Occupational Therapist


Many people who have difficulty in talking are clumsy in making movements though they are able to walk and do not appear to have major physical impairments. Dressing, eating, grooming look awkward. Manipulating small objects such as buttons, money or bottle tops may pose problems. Learning new physical skills such as throwing a ball or riding a bike takes longer than usual.  Even after prolonged instruction and practice, movement rarely becomes fluent.

One activity that these people may find hard to master is the skill of handwriting.

 Difficulties such as these are to some degree a result of motor planning problems. These people have difficulty in analysing and co-ordinating the many components of a successful action, despite knowing what needs to be done; also, for some reason, they have difficulty making a movement pattern automatic. Let us go back to doing up buttons. This task is accomplished easily by an average one-year-old.

Two children go through the same stages in learning this task - coordinating muscles, coordinating hands together, coordinating hands in relation to the button. The difference is that for one child the movement eventually becomes smooth and she can then do it without thinking. For the child with motor planning problems, not only is the task of doing up buttons more difficult initially but the movement remains difficult, and requires concentration, even after years of experience.

Handwriting is similar. Many people with clumsy movements never master handwriting in spite of many hours of practicing, copying, or using letter guides or templates.  They may be able to form some letters and write words they have practised often, such as their name, but forming new words and spelling words without a visual cue remains difficult. Most of these people can trace words, although without great accuracy. When copying words it is difficult for them to start; they appear not to know where to begin the letters or how to go into the next letter.

It is often assumed that such writing problems are due to lack of understanding or lack of spelling skills - Ben cannot write ‘cat’ because he cannot remember that ‘cat’ is spelt CAT. This may not be the case. Children without disabilities who are learning to write often go through a stage where they can spell a word aloud but are unable to write it correctly, despite being able to produce the individual letters in isolation. This is because the sheer effort of getting the letters down on the page distracts them from the content.  For most children this is a short-lived stage (as with doing up buttons, eventually the letter shapes become automatic and the child is able to concentrate on content), but for some children writing remains problematic. If the child cannot talk well s/he bas no way of telling the teacher that s/he does know how to spell the word, even though s/he hasn't written it correctly.            

As with any problem there is a range of severity: some children will be slower than average at achieving automatic writing; others will be able to write but only by dint of expending far more conscious effort than their peers - effort that generally detracts from content[1] -- and others again will be restricted to a few words that they have been taught individually. The most severely affected children will still have difficulty writing their names in late primary school, despite much practice.

Research has shown that the ability of a person to reproduce a pattern is much increased if the person

·      is allowed to trace the shape first - that is, experience it kinaesthetically.

·      is simultaneously given verbal reinforcement, e.g.: 'The big Q goes round and round and has a short sharp line here!"

The person must receive an accurate message of the shape he is tracing for it to be meaningful.  It is no good if he wobbles all over the place in attempting to trace a letter, or follow, the lines in a different order or direction each time. His brain will receive an imperfect, inconsistent picture of the shape, and he will be unable to reproduce it later1. If the student has such problems it is imperative that his hand is guided co-actively through an accurate movement pattern at the same time as the pattern is being verbally reinforced.             

The following stages are the rough guidelines of a handwriting strategy that provides kinaesthetically (movement) based cues as well as visual and verbal cues. For older children and adults joined writing is likely to be preferable to printing, as each word can then be learnt as one unit without the pen leaving the paper.

·      Stage I
The student is physically guided through the tracing of the letter/word. She can trace with a finger or a pen. If a pen is used it is an idea to use contrasting colours to give feedback. Most importantly, verbal cuing is provided.
If the problem is severe (see Anna, below) this may need to be repeated many times.

·      Stage II
The student copies the shape and is guided physically if she is unable to do this accurately. Again, the student is given verbal reinforcement and is encouraged to provide this herself where possible.              

·      Stage III
The student is asked to reproduce the letter or word without visual cues. It may be necessary to guide the hand and provide some verbal cuing. 

·      Stage IV
The student is asked to reproduce the letter or word without visual cues – however, the student is encouraged to provide her own verbal cuing; and physical support is gradually faded.

·      Stage V
The student writes the letter or word independently.

 These stages are a guide only. It may be necessary to repeat some steps a number of times before moving on to the next stage.

It will assist the student to remember new words if handwriting training is incorporated into an activity or discussion rather than done in isolation. Activity meets could be provided containing drawings to be labelled, word squares, or sentence completions. This creates a more relaxing environment and puts the skill of handwriting in context as well as providing cues for the memory. In general the student will organize and remember new material more efficiently if she is allowed to experience it kinasthetically at the same time that verbal input is provided -- running her finger around the map in the atlas, for example, at the same time as the teacher discusses the map on the board.

All fine motor skills such as handwriting or eating are made easier if the person is provided with a firm base of support.  If the trunk is firmly supported the arms and hands can work more efficiently. For this reason it is important that the student is sitting with both feet firmly on the floor and the thighs well supported. The writing surface should be at such a height that the forearms are supported.    

Before instituting a handwriting program for a person with writing difficulties a number of questions need to be answered:

·      How old is the person?              

·      How much effort has been devoted to teaching them to write previously? 

·      How successful have they been with writing?

·      How important is handwriting for them?

·      Would their need to produce written material be better met by typing?

·      What do they have to write?     

Mario, an 8-year 014 who is writing at a 6-year old level, is obviously a good prospect for intensive handwriting training. Progress should be monitored closely and every effort made to ensure that he does not experience failure in other aspects of his schooling due to his handwriting difficulty. If Mario's handwriting does not equal that of his peers by the end of primary school then a typewriter should be considered, at least for essays, in secondary school.

Jill, a 14-year old attending a regular secondary school whose writing is at an 8-year old level, has more complex problems. Obviously her schoolwork is suffering, and she probably does not have the time for an intensive handwriting program. A typewriter should be tried immediately; however, some attempt to improve her handwriting is certainly warranted. Form filling, maths and science are difficult to do on typewriters.

Alan, a 25-year old with writing problems, should have his needs examined carefully. Alan can already Write his name and address and fill in simple forms so he probably has enough handwriting skills to get him by if he does not want to do clerical work. The reason for his difficulties should be ascertained - if they are due to motor problems a typewriter will be helpful for writing letters and so on. If Alan's writing problems are exacerbated by lack of literacy skills an adult literacy course may be appropriate.

Anna, also aged 25, is different. Despite considerable practice copying and tracing simple words she is still unable to write any of them without a model. Any handwriting program for Anna should set goals and timelines to avoid subjecting her to unnecessary failures. A decision should be made about what Anna needs to write - she needs a signature (though this can be a cross), and if she has speech impairments it would be useful for her to be able to write her address or phone number.

Because of the flow, joined writing will be easier for Anna than printing. An intensive effort should be made to teach her to write a short signature, starting with co-active movement, not tracing. People with severe motor planning problems are likely to trace each letter differently each time, thus defeating the aim of learning through repetition - this may well be why Anna has not learnt to write by tracing previously. If Anna is not producing a recognizable signature after eight 15-minute sessions handwriting instruction should be discontinued, and a keyboard used for all future literacy activities. Failure to acquire handwriting skills need not be synonymous with illiteracy - many individuals without any writing skills have learnt to read.


[1] One way to spot this is to examine items such as spelling tests - if a child regularly gets only the first few words correct, and the writing deteriorates along with the spelling, it would suggest a writing problem. Another indication of difficulty is a significant deterioration in content and writing between first and last sentences of a paragraph.


Anne McDonald Centre. 538 Dandenong Road, Caulfield 3162 Victoria, Australia Ph: 03 9509 6324, Fax: 03 9509 6321
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