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Handwriting: More than Form and Function - March 2007

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Handwriting: More than Form and Function

By: Susan N. Schriber Orloff, OTR/L
CEO/Executive Director, Children's Special Services, LLC, Atlanta, Georgia

“It’s just handwriting.”
“With handwriting like this, my kid is sure to be a doctor!”
“What’s the fuss, just teach him keyboarding.”
“We are turning into a paperless world anyway.”
“If he slows down, he can do it!”
And so on and so on and so on.

News Flash!!! ---All of the above --- WRONG!!
  • Handwriting issues in young children are all too often overlooked as unimportant and some teachers or therapists making a big deal over a small issue.
  • In truth, handwriting is a big issue that needs quick, immediate attention as early as possible.
  • It is the primary graphic production that a child makes in school and out.
  • Because it is supposed to be “automatic,” difficulties in this area are often looked at as something that can be easily fixed—quickly.
  • Preschool is not too early to be looking at these fine motor essentials.
  • Handwriting issues in young children are all too often overlooked as unimportant and some teachers or therapists making a big deal over a small issue.
  • In truth, handwriting is a big issue that needs quick, immediate attention as early as possible.

Imagine this scenario:

Mrs. Stevens, a preschool teacher at Your Favorite Preschool, notices that 4-year old Timmy is using an awkward grip when holding his crayons and pencils. He often rushes through fine motor tasks, and complains that his “hand hurts” when he writes.

Mrs. Stevens asks the Occupational Therapist for a screening of the child’s basic performance abilities. The screening, which is a brief assessment of fine/gross motor, perceptual and sensory abilities, differs from an evaluation greatly. A screening usually does not include standardized tests. Screenings are often criterion referenced as to normative age standards and are conducted as task specific clinical observations. This is important to know, because the occupational therapist may suggest further testing and the parent must know that this was not an in depth developmental evaluation, but a superficial initial “look see” into the child’s basic performances.

The Occupational Therapy Screening was written as follows and a copy given to the parents:

Timmy Smith*, Grade: PreK, Eddy, Screening Date 10/27/06, Report
Date: 11/1/06
*Not his real name


Scope of a Screening:

A screening is a preliminary assessment using both subjective and objective tools to determine if certain cognitive motor perceptual performances noted in the initial observation should be further investigated.

It is not an evaluation. A full evaluation is 5-7 standardized tests, a 24-point sensory integrative battery, sensory checklist and functional assessment followed by specific goals and a treatment plan for remediation.

Initial Observations:
  • Timmy is a delightful and engaging little boy who appears to exert much effort in trying to do his best at all times.
  • He clearly is uncomfortable with paper pencil tasks, saying “I can’t do it” before giving it his full effort.
  • In addition, he appeared to require repeated directions with some assists by the therapist.

Assessment tools used:
  • Selected Clinical observations based on the Southern California
    Sensory Integrative Tests
  • Goodenough-Harris Drawing Test
  • Criterion Referenced Functional Tasks
Results:

The Goodenough-Harris Drawing Test is a test of fine motorcognitive/organizational abilities as well as body image. Teddy’s drawing was below age/grade expectations, with only sketchy lines with no real form to resemble a person. Grasp of the pencil was unstable with weak control.

Strengths:
  • Good self-care abilities with the exception of tying, which is not expected at this age level.
  • Right dominance established
  • Secure left/right awareness
  • Able to write name
  • Gross motor skills were well within normal limits for:

    1. Running
    2. Skipping
    3. Jumping: forward and back
    4. Heel-toe walking forward and back
    5. Galloping
    6. Hopping on 1- foot



Functional Task Observations

Fine motor/Visual Perceptual Skills
  • His fine-motor and visual perceptual skills are below age/grade expectations and may be causing him to currently reject written tasks.
  • This is also important to remediate at this time, as academic requirements increase with age, his rejection of writing and fine motor tasks will prevent him from fully demonstrating all of his abilities.
  • Visual tracking was incomplete with eyes darting about without following a specific movement.
  • Finger isolation and opposition movements were not achieved within age expectations.
  • Hand strength was also noted to be below chronological expectations.


Gross motor/balance and coordination:
  • Well within normal limits with some difficulty with catching and targeting a ball.

Organization:
  • Therapist dependent and seems easily intimidated by unfamiliar and not quickly successful tasks.
  • During this screening, Timmy made several remarks that all the other kids in class were “mean” and that they made fun of his drawings and didn’t play with him.

Recommendations:
  • Participation in Occupational Therapy groups to address issues with fine motor skills and handwriting.
  • Further testing is recommended to assess visual perceptual abilities.
  • It is suggested that parents consider participation in occupational therapy to address the above-mentioned concerns.


It is important to note that Timmy is a first child, and that the parents did not previously note that any skills were in need of remediation. Their reaction to this report was to become very defensive, verbally attacking the therapist and the teacher. Developmentally we are looking at a child with multiple sensory issues that are impacting not only his functional task performances but his social interactions as well. So this simple issue of having Timmy draw better has evolved into a much larger concern involving skills throughout the developmental scheme. In addition to the recommendations to have Timmy participate in occupational therapy, there are also things that the teacher can do. The following suggestions were made to the teacher.

Select activities that encourage the children to use the sensory skills necessary to address the underlying deficits that are often at the root of handwriting issues. Often remediation can be done in games, activity center activities and alternative activities, including:
  • Playing pick-up sticks for creating and strengthening pincer grasp as well as 5 finger coordination.
  • Teaching simple in-hand magic tricks can make a less popular child a positive center of attention as well as showing him or her to be “special” in a positive way
  • Working with maps and charts is often done in many classroom situations. When cutting is required using light tag board paper for new “cutters” makes maneuvering the paper easier. You can paste magazine pictures onto the tag paper and turn familiar pictures into puzzles
  • Paper Mache’ is a wonderful activity to increase tactile awareness. The entire process can increase hand skills! Tearing the paper requires pincer grasp on one hand and mobility with the other. The placing of the wet paper is another fine motor challenge. And the final painting of the object requires planning and placement
  • Tracing forms and the use of stencils is a great way to increase in-hand prewriting skills while insuring success
  • Making magnets move across a path with one magnet on top of the paper and the other on the bottom increases hand security and kinesthesia. (fine eyehand motor planning)
  • Using Wikki Sticks for feeling shapes, forms and letters is an excellent way for children to learn automatic reproduction patterns necessary for fluid writing.
  • Practicing ball and jacks for facilitating eye-hand coordination and increasing hand strength and dexterity. If jacks are too difficult, consider catching balls in scoops made from empty laundry detergent plastic bottles with the bottoms cut out or in wiffle ball scoops or fishing nets
  • Adapting games such as Connect- Four and checkers by using wooden clothespins for picking up the pieces and placing them in the slots. In addition to fostering strategy skills, this is a grasp release activity needed for holding and controlling pencils while writing
  • Using maze books with wide to medium “avenues” for stimulating the writing/tracking connection
  • Tracing from a coloring book with old- fashioned tracing paper and then coloring the traced picture with short colored pencils for fostering better control
  • Shuffling cards for increasing hand strength and dexterity

These are but a few ideas that both teachers and parents can use to help children learn the underlying sensory motor skills necessary for secure writing abilities. All of these activities should be done in a fun, game-like atmosphere and should not be treated like an assignment or if done at home, like homework. Teachers should encourage parents to “play” with their children while reminding parents not to become anxious during these activities. Children will pick up on that emotion and reject the activity, making it almost impossible to re- engage them in similar situations.

So take a deep breath, both parents and teachers should do a few deep knee bends, and plop down on the floor with the children for an old-fashioned round of jacks. Most importantly, make sure to have fun!


This Month's Featured Program/Site: Children's Special Services, LLC

Special Thanks to Susan N. Schiber Orloff and Children's Special Services LLC for providing an article for this issue's Therapy Corner.

Ms. Schriber Orloff is the author of the book, Learning RE-Enabled (a National Education Association featured book), and is the “Ask the Therapist” columnist for Exceptional Parent Magazine, as well as the author of the US Trademarked handwriting program, Write Incredibly Now, W.I.N.™. In addition, she is the columnist of the “Sensory Scene” for Advance for Occupational Therapy Magazine. She presents seminars on social skills, development, skill attainment and more, through Advanced Rehabilitation Services, Inc. Most recently she was awarded the “Georgia OT of the Year Award” for 2006. -- Congratulations, Susan!

Please support our contributing authors and vendors. Visit Children’s Special Services, LLC on the web at http://www.childrens-services.com. Ms. Schriber-Orloff can also be reached by email at [email protected].


Tags: March 2007 Newsletter Handwriting Article