated between good and poor writers. The relationship between teacher and student ratings was significant, although teachers of poor writers rated the children lower than the children rated themselves.

CONCLUSION. These studies provide support for the tool’s validity.

Children's head movements and postural stability as a function of task

Manual dexterity and postural control develop throughout childhood, leading to changes in the synergistic relationships between head, hand and posture. But the postural developments that support complex manual task performance (i.e. beyond pointing and grasping) have not been examined in depth. We report two experiments in which we recorded head and posture data whilst participants simultaneously performed a visuomotor task. In Experiment 1, we explored the extent to which postural stability is affected by concurrently performing a visual and manual task whilst standing (a visual vs. manual-tracking task) in four age groups: 5-6 years (n = 8), 8-9 years (n = 10), 10-11 years (n = 7) and 19-21 years (n = 9). For visual tracking, the children's but not adult's postural movement increased relative to baseline with a larger effect for faster moving targets. In manual tracking, we found greater postural movement in children compared to adults. These data suggest predictive postural compensation mechanisms develop during childhood to improve stability whilst performing visuomotor tasks. Experiment 2 examined the extent to which posture is influenced by manual activity in three age groups of children [5-6 years (n = 14), 7-8 years (n = 25), and 9-10 years (n = 24)] when they were seated, given that many important tasks (e.g. handwriting) are learned and performed whilst seated. We found that postural stability varied in a principled manner as a function of task demands. Children exhibited increased stability when tracing a complex shape (which required less predictive postural adjustment) and decreased stability in an aiming task (which required movements that were more likely to perturb posture). These experiments shed light on the task-dependant relationships that exist between postural control mechanisms and the development of specific types of manual control.

Neuroimaging correlates of handwriting quality as children learn to read and write

Reading and writing are related but separable processes that are crucial skills to possess in modern society. The neurobiological basis of reading acquisition and development, which critically depends on phonological processing, and to a lesser degree, beginning writing as it relates to letter perception, are increasingly being understood. Yet direct relationships between writing and reading development, in particular, with phonological processing is not well understood. The main goal of the current preliminary study was to examine individual differences in neurofunctional and neuroanatomical patterns associated with handwriting in beginning writers/readers. In 46 5-6 year-old beginning readers/writers, ratings of handwriting quality, were rank-ordered from best to worst and correlated with brain activation patterns during a phonological task using functional MRI, and with regional gray matter volume from structural T1 MRI. Results showed that better handwriting was associated negatively with activation and positively with gray matter volume in an overlapping region of the pars triangularis of right inferior frontal gyrus. This region, in particular in the left hemisphere in adults and more bilaterally in young children, is known to be important for decoding, phonological processing, and subvocal rehearsal. We interpret the dissociation in the directionality of the association in functional activation and morphometric properties in the right inferior frontal gyrus in terms of neural efficiency, and suggest future studies that interrogate the relationship between the neural mechanisms underlying reading and writing development.

Manual control age and sex differences in 4 to 11 year old children

To what degree does being male or female influence the development of manual skills in pre-pubescent children? This question is important because of the emphasis placed on developing important new manual skills during this period of a child's education (e.g. writing, drawing, using computers). We investigated age and sex-differences in the ability of 422 children to control a handheld stylus. A task battery deployed using tablet PC technology presented interactive visual targets on a computer screen whilst simultaneously recording participant's objective kinematic responses, via their interactions with the on-screen stimuli using the handheld stylus. The battery required children use the stylus to: (i) make a series of aiming movements, (ii) trace a series of abstract shapes and (iii) track a moving object. The tasks were not familiar to the children, allowing measurement of a general ability that might be meaningfully labelled ‘manual control’, whilst minimising culturally determined differences in experience (as much as possible). A reliable interaction between sex and age was found on the aiming task, with girls' movement times being faster than boys in younger age groups (e.g. 4–5 years) but with this pattern reversing in older children (10–11 years). The improved performance in older boys on the aiming task is consistent with prior evidence of a male advantage for gross-motor aiming tasks, which begins to emerge during adolescence. A small but reliable sex difference was found in tracing skill, with girls showing a slightly higher level of performance than boys irrespective of age. There were no reliable sex differences between boys and girls on the tracking task. Overall, the findings suggest that prepubescent girls are more likely to have superior manual control abilities for performing novel tasks. However, these small population differences do not suggest that the sexes require different educational support whilst developing their manual skills.

Effectiveness of a co-taught handwriting program for first grade students

Our study examined the effects of Write Start, a classroom-embedded handwriting/writing program on handwriting and writing fluency for first grade students, co-taught by occupational therapists and teachers. Two first grade classrooms received the Write Start and two received standard handwriting instruction. This co-taught program included specific feedback during handwriting practice, small group activities, student self-evaluation, and peer supports. The students were evaluated on handwriting legibility, fluency, and written expression at baseline, immediately after the program, and 6 months later. When performance was compared between the two groups, the students in the Write Start program improved significantly more in legibility (d = .57) and fluency (d = .75) than students who received standard instruction. Gains in handwriting speed (d = .18), average legibility (d = .26), and written expression (d = .25) did not differ significantly between the two groups. A co-taught, inclusive handwriting/writing program can promote first grade students' achievement of lower case legibility and writing fluency.

Visual-perceptual-kinesthetic inputs on influencing writing performances in children with handwriting difficulties

This study investigated the role of visual-perceptual input in writing Chinese characters among senior school-aged children who had handwriting difficulties (CHD). The participants were 27 CHD (9-11 years old) and 61 normally developed control. There were three writing conditions: copying, and dictations with or without visual feedback. The motor-free subtests of the Developmental Test of Visual Perception (DTVP-2) were conducted. The CHD group showed significantly slower mean speeds of character production and less legibility of produced characters than the control group in all writing conditions (ps<0.001). There were significant deteriorations in legibility from copying to dictation without visual feedback. Nevertheless, the Group by Condition interaction effect was not statistically significant. Only position in space of DTVP-2 was significantly correlated with the legibility among CHD (r=-0.62, p=0.001). Poor legibility seems to be related to the less-intact spatial representation of the characters in working memory, which can be rectified by viewing the characters during writing. Visual feedback regarding one's own actions in writing can also improve legibility of characters among these children.

Visual-motor perception in students with attention deficit with hyperactivity disorder

PURPOSE

The aim of this study was to characterize and to compare the visual-motor perception of students with Attention Deficit with Hyperactivity Disorder (ADHD) with students with good academic performance.

METHODS

Forty students from 2nd to 5th grades of an elementary public school, male gender (100%), aged between 7 and 10 years and 8 months old participated, divided into: GI (20 students with ADHD) and GII (20 students with good academic performance), paired according to age, schooling and gender with GI. The students were submitted to Developmental Test of Visual Perception (DTVP-2).

RESULTS

The students of GI presented low performance in spatial position and visual closure (reduced motor) and inferior age equivalent in reduced motor perception, when compared to GII.

CONCLUSION

The difficulties in visual-motor perception presented by students of GI cannot be attributed to a primary deficit, but to a secondary phenomenon of inattention that interferes directly in their visual-motor performance.

Visual profile of children with handwriting difficulties in Hong Kong Chinese

The purpose of this study was to find out the visual profiles of children with handwriting difficulties (HWD) in Hong Kong Chinese. Forty-nine children with HWD (mean age 8.4 ± 1.1 years) and 27 controls (mean age 7.7 ± 0.7 years) were recruited. All subjects received eye examination and vision assessment included ocular health, refraction, accommodative functions, binocularity, visual perception (by Gardner reversal frequency test: recognition subtest; Test of visual perceptual skills (non-motor)-revised) and motor skills (by The Beery-Buktenica developmental test of visual motor integration; Detroit test of motor speed and precision). Higher percentages of tropia and phoria (of magnitude >6 prism dioptres) were found in children with HWD of 6.1% and 14.3% respectively. After adjusted for the effect of age, children with HWD showed significantly worse accommodative facility, directionality, visual discrimination, visual spatial relation, visual form constancy, visual sequential memory, visual figure ground, visual closure and visual motor integration. Studies reported the visual functions of children with HWD were mostly concerned with alphabetic languages, while studies concerning Chinese HWD were relatively less. This study provided the visual profiles of children with Chinese HWD. Based on the visual profile, further study is indicated to investigate the effect of optometric interventions on the assessment and remediation for children with HWD.

Neural correlates of paediatric dysgraphia

Writing is an important skill that is related both to school performance and to psychosocial outcomes such as the child's self-esteem. Deficits in handwriting performance are frequently encountered in children with developmental coordination disorder. This review focuses on what is known about the neural correlates of atypical handwriting in children. Knowledge of the neural correlates is derived from studies using clinical case designs (e.g. lesion studies), studies using neuroimaging, and assessment of minor neurological dysfunction. The two functional imaging studies suggest a contribution of cortical areas and the cerebellum. The largest study indicated that cortical areas in all regions of the brain are involved (frontal, temporal, parietal, and occipital). The two lesion studies confirmed cerebellar involvement. The findings of the study on minor neurological dysfunction in children with writing problems correspond to the imaging results. The limited data on the neural substrate of paediatric dysgraphia suggest that at least a subset of the children with dysgraphia have dysfunctions in extensive supraspinal networks. In others, dysfunction may be restricted to either the cerebellum or specific cortical sites.

Handwriting features of children with developmental coordination disorder--results of triangular evaluation

Developmental coordination disorders (DCD) is one of the most common disorders affecting school-aged children. The study aimed to characterize the handwriting performance of children with DCD who write in Arabic, based on triangular evaluation. Participants included 58 children aged 11-12 years, 29 diagnosed with DCD based on the DSM-IV criteria and the M-ABC, and 29 matched typically developed controls. Children were asked to copy a paragraph on a sheet of paper affixed to a digitizer supplying objective measures of the handwriting process. The handwriting proficiency screening questionnaire (HPSQ) was completed by their teachers while observing their performance and followed by evaluation of their final written product. Results indicated that compared to controls, children with DCD required significantly more on-paper and in-air time per stroke while copying. In addition, global legibility, unrecognizable letters and spatial arrangement measures of their written product were significantly inferior. Significant group differences were also found between the HPSQ subscales scores. Furthermore, 82.8% of all participants were correctly classified into groups based on one discriminate function which included two handwriting performance measures. These study results strongly propose application of triangular standardized evaluation to receive better insight of handwriting deficit features of individual children with DCD who write in Arabic.

Development of fine motor skills in preterm infants

Fine motor skills are related to functioning in daily life and at school. We reviewed the status of knowledge, in preterm children, on the development of fine motor skills, the relation with gross motor skills, and risk factors for impaired fine motor skills. We searched the past 15 years in PubMed, using ['motor skills' or 'fine motor function' and 'preterm infant'] as the search string. Impaired gross and fine motor skills are among the most frequently occurring problems encountered by preterm children who do not develop cerebral palsy. The prevalence is around 40% for mild to moderate impairment and 20% for moderate impairment. Fine motor skill scores on the Movement Assessment Battery for Children are about 0.62 of a standard deviation lower compared with term children. Risk factors for fine motor impairments include moderately preterm birth (odds ratio [OR] 2.0) and, among very preterm children (<32 wk gestation), intra-uterine growth restriction (ORs 2-3), inflammatory conditions (late-onset sepsis and necrotizing enterocolitis, ORs 3-5), and dexamethasone therapy for bronchopulmonary dysplasia (OR 2.7). A better understanding of factors that play a role in the development of and recovery from brain injury could guide future intervention attempts aimed at improving fine motor skills of preterm children.

Reprint of 'Development, maturation and learning influence on handwriting kinematics'

Handwriting is the result of a process in which linguistic, psychomotor and biomechanical factors interact with physical maturation, cognitive development and learning. Digital tablets, which record the writing in real time, allow a kinematic analysis of written trace: the implemented algorithms analyze parameters as length, duration and speed of the components (trace between two pen-lifts) and strokes (trace between two minima of curvilinear velocity). The purpose of this work is to fill, at least for Italy, the lack of normative data on typical handwriting processes. This cross-sectional study will present data on 218 right-handed and Italian mother-tongue students, attending classes from 2nd to 8th grade. They performed specific tasks (tests of writing speed; transcription of a sentence accurately vs. speedily) by a digital tablet. The analysis showed many changes of the considered parameters across the classes, as in the horizontal, curvilinear mean and peak velocities of components and strokes, with higher values in the last years of schooling and a parallel decrease in the number of strokes/letter (improvement of automation). In conclusion, some of these parameters are useful for studying development and learning of writing and their values can be used as references to evaluate samples with different characteristics.

Writing to dictation and handwriting performance among Chinese children with dyslexia: relationships with orthographic knowledge and perceptual-motor skills

The purpose of this study was to investigate the relationships between writing to dictation, handwriting, orthographic, and perceptual-motor skills among Chinese children with dyslexia. A cross-sectional design was used. A total of 45 third graders with dyslexia were assessed. Results of stepwise multiple regression models showed that Chinese character naming was the only predictor associated with word dictation (β=.32); handwriting speed was related to deficits in rapid automatic naming (β=-.36) and saccadic efficiency (β=-.29), and visual-motor integration predicted both of the number of characters exceeded grid (β=-.41) and variability of character size (β=-.38). The findings provided support to a multi-stage working memory model of writing for explaining the possible underlying mechanism of writing to dictation and handwriting difficulties.

Writing forces associated with four pencil grasp patterns in grade 4 children

OBJECTIVE. We investigated differences in handwriting kinetics, speed, and legibility among four pencil grasps after a 10-min copy task. METHOD. Seventy-four Grade 4 students completed a handwriting assessment before and after a copy task. Grip and axial forces were measured with an instrumented stylus and force-sensitive tablet. We used multiple linear regression to analyze the relationship between grasp pattern and grip and axial forces. RESULTS. We found no kinetic differences among grasps, whether considered individually or grouped by the number of fingers on the barrel. However, when grasps were grouped according to the thumb position, the adducted grasps exhibited higher mean grip and axial forces. CONCLUSION. Grip forces were generally similar across the different grasps. Kinetic differences resulting from thumb position seemed to have no bearing on speed and legibility. Interventions for handwriting difficulties should focus more on speed and letter formation than on grasp pattern.

Validation of the Chinese Handwriting Analysis System (CHAS) for primary school students in Hong Kong

There are more children diagnosed with specific learning difficulties in recent years as people are more aware of these conditions. Diagnostic tool has been validated to screen out this condition from the population (SpLD test for Hong Kong children). However, for specific assessment on handwriting problem, there seems a lack of standardized and objective evaluation tool to look into the problems. The objective of this study was to validate the Chinese Handwriting Analysis System (CHAS), which is designed to measure both the process and production of handwriting. The construct validity, convergent validity, internal consistency and test-retest reliability of CHAS was analyzed using the data from 734 grade 1-6 students from 6 primary schools in Hong Kong. Principal Component Analysis revealed that measurements of CHAS loaded into 4 components which accounted for 77.73% of the variance. The correlation between the handwriting accuracy obtained from HAS and eyeballing was r=.73. Cronbach's alpha of all measurement items was .65. Except SD of writing time per character, all the measurement items regarding handwriting speed, handwriting accuracy and pen pressure showed good to excellent test-retest reliability (r=.72-.96), while measurement on the numbers of characters which exceeded grid showed moderate reliability (r=.48). Although there are still ergonomic, biomechanical or unspecified aspects which may not be determined by the system, the CHAS can definitely assist therapists in identifying primary school students with handwriting problems and implement interventions accordingly.

The artist's advantage: Better integration of object information across eye movements

Over their careers, figurative artists spend thousands of hours analyzing objects and scene layout. We examined what impact this extensive training has on the ability to encode complex scenes, comparing participants with a wide range of training and drawing skills on a possible versus impossible objects task. We used a gaze-contingent display to control the amount of information the participants could sample on each fixation either from central or peripheral visual field. Test objects were displayed and participants reported, as quickly as possible, whether the object was structurally possible or not. Our results show that when viewing the image through a small central window, performance improved with the years of training, and to a lesser extent with the level of skill. This suggests that the extensive training itself confers an advantage for integrating object structure into more robust object descriptions.

Facilitating complex shape drawing in Williams syndrome and typical development

Individuals with Williams syndrome (WS) produce drawings that are disorganised, likely due to an inability to replicate numerous spatial relations between parts. This study attempted to circumvent these drawing deficits in WS when copying complex combinations of one, two and three shapes. Drawing decisions were reduced by introducing a number of facilitators, for example, by using distinct colours and including facilitatory cues on the response sheet. Overall, facilitation improved drawing in the WS group to a comparable level of accuracy as typically developing participants (matched for non-verbal ability). Drawing accuracy was greatest in both groups when planning demands (e.g. starting location, line lengths and changes in direction) were reduced by use of coloured figures and providing easily distinguished and clearly grouped facilitatory cues to form each shape. This study provides the first encouraging evidence to suggest that drawing of complex shapes in WS can be facilitated; individuals with WS might be receptive to remediation programmes for drawing and handwriting.

Assessing handwriting intervention effectiveness in elementary school students: a two-group controlled study

This study examined the effectiveness of two approaches used in elementary schools to improve children's handwriting. Participants were 72 New York City public school students from the first and second grades. A nonequivalent pretest-posttest group design was used in which students engaged in handwriting activities using two approaches: intensive handwriting practice and visual-perceptual-motor activities. Handwriting speed, legibility, and visual-motor skills were examined after a 12-wk Handwriting Club using multivariate analysis of variance. The results showed that students in the intensive handwriting practice group demonstrated significant improvements in handwriting legibility compared with students in the visual-perceptual-motor activity group. No significant effects in handwriting speed and visual-motor skills were found between the students in intensive handwriting practice group and the students in visual-perceptual-motor activities group. The Handwriting Club model is a natural intervention that fits easily into existing school curriculums and can be an effective short-term intervention (response to intervention Tier II).

An electromyographic analysis of two handwriting grasp patterns

BACKGROUND

Handwriting is a fundamental skill needed for the development of daily-life activities during lifetime and can be performed using different forms to hold the writing object. In this study, we monitored the sEMG activity of trapezius, biceps brachii, extensor carpi radialis brevis and flexor digitorum superficialis during a handwriting task with two groups of subjects using different grasp patterns.

SUBJECTS AND METHODS

Twenty-four university students (thirteen males and eleven females; mean age of 22.04±2.8years) were included in this study. We randomly invited 12 subjects that used the Dynamic Tripod grasp and 12 subjects that used the Static Tripod grasp.

RESULTS

The static tripod group showed statistically significant changes in the sEMG activity of trapezium and biceps brachii muscles during handwriting when compared to dynamic tripod group's subjects. No significant differences were found in extensor carpi radialis brevis and flexor digitorum superficialis activities among the two groups.

CONCLUSION

The findings in this study suggest an increased activity of proximal muscles among subjects using a transitional grasp, indicating potential higher energy expenditure and muscular harm with the maintenance of this motor pattern in handwriting tasks, especially during the progression in academic life.

Co-variation between graphic pattern stability and attentional cost: a clue for the difficulty to produce handwritten traces

Attentional cost incurred for generating handwritten graphic patterns was investigated using a classic dual-task procedure, in which a concurrent reaction time (RT) task was used as an index of the attentional cost incurred by the primary graphic task. Eight right-handed adults had to trace graphic patterns, characterized by a 0°, 45°, 90°, 135° or 180° relative phase and corresponding to shapes ranging from lines to ellipses to circles, while responding by a key press as fast as possible to an auditory signal. The results evidenced a strong and significant correlation between the stability of the produced pattern and the associated attentional cost. The amplitude of the minor and major axes of the produced ellipsoids decreased with the increase of movement frequency, as expected by nonlinear models of oscillatory pattern generation. These findings pave the way to the study for the (coordinative) processes for letter (mal)formation in cursive handwriting.

The effect of lower body stabilization and different writing tools on writing biomechanics in children with cerebral palsy

A high percentage of children with cerebral palsy (CP) have difficulty keeping up with the handwriting demands at school. Previous studies have addressed the effects of proper sitting and writing tool on writing performance, but less on body biomechanics. The aim of this study was to investigate the influence of lower body stabilization and pencil design on body biomechanics in children with CP. Fourteen children (12.31±4.13 years old) with CP were recruited for this study. A crossover repeated measures design was employed, with two independent variables: lower body stabilization (with/without) and pencil (regular/assigned grip height/biaxial). The writing task was to trace the Archimedean spiral mazes. Electromyography (EMG) of the upper extremity, the wrist flexion/extension movements, and the whole body photography were recorded to quantify the changes in posture and upper extremity biomechanics. Two-way repeated measures ANOVA was used for statistical analysis. No significant main effects were revealed in the EMG and wrist kinematics. The lower body stabilization significantly decreased the trunk lateral and forward deviations, and the visual focus-vertical angle. The biaxial pencil and the assigned grip height design significantly decreased the head, shoulder, trunk, and pelvic deviations compared with the regular design. The results indicated that the lower body positioning was effective in improving the trunk posture. A pencil with an assigned grip height or with a biaxial design could improve head, shoulder, trunk and pelvic alignment, but did not influence the muscle exertion of the upper extremity. This study could provide guidelines for parents, teachers and clinicians regarding the selection of writing tools and the knowledge of proper positioning for the children with handwriting difficulties. Further analyses can focus on the design, modification and clinical application of assitive sitting and writing devices for the use in children with handwriting difficulties.

Screening for motor dysgraphia in public schools

OBJECTIVE

To screen for warning signs of dysgraphia in schoolchildren at the sixth grade of elementary school.

METHOD

This was a descriptive, exploratory, cross-sectional cohort study performed with 630 schoolchildren assessed through the (adapted) Analytical Dysgraphia Inventory, which recognizes difficulties in writing through the tracing the graphics.

RESULTS

A total of 22% (n=138) of the sample presented all indications of dysgraphia; the most prevalent indicator was ascending/descending/fluctuating lines (53.6%). When the indicators were correlated to gender, males showed a significant difference (p<0.05) in most of them. Among the warning signs of co-occurrences, dyslexia was the most prevalent indicator (22%).

CONCLUSION

Given the large number of warning signs of dysgraphia observed in schoolchildren, it is advisable to screen for these signs, in order to implement early interventions.

Age effects on sensory-processing abilities and their impact on handwriting

Background.

Sensory-processing abilities are known to deteriorate in the elderly. As a result, daily activities such as handwriting may be impaired. Yet, knowledge about sensory-processing involvement in handwriting characteristics among older persons is limited.

Purpose

To examine how age influences sensory-processing abilities and the impact on handwriting as a daily performance.

Method.

The study participants were 118 healthy, independently functioning adults divided into four age groups: 31–45, 46–60, 61–75 and 76+ years. All participants completed the Adolescent/Adult Sensory Profile (AASP). Handwriting process was documented using the Computerized Handwriting Penmanship Evaluation Tool (ComPET).

Findings.

Age significantly affects sensory processing and handwriting pressure as well as temporal and spatial measures. Both handwriting time and spatial organization of the written product were predicted by sensory seeking. When examining age contribution to the prediction of handwriting by sensory processing, sensory seeking showed a tendency for predicting handwriting pressure (p = .06), while sensory sensitivity significantly predicted handwriting velocity.

Implications.

Age appears to influence sensory-processing abilities and affect daily performance tasks, such as handwriting, for which sensitivity and seeking for sensations are essential. Awareness of clinicians to sensory-processing deficits among older adults and examining their impact on broader daily activities are essential to improve daily performance and quality of life.

Arm trajectories and writing strategy in healthy children

Background

Evaluation of elementary writing skills in children is usually obtained with high resolution (and high cost) techniques or with low resolution pen-and-paper tests. In this observational study we tested a quantitative method to obtain normative data to describe arm movement during a writing precursor gesture.

Methods

We recruited 226 healthy children (mean age 9,1 years [range: 6.3 – 11.4 years]), attending primary schools belonging to the “Istituto Comprensivo” of Rivanazzano Terme (Pavia). We asked to drive a cursor through a polygonal path (labyrinth) projected in front of them using a wireless mouse. Dartfish™ video analysis software was used to elaborate images and Excel™, MedCalc™ and Statistica 7™ to analyze values of shoulder, elbow and wrist ranges of motion, arm trajectories, execution times and gesture accuracy.

Results

Differences seen in motor strategies, when divided according to attended class, suggest a proximal-distal maturation of motor control. Obtained values were not significantly correlated with variables such as gender, ethnicity or cognitive functioning.

Conclusions

This type of approach to a study of arm movement during childhood represents a valid alternative to other tests, considering that it can differentiate children who perform similarly in the VMI test and is non-invasive, low-cost and easily reproducible.

An investigation of visual contour integration ability in relation to writing performance in primary school students

A previous study found a visual deficit in contour integration in English readers with dyslexia (Simmers & Bex, 2001). Visual contour integration may play an even more significant role in Chinese handwriting particularly due to its logographic presentation (Lam, Au, Leung, & Li-Tsang, 2011). The current study examined the relationship between children's performance in visual contour (VC) integration and Chinese handwriting. Twenty students from grade 3 to grade 6 were recruited (M=9.51, SD=1.02) from a mainstream primary school using the convenience sampling method. Ten students were identified by teachers as having handwriting problems, and the other 10 were typical students. Participants performed the VC tasks and their handwriting performance was assessed by a Chinese Handwriting Assessment Tool (CHAT) in a classroom setting. Correlation analyses revealed that VC accuracy was significantly and negatively correlated with on paper time and total writing duration. t-Test analyses revealed statistically significant differences in VC accuracy between students with typical and poor handwriting, with consistently better VC accuracy performance in all conditions in the typical handwriting group. The results may have important implications for interventions aiming at improving children's handwriting.

Relationship between writing skills and visual-motor control in low-vision students

The purpose of this study was to investigate the relationship between handwriting skills and visual motor control among students with low vision and to compare this with the performance of their normal sighted peers. 42 students with low vision and 26 normal sighted peers participated. The Bruininks-Oseretsky Motor Proficiency Test-Short Form (BOTMP-SF), Jebsen Taylor Hand Function Test's writing subtest, and a legibility assessment were administered. Significant differences were found between groups for students' writing speed, legibility, and visual motor control. Visual motor control was correlated both writing speed and legibility. Students with low vision had poorer handwriting performance, with lower legibility and slower writing speed. Writing performance time was related to visual motor control in students with low vision.

Writing and reading training effects on font type and size preferences by students with low vision

The effect of writing and reading training on preferred font type and size in low-vision students was evaluated in 35 children. An ophthalmologist confirmed low vision according to ICD-10-CM. Children identified the font type and size they could best read. The writing subtest of the Jebsen-Taylor Hand Function Test, read in 1 min., and legibility as measured by the number of readable written letters were used in evaluating the children. A writing and reading treatment program was conducted, beginning with the child's preferred font type and size, for 3 months, 2 days per week, for 45 min. per day at the child's school. Before treatment, the most preferred font type was Verdana; after treatment, the preferred font type and size changed. Students had gained reading and writing speed after training, but their writing legibility was not significantly better. Training might affect the preferred font type and size of students with low vision. Surprisingly, serif and sans-serif fonts were preferred about equally after treatment.

Prevalência de déficits motores e desordem coordenativa desenvolvimental em crianças da região Sul do Brasil

OBJETIVO: Investigar a prevalência de provável desordem coordenativa desenvolvimental e de seu risco e o desenvolvimento típico em meninos e meninas, com quatro a 12 anos de idade. MÉTODOS: Foram avaliadas 1.587 crianças da região Sul do Brasil com o Movement Assessment Battery for Children. Os participantes foram divididos em quatro grupos de acordo com a idade (G1, de quatro a seis anos; G2, de sete a oito; G3, de nove a dez; e G4, de 11 a 12). RESULTADOS: Ao todo, 19,9% das crianças foram identificadas com provável desordem coordenativa desenvolvimental (percentil ≤5%) e 16,8% com risco de tal desordem (percentil ≤15%), todas avaliadas pelo Movement Assessment Battery for Children. Houve interação significativa entre a classificação no Movement Assessment Battery for Children, por grupo de idade e sexo (p<0,0001). A análise por gênero demonstrou maior prevalência de desordem coordenativa desenvolvimental no grupo de meninas nas faixas etárias G3 e G4 (p<0,05). Observaram-se interações significativas para a destreza manual (p=0,0001), habilidades com bola (p<0,0001) e equilíbrio (p<0,0001). Destreza manual foi o item com maior peso nas variações observadas. CONCLUSÕES: As dificuldades nas tarefas de destreza manual repercutiram mais fortemente para o diagnóstico de provável desordem coordenativa desenvolvimental e no risco de tal desordem. Os meninos apresentaram pior desempenho nas tarefas de destreza manual e equilíbrio, enquanto as meninas apresentaram maior deficiência nas habilidades com bola. O desempenho motor deficitário foi mais prevalente no grupo etário de crianças mais velhas.

SOS: a screening instrument to identify children with handwriting impairments

Poor handwriting has been shown to be associated with developmental disorders such as Developmental Coordination Disorder, Attention Deficit Hyperactivity Disorder, autism, and learning disorders. Handwriting difficulties could lead to academic underachievement and poor self-esteem. Therapeutic intervention has been shown to be effective in treating children with poor handwriting, making early identification critical. The SOS test (Systematic Screening for Handwriting Difficulties) has been developed for this purpose. A child copies a sample of writing within 5 min. Handwriting quality is evaluated using six criteria and writing speed is measured. The Dutch SOS test was administered to 860 Flemish children (7-12 years). Inter- and intrarater reliability was excellent. Test-retest reliability was moderate. A correlation coefficient of 0.70 between SOS and "Concise Assessment Methods of Children Handwriting" test (Dutch version) confirmed convergent validity. The SOS allowed discrimination between typically developing children and children in special education, males and females, and different age groups.

Handwriting difficulties in children with autism spectrum disorders: a scoping review

Functional handwriting involves complex interactions among physical, cognitive and sensory systems. Impairments in many aspects of these systems are associated with Autism spectrum disorders (ASD), suggesting a heightened risk of handwriting difficulties in children with ASD. This scoping review aimed to: (1) survey the existing evidence about potential contributions to compromised handwriting function in children with ASD, and (2) map out the existing studies documenting handwriting difficulties in children with ASD. The current evidence implicates impairments in fine motor control and visual-motor integration as likely contributors to handwriting difficulties in children with ASD, though the role of the latter is not well-understood. Moreover, diminished overall legibility and compromised letter formation are emerging points of convergence among existing studies of handwriting quality in children with ASD.

Occupational therapy practitioners' perceptions of important competencies for handwriting evaluation and intervention in school-aged children

OBJECTIVE

The primary purpose of this study was to identify the practitioner competencies that occupational therapists perceive as important for handwriting evaluation and intervention in school-aged children. A secondary purpose was to compare the practitioner perceptions of those in school-based practice with those from other primary practice settings.

METHOD

A stratified random sample of 376 occupational therapists recruited from a national professional organization database participated by completing a survey instrument containing 80 competency items.

RESULTS

A majority of the 80 practitioner competency items were perceived to be of high importance to the respondent groups. A significance difference in perception when comparing the school-based practitioners to all other practitioners was revealed in only 3-12 competency summary categories.

CONCLUSION

Practitioner competency survey items were perceived to be of high importance to the participants. School-based practitioner perceptions of competency were, for the most part, mainly similar to those in other primary practice settings.