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Hand writing is a complex skill with perceptual, cognitive and motor components, and different writing tasks vary in the extent that each of these components are involved. Many children who are referred to Occupational Therapy from main stream schools have difficulties with handwriting. It is the Occupational Therapist’s task to assess the child’s handwriting and identify the underlying cause of the difficulties. When the teacher and the therapist work together, combining medical and educational knowledge, the results are often very positive in achieving legible handwriting.

A child’s stage of development and “readiness” for handwriting needs to be taken into consideration. All research tends to agree that children should not be taught handwriting before they are ready as this can result in creating writing difficulties that are hard to reverse. Letter formation requires the integration of visual, motor, sensory and perceptual systems and it has been concluded that most kindergarten children who are typically developing should be ready for formal handwriting instruction in the latter half of the kindergarten school year (4-6 year olds).

When a child with handwriting difficulties is presented to the Occupational Therapist, the therapist will need to assess the level of functioning in the following areas:

  • Visual Motor Integration (neural function transferring what is seen into motor expression)
  • Fine Motor Skills (hand dominance, bilateral and motor co-ordination, in-hand manipulation, functional pencil grip, muscle tone, hand, arm and shoulder strength).
  • Visual Perception (discrimination between numbers, letters and words that are similar; spacing between letters; placing letters on the writing line and using margins correctly; identifying which letters have been formed completely; letter and number reversal).
  • Cognition (memory; language comprehension; specific learning difficulties e.g.  spellings; problem solving and reasoning).
  • Possible sensory processing difficulties (that interfere with posture, attention, tactile, visual or proprioception having an effect on handwriting).

These may all impact on handwriting so it is important to determine and diagnose the underlying cause of the handwriting problem.

There are a number of activities that a child can do to help with handwriting difficulties. An Occupational Therapist will usually provide a programme of activities to be done daily alongside the chosen handwriting programme that focuses mainly on letter formation and legibility. 

There is evidence to suggest that mild Occupational Therapists will make a noticeable difference for most children with their professional intervention. 



Inspiring Possibilities: MOBILE Occupational and speech therapy
T: 1300 845 863
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