Most of the children I treat have handwriting difficulties (even if that was not why their parents initially contacted me) and messy handwriting is by far the most common reason why primary schools refer their pupils to me.
Despite the rise in technology, handwriting remains an essential life skill and an important foundation for academic success. It is the primary means by which a child displays their cognitive ability in classwork, homework and written examinations.
Children with handwriting difficulties may struggle to keep up with their peers in classroom activities and may quickly lose motivation and become frustrated.
Early intervention to address any handwriting difficulties will minimize the impact on a child's academic performance.
The range of handwriting difficulties that I see is enormous and it is common for children to have difficulties developing the skills and the appropriate pencil grip needed for fluent, legible handwriting.
Does your child display any of the following handwriting difficulties?
- poorly formed letters and/or difficulty remembering how to form letters
- slow, painful and laboured writing with poor endurance
- poor organisation and spacing of writing, both on the page and within words/sentences
- abnormal or inefficient pencil grip
- difficulty copying from the whiteboard or from a book
- too much or too little pressure being put on the paper
- poor legibility of written work
- difficulty gaining writing speed and struggling to keep up with their peers during written work
- a reluctance to engage in written work
- reversals and transposition errors
- poor sitting posture, leaning forwards with head on table or close to work or leaning backwards with arm extended
- difficulty understanding the concepts of shape, size and form
- pain in the hand and/or excessive tiredness after even short periods of writing
- an inability/reluctance to support the paper with the non-dominant hand whilst writing
- difficulty transitioning from print to cursive
- written work does not reflect their academic potential
Handwriting is a complex task which requires the integration of many component skills.
My aim as a physiotherapist is to assess each child as an individual to determine the nature of their difficulties and the specific underlying reasons for those difficulties.
Some children have never really mastered (or perhaps haven't had the opportunity to learn) the fundamental skills which are necessary for the development of the various aspects of handwriting. My assessment will include analysis of each of these skills, including:
- fine motor skills, including coordination, dexterity and strength
- trunk control, including core stability
- upper limb control, including shoulder and wrist strength/stability
- visual perception
- hand-eye co-ordination
- postural control
- visual-motor integration
- spatial awareness
- motor planning
- development of hand dominance
- hand strength & pencil grip
- bilateral and reciprocal integration (including midline crossing)
- ocular-motor control
- primitive reflex integration
- attention, focus and concentration
- the range of movement in the joints of the hand
Of course, the assessment will also include an analysis of your child's handwriting, including speed, letter formation, sizing, alignment and spacing. During the assessment, your child may also have the opportunity to try new equipment such as pencil grips.
Following the assessment, you will receive a report detailing my findings along with recommendations.
Following the assessment, my aim is to develop a targeted treatment programme to address those deficits which impact on the child’s handwriting.
Whatever the problems are, treatment methods will be chosen to help the child to develop the skills they are lacking or compensate for their difficulties. These may include a combination of:
- remedial exercises, activities and games
- well recognised programmes
- specialist remedial handwriting materials
- advice on biomechanical and ergonomic factors impacting on handwriting
- pencil grips and other aids and equipment as appropriate
Whilst all treatment methods will be targeted at improving the child's writing, not all activities will involve the use of a pencil!