Handwriting Difficulties

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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.

Lets start with BILATERAL MOTOR INTEGRATION ACTIVITIESDRINKING WATER

Activates the brain for :Efficient action between the brain and the nervous systemEfficient 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 ones 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 8s

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 ?

THERAPISTTEACHERis 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.TEACHERTHERAPISTExample of handwriting difficulties:

CASE 1.

CASE 2.

CASE 3.

CASE 4.

CASE 5.Lets experience itBy using your in-dominant hand, write the sentence from the screen. You have 5 minutes to complete the task.

Pen & PaperMost 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?videoSTAGE 1Students readiness for writing

CHECK YOUR STUDENTS READINESS

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 floorArm 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 STUDENTS READINESS

Pincer GripAbility to grasp small objects with thumb and forefinger. It is an important part of the childs 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 pinchSUGGESTION ACTIVITIESCHECK YOUR STUDENTS READINESS

AttentionA crucial step in learning process.

Find beads in the puttyJigsaw puzzles Lacing beadsSequencing alphabets/numbers foamSUGGESTION ACTIVITIES

Question

QuestionCHECK YOUR STUDENTS READINESS

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 STUDENTS READINESS

Visual Perception Ability to recognize forms, notice likeness and differences

SUGGESTION 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 PARTNERACTIVITIES TO IMPROVE CHILDRENS 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 childs 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 2Student will be able to color using dominant hand with proper grasping pattern with appropriate force.

Radial cross palmarPalmar supinateDigital pronate, only finger extendedBrushGrasp with extended fingersCross thumbStatic tripodFour fingersLateral tripodDynamic tripod(Schneck & Henderson, 1990)Pencil Grasp:STAGE 1

Colouring : ScribblePalmar graspHand not leaning on the tableLight pressureStrategies / 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 partsBALLOONSBALLOONSProblemStudent 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 teachers cue to proceed to the next.(orientate skill not establish yet).

Example of cuesBALLOONSBALLOONS12345BALLOONSArrow Number cueBold the balloon with different colourToo 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 3Student should be able to do the pre-writing task.

Pre-writingChildren needs to be able to draw pre-writing shapes/lines before they are able to form letters/numbers correctly.

Example of pre-writing activityHorizontal lineVertical lineslanting lineCurve lineCirclePre-writing : Tracing stepsStep 1Step 2Step 3Step 4Cue fadingPre-writing : Tracing between 2 lines

Starting point

Pre-writing : Tracing between 2 linesFREE DRAWINGACTIVITIES 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 4Student 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 alphabetsSTRATEGIESLetter formation :TracingTracing steps:

Step 1Step 2Step 3Step 4Step 5STAGE 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 wordCopy two wordsCopy three wordsCopy 4-6 wordsin 2 lines3-4 letters4-6 lettersPromote spacing between wordsCopy from the book (up to down, left or right side) and from the boardPre 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 8sPen & Paper