Handwriting Difficulties

MANAGING STUDENTS WITH HANDWRITING DIFFICULTIES

NUR THAQQIFAH MD SANIOCCUPATIONAL THERAPIST U29KLINIK KESIHATAN UJONG PASIR

Enhance client ability to engage in the occupations they want to, need to, or are expected to do, or by

modifying the occupation or the environment to better support their occupational engagement.

Let’s start with BILATERAL MOTOR

INTEGRATION ACTIVITIES

DRINKING WATERActivates the brain for :Efficient action between

the brain and the nervous system

Efficient storage and retrieval of information

BRAIN BUTTONS

Improves academic skills such as :Crossing the visual midline for

readingThe correction of letter and

number reversalsConsonant blendingKeeping one’s place while

reading

CROSS CRAWL

Improves academic skills such as :SpellingWritingListening reading and

comprehension

THINKING CAPS

Activates the brain for:Short term working memorySilent speech and thinking

skillsHearing with both ears

together

LAZY 8’s

Improves academic skills in:Mechanics of readingDecoding of written

languageReading comprehension

HOOK UPS

Improves academic skills in:Clear listening and

speakingTest talking and similar

challengesWork at keyboard

HOW DO YOU FEELS ?

THERAPIST

TEACHER is primarily for handwriting instruction…......

determine underlying postural, motor, sensory integrative or perceptual deficits that might interfere with the

development of legible handwriting

+When the teacher and the therapist work together, combining medical and educational knowledge, the result are often very POSITIVE in achieving legible

handwriting.

TEACHERTHERAPIST

Example of handwriting difficulties:

CASE 1.

CASE 2.

CASE 3.

CASE 4.

CASE 5.

Let’s experience it…

By using your in-dominant hand, write the sentence from the screen.

You have 5 minutes to complete the task.

Pen & Paper

“Most people do not realize that good handwriting is a direct result from good upper body strength.

Crawling is a natural milestone that children need to learn. Crawling develops power in the shoulders,

arms, wrists, and hands. Have you heard or personally ever stated “My child skipped crawling and went straight to walking!” While walking skills

may be advancing quickly, it is also a good indication that the child will have poor fine motor

skills”-Wiggins.

How do you feel?

What will you get when your student

success?video

STAGE 1

Student’s readiness for writing

CHECK YOUR STUDENT’S READINESS

1.Sitting BehaviorA good position at the table will help the child to be stable and be able to concentrate and use their

hand effectively.

Feet flat on the floor

Arm forward symmetrically

Hip 90 degreeKnee flex 90 degreeFeet flat on the floorAnkle 90 degree

Prevent foot hanging: Provide a stool to rest feet

Important for all desk work!

CHECK YOUR STUDENT’S READINESS

2. Pincer GripAbility to grasp small objects with thumb and forefinger. It is an important part of the child’s fine motor development and necessary for holding and manipulating the pencil.

Cloth peg open with tripod pinch (thumb, index and

middle finger)

Play with play dough/ putty

Pick up small object with tripod pinch

SUGGESTION ACTIVITIES

CHECK YOUR STUDENT’S READINESS

3. AttentionA crucial step in learning process.

Find beads in the putty

Jigsaw puzzles

Lacing beads

Sequencing alphabets/numbers foam

SUGGESTION ACTIVITIES

Question……

Question……

CHECK YOUR STUDENT’S READINESS

4. Eye Hand CoordinationUses the eyes to direct attention and the hands to

execute a task. SUGGESTION ACTIVITIES

Scissor activities Ball activities Dot to dot Mazes

Nuts and bolts

CHECK YOUR STUDENT’S READINESS

5. Visual Perception Ability to recognize forms, notice likeness and

differencesSUGGESTION ACTIVITIES

Figure Ground Visual Memory

Visual Discrimination

Visual Closure

Visual Form Constancy

Activities to improve stability of proximal joint Activities to improve children's fine motor control and

isolated finger movements Activities to improve ability to hold writing tools Activities to enhance right-left discrimination

Handwriting readiness can be developed by:

ACTIVITIES TO IMPROVE STABILITY OF PROXIMAL JOINT

Games such as tug-of-war, wheelbarrow walking, animal walks

Scooter board

Tug of war

Heavy work: Pushing furniture, carrying

shopping bags, carrying chair, etc

Wall/floor push up

Commando crawl

Tummy-lying on the floor to color or do puzzles

Use the playground equipment, such as the

climbers and monkey bars

ACTIVITIES TO IMPROVE CHILDREN'S FINE MOTOR

CONTROL AND ISOLATED FINGER

MOVEMENTS

Picking up small objects with tweezers/

adapted chopsticks

Rolling tiny balls of clay or therapy-putty between the tip of the thumb and tips of the

index and middle fingers

Find hidden beads in putty

Lace beads with strings

Tug of war with fingers using coffee stirrer and/or

tongue depressor

Stretching rubber band onto

cylindrical object

TRY IT WITH YOUR PARTNER

ACTIVITIES TO IMPROVE CHILDREN’S ABILITY

TO HOLD WRITING TOOLS

Linking chain

Pick up small objects (toys, sweets etc.) with thumb

and first finger rather than whole hand, or thumb and

middle finger

While doing pincer grip activities place a small object (e.g. a rubber) in the child’s palm to be held in place by

the middle, index and little finger. This will help with pincer isolation i.e. only using thumb and first finger

Clothes pegs opened with the thumb and index finger help to strengthen pincer grip

ACTIVITIES TO ENHANCE RIGHT-LEFT

DISCRIMINATION

Lacing activities

Screwing nuts and bolt

STAGE 2

Student will be able to color using dominant

hand with proper grasping pattern with

appropriate force.

Radial cross palmar

Palmar supinate Digital pronate, only finger extended

Brush Grasp with extended fingers

Cross thumb Static tripod Four fingers Lateral tripod Dynamic tripod

(Schneck & Henderson, 1990)

Pencil Grasp:

STAGE 1

Colouring : Scribble

Palmar grasp

Hand not leaning on the table

Light pressure

Strategies / activitiesFold paper

Manipulating small objects

Tear the paper Play tennis ball

Play dough/ putty Use crayon-down flat

Trace on the sand

Colour on the wall

Colouring : Part by parts

BALLOONS

BALLOONS

ProblemStudent colour the whole picture as they do not understand that

they have to colour part by parts yet.

Student has grasped the understanding to colour part by parts, but waiting for teacher’s

cue to proceed to the next.(orientate skill not establish yet).

Example of cues

BALLOONS

BALLOONS

1 2

3 4 5

BALLOONSArrow Number cue Bold the balloon with

different colour

Too much cues will lead

student to be dependent: cue

fading as soon as possible.

To emphasize student to

colour within line

COLOUR : Follow border line

STAGE 3

Student should be able to do the pre-writing

task.

Pre-writing

Children needs to be able to draw pre-writing shapes/lines before they are able to

form letters/numbers correctly.

Example of pre-writing activity

Horizontal line

Vertical line

slanting line

Curve line

Circle

Pre-writing : Tracing stepsStep 1 Step 2 Step 3 Step 4

Cue fading

Pre-writing : Tracing between 2 lines

Starting point

Pre-writing : Tracing between 2 lines

FREE DRAWING

ACTIVITIES TO PROMOTE

PREWRITING SKILLS

Drawing lines and copying shapes using shaving

cream, sand trays or finger paints

Drawing and colouring pictures of people,

houses, trees, cars or animals

Tracing on simple dot-to-dot pictures/lines

Completing mazes

Tracing on lines or shapes using stickers

Tracing on lines or shapes using buttons or any other tiny objects

Copy and construct blocks according to cue cards to encourage

constructional skills

STAGE 4

Student should be able to trace and write alphabets

and numbers

Letter formation:The ability to make a letter on a page/paper using eye-hand coordination, correct posture, directionality, and visual motor memory.

Free drawing + Tracing alphabets

(Capital letter) =Get faster result in writing alphabets

STRATEGIES

Letter formation :TracingTracing steps:

Step 1

Step 2

Step 3

Step 4

Step 5

STAGE 5Student should be able to

copy words and sentences from ;

• book ( up to down )• book ( copy from left or

right )• board ( into book )

Writing:Copy one word

Copy two words

Copy three words

Copy 4-6 wordsin 2 lines

3-4 letters

4-6 letters

Promote spacing between words

Copy from the book (up to down, left or

right side) and from the board

Pre Academic skill assessment / School readiness assessmentPre-School Visual Motor Integration Assessment (PVMIA)

Miller Assessment for Preschooler Minnesota Handwriting AssessmentTest of Handwriting Skills – RevisedMiller Assessment for PreschoolerShore Handwriting AssessmentBeery VMI

 Assessment on Client Needs Canadian Occupational Performance Measure(COPM)(parents

questionnaire) 

ASSESSMENT

QUESTION?

PRACTICAL SESSION

LAZY 8s

Pen & Paper