Validating the use of the evaluation tool of children's handwriting-manuscript to identify handwriting difficulties and detect change in school-age children

Pressure distributions on the chair seat and backrest correlate with handwriting outcomes of school children

BACKGROUND

Postures while sitting are believed to have an important influence on the process of writing and quality of handwriting, but data in this field are sparse.

OBJECTIVES

The current study was undertaken to investigate correlations between 'ordinary' children's handwriting skills and their posture and stability while sitting.

METHODS

Twenty-nine children with typical development (age 9.2±0.8 years) underwent the Hebrew Handwriting Evaluation, while the pressure distributions on their seats and backrests were recorded using a pressure mapping system.

RESULTS

There was an increase in the odds of erasing and overwriting letters in dictation tasks when body displacements of the buttocks increased [Odds Ratio (OR) = 1.01, 95% CI 1.000-1.02, p = 0.050]. Children who did not lean on the backrest were more likely to have legible handwriting in copying tasks (OR = 0.136, 95% CI 0.026-0.723, p = 0.019).

CONCLUSIONS

The awareness and involvement of health practitioners in sitting postures of children at school might promote activities such as writing. Further investigation of movement patterns while writing and of the correlations of these patterns with handwriting outcomes is recommended. More research regarding adjustments at the school environment for children with developmental disorders is also warranted.

Children and youth instrument development and testing articles published in the American journal of occupational therapy, 2009-2013: a content, methodology, and instrument design review

We extracted 35 articles published between January 2009 and September 2013 in the American Journal of Occupational Therapy (AJOT) that focused on children and youth instrument development and testing, summarized study details and traits of the 37 measures reported in them, and then critiqued the measures. Most of the articles contained Level III evidence (one-group nonrandomized and noncontrolled). The most common types of reliability reported in the articles were internal consistency, test-retest reliability, and interrater reliability; the most frequent types of validity reported were discriminant validity and construct validity. Most pediatric assessment tools were designed for school-age children between ages 5 and 12 yr. The two most common purposes for the assessments were reported as descriptive and discriminative. The continued publication of instruments that measure children and youth participation in meaningful occupations and life roles in home, school, and community environments is recommended.

Persistent Handwriting Difficulties in Children With ADHD After Treatment With Stimulant Medication

OBJECTIVE

Children with ADHD often present with handwriting difficulties. However, the extent to which motor and attention skills influence performance in this group has not yet been explored. The objective of this study was to examine the factors associated with change in handwriting performance.

METHOD

This study examines the factors associated with change in handwriting performance of 49 children newly diagnosed with ADHD (mean age = 8.4 [SD=1.3] years) prior to and 3 months following use of a stimulant medication.

RESULTS

Handwriting legibility and speed improved significantly at follow-up evaluation. However, most of the children with legibility difficulties at baseline continued to demonstrate difficulties when evaluated 3 months after initiation of medication. Change in handwriting legibility was best determined by improvements in visual-motor integration skills (β = 0.07-0.10; p < .001), while the change in speed did not appear to be consistently related to a single factor.

CONCLUSION

Handwriting difficulties are common in children with ADHD, and medication alone is not sufficient to resolve these challenges.

Review of instrument development and testing studies for children and youth

We reviewed 12 articles from 2012 that addressed development and testing of instruments for children and youths and American Journal of Occupational Therapy articles from 2009-2013 that addressed 11 activity and participation instruments to determine how well this group of instruments facilitates the generation of evidence sufficient to support practice in accordance with the Centennial Vision. We observed an increase in the number of instrument development and testing studies and in higher level studies and larger cohorts; funding was provided for almost half of the studies, and attention was given to use of blind testing and transition to adult-age assessments. Further development of performance-based activity and participation instruments; instruments that examine biomedical molecular-cellular, biomedical, and environmental mechanisms; and intervention fidelity measures and increased use of blind testing are necessary for occupational therapy to meet the Centennial Vision.