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

Kindergarten Visual-Perceptual and Motor Skills and Behavioral Traits Predict First-Grade Chinese Handwriting Legibility and Speed

IMPORTANCE

Clarifying the relationship between kindergarteners' characteristics and their future handwriting performance is beneficial for the early detection of children at risk of handwriting difficulties.

OBJECTIVE

To determine which visual-perceptual and motor skills and behavioral traits significantly predict kindergartners' Chinese handwriting legibility and speed in the first grade.

DESIGN

One-year longitudinal, observational design.

SETTING

Kindergarten and elementary schools.

PARTICIPANTS

One hundred six kindergarten children (53 boys and 53 girls; ages 5 or 6 yr) were recruited.

OUTCOMES AND MEASURES

The participants completed two subtests of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, Test of Visual Perceptual Skills-Third Edition, Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery™ VMI), and the Attention-Deficit/Hyperactivity Disorder Test-Chinese Version in kindergarten. Their handwriting legibility (character accuracy and construction) and speed were assessed by investigator-developed Chinese handwriting tests in the first grade.

RESULTS

Multivariate regression analyses indicated the independent predictive power of spatial relationships (p = .042) and inattention (p = .004) for character accuracy. Visual-motor integration (VMI; p = .008) and inattention (p = .002) were the key predictors of character construction. Manual dexterity (p = .001) was the only significant predictor of writing speed.

CONCLUSIONS AND RELEVANCE

Kindergarteners who perform poorly in spatial relationships, VMI, manual dexterity, and attention are likely to have less legible Chinese handwriting and slow writing speed in first grade. Plain-Language Summary: Children's visual-perceptual and motor skills and behavioral traits in kindergarten can predict their Chinese handwriting legibility and speed in first grade. This study found that kindergarteners who performed poorly in spatial relationships, VMI, manual dexterity, and attention were likely to have less legible Chinese handwriting and slow writing speed in the first grade.

Reliability, validity, and measurement invariance of a Chinese handwriting legibility scale among primary students in central China

Background

Chinese handwriting has a close relationship with spatial cognition, and the legibility dimension is prominent with its spatial-oriented characteristics. However, handwriting evaluation focusing on the detailed spatial aspects of the legibility dimension in the Chinese context is rare.

Aims and methods

We aimed to develop a Chinese Handwriting Legibility Scale (CHLS) and examine its reliability, validity, and measurement invariance among Chinese primary students of different grades. A total of 684 students aged 8-12 years were recruited from a mainstream primary school in central China and were asked to copy a Chinese template as legibly as possible within 4 min. The developed CHLS was used to assess these students' legibility performance.

Results

The seven-criteria CHLS favored content validity. The inter-rater reliability was good; however, the scoring instructions need to be refined. Principal component analysis (PCA) revealed a one-factor solution explaining 62.336% of the variance of the seven-criteria CHLS, and confirmatory factor analysis (CFA) confirmed its appropriateness. There was a high internal consistency (α = 0.902). In terms of measurement invariance, the factor structures and loadings of the CHLS were consistent across students of different grades; however, significant intercept variations were detected between students of Grades 2 and 4.

Conclusion

CHLS may be effective for evaluating Chinese handwriting legibility performance in the Chinese primary school context in the central region. Students' Chinese handwriting legibility performance may have developmental specificity in different grades.

Association between Visual Perception and Socioeconomic Status in Malaysian Preschool Children: Results from the Test of Visual Perceptual Skills-4

Visual perception in children can be evaluated using the Test of Visual Perceptual Skills-4th edition (TVPS-4) with normative data developed for the U.S. population. It is widely used by healthcare practitioners in Malaysia, despite reports that children in Asia outperform their U.S. peers in visual perception assessment. We compared TVPS-4 scores among 72 Malaysian preschool children (mean age: 5.06 ± 0.11 years) with U.S. norms and investigated the association between socioeconomic factors and TVPS-4 scores. Malaysian preschoolers had significantly higher standard scores (116.60 ± 7.16) than the U.S. norms (100 ± 15; p < 0.001). They also had significantly higher scaled scores (between 12.57 ± 2.10 and 13.89 ± 2.54) than the U.S. norms (10 ± 3, all p < 0.001) for all subtests. Multiple linear regression analyses revealed that socioeconomic variables were not significant predictors for five visual perception subtests and the overall standard score. The visual form constancy score could be predicted by ethnicity (β = -1.874, p = 0.03). The visual sequential memory score could be predicted by the father's employment status (β = 2.399, p < 0.001), mother's employment status (β = 1.303, p = 0.007), and low household income (β = -1.430, p < 0.037). In conclusion, Malaysian preschoolers outperformed their U.S. peers in all TVPS-4 subtests. Socioeconomic variables were associated with visual form constancy and visual sequential memory, but not with the other five subtests or TVPS-4's overall standard scores.

Developing a Nomogram Model to Predict the Risk of Poor Chinese Handwriting in First Grade

IMPORTANCE

Few predictive models for later handwriting difficulties have been developed for kindergarteners.

OBJECTIVE

To develop a nomogram for the purpose of detecting the risk of later poor Chinese handwriting among Taiwanese kindergarteners.

DESIGN

One-year prospective longitudinal, observational study.

SETTING

Kindergarten and elementary school.

PARTICIPANTS

One hundred fifty-six kindergarteners were included. In first grade, they were grouped into the normal and poor handwriting groups on the basis of handwriting performance in first grade.

OUTCOMES AND MEASURES

Participants received fine motor (FM), visual-perceptual (VP), and visual-motor integration tests in kindergarten and handwriting assessments in first grade.

RESULTS

Logistic regression results indicated that younger age at school entry and lower scores on measures of FM and VP in kindergarten increased the risk for later poor handwriting. The area under the receiver operating characteristic curve in the nomogram built with these risk factors was .75, indicating that the nomogram had acceptable diagnostic value.

CONCLUSIONS AND RELEVANCE

This nomogram could be used as a screening tool to detect kindergarteners at risk of poor Chinese handwriting in first grade.

WHAT THIS ARTICLE ADDS

This study is the first to establish a nomogram constructed with significant predictors in kindergarten of a child's probability of poor handwriting later in first grade. This predictive nomogram may help occupational therapists, educators, and parents identify at-risk kindergarteners early for the purpose of early interventions to prevent later poor Chinese handwriting.

Validity of the Wide-range Assessment of Vision-related Essential Skills in Japanese Children with Learning Problems

SIGNIFICANCE

Our study revealed that the validity of a new Japanese visual-perceptual test was acceptable. Visual-perceptual abilities are important to activities of daily living; thus, accurate assessment of visual perception is especially important for children with neurodevelopmental disorders and particularly so for those with learning problems.

PURPOSE

Visual perception refers to the process by which one receives visual information through sensory impulses and then translates those impulses into meaning based on a previously developed view of the environment. A problem in Japan is the paucity of visual perception tests that use normative data from children who are native Japanese. The Wide-range Assessment of Vision-related Essential Skills (WAVES), which measures visual perception and eye-hand coordination skills and is based on Japanese normative data, was recently published in Japan. The validity of this test has not been comprehensively established.

METHODS

To investigate the validity of the WAVES, we used the Pearson correlation coefficient to calculate the degrees of association among WAVES scaled and index scores compared with Developmental Test of Visual Perception, Third Edition, scores from 108 elementary school children with symptoms of learning problems. Participants were recruited at Osaka Medical College Learning Disability Center and Sakai Seikeikai Learning Disability Center.

RESULTS

The concurrent validity of the WAVES was supported by moderate correlation (r = 0.67, P < .01) between the total scores for visual perception and eye-hand coordination index from the WAVES and general visual perception index from the Developmental Test of Visual Perception, Third Edition, even though a correlation analysis of subtests found differences between the two tests.

CONCLUSIONS

Our results showed that the indices from the two tests measured nearly the same underlying visual-perceptual constructs and indicated that the WAVES had acceptable levels of concurrent validity.

Reliability and validity of Handwriting Test for Preschool Children (HT-PRE): A new tool to assess the handwriting ability of preschool children aged 5-6 years old in Mainland China

BACKGROUND

Handwriting ability is related to many neuronal functions, such as visual-perceptual skills, orthographic coding, motor planning and execution, kinesthetic feedback and visual-motor coordination. To date, there is no specific assessment tool for to assess preschool children's handwriting ability in Mainland China. Our study aimed to develop a tool to assess the handwriting ability of children aged 5-6 years old in Mainland China and to analyze its reliability and validity.

METHODS

The investigation comprised three phases: 1) original tool generation, 2) tool revision, 3) reliability analysis (i.e., interrater, test-retest) and validity analysis (i.e., content, criterion).

RESULTS

The sample included a total of 482 children. The internal consistency (Cronbach alpha) was 0.74. The test-retest correlation coefficients ranged from 0.38 to 0.80. As expected, our data showed an improving trend in handwriting, and differences in respect to age and gender. When compared with the 'handwriting difficulty' group, each subtest score of children in the 'normal' group showed significant differences (p < 0.05). The correlation validity, compared with the visual-motor integration development test (VMI), was 0.17-0.52.

CONCLUSION

The Handwriting Test for Preschool Children (HT-PRE), which is a newly developed handwriting screening tool for preschool children aged 5-6 years old in Mainland China, has displayed a very good internal consistency, acceptable test-retest reproducibility, and good criterion-based validity, and has also shown good application prospects for handwriting difficulty screening in a clinical setting.

Developmental skills between kindergarten children with handwriting difficulties in Chinese and/or English

AIM

This study aimed to examine the differences in developmental skills between children with and without handwriting difficulties in their last year of kindergarten education.

METHODS

Standardised tests on handwriting performance and developmental skills were administered to 20 typically developing children, 21 children with handwriting difficulties in Chinese and 23 children with handwriting difficulties in both Chinese and English. We used one-way MANOVA, univariate ANOVA and post hoc comparisons, to compare the developmental skills between children with and without handwriting difficulties. Multiple regression analysis was used to identify the significant predictors of developmental skills for Chinese and English handwriting performance.

RESULTS

Higher proportion of children faced handwriting difficulties in Chinese than in English. Their major problem in Chinese handwriting was on stroke formation, while the results did not indicate the key factor leading to English handwriting difficulties. The results also showed that children with handwriting difficulties had significantly poorer visual motor integration, some aspects of visual perception and fine motor skills than typically developing children. Reading skills were not a key factor contributing to handwriting performance. In addition, visual and fine motor integration and spatial relationship were the significant predictors of Chinese and English handwriting performance, which accounted for 39.7 and 43.6% of the variance respectively.

CONCLUSION

First, the results suggested that more resources should be devoted to coaching children to learn Chinese than English handwriting. Second, besides direct repetitive practice on handwriting, there is a need to incorporate learning activities to facilitate the development of visual motor skills, visual perception, and fine motor skills as a preparation for learning to write or in improving handwriting performance among kindergarten children.

Handwriting assessment to distinguish comorbid learning difficulties from attention deficit hyperactivity disorder in Chinese adolescents: A case-control study

OBJECTIVES

Attention deficit hyperactivity disorder (ADHD) and learning difficulties (LDs) are proposed as 2 overlapping disorders. The objective of this study was to investigate the handwriting performance in ADHD and comorbid ADHD-LD adolescents.

METHODS

The study examined the Chinese and English handwriting performance and sensorimotor skills of 32 ADHD, 12 ADHD-LD, and their matched controls.

RESULTS

Participants with ADHD had comparable writing time and speed, but the readability was lower than their controls. Participants with ADHD-LD had lower writing speeds in both Chinese and English handwriting than their controls. The ADHD and ADHD-LD groups also showed larger variations in either speed or pen pressure than their controls. Chinese handwriting assessment effectively classified ADHD and ADHD-LD with good sensitivity and positive predictive value.

CONCLUSIONS

Clinicians should be aware of the fundamental difference between the 2 disorders and make good use of handwriting assessment as a reference to deliver effective therapies and trainings.

The correlation between proprioception and handwriting legibility in children

[Purpose] This study investigated the association between proprioception, including joint position sense and kinetic sense, and handwriting legibility in healthy children. [Subjects and Methods] Assessment of joint position sense, kinetic sense, and handwriting legibility was conducted for 19 healthy children. Joint position sense was assessed by asking the children to flex their right elbow between 30° to 110° while blindfolded. The range of elbow movement was analyzed with Compact Measuring System 10 for 3D motion Analysis. Kinetic sense was assessed using the Sensory Integration and Praxis Test. The children were directed to write 30 words from the Korean alphabet, and the legibility of their handwriting was scored for form, alignment, space, size, and shape. To analyze the data, descriptive statistics and Spearman correlation analysis were conducted using IBM SPSS Statistics 20.0. [Results] There was significant negative correlation between handwriting legibility and Kinetic sense. A significant correlation between handwriting legibility and Joint position sense was not found. [Conclusion] This study showed that a higher Kinetic sense was associated with better legibility of handwriting. Further work is needed to determine the association of handwriting legibility and speed with Joint position sense of the elbow, wrist, and fingers.

Validity and Reliability of the Developmental Test of Visual Perception - Third Edition (DTVP-3)

The Developmental Test of Visual Perception - Third Edition (DTVP-3) is a recently published revision of a visual perceptual test from the United States, frequently used by occupational therapists. It is important that tests have adequate documented reliability and validity and are evaluated in cross-cultural contexts. The purpose of the study was to assess the reliability and validity of the DTVP-3 when completed by a group of Australian participants. Thirty-nine typically developing children 6-8 years of age completed the DTVP-3 and the Developmental Test of Visual-Motor Integration - 6th edition (VMI-6). The internal consistency of the DVTP-3 was assessed using Cronbach alpha coefficients and the DTVP-3's convergent validity was examined by correlating it with the VMI-6 and its two supplementary tests. The five DTVP-3 subscales' Cronbach alpha coefficients ranged from.60 to.80 while its three composite indexes had coefficients all at the.80 level. The VMI-6 was significantly correlated with the DTVP-3 Figure Ground and Visual Closure subscales and the Motor-Reduced Visual Perception Index (MRVPI). The VMI-6 Visual Perception Supplementary Test was significantly correlated with the DTVP-3 Figure Ground, Visual Closure, Form Constancy, MRVPI, and General Visual Perception Index. The DTVP-3 exhibited acceptable levels of internal consistency and moderate levels of convergent validity with the VMI-6 when completed by a group of Australian children.

Writing, Reading, and Listening Differentially Overload Working Memory Performance Across the Serial Position Curve

Previous research has assumed that writing is a cognitively complex task, but has not determined if writing overloads Working Memory more than reading and listening. To investigate this, participants completed three recall tasks. These were reading lists of words before recalling them, hearing lists of words before recalling them, and hearing lists of words and writing them as they heard them, then recalling them. The experiment involved serial recall of lists of 6 words. The hypothesis that fewer words would be recalled overall when writing was supported. Post-hoc analysis revealed the same pattern of results at individual serial positions (1 to 3). However, there was no difference between the three conditions at serial position 4, or between listening and writing at positions 5 and 6 which were both greater than recall in the reading condition. This suggests writing overloads working memory more than reading and listening, particularly in the early serial positions. The results show that writing interferes with working memory processes and so is not recommended when the goal is to immediately recall information.