Jennifer Schwarzschild, M.S., OTR/L, Occupational Therapist
January 23rd is the birthday of John Hancock, aka the first person to sign the Declaration of Independence! On this day, all over the country the importance of writing is celebrated, with a special significance to occupational therapists, as handwriting is one of the areas of practice we work on most frequently. Occupational therapists evaluate the underlying components that support a child’s handwriting and provide education to parents and teachers on what techniques they can utilize at home and school to promote improved handwriting skills (AOTA, 2017).
Handwriting skills are essential for children and, even with increasing technology, remain the primary tool for communication and knowledge assessment for students in the classroom (Handwriting Without Tears, 2015). As cited in Handwriting Without Tears (2015), ten to thirty percent of school-age children struggle with handwriting and as a result may experience negative impacts on other areas of learning, poor academic performance or school achievement, and self esteem (Engel-Yeger, Nagakur-Yanuv & Rosenblum, 2009; Feder and Majnemer 2007; Karlsdottir & Stephansson, 2002; Marr et al. 2003; Saperstein Associates, 2012). Evidence based studies examined by HWT (2015) report structured handwriting instruction leads to improved writing performance, academic success, and overall student self-esteem (Graham, Harris, & Fink, 2000b; Graham & Harris, 2005; Jones & Christensen, 1999; Saperstein Associates, 2012).
In addition to articles published in peer reviewed journals over the last two to three decades, handwriting has been recognized as a growing area for occupational therapy intervention in the media. According to the New York Times (2010) article, “Watch How You Hold That Crayon,” in recent years handwriting assistance has become one of the most commonly sought out services for school aged children, broadening the scope of occupational therapy practitioners (Tyre, 2010). Thirty years ago, pediatric occupational therapists primarily served children with severe disabilities such as spina bifida, autism or cerebral palsy (Tyre, 2010). However, nowadays occupational therapists are just as focused on helping typically developing children with tasks such as grip strength and controlling a pencil (Tyre, 2010). The article goes on to state,“…occupational therapists have taken their place next to academic tutors, psychologists, private coaches and trainers — the army that often stands behind academically successful students” (Tyre, 2010). Occupational therapists are being nicknamed handwriting therapists in pediatric settings because so many of them spend the majority of their time working on handwriting (Tyre, 2010).
Many pediatricians, teachers, and specialists have explained to concerned parents that early intervention for children who are struggling with handwriting can prevent small problems from developing into larger ones (Tyre, 2010). Anthony DiCarlo, an elementary school principal in Manhattan, expressed growing concern with a rise in young children who are experiencing delays in fine motor skills (Tyre, 2010). “DiCarlo stated ‘Almost all our kids come into kindergarten able to recite their letters and their numbers. Some can even read. But in the last five years, I’ve seen a dramatic increase in the number of kids who don’t have the strength in their hands to wield scissors or do arts and crafts projects, which in turn prepares them for writing” (Tyre, 2010). Like many other elementary schools around the country have done in recent years, Mr. DiCarlo hired a full-time occupational therapist to work with the struggling K-5 students at his school (Tyre, 2010).
Although instructional handwriting programs can be purchased by parents and implemented at home, most often, children are experiencing underlying issues that have not been discovered or addressed. Visual perception, fine and gross motor control, motor coordination, muscle strength, sensory processing abilities, and cognition are all contributing factors in ability to successfully produce legible handwriting (AOTA, 2017). An occupational therapist is able to step in and assess a child’s specific needs, establish goals, and provide engaging and interactive therapeutic interventions using sensorimotor approaches, adaptive, and compensatory strategies to improve the foundational skills needed to support writing development.
Additionally, occupational therapists use their expertise to analyze and address handwriting deficits in greater depth than can be achieved in the day-to-day operation of a classroom. In a classroom environment, a teacher is responsible for instructing the entire class equally, although several children may have a greater need for individualized attention and instruction in this area of learning. Elementary schoolers who benefit from handwriting intervention may have developmental delays, visual perceptual deficits, or be typically developing children who just need extra support. Depending on the needs of the child, occupational therapists will focus on establishing a functional and efficient grasp pattern, promoting postural support, strengthening fine and visual motor skills, and honing in on proper letter formation, spacing, legibility, writing speed, and line quality. Occupational therapists can then support carry-over in the classroom and provide teachers and educators insights and strategies to help facilitate successful writing practices for their students. It takes a village, right?!
Elementary school students spend twenty-four to fifty-eight percent of their school day on paper-pencil tasks, and the demands for writing will only increase as the child continues on to middle school (HWT, 2015). These foundational writing skills are paving the way to your child’s learning and future academic success. If you have concerns about your child’s writing, don’t hesitate to seek advice or intervention! Reach out to our occupational therapy team today.
American Occupational Therapy Association. (2017). Handwriting. Retrieved from https://www.aota.org/About-Occupational-Therapy/Patients-Clients/ChildrenAndYouth/Schools/Handwriting.aspx
Handwriting Without Tears. (2015). Research review. Retrieved from http://www.hwtears.com/files/HWT%20Research%20Review.pdf
Tyre, P. (2010, Feb 24). Watch How You Hold That Crayon. New York Times. Retrieved from http://www.nytimes.com/2010/02/25/fashion/25Therapy.html?pagewanted=all&_r=0
It’s All About Your Child at All About Speech & Language!
All About Speech & Language provides speech-language pathologists to assist with writing skills, particularly in the formulation process (combining words into sentences, sentences into paragraphs, organization, editing skills, etc.). The physical “act” of writing (also known as handwriting) is best remediated through work with an occupational therapist to address these fine-motor skills and associated abilities. Learn more here.
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Tags: handwriting, occupational therapy