Unit 2 - Handwriting

Question 1

5 prerequisite skills that children must have before handwriting instruction begins

Answer 1

1. small-muscle development
2. eye-hand coordination
3. the ability to hold utensils or writing tools
4. the capacity to smoothly form basic strokes (circles and lines)
5. letter perception (recognizing forms, noting similarities and differences)

Question 2

Development of Prewriting and Handwriting in Young Children

Answer 2

Scribbles on Paper: 10-12 months
Imitates horizontal, vertical, and circular marks on paper: 2 years
Copies a vertical line, horizontal line, and circle: 3 years
Copies a cross, right oblique line, square, left diagonal line, left oblique line, some letters and numerals, may write own name: 4-5 years
Copies a triangle, prints own name, copies most lowercase letters and most uppercase letters: 5-6 years

Question 3

3 components of handwriting

Answer 3

1. in hand manipulation skills
2. sensory processing
3. neuromuscular

Question 4

in hand manipulation skills

Answer 4

the action produced by the hands in relationships to objects held or grasped by the hand

Question 5

classification of in hand manipulation skills

Answer 5

• Translation – linear movement of the object in the hand from the finger surface to the palm or the palm to the fingers
• Finger-to-Palm Translation – an object is held by the distal fingers and the pad of the thumb and moved into the palm
• Palm-to-Finger Translation – an object is moved from the palm area to the distal finger surface. The thumb moves from a pattern of flexion to extension

Examples:
Picking up a quarter and manipulating it to put in a bank, drink machine

Question 6

Shift

Answer 6

occurs at the finger and thumb pads with alternating thumb and finger movement. Typically used for fine adjustments to an object after grasp or after use of another in-hand skill. It is used for refinement of an object between the thumb and fingers.

Examples: child holds a marker at midpoint and moves fingers down towards the writing end. Shift with stabilization involves holding one object while shifting another in the same hand.

Question 7

Rotation

Answer 7

an object is moved around one or more axes, the movement occurs near the pad of the fingers.
• Simple rotation – an object is turned or rolled between the pads of the fingers and thumb, the rotation is less than 180 degrees. Typically the object is rotated to about ¼ or ½ its circumference
• Complex rotation – rotation of an object that requires isolated movements of the fingers and thumb. The object is typically turned 180-360 degrees. Then the object is stabilized by the thumb, the fingers are moving, when it is stabilized by the fingers, the thumb is moving.

Examples: Simple rotation – unscrewing a jar lid, rolling ball of clay at finger tips
Complex rotation – picking up marker from table and rotating 180 degrees or greater to orient writing side towards paper

Question 8

In-hand skills and young children

Answer 8

• The age period in which the greatest number of skills emerge is between 2 and 2 ½ years of age
• Most in-hand skills without stabilization (ie. complex rotation, shift) are seen in children by the age of 3
• New skills are usually seen first with small-sized objects rather than medium sized or tiny sized.
 Medium sized = 1in.
 Small = 1/2in to 1 in.
 Tiny = less than ½ in.

Question 9

Sensory processing components

Answer 9

1. tactile, proprioceptive, and kinesthetic input
2. visual receptive components
3. form constancy and visual discrimination
4. position in space
5. vestibular

Question 10

Neuromuscular components

Answer 10

1. muscle tone
2. strength
3. postural control
4. crossing the midline
5. bilateral integration
6. laterality
7. praxis

Question 11

FOR - neurodevelopmental

Answer 11

• focuses on children who have inadequate neurodevelopmental organization exhibited by poor postural control, automatic reactions, and/or limb control.
• influenced by problems in muscle tone, inadequate righting and equilibrium responses, poor proximal stability at the shoulder joint.
• Focus of treatment:
Postural activities to regulate muscle tone and prepare limbs for writing
- Increase or decrease tone, Activities to improved proximal stability and co-contraction through the neck, shoulders, elbows, and wrists, animal walks, calisthenics, routine daily tasks, alternate positions during writing, in-hand strengthening activities

Question 12

FOR - acquistional

Answer 12

• Handwriting can be improved through practice, repetition, feedback, and reinforcement
• Focus of treatment
 Structured progression of introducing and teaching letter and numeral forms.
 Each child’s program can be individualized to work on “problem” letters
 Combine newly acquired letters with previously mastered letters
 Includes modeling, tracing, copying, composing (a word or sentence), and self-monitoring and correcting own mistakes
 Cues should be faded as the child successfully masters a new letter

Question 13

FOR - sensory integration

Answer 13

• Controlling sensory input through selected activities to enhance the integration of sensory systems for effective motor outputs
• Using a variety of sensory experience, mediums, and instructional methods

 Color changing markers, Paintbrushes, Weighted or vibrating pens, chalk, different surfaces, textures

Question 14

FOR - behavioral

Answer 14

• Adaptive writing behaviors can be learned in a reinforcing environment
• Reward child with a special certificate for meeting handwriting goals
• Use a “handwriting group” or club with 3-4 children to develop writing and social skills
• Develop readable material for a purpose
 Address an envelope to send a letter to a friend
 Write a valentine
 Make a list of toys for Santa or birthday

Question 15

FOR - biomechanical

Answer 15

• Sitting posture – the child should be sitting with feet firmly planted on the floor. The table surface should be 2 inches above the flexed elbows when the child is seated in the chair.
- adjusting heights of desks and chairs, providing needed foot rests for children, adding seat cushions or inserts, repositioning a child’s desk to face the chalkboard straight-on

• Paper position – paper should be slanted on the desktop. Right-handed students may slant the top of their paper with the right side higher than left.
• Pencil grasp – the ideal pencil grasp is a dynamic tripod with an open web space. The movement of the pencil is primarily from the thumb, index, and middle fingers moving in flexion and extension.

Question 16

Grasps and ages

Answer 16

• palmar supinate grasp (1-2)
• digital pronate grasp (2-3)
• static tripod grasp (2.5-4)
• dynamic tripod grasp (4-6)

Question 17

Children can be functional with an immature grasp. An OT can consider changing the child’s grasp if:

Answer 17

1. handwriting results in muscular tension and fatigue
2. handwriting formation or speed is impeded by inefficient grasp
3. the child’s cannot use controlled and precise finger and thumb movements if the web space is closed
4. the child holds the pencil too tight with too much pressure, breaks the lead off the pencil, makes holes in the paper, and needs to “shake-out” the hand repeatedly due to fatigue

Question 18

gather assessment info - student handwriting samples

Answer 18

• Spelling lessons
• Mathematical worksheets
• Homework
• Compare child’s work to those of same age peers in class completing the same type of work

Question 19

gather assessment info - interviews with parent, teacher, other team members

Answer 19

• Helps build rapport with teachers and parents
• Helps provide a picture of the child’s capabilities, behaviors, and struggles at school or home
• Sample questions:
 What are the student’s educational strengths?
 What type of handwriting method is being used?
 What do you think is causing the handwriting problem?
 When does the child do his/her best writing? Worst writing?
 Are there any other daily tasks that the child is having problems with? (ie. scissors and cutting, keeping organized, getting along with peers)

Question 20

gather assessment info - review of the child’s educational and clinical records

Answer 20

• Past academic performance
• Any special testing accommodations
• Any other educational or medical reports from previous years

Question 21

gather assessment info - observation of the child when he/she is writing

Answer 21

• Note child’s self-regulation and organizational abilities
• Transition between activities
• Classroom or home arrangement (noise, lighting, instructional media)
• Note problem areas:
 Copying or composing original work
 Avoidance behaviors when child required to write
 Need for constant re-direction or verbal/physical cues
 Poor attention and easily distracted

Question 22

gather assessment info - evaluation of child’s actual performance of handwriting

Answer 22

• In-hand manipulation
• Legibility components
 Letter formation (poor stroke sequence)
 Alignment – placement of letters and words on and within the writing margins
 Spacing (between letters, between words)
 Size consistency
 Over and under extension of lines
 Poor re-trace strokes
 Incomplete closure of letters
 Reworking of letters
 Reversals
 Case consistency

Question 23

speed of handwriting

Answer 23

1st grade 32 letters per minute (Phelps et al., 1987) <20 letters per minute (Larsen & Hammill, 1989)

2nd grade 35 letters per minute (Phelps et al., 1987) 20-25 letters per minute (Larsen & Hammill, 1989)

4th grade 37 letters per minute (Phelps et al., 1987) 34-40 letters per minute (Larsen & Hammill, 1989)

Question 24

ergonomic factors

Answer 24

 Posture
 Upper extremity stability
 Pencil grasp

Question 25

domains of handwriting

Answer 25

 Writing the alphabet and numerals from memory
 Copying; near-point (nearby model) and far point (distant vertical model)
 Manuscript to cursive transition
 Dictation
 Composition

Question 26

handwriting assessments

Answer 26

1. The Test of Handwriting Skills (THS)
2. The Evaluation Tool of Children’s Handwriting (ETCH)
3. The Children’s Handwriting Evaluation Scale (CHES)
4. The Diagnosis and Remediation of Handwriting Problems (DRHP)
5. The Minnesota Handwriting Assessment (MHA)

Question 27

Test of Handwriting Skills purpose

Answer 27

To provide a measure of a child’s handwriting skills; the child’s neurosensory integration ability in handwriting in either manuscript or cursive in both upper and lowercase forms. It also measures the speed with which a child handwrites. The authors recommend using the THS inconjunction with other evaluative instruments to determine a child’s handwriting skills (or lack of skills).

Assumptions made by authors:
 Almost all schools begin manuscript at kindergarten
 Manuscript instruction occurs mostly in K, 1st, and 2nd grade. Some teachers continue manuscript instruction into 3rd grade
 The 3 main methods of handwriting are D’Nealian, Palmer, Zaner-Bloser

Question 28

Whole Language

Answer 28

the child is given instruction or correction on handwriting in the context of writing for a theme in school
Ex. – child is writing about monsters and forms “n” incorrectly, teacher corrects and makes suggestions on correct letter formation

Question 29

Traditional

Answer 29

the child is systematically introduced to each letter outside the context of writing

Question 30

The Debate on Teaching Manuscript Writing First…

Answer 30

1. Manuscript writing is simpler and easier to form (less height variation in each letter)
2. Closely resembles print of textbooks and reading materials
3. Beginning manuscript is more readable than cursive
4. Manuscript is easier to discriminate than cursive letters

Question 31

The Debate for Teaching Cursive Writing First…

Answer 31

1. Cursive allows for faster and more automatic writing
2. Reversal of individual letters is more difficult
3. Cursive is faster than manuscript
4. The fluid lines may be easier for children to write than stop and start manuscript

Question 32

problem/solution for spacing between letters

Answer 32

1. Use finger spacing with index finger
2. Use small sticker between letters
3. Teach “no letter” touching rule

Question 33

problem/solution for spacing between words

Answer 33

1. Make space with a rubber stamp, larger sticker

2. Use a dot or dash with a marker

Question 34

problem/solution for spacing on paper

Answer 34

1. Use grid paper

2. Write on every other line of paper

Question 35

problem/solution for placing text on lines (alignment)

Answer 35

1. Use raised line paper (or make with colored glue)

2. Use visual cues to prevent over or under extensions

Question 36

problem/solution for sizing letters

Answer 36

1. Use individual boxes for letters

Question 37

problem/solution for near point copying

Answer 37

1. Highlight the text on the worksheet to be copied

2. Teach students to copy 2-3 letters at a time

Question 38

problem/solution for far point copying

Answer 38

1. Enlarge letters to be copied for better viewing
2. Start with copying nearby letters, work up to far copying
   3 Attach alphabet strip on desktop if copying letters from the board is problematic

Question 39

problem/solution for composition

Answer 39

1. Be certain child can form letters from memory first

2. Talk about story before writing, use picture from magazines, books to help compose story

Question 40

problem/solution for speed

Answer 40

1. Begin assignments before peers
2. Work on speed gradually, make sure child feels successful
3. Use a timer, put child in charge of timer to help them to learn concept of time

Question 41

habits of left-handed writers

Answer 41

• A hooked grasp - the wrist bends forward (this positions a child’s fingers above his writing and allows him to see what he is writing). This is a very bad position for writing since it does not allow efficient finger control for good letter formation.
• An “ulnar” grasp - the child holds the pencil between his thumb with all four fingers along the shaft. The pinky finger is closest to the pencil tip. This grasp is undesirable because the pinky must guide pencil movements and the hand is unstable.

Question 42

Tips For Teaching “Lefties” to Write:

Answer 42

1. Position the paper on the desk so it is completely left of the child’s midline. Avoid having the child cross over the midline or reach to right side while writing.
2. Angle the paper so that the L side is higher than the right and the forearm lies parallel to the paper. Encourage kids to learn how to position paper themselves. To ensure correct positioning, affix tape to the desk to provide an outline of the position in which a paper should lie.
3. Samples for the child to copy should lie on the right side of the paper, not the left.

Question 43

alternatives to writing

Answer 43

1. keyboarding programs
2. dictate versus writing answers
3. receives copies of material versus handwriting notes