Handwriting Games that go BAM!

Adding a game format to handwriting practice increases student motivation.

By Kathryn Mason, OTR/L

On the Handwriting is Fun! Blog

Bam! Is a fun and challenging handwriting game that can be made with popsicle sticks and a jar!
Bam! for handwriting!

As a school-based occupational therapist, I understand that

most of us work in multiple schools and need to haul activities with us from building to building to meet the individual needs of many students. It is important to have activities that take up little space, are easily graded to address varied skill levels, and progress with the students. Limited school budgets heighten the need to find inexpensive activities that fit these requirements. It is also important to find strategies that will keep our students motivated toward participation in therapy and engaged in tasks designed to meet their academic goals. Handwriting mastery continues to be a goal for many of our students; and for this reason and those I’ve mentioned above, I’ve created a number of game adaptations designed to reinforce letter recognition, formation, and proper positioning.

Students became bored fairly quickly with the other activities, such as worksheets, that I had used previously to teach these components of correct printing. By adding a game format, students became much more motivated to work on the requested tasks. I started using them about 3 years ago and gradually discovered other benefits and ways to adapt the use of the games.

I began letting students pick the board and playing pieces they used and discovered that they felt more in control of the therapy session. I always let the students go first and I’ve designed the individual game die so that they were likely to win about 5 out of 6 games. This kept the students feeling successful and more motivated to work on the expected tasks. I was able to gradually grade the expectations required to move the playing piece and never experienced resistance from the students. I have used these games with students from the first to fourth grades, with diagnoses of learning disabilities, neurological conditions, Autism, and ADHD. I’d like to share two game adaptations with you now that I’ve created and that have helped my students build their handwriting development skills.

Bam!Takes On Handwriting Skills!

The first game adaptation I’ve developed is a variation of Bam! The game called “Bam!” is one in which the players are offered opportunities to learn new information through different learning strategies. The game is easily adaptable for any subject or skill. For example, the students can learn by answering science questions; solving math problems; identifying incorrectly spelled words; or, in our case, working on handwriting skills.

Many teachers use the Bam! game to teach sight words, but I could not find a version that addressed printing components. So, I decided to create one of my own! I wanted a sequence of activities that was easily gradable and could be played by students of varying skill levels, with the therapist or with the parent as a home program activity. By adapting the Bam! game for our needs, the strategy could be graded to allow for

verbally identifying upper vs. lower case letters,

verbally identifying lower case letter positions,

copying letters from a model, or

printing the letters using visual memory.

Data collection is conducted simply by counting the sticks showing letters with incorrect answers. The game can also be graded by starting with just “tall” and “small” letters, later adding in “tail” letters. Bam! sticks can also be used without actually playing the game. For instance, they can be placed in a row to form an upper case or lower case alphabet or to sort lower case letters into the three size and/or position groups.

The simple and inexpensive DIY materials needed to create the game can be found at home or at a dollar store and are listed on the downloadable game instructions you’ll find by clicking on the picture below.

Bam! For Handwriting Game Instructions

Generic Game Board Handwriting Games

Another game format I’ve developed is like that of a typical game board. Many homemade game boards are available on Pinterest by searching for “learning board games.” Many offer free printable board games designed to provide a wide variety of learning opportunities. I decided to try my hand at it and came up with several different styles that allowed the students to participate in the selection of the board. The structure is the same on all of the boards, with each consisting of 30 – 1.25” squares, allowing for play that includes the entire alphabet, start and win squares, and 2 “go for one more” squares. Each board progresses to the right, up one, back to the left, and up one until the winner moves to the right across the top row to the “Win” space. The directions provided in the downloadable handout below are given for the vehicle game board; however, the pictures in the slideshow present my other variations. I’ve used a variety of themes to appeal to my students’ interests, as well as different levels of advancement rules to address their individual needs.

Generic Board Games Downloadable Directions

A Game Board Slide Show!

Stickers are used to “theme” the boards for those interested in cars, sports, or current movies. On a more traditional style of board, students are asked to answer questions about letters (“Is this a ‘tall’ or ‘small’ letter?”) or print a requested letter in order to advance to the next space. Here’s a video of one of my students doing just that!

Game boards that are aimed at handwriting mastery can be designed easily and inexpensively.
Click on the board to watch a student playing a handwriting game!

The biggest challenge I was faced with as I created these games was how to compensate for the OT always having the right answer on his or her turn! My answer to that was to create special dice for the staff to use during their turn. I’ve included pictures of the dice and have explained their uses on the downloadable instruction sheet above.

Handwriting board games can include special dice that add to the fun and challenge of the game.

Including dice in the game offers additional advantages.

First, students almost always want to roll the die for the OT staff and this helps to develop the arches of the hand.

A second advantage is the opportunity for the students to practice regulating their movements. I’ve created a rule that has them lose the privilege of rolling the die if it rolls off the table. In some cases where the students needs extra assistance in this area, I will place a small box lid on the table to corral the thrown die.

Having the student throw the die for the therapist’s turn offers an additional advantage in that the child needs to put down the pencil and pick it up repeatedly, up to 26 times, depending on the board. This provides great practice on correct pencil grasp, with or without the use of a rubber adapted grip, and the student never notices this practice!

Also, I’ve selected various types of beads and other small items for the students to select as markers that are small enough to require pinch or tripod grasp. The downloadable directions offer additional modifications to help you grade the activity for your students.

Board game pieces can be found at home or a discount store.
Generic Board Game Pieces should be of a size that will facilitate refined grasp patterns and can be created from items found at home or markers rescued from other games.

And the students love them!

Students will often request that I bring a particular game board for the next session, showing that they are motivated to work on these activities. The games are great strategies to suggest to families for at-home play and practice rather than suggesting somewhat more “official homework.” It is nice to see the children laughing during sessions. They enjoy competing against the therapist or other students in group sessions. If the children in the group are at different levels, for example in different grades or are working on different skills, the challenge can be modified for each one as long as the modification is explained to them. It seems to me that games are a win-win for everyone!

A Success Story!

Comparison of the top handwriting sample with that of the bottom demonstrates the benefits of using an adapted game board.

A very verbal first grade student with Autism transferred into our school. It was difficult to determine his true functional level because he appeared to demonstrate a lack of motivation towards classroom activities that were presented to him. Questions were raised as to whether it was motivation or skill level. I decided to use a game board strategy to help me tease out the answer. The top sample of his handwriting (above) was completed in the morning in his classroom. The bottom sample (a section of the completed alphabet) was completed the same day in an occupational therapy session using adapted paper and an adapted game board designed to increase motivation with a handwriting activity. Impressive, wouldn’t you say?

Kathryn Mason, OTR/L, is a graduate of Tufts University 1977, BSOT. She was previously the Director of the OTA Program at J. Sargeant Reynolds Community College, Richmond, Virginia. Currently she is working in the Chesterfield County Public Schools in Virginia. She can be reached at Kathywmason@yahoo.com

All photos are the property of the author and cannot be used without her permission.

Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.

The Handwriting is Fun! Blog is published and is the property of Handwriting With Katherine.

Kindergarten Readiness Skills

 

As this school year begins, some children will be entering pre-school and beginning to learn kindergarten readiness skills.  The stakes are higher now for kindergarteners, with this grade becoming the “new first grade.”  What was once a time for honing socialization skills, understanding school behaviors, and becoming familiar with the use of school utensils, kindergarten is now a place to jump in with both feet to learn math, language, and all about their world! Therefore, it is important for parents to be knowledgeable about what will be expected of their children when they open those kindergarten doors.

As therapists and teachers, it is important for us to understand this as well and to have resources at hand to help guide parents.  The blog below, “10 Handy Helpers for Kindergarten Readiness,” is just that – a resource for professionals and parents to share.  It provides a bit of research findings relative to kindergarten readiness, a general list of skills that kindergarteners are expected to have to enhance their learning and growth, and a group of easy-to-implement and family-friendly activities that can help build those readiness skills.

I hope that you will find it helpful!  Just click on the little gal below to read the article!

As always, thank you for reading!

 

Kindergarten readiness skills can be developed at home with simple everyday tasks!

 

 

 

The Handwriting is Fun! Blog is published and is the property of Handwriting With Katherine.

 

Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine

Katherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and remediation of handwriting skills. In her current book, Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists, she shares a comprehensive guide and consistent tool for addressing handwriting development needs. She can be contacted via her website, Handwriting With Katherine.

Collmer Handwriting Development Assessment and Remediation

 

 

 

 

 

Pictures are the property of the author and must provide a link back to this article or her website.  Those that provide a link to the originating source should include that link when they are shared.

Picture included with the link to the article is the property of Pixabay.

Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.

 

 

 

 

 

 

 

 

 

 

 

 

Slow Down! Handwriting is not a race!

Keijj44 pixabaySlow Down! Handwriting is not a race!

by Katherine J. Collmer, M.Ed., OTR/L

on the Handwriting is Fun! Blog

I recently received an inquiry through my Handwriting With Katherine website regarding an aspect of handwriting that can be the final mastery challenge for many of my older students: handwriting speed.  My reader wrote:

“I have a 6th grade boy who writes crazy fast!  He wrote 99 letters/minute today.  According to the criteria I have, he should only need to be writing ~50 letters per minute for his age (11 years old).  And of course it looks very messy.”

This therapist indicated that the student produced “great precision and control when he slows down;” and while his grip was not considered anything “to be desired,” it was functional and did not affect his precision. His speed was affecting his ability to produce legible written work.  The therapist also inquired about the use of metronomes and music to assist in slowing her writer down.

Since I’m sure there are many therapists and teachers who have students who race through their written assignments, I thought I’d share my response to her. Here are some tips for helping students to get out of the handwriting race!

Editing Skills provide a foundation for appropriate speed.

Writing too fast can actually slow the writer down.  This can be both a good and a not-so-good thing.  In both cases, this is only true if students have been taught self-editing skills.  Self-monitoring their own work has been shown to increase the students’ sense of ownership and responsibility for their work (Thomson & Gilchrist, ed., p. 123).  They should understand the reasons for editing and have been instructed in the appropriate ways to incorporate editing skills as they are writing.  The foundation for self-editing is an important facet of a structured and guided handwriting instruction program.  In the early learning stages, they are taught to review their handwriting skills by going back to review a line of letter formation practice exercises as they complete each one.  As they become more proficient and begin to write words then sentences, they will train their eyes to recognize letter formation, alignment, and spacing errors as they are writing.  With these editing tools in hand, speedy writers will find themselves having to frequently

Self-editing skills (Photo property of Handwriting with Katherine)
Self-editing skills
(Photo property of Handwriting with Katherine)

erase and rewrite their work during its production.  As they recognize an error, they will attend to it and make the corrections.  So, editing can slow the pace of students’ handwriting.  This is a good thing if the writers are not producing so many errors that the time used in erasing and correcting hampers their ability to produce legible written work that accurately shares their knowledge in a timely manner.  This would indicate that the students have not yet mastered the foundational skills necessary for handwriting mastery.  In this case, it is important to return to practice or rehabilitation activities that will address letter formation, alignment, and spacing skills.  If the writers are producing sloppy work because of speed and not due to poor foundational skills, and their current level of self-editing has not assisted them in slowing down, then I suggest a fun game to help them to become “turtles.”  (Don’t let the name fool you. This game is appropriate for children in all grades.)

The Turtle Race.  For students who write very, very fast, I present an activity that is the opposite of my “Minute Mania” strategy.  (You can find many other excellent handwriting activities in my book, “Handwriting Development Assessment and Remediaiton:  A Process Model for Occupational Therpists.” )
Where in the “Minute Mania” strategy you ask the student to write very fast and worry about editing later, the “Turtle Race” is just the opposite.  Although I feel that metronomes and music can be effective timing tools, they do not present the functional basis for slowing down in a “fun and playful” way.*  I feel that this activity can do just that!

1. As with the “Minute Mania” strategy, you and the student can come up with a silly sentence (versus words) consisting of 5-8 words (perhaps more depending upon the age and handwriting skill of the student).

2. Present the sentence in typewritten format to prevent confusion over letter formations or handwriting style and cut the words into individual pieces of paper.

3. Place the individual words in sentence format above the student’s paper or taped on the board, depending on what type of task you are working on (near or distance copying).

4. Provide the student with these directions:

• Explain that the object of the game is to help him slow his handwriting speed in order to produce legible written work in a timely manner. Discuss self-editing strategies and how they are used to recognize and correct handwriting errors during the writing process.  (If the student is unfamiliar with these strategies – e.g., attention to detail and focusing on the letters produced versus his hand or pencil – take time to provide some

Makamuki0

instruction in them.)  Discuss the importance of correcting errors right away, so that during writing assignments he won’t have so many words to edit after his assignment is complete.  Explain that in the “Turtle Game,” he will correct his work during the writing process.  In addition, he will conduct a final edit of his work at the end of the game. At that time, he will create a score for the game by recording the number of words that he needed to rewrite during the final edit.  Finally, be sure that the student understands that the lowest score during final editing is the better one.

• Explain to the student that you will be pointing to each word in the order it appears in the sentence and that he will have a certain amount of time during each pointing to copy the word.  Emphasize that he cannot move on to the next word until you have pointed to it, so the student has LOTS of time to write it as neatly as he can and to edit his work.  You can decide on the amount of time you will allow for each word.  For example, 30 seconds per word for very fast writers will provide them with a sense that they have enough time to go slow; and that even though they may go fast, they will have to wait until the time is up until they can move on.

*You can enhance the students’ sense of timing by adding a metronome to the game, using its rhythmic sound and speed to help the writers’ slow down their handwriting speed.  Be sure to explain and demonstrate its purpose in the game and gradually remove it from the game to encourage carryover in a functional task.

• Be sure to let the student know that he should edit his work as it is written and not to wait until the end.

• Finally, remind the student that final editing will occur after the game; and for each word that includes an error, he will be asked to rewrite the word correctly and record the number of words that required rewriting. Remind him that the lowest score during final editing is the better one.  You can even make up a rubric for this if you want to so the student can monitor his own progress and take responsibility for it after each session.

5.  Now, students will most likely continue to write very fast at first even though you’ve given them time to work on each word.  This is a habit; and just like any other, it will need time to be replaced with a better one.  Don’t get discouraged.  Let them work it out as the game goes along.

6.  After the student has written the entire sentence, have him conduct the final edit and rewrite each word below the original, allowing the same amount of time you provided for each word during the original writing.  Have the student tell you what needs to be edited; and if he cannot find the errors, go ahead and discuss each word and/or letter formation with him.

7.  Have the student record his score on a score pad or your rubric.  Be sure to discuss his progress to help him understand the types of corrective actions that can help him improve his score.

8.  Then, run the “Turtle Race” again, with the same sentence, using the same time limits, and reminding the studentFotoShopTofs pixabay that he will want to beat his own score. Self-competition is a friendly, less stressful strategy for some students.  For others, healthy competition with another person can facilitate an understanding of speed and the motivation to slow down.

• If you are working with an individual student, you can add a more competitive component by including yourself in the game.  Both you and the student can write the words of the sentence sticking to the time limits.  By working alongside the student, you can demonstrate appropriate speed and timing, allowing him to get a sense of how fast he is writing compared with your speed.

• If you are working with more than one student at a time in your session or within a classroom setting, you can group the students and have them compete with each other by comparing scores.  This set-up can also provide students with an opportunity to model their speed after the slower writers.

Ideas for turning this strategy from practice into function.

• You can work with the student’s vocabulary or spelling lists.  Instead of providing a sentence format, simply flip over the words as they are presented in the “Minute Mania” game using a specific time limit for each word.

• Story-telling works well to incorporate writing skills into the session (which is the ultimate goal for handwriting mastery).  Have the student dictate a very short story to you, type it or write it on the board, and then conduct the game as originally presented.  As you point out the words, the student is actually recording his own original story.

Be Patient!  Sometimes the “Turtle Game” strategy very quickly accomplishes its goal of alerting students to the need to slow down.  Other times, it can take a while but then it clicks in.  Be patient – with yourself, the student, and the game.  There will always be a learning curve and it’s best to just let the learning take its course.  Remember, each student learns differently and that approaches to the game need to take those learning styles into account.

Be Prepared!  As an introductory preparation for this game, its best to begin with an activity that focuses on gross motor skills, especially those that include a visual component that requires diminished speed and precision.

• Let’s say for the little ones, the activity can be as simple as having them carry small objects across the room with a spoon to deposit into a small container.  This can work for older children, as well, if the props are appropriate.

• For older children, try a tether ball activity.  Hang a soft baseball-sized ball by a string from an overhead light or a ceiling tile at a height slightly above or at the students’ eye level.  Have your students stand about an arm’s length away, slightly less, and bat at it lightly.  Explain to them that the object is to have the ball cross just over their midline, back and forth just traveling from shoulder to shoulder.  Speed will need to be slower in order to maintain shoulder width and to keep the ball in control.  To help the students measure their speed, have them recite the alphabet slowly with each tap.  It also helps to enter into a conversation with the students, demonstrating speed by measuring the timing of your words.  As they converse with you, the students can model your speed.

I feel it’s very important to keep the functional aspect of therapy in the forefront of the student’s mind. Why do we need to write slow?  For the same reason we need to walk slowly with the spoon or tap the ball lightly – to maintain control and accuracy.  During the “Turtle Race,” discuss the reason why control and accuracy are important – many times!  It’s the ultimate object of the game, after all!  Enjoy!

The Handwriting is Fun! Blog is published and is the property of Handwriting With Katherine.

Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine

Katherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and remediation of handwriting skills. In her current book, Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists, she shares a comprehensive guide and consistent tool for addressing handwriting development needs. She can be contacted via her website, Handwriting With Katherine.

Collmer Handwriting Development Assessment and Remediation

Reference:  Thomson, P., Gilchrist, P., ed. Dyslexia – A multidisciplinary approach. Stanley Thornes (Publishers) Ltd., United Kingdom, 1997.

Pictures that are marked the property of the author must provide a link back to this article or her website. All others must provide a link to the originating source.

Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.

From Flapping to Function: A Parent’s Guide to Autism and Hand Skills – A book review

 

from-flapping-to-function-picture

 

From Flapping to Function:  A Parent’s Guide to Autism and Hand Skills – A book review

by Katherine J. Collmer, M.Ed., OTR/L

on the Handwriting is Fun! Blog

 

 

 

 

 

From Flapping to Function:  A Parent’s Guide to Autism and Hand Skills advances the work of Barbara Smith, M.S., OTR/L, on the development of hand skills to a broader level and will serve as a relevant and worthy resource to both her profession and parents worldwide.  Barbara’s landmark book, From Rattles to Writing:  A Parent’s Guide to Hand Skills, won the National Association of Parenting Publications Award in 2011 and proved to be a valuable guide to parents and occupational therapists alike.  In her continued drive to enhance family education, she has organized her newest contribution to serve as an excellent companion tool aimed toward understanding sensory processing disorders and their impact on hand skill development.

 

A journey through Barbara’s book reveals the caring and insightful manner in which she carries out her practice of occupational therapy.  She has transformed what can be a perplexing disorder into a concise and parent-friendly outline of facts and definitions, linking them to the development of hand skills, and most importantly, providing easy-to-implement strategies to enhance the development of those skills.  The concise introduction provides the basics in a clear and understandable breakdown of the medical definition of Autism Spectrum Disorder (ASD) including the other conditions that commonly occur with it.  Barbara provides a list of key acronyms that will serve as a guide throughout the book.  Part I dives right into the uniqueness of each individual with autism and defines the developmental factors that may impact their hand skills – sensory processing, functional vision and visual perception, and executive functioning.  This section focuses on Sensory Processing Disorder (SPD) and defines the symptoms of the disorder itself, as well as three primary SPD types:  sensory modulation, sensory-based motor, and sensory discrimination disorders.  Each disorder is discussed relative to its symptoms and impact on the development of hand skills and is matched to a multitude of strategies that have been found beneficial to enhance hand skill development.

 

Perhaps my favorite chapter of the book is “Chapter 3:  Functional Vision, Visual Perception, and Hand Skills.”   Barbara provides not only the essential information about vision and its link to learning but also the critical red flags that can alert parents to the need for a vision assessment conducted by a developmental optometrist.  The greatest asset of this chapter, however, is her link between the visual symptoms of ASD and the adaptations and activities that can stimulate the visual system.  Very well done!

 

In Chapter 4, Barbara discusses executive functioning skills and their link to hand skills, providing adaptations that encourage and provide the “just right challenge” for “Getting Things Done!”  One of the most critical and confusing aspects of any remedial program is the implementation of appropriate reinforcement strategies that will promote learning and generalization.  Barbara does an excellent job of explaining positive reinforcers that use movement and sensory input to produce the desired response while meeting the child’s needs.  Of course, the discussion of each type of reinforcement comes with its own list of possible interventions.

 

Part II focuses on Interventions and can best be described as the “go-to source” for teaching strategies.  The book stays true to the occupational therapy perspective of linking the strategies utilized in skill development to the eventual functionality of a skill, defining generalization with familiar examples. Barbara provides parents (and therapists, too) with approaches for self-regulation, methods for grading tasks, the concept of “The 80-20 Rule” used in education (you must read the book to find out!), the effective use of nonverbal directions and “success-only adaptations,” and the backward and forward chaining strategies for breaking tasks into steps.  Forever true to her Recycling Occupational Therapist’s mission, Barbara provides a treasure trove of activities that are created from items found in every home and that address the enhancement of skills in the most functional ways.  And for many of them, she includes pictures!

 

The most important element of any book is the reader’s ability to understand the content and to reflect on its meaning.  Barbara has achieved that goal by providing her readers with the opportunity to do that with Summary outlines at the end of each section.  These bulleted reviews reinforce the key facets of the chapter and ensure the readers’ understanding of what they have just read while they guide them toward the next section.

 

Once again, Barbara Smith has delved into her vast bank of experience, both professional and personal, to present us with a guide that will become frayed at the edges and littered with yellow highlights as we put it to use in our family and therapy lives.  Thank you, Barabara!

 

 

 

Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine

Katherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and remediation of handwriting skills.  In her current book, Handwriting Development Assessment and Remediation:  A Practice Model for Occupational Therapists,  she shares a comprehensive guide and consistent tool forCollmer Book addressing handwriting development needs. She can be contacted via her website, Handwriting With Katherine.

 

 

 

 

 

 

 

 

Pictures are the property of the Barbara A. Smith, MS, OTR/L and must provide a link back to this article, the link provided,  or her website.
 Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.

10 Must-Haves in your Handwriting Tool Box

-----My OT Tool Box-----
——————-My OT Tool Box——————-

10 Must-Haves in your Handwriting Tool Box

by Katherine J. Collmer, M.Ed., OTR/L

on the Handwriting is Fun! blog

Helping students work on their handwriting development skills is fun and exciting!  And there are so many cool games, gadgets, toys, and widgets out there to gather up and hoard in our OT Tool Boxes.  Unfortunately, too much of a good thing leads to….well, too much of a good thing!  It’s often necessary to weed out the extraneous (no matter how many you were able to buy at The Dollar Store!) and pick out the tools that will serve the needs of your diverse groups of children in the most efficient manner.  Those are the gadgets and widgets that can be used in multiple ways to address a variety of developmental skills for children within a wide age range and who have many types of diagnoses.   Yes, it can be done!

My OT Tool Box has traveled with me from Maine to Maryland to Massachusetts and finally to Arizona.  It has held basically the same items for all these years, beginning in the days when I was new to the pediatric scene until these times when I’ve got the thought of retirement tucked away in the peaceful, relaxing spot in my mind.  I’m sure you have some type of box or bag that holds your treasured items, as well.  I thought I’d share my must-haves in the hopes that you will share yours, too!  Here goes!

My OT Tool Box

All of my sessions are organized in the same way:

  • Gross Motor Warm Ups
  • Vision Skill Warm Ups
  • Visual-Perception Work
  • Fine-Motor Work
  • Functional Handwriting Tasks.

So, I’ve organized my tool box outline in the same manner.

Gross Motor Warm-Ups:

  1. Balls and balloons are indispensable to me! A foam ball or two and a bag of balloons can carry us through balance and movement actions that

    In Toys and Games on Amazon.com
    In Toys and Games on Amazon.com

    also provide a touch of vision challenges.  Reaching, throwing, catching, kicking, and juggling are great ways to warm up the large muscles and to prepare the body’s core for fine motor work.  These are the muscles that help children sit appropriately and quietly while they work on handwritten assignments.

 

  1. Yoga – can you beat it for covering just about every muscle group need there is?  While balls and balloons provide action movements to wake up the muscles, yoga positions help the muscles pay attention to the commands directed at them.  Sitting with appropriate posture requires both strong and coordinated muscles.  And best yet, yoga is a double-duty activity.  Performing yoga exercises at the beginning of a session helps to prepare the large muscles, as well as the brain, for the precision work ahead.  Including yoga positions at the end of the session gives the large muscles time to reenergize with oxygen and provides the student with a cool down period before reentering the classroom.

Yoga

There are many free downloadable yoga charts on the internet with moves designed just for children.  It’s important to choose ones that provide easy-to-understand directions in case you want to include them in the student’s home program.

Vision Skills Warm-Ups:

  1. The Cotton Ball Game* has been a favored vision skill assessment and remediation tool for both me and my students for quite some time now. It’s a great way to warm up the eyes and the visual system for both close and distance work.  Blowing on a straw addresses divergence, or the ability of the eyes to move outward simultaneously and focus together on an object in the distance to produce a single picture.  This skill is especially helpful during copying-from-the board activities.  Convergence, or the ability of the eyes to move inward simultaneously during close work, is addressed by sucking on a straw.  Just a cotton ball or two and a few straws can be magically turned into target or carry games that address these important vision skills.

The Cotton Ball Game helps build efficient visual skills.
The Cotton Ball Game helps build efficient visual skills. (Photo is the property of Handwriting With Katherine.)

Cotton Ball Game
(Photo is the property of Handwriting With Katherine.)

Have your students create and produce a target as part of their fine-motor work and then use it in the next session to warm up their eyes in the Cotton Ball Game.  They can move the cotton ball along a track (created with masking tape) by blowing through the straw or carry it across the table toward the target by sucking on the straw to keep it stuck there.  Your students will love creating the track on the floor or a table, making intricate maze designs that will challenge their vision skills.

  1. Word Search Books (or free downloadable puzzles) come in very handy for vision skill warm-ups. It is important to prepare the eyes for fine motor work, especially scanning and tracking, to set the students up for achieving their personal best in your session.  These activities also serve double-duty as they can be included in your visual perception portion of the session!  If they are not completely finished during the session, they are simple to include in the students’ home programs.

Visual-Perceptual Work:

  1. Tangrams are terrific! I know that there a lot of expensive kits you can buy with plastic, colorful tangram pieces.  But, there are also free downloads that will provide you with tangram kits that you can cut out, ask the children to color them if you’d like, then laminate them to preserve them for use year after year.  I was fortunate to have purchased a Getting It Write **  book by LouAnne Audette and Anne Karson that provided a great group of tangrams (shown below).  The answer keys are separate and that helped me a great deal when BOTH the student and I were having trouble figuring the picture out.  Of course, I got to peek at the answer; they did not!  (But I did give them hints!)

Tangrams
(Photo is the property of Handwriting With Katherine.)

Tangrams work on visual closure, visual discrimination, and visual spatial relationships skills, while they enhance visual attention skills.

  1. Small playing cards are a dream tool to have on hand. Small ones help to develop fine motor skills and can work on so many visual-perceptual skills at the same time.
  • They can be used for memory games such as Concentration, where the cards are placed face down and then two are turned over to expose their faces.  If they are not a match, then they are turned over again and the next person reveals two more.  As the card faces are revealed, the object is to remember where you saw that one before and turn it over for a match!  Concentration games are wonderfully fun ways to enhance visual memory, visual attention, and visual discrimination skills.

how-to-play-concentration-1

  • Playing cards can be used for sequencing games such as those that teach math (1) to encourage the enhancement of visual attention and visual sequencing skills.  War, the ever popular two-person game, is great for visual attention and visual memory.  To change this game up a bit, I made small playing cards out of cardstock that each had a letter of the alphabet on them, then laminated them.  We played sequencing games and war by ranking the letters according to their placement in the alphabet.  Just think of all the ways you can then include handwriting practice in the game?  (Hint:  The student can write the letter or words that begin with the letter on his handwriting paper!)
  • My favorite small playing card game of all is The Number 10 Game!*  A long time ago, I found a small card game called that in a dollar-type store in Canada.  The cards had simple numbers on them from 1-10.  I still have those cards, although they are pretty worn out.  I wasn’t ever able to find the game again; so I use small playing cards now, removing the face cards and using just the number cards.  The goal is to find all the matches that add up to 10.  It’s simple to set up and a fun way to address both fine motor and visual-perceptual skills.  First the cards are set up in 4 rows with 4 cards in a row.  As the students make a match, those cards are put off to the side.  When there are no more matches in that set up, the removed cards are replaced to fill in the rows and the student continues to find more tens.  You can decrease the number of rows depending on your students’ strengths and needs.  If your students have difficulty with math concepts, post an addition chart by the table or next to the game so that they can reference it.  However, if your students are proficient in their addition skills, then you can set up the game as a race to beat their personal best.  Of course, I’ve played it with them as a race; but most often the scales are tipped unfairly – with them beating me every time!!!

Number 10 Game
(Photo is the property of Handwriting With Katherine.)

Fine-Motor Work:

  1. Putty, Always Putty!!! Therapeutic putty maintains a permanent place of honor in my tool box.  I don’t leave home without it.  Pegs, golf tees, marbles, tweezers, and coins are staples that come along for the ride, giving my students a fine-motor workout while they play.  Both the younger and older students enjoy creating objects out of the putty, rolling it out again, and setting their creative juices to work on it once more.  I do have a set of putty exercises* we work on, too, which often becomes part of their home programs.  For the more advanced students, I bring along clay especially for them so that they can warm up their fingers before beginning handwriting tasks.

Fine Motor Tools
(Photo is the property of Handwriting With Katherine.)

  1. My collection of fine-motor sundries make hand and finger warm-ups fun. Small sponge pieces, blocks, paper clips, and pegs match up with tweezers and tongs to exercise the arches of the hand and the fingers and wrist.  These pieces can be combined to outline the directional concepts of a letter formation, to place along the pathway of a maze, or to stack and create an object.  Pickup Sticks work the pincer grasp, shoulder and arm control, and visual attention and figure-ground discrimination skills.  Patience and critical thinking are added bonus skills that are touched on in this game!  Dice are wonderful tools to enhance in-hand manipulation skills.  They can be used during board games or activities that you design to address the handwriting development skills your students are working on.  For instance, you can play BINGO with them using the numbers they roll to determine what the students will write in the boxes.  In the example below, the die is rolled twice.  With the first roll, a 1 would indicate that the student would write a lower case “u.”  With the second roll, a 4 would indicate that the student would write that letter in the first box in the “G” column.  I always play along with the student so that we could compete to win.  The game would continue until the first person had BINGO!

Bingo Rules for Site

I’ve also used dice with the small playing cards, changing the Number 10 Game rules just a bit.  After the cards are set up, the student rolls the dice and selects the cards that add up to that number.  When all of those matches are made and the rows are filled in with additional cards again, the student rolls the dice again for a new number.  This adds to the suspense!

Functional Handwriting Tasks:

  1. I always carry a supply of postcards, sticky notes, children’s stationery, and lined and blank paper with me. The blank paper comes in handy for the younger children to draw a picture and then write a short story on handwriting paper describing what their picture shows me.  The older children can draw a directional map to guide me to their favorite place in town or a room diagram to show me what their living room or classroom looks like.  They label the items in their best handwriting and then write directions to the place or a provide a description of it.  To practice writing in small spaces, the students can write a postcard to a friend, their sister, or the teacher and hand deliver it; write the teacher or their parent a message on the sticky note; or write a recipe on an index card to share with me (they usually do this as part of their home program).  Handwriting practice that doesn’t look like handwriting practice.
  1. The most functional tool in my tool box doesn’t actually come with me to the session.  I often ask the students to bring in a homework or classwork assignment that addresses their particular handwriting need.  They will bring in their worksheets that include small, unlined spaces; book reports that are not quite completed; or math and spelling sheets.  These provide us with opportunities to work on spatial and editing skills, as well as discuss the areas that give them problems in class and at home.

Last but not least.

Other Tools
(Photo property of Handwriting With Katherine.)

Chalk Board
(Photo property of Handwriting With Katherine.)

I also carry a stash of supplies that will come in handy when the need presents itself.  A roll of blank paper and masking tape are two essentials to have on hand to practice letter formations skills (with drawings, doodles, mazes, or tracing) using large motor movements on a vertical surface.  Of course, sand paper, aluminum foil, and tissue paper are must haves for tactile feedback tools for pencil pressure.   I never leave home without my small chalkboard (have had this one for years!), tons of chalk, Q-tips, and a paper cup for water!  There is simply nothing that can replace these tools for the development of motor memory skills.  Writing the letters with chalk and then tracing over them with a Q-tip dipped in water is my all-time favorite disappearing act trick!  I usually have a bunch of construction paper on hand, too, to use as a substitute for the chalk board.  We write the letter in chalk on the paper and then trace it with the wet Q-tip.  (PS:  I never use white boards or markers.  Not enough tactile input to make the activity beneficial.  I like to get the most out of every minute the students are with me!)

So there you have it!

Well, I guess if you add up all of the individual pieces in my tool box, I wouldn’t be able to cash out in the “Around 15 items” checkout at the grocery store!  But, all in all, these are the tools I have been carting around for years.  I don’t know if they are the best ones; but I do know one thing.  Whenever I get overly creative and start to stuff boxes of toys and equipment into my trunk and lug them into the session, the children and I most often revert back to the old standbys!

Please let me and your fellow readers know “What’s in your tool box?”

And as always, thanks for reading and sharing my work!

*These activities, and many more, are included as downloadable handouts in my Handwriting Development Assessment and Remediation book.

**Updated 07/13/19:  It appears that the Getting It Write book is no longer available.

Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine

Katherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and remediation of handwriting skills. In her current book, Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists, she shares a comprehensive guide and consistent tool for addressing handwriting development needs. She can be contacted via her website, Handwriting With Katherine.

Collmer Handwriting Development Assessment and Remediation

(1) https://topnotchteaching.com/math/math-card-games/
Pictures are the property of the author and must provide a link back to this article or her website.  If the photos are linked to another source, their use must provide a link to the originating source.
 Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.

The Core Strengthening Handbook: A book review

The Core Strengthening Handbook 2

The Core Strengthening Handbook:  A Book Review

by Katherine J. Collmer, M.Ed., OTR/L

A great deal of my energy on the internet focuses on reading and sharing the work of my peers and the many knowledgeable professionals in the therapy and educational fields.  My belief in the networking system that technology affords us encourages me to seek out their work and to offer it to others in an effort to support both the writers and the readers.  The realm of social media casts a brand new opportunity in our direction to learn and grow together in ways that were never before available to us.  My quest for knowledge and the responsibility I feel for sharing it freely has set my course as one of impartiality and equality, allowing me to turn so many brilliant people’s work around for others to see.  In the end, that means that I rarely accept promotional offers to review products and to advertise them on any of my platforms.  And when I do, I never accept compensation for the privilege.  Those are the times when a product comes along that I believe offers exceptional benefits for us as therapists, parents, and teachers.

I have just recently come across a publication that speaks in a very eloquent way to a facet of handwriting skill development that I consider to be the most important building block for success.  The Core Strengthening Handbook is a new resource offered by Lauren Drobnjak, BS, PT, and Claire Heffron, MS, OTR, from The Inspired Treehouse.  I feel that it will serve as a valuable resource for parents, teachers, and therapists and I think that you will agree.   Let me share a review of the book to help you get acquainted with what it has to offer.

But before we begin, I’d like to discuss briefly the vital connection that core body strengthening has with handwriting mastery.  Elementary school children spend 30-85% of their classroom time working at their desks, dedicating their visual and fine motor skills to close work that predominantly involves handwriting activities.  (1,2)   Close work places demands on the visual system to maintain efficient focusing, scanning, fixating, and accommodating skills for reading, writing, and copying from text or the board.  The eyes need to stabilize their positon while the head and body move.  Core muscle strength provides the platform for this to happen.  In addition, upper body control plays a key role in the development of an efficient pencil grasp and a fluid penmanship style that allows the hand to glide across the paper in a timely manner.  The core body muscles provide the stability for efficient eye and upper body positioning allowing the student to attend to the task at hand instead of having to expend cognitive and physical energy on maintaining an upright head and body position.  This is accomplished with the help of muscle strengthening and the development of the vestibular system and balance skills.  In a New York Times article, “The Unappreciated, Holding our Lives in Balance,” Dr. Daniel Merfeld, director of the Vestibular Physiology Lab at Massachusetts Eye and Ear Infirmary, described the Vestibular System’s job in a most interesting way:human-skeleton-johan-georg-heck

“Whenever we stand up and arrange our calves, thighs, torso and head into a stable, vertical configuration, we are unconsciously juggling six inverted pendulums, six mechanically independent units with masses above the pivot point – a feat that amounts to balancing six pencils on your palm simultaneously.”

The Vestibular System figures out where our head is relative to the floor and then tells the brain how to direct the muscles, joints, and ligaments in adjusting all of the masses and their pivot points to maintain our balance against gravity.  However, although an inefficient vestibular system can result in poor postural efficiency, its efficiency can also be limited due to inefficient core body strengthening.

The Core Strengthening Handbook

Lauren and Claire have designed their book to present the important message about core strengthening using developmental guidelines to instruct the reader about the muscles included in the body’s core and the progression of their development following typical gross motor milestones.  Their stated intent was to provide “a guide for supporting the development of core strength in children” and they have done that in an easy-to-understand resource for therapists, teachers, and parents.  They have acknowledged that the progression of a child’s gross motor development can be observed by his parents, who may often be the first to detect that their child is struggling with movement activities, as well as his teachers in their preschool through elementary grade classrooms.  The authors provide a well-written description of the journey a baby takes through tummy time, pulling to stand, and finally jumping using examples of observable movement patterns to help the reader visualize the muscles involved in the baby’s gross motor growth. For readers who are interested in the technical, Lauren and Claire share a brief description of the core muscles.

boy beach toys DariuszSankowski pixabayProbably one of the most important informational portions of the book is the section on “Why today’s kids aren’t as strong as they used to be.”  The authors discuss the importance of unstructured, spontaneous play in a child’s development of his core strength.  While they endorse the benefits of providing goal-directed activities to enhance core muscle strength, they recognize the importance of providing opportunities for children to have fun with simple playtime activities such as swinging, running, and climbing.  In an effort to encourage their readers to investigate the importance of play further, they have provided a link to an excellent article that shares a wealth of additional links and information.

The introductory chapter that begins their exciting list of core strengthening activities provides the reader with a better understanding of the behaviors that a child can exhibit when he is experiencing weak core muscles.  This is perhaps the most enticing method for gaining the attention of their audience and to compel them to buy their book!  When a parent or teacher understands that inefficient core muscle strength can result in poor posture, difficulty with transitional movements such as going from sitting to standing, challenges with dressing skills, and a poor pencil grasp, they will certainly want to learn more about how they can help their children with the fun and easy-to-use activities that follow!

The first impression I had when I began to investigate the book’s activities was that Lauren and Claire certainly know how to have fun!  They have provided a wide-range of strategies designed to engage the individual interests of the children as well as to facilitate their use in the home, classroom, or playground.  The activities range from those that include yoga, ball, and wedge components, which are the more advanced forms of core body strengthening work, through the easier to complete and more readily accessible everyday activities such as helping with chores or playing games on “all fours.”  Each strategy shares suggestions for grading the activity to match the child’s needs and for making the work fun for everyone.  The authors did not forget the babies!  They provide a group of playful activities that encourage tummy time and in turn engage the parent or caregiver in interaction with their child.

babies twins tummy time kangheungbo pixabay

My favorites?  Well, that was a difficult, for sure!  I lean toward selecting the Playground Ball Activities since they engage both the visual and the vestibular system in a very natural way.  But, who could not be interested in their Towel Activities!  I will definitely be including the Oblique Wake-Up Call in my next therapy session!  As far as assessment tools, I feel that their section on “Other Quick Core Strengthening Ideas” will come in handy the next time I’m working with a new client.  These six activities will tell me a great deal about his gross motor skills.

And did I mention that the book has pictures of the cutest children imaginable?  The Core Strengthening Handbook is certainly that – a handbook.  It is designed as both an informational resource as well as a quick reference for selecting activities that will work the core muscles.  If you have a moment, stop by The Inspired Treehouse and take a look at their site and this book.  I think you will be happy that you did!

Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine

Katherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and remediation of handwriting skills and is the author of “Handwriting Development Assessment and Remediation:  A Practice Model for Occupational Therapists.”  She can be contacted via her website, Handwriting With Katherine.

 
 
 
 
 Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.
 
Title photo is the property of  The Inspired Treehouse and should not be used without their expressed permission.  The human skeleton photo was published on the Figure Drawing Website  and its use should include the link to the author’s site.  All others are the property of the photographers at Pixabay.    Their use should include the link provided with the pictures.
References:
(1) Marr, D., Cermak, S., Cohn, E.S., & Henderson, A. (2003) Fine motor activities in Head Start and kindergarten classrooms.  American Journal of Occupational Therapy, 57, 550-557.
(2) Mchale, K., and S. A. Cermak. “Fine Motor Activities in Elementary School: Preliminary Findings and Provisional Implications for Children With Fine Motor Problems.” American Journal of Occupational Therapy 46.10 (1992): 898-903. Web. 26 June 2015.

Handwriting and the non-dominant hand

hand sketch AlexandruPetre Pixabay

Handwriting and the non-dominant hand

by Katherine J. Collmer, M.Ed., OTR/L

Frank R. Wilson, in his renowned discussion of the evolution of the hand, poses the suggestion that bimanual tasks result in the development of a visual vocabulary.  He defines a “visual vocabulary” as one that is established as a result of a mysterious, nonverbal language.  This language can be witnessed in the arts, from jewelry making to writing, as each creator uses “internalized rules for combining materials and structural elements” to produce unique patterns of work.   These works of art take on a meaning for both the designer and viewer and become the personal stamp of the creator. (1)  In this sense, handwriting can be defined as a nonverbal language that results from the production of lines and shapes that are placed within spatial constraints according to predetermined directional and alignment rules.  They become words and sentences that take on a meaning that the writer conjures up in our minds to share thoughts, feelings, information, and knowledge.  Although Wilson describes handwriting as a task commonly considered to be a unilateral hand skill, (1) one that is considered by researchers to require only the “specific coordination between the finger and wrist movements” of one hand, (2) it appears that handwriting under the label of a visual vocabulary would then be considered a bimanual task.

The production of a visual vocabulary, in the arts and handwriting, depends on the ability of the hands to form a complementary partnership in their role as a vehicle for expression.  This partnership consists of a dominant and non-dominant hand that become one unit in the completion of bimanual tasks. Brain lateralization and the intercommunication between the two sides of the brain have been considered the foundational requisites that facilitate the establishment of a dominant hand and determine handedness in humans. However, the establishment of hand dominance remains a confusing and baffling human trait that scientists admit there is little known about its history or neurologic foundations.  The study of the evolution of handedness has taken anthropologists back to an examination of how the hands were used by our Stone Age predecessors to wield stones as hammers to create tools for building or cooking or to design weapons intended to kill game or to act as protection against predators.  Their studies revealed that the tool users would have divided the tasks of hammering or throwing into two distinct parts, utilizing one hand to steady the object to be hammered or to balance two hands machines pashminu Pixabaythe body against gravity in throwing and the other hand to perform the precise movements necessary to direct the stone toward a target with accuracy.  This division of labor has been labeled as the dominant and non-dominant hand movements.

Hand dominance** has been suggested to have been a “critical survival advantage” to hunters and gatherers as they engaged precision tasks within their competitive environments.  (1)  Given that precision tasks demand practice for mastery, their consistent use of one hand to perform and perfect an accurate aim-and-throw movement may have organized the brain-hand pathways and established a hand dominance.  Again, the baffling question remains:   Why did these early humans select the right versus the left hand for precision tasks?  While scientists have yet to uncover the answer to this conundrum, they have turned with equal wonder at the mystery of the perceived underdevelopment of the non-dominant hand.  Some ask the question, “Did it stagnate?  Was it ‘dumbed down’ somehow, in order to guarantee the emergence of a manual performance asymmetry?”  Or was the non-dominant upper limb intended to become specialized in a different way?  (1)   This latter view of the non-dominant hand suggests that the two hands are complementary, forming a whole that is dependent on the accurate production of the specified movements of both sides.  This is an enlightening perspective on the role of the non-dominant hand, for sure.

Dominant and non-dominant hands were once referred to as the “good” and “bad” hands, with the non-dominant hand being labeled as the “somewhat disabled one.” (1) The right hand was viewed as the “good” hand despite the occurrence of left-handedness in some children.  Left-handedness, in fact, was considered to be a deficit and children were strongly encouraged, sometimes forced, to ignore their tendency to use their left hand and to switch Left-Hand-vs-Right-Handinstead to their right hand for writing and drawing.  The argument and prejudice against left-handedness was promoted by the confusing fact that an overwhelming number of people were right-hand dominant.  In the end, regardless which hand became dominant, the non-dominant hand was believed to be an unequal force in the production of bimanual tasks.  It was considered to be inferior to the more precise hand.  As researchers began to investigate more closely the interaction of the hands in bimanual skills, they questioned this idea and considered instead the likelihood that they were interdependent.  Bimanual tasks, by definition, involve the use of both hands.  While some bimanual tasks can be accomplished with the use of one hand (as evidenced by the rehabilitation efforts of persons who have suffered from a stroke), most often the speed, fluidity, and accuracy of their production are compromised by the lack of a supporting hand.  In general, then, bimanual tasks demand the use of both hands for efficiency, as is seen in activities such as playing a musical instrument, golfing, tying our shoes, cutting our food, and handwriting.

Wilson describes handwriting as a task commonly considered to be unilateral hand skill, (1) one that is considered by researchers to require only the “specific coordination between the finger and wrist movements.” (2)  However, in light of the research that considers the two hands as partners in a task, an analysis of the the non-dominant hand in handwriting has revealed it to play “a complementary, though largely covert, role by continuously repositioning the paper in anticipation of pen movements.”  (3, qtd in 1)  In 1987, French psychologist Yves Guiard studied the complementary hand movements in handwriting relative to the idea that the physical characteristics of the movements of each hand,  as well as the sensory control mechanisms that supported those movements, were significantly different.  He proposed that their scaled movements were spatially and temporally divided into two categories.  In Guiard’s theory, the scale of the dominant hand’s movements is considered to be “micrometric,” or produced within a smaller space with slower speeds relative to the supporting hand.  Its performance is rehearsed and mostly internally driven or pre-programmed, directed by the development of motor patterns and the automatic reproduction of those patterns.  (1)   In contrast the movements of the non-

Photo: Property of Handwriting With Katherine
Photo: Property of Handwriting With Katherine

dominant hand in its role as the paper positioner are “macrometric.”   They are conducted to facilitate improvised adjustments using faster speeds within a larger context.  They are externally driven, being directed by the writing hand to set the spatial boundaries within which it can perform its skilled movements.  In effect, the non-dominant hand is supporting the precise movements of the dominant one by providing a stabilizing environment that allows for frequent alterations that are responsive to the movements of the skilled hand.  This perspective of the non-dominant hand elevates its significance in the production of handwritten work.  The actions of the supporting hand require controlled motor movements that can transition within a diverse range of “improvised hold and move sequences” that do not follow strict rules for patterns or rhythm.  These movements require sensory control mechanisms that can detect, analyze, and integrate visual perceptual information, such as spatial boundaries or paper angles, relative to the movements of the dominant hand.  The supporting role of the non-dominant hand demands flexibility to “conform its movements both to the behavior of an external object and to the actions of the other hand, to ensure that the object and the handheld tool will intercept at the intended time and place.”  (1)  Guiard discovered that these alterations are anticipated and initiated before the movements of the skilled hand take place, leading to his proposition that “there is a logical division of labor between the two hands that appears to govern the entire range of human bimanual activities.”  (1)

The precise, rehearsed, and preprogrammed facets of handwriting rely on the supportive role of the less-precise hand to guide the dominant one in producing the “collection of identical hash marks” (1) that create an individual penmanship style and comprise the visual vocabulary that delivers each writer’s personal message.  The supporting role of the non-dominant hand places handwriting among our most creative bimanual tasks.  In this light, an assessment of handwriting development skills would warrant an evaluation of the behaviors demonstrated by the supporting hand and rehabilitative efforts designed to develop it to its highest skill level.

**For more information about the developmental stages of hand dominance and the it plays in handwriting mastery, please read my article, “Hand Dominance – a key factor in handwriting success,” and my book, Handwriting Development Assessment and Remediation:  A Practice Model for Occupational Therapists,” which can be purchased on my website.

Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine

Katherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and author of the book, Handwriting Development Assessment and Remediation:  A Practice Model for Occupational Therapists.  She can be contacted via her website, Handwriting With Katherine.  
 Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.
Photos are the property of online sites or the photographers at Pixabay.    Their use should include the link provided with the pictures.  All other photographs are property of the author and are not to be used without her written permission.
(1) Wilson, Frank R. The Hand: How Its Use Shapes the Brain, Language, and Human Culture. New York: Pantheon, 1998. Print.
(2) H. Reinders-Messelink, M. Schoemaker, and L. Goeken, Kamps, W. “Handwriting and Fine Motor Problems After Acute Lymphoblastic Leukemia.” Handwriting and Drawing Research: Basic and Applied Issues. Amsterdam: IOS, 1996. 215-25. Print.
(3) Guiard, Yves. “Asymmetric Division of Labor in Human Skilled Bimanual Action.” Journal of Motor Behavior 19.4 (1987): 486-517. Web.

Hand Dominance – a key factor in handwriting success

Hand Dominance – a key factor in handwriting success

by Katherine J. Collmer, M.Ed., OTR/L

hand dominance iwanna pixabayHand dominance is a key factor in handwriting mastery.  Handwriting is a complex functional task that demands the hand to work efficiently with a tool.  This is accomplished through the hand’s intricate link with the brain.  Handwriting is considered to be the highest form of unilateral hand dexterity skill attained by the general population.  (1)   The establishment of hand dominance provides the child with a skilled hand for efficient pencil control to facilitate the learning of letter formations and line alignment as well as a stabilizing hand to monitor paper placement.

What is hand dominance or handedness?

Hand dominance is the term used to describe the hand a child is observed using spontaneously during skilled activities such as brushing his teeth, using scissors, or handwriting tasks.  It is the hand a child naturally prefers to use because it performs skilled tasks more efficiently, leaving the other hand to act as a stabilizer.  For example, a child who is right-hand dominant, or right-handed, will use his right hand to manipulate the scissors and his left hand to stabilize the paper during a cutting task.  The development of hand preference is a sign that the brain is maturating and that brain lateralization is occurring. Initial development of a preferred hand occurs from about the age of 4 months to the age of three to four, shifting from a reach that is convenient (such as using the right hand to pick up objects on the right side) to one that crosses the body’s midline.  Hand preference for the completion of unilateral tasks becomes more evident during this time with further bilateral differentiation occurring between 5 and 7 years.  Although children may continue to switch preferred hands at this stage for use with different fine-motor skilled activities, a fully established hand dominance presents itself between the ages of 6 and 9.

What are the behaviors associated with an Unestablished Hand Dominance?

Hand dominance is a foundational skill that promotes using the hands together efficiently during activities that involve more complex motor plans, motor accuracy, and greater skill.  These tasks include tying shoes, buttoning a coat, playing with interconnecting blocks, or handwriting.  Crossing

Little Boy Lacing his Shoes --- Image by © Royalty-Free/Corbis
Image by © Royalty-Free/Corbis

the midline and bilateral coordination are contributing foundational skills for the establishment of hand dominance and equally important in the performance of skilled tasks.  Difficulties in either of these skills can result in unilateral hand preference (using the right hand for performance on the right side and vice versa), difficulty with symmetrical bilateral hand skills such as catching a ball or holding an object with two hands, or competing dominance where the child switches hands during a fine-motor task.  It is also important to note that if a child who demonstrates a clear preference for one hand is observed switching between his dominant and non-dominant hand during skilled activities, muscle fatigue could be the underlying cause rather than difficulty with any of the above skills.

How can you determine the Establishment of Hand Dominance?

There are several ways to determine a child’s preferred hand and to determine the establishment of hand dominance.

Boy Playing with Building Blocks

  1. Observe the child participating in skilled fine-motor tasks such as brushing his teeth, buttoning his coat, drawing, playing with construction toys, or cutting paper.  Record the number of times that he uses a specific hand as the dominant one within each task, switches hands within the task, or uses only the hand located closest to the object when reaching for it (e.g., using the left hand solely to reach for items on the left side).
  1. Place items at the child’s midline on a table during a fine-motor play or functional activity.  Observe the use of a dominant hand or the switching of hands during the activity.
  1. Place items for use in activities such as puzzles, tangrams, or construction tasks in random positions on the table on the child’s left and right sides as well as in midline. Observe his use of a dominant hand, his switching hands, or the use of a unilateral reach as he completes the activity.

Activities that Promote the Development and Establishment of Hand Dominance.

After collecting observational data that reflects the child’s level of hand dominance, determine the hand that he appears to prefer.  Direct him to use that hand in activities that will reinforce it as the dominant hand.   If the child does not yet appear to have a preferred hand, begin with the foundational activities below to encourage the development of a dominant hand.  Progress to the activities that follow to enhance the underlying skills that promote the development and establishment of hand dominance.

Foundational Activities:

  1. Place objects for a task at the child’s midline. This provides him with the opportunity to select which hand to use and enhances the development of a dominant hand by lessening the chances to use the unilateral hand to avoid having to cross midline.
  1. Use auditory cues to direct the child’s reach across his body during play and functional tasks.  Positions items included in the activity randomly on the table on both sides of his midline.  Ask him to reach for them using the opposite hand.  For example, to direct him to reach across his midline to an object on his left, you might say, “Joey, please pick up the yellow marker with your right hand.”  This activity also promotes the development of crossing the midline and bilateral coordination skills as well as the understanding of directional concepts.
  1. Use auditory and visual cues to establish labels for his skilled and stabilizing hands. This helps him to understand how he uses his hands for fine-motor activities and supports their use as skilled or stabilizing hands.  For example, if the child has been observed to use his left hand predominantly during skilled tasks, you might verbally label his left as the “worker hand” and his right as the “helper hand.”  Demonstrate these labels as you and he complete tasks such as cutting, lacing, or construction play.  You may add a sticker to his worker hand to remind him of its role in the activity.
  1. Use auditory cues as reminders to continue to stay with one hand for the duration of a skilled activity.

Enhancement Activities:

Gross motor games.  Position balls or bean bags on the side of a child’s preferred hand and have him toss them at a target placed at his midline or on the opposite side of his body.  This activity promotes the development of hand dominance, as well as balance, bilateral coordination, visual attention, and crossing the midline skills.  Games of throw and catch (for example, baseball or bowling) and basketball (dribbling and throwing) also promote these skills.

Girl (6-8) Painting an Egg --- Image by © Royalty-Free/Corbis
Image by © Royalty-Free/Corbis

Fine motor activities.  The activities below promote the use of a dominant hand as well as the development of visual attention, crossing the midline, and bilateral coordination skills.

    • Drawing circles or lazy 8’s simultaneously on the left and right sides of a paper taped to the wall or on a chalkboard using a pencil or chalk in the hand on each side
    • Clapping games or games that tap knees and ankles on the opposite sides of the body
    • Tracing the non-dominant hand with the dominant
    • Drawing or coloring with the preferred hand.  The performance of this activity on a vertical surface will further enhance balance and visual attention.
    • Stacking blocks with the preferred hand
    • Activities that include stencils, rulers, or rubbing motions over textures using the dominant hand with the pencil or crayon and the other hand to stabilize the stencil, ruler, or paper.
    • Molding clay or putty using the dominant hand to pull and mold while the other stabilizes the clay or putty
    • Beading, lacing, and interlocking toys using the dominant hand to thread or position the interlocking toy while the other hand stabilizes the string, board, or opposite toy part.
    • Cutting and pasting using the dominant hand to perform the task and the other to stabilize the paper.
    • Construction activities with blocks, hammers, or screwdrivers using the dominant hand to perform and the other to stabilize during the task.
  • Opening containers using the preferred hand to turn or pull open the lid while the other hand stabilizes the container.

Academic activities.

  • Whole body writing (making large movements using the dominant hand) promotes the use of the dominant hand as well as the enhancement of motor movement planning skills.
  • Activities that include non-traditional materials such as finger paints, shaving cream, sand trays, or writing with water on the chalkboard or a piece of paper taped to the wall provide increased tactile input to promote the use of the dominant hand as well as the enhancement of motor movement skills.
  • Create letter formations by shaping them out of pipe cleaners or other tactile tools to promote the use of the dominant hand.
  • Writing or practicing letter formations with a pencil on a piece of paper over fine-grade sandpaper using the dominant hand for tool use and the non-dominant to stabilize the paper provides additional tactile input to promote the use of the dominant hand.
  • Tracing letter formations on a vertical surface using the dominant hand while the other hand positions and supports the paper also enhances visual attention skills.

Children who have not established a dominant hand may also be working with inefficient body image and spatial awareness skills.  It is important to observe the child in a diverse array of activities and provide a variety of opportunities to engage in bilateral tasks in order to determine the underlying  developmental skill needs.

Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine

Katherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and remediation of handwriting skills. In her current book, Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists, she shares a comprehensive guide and consistent tool for addressing handwriting development needs. She can be contacted via her website, Handwriting With Katherine.

Collmer Handwriting Development Assessment and Remediation

Photos are the property of the  photographers at Pixabay or Royalty-Free/Corbis where indicated.    Their use should include the link or copyright provided with the pictures.

Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.

References:

  1. Yancosek, Kathleen E., and David R. Mullineaux. “Stability of Handwriting Performance following Injury-induced Hand-dominance Transfer in Adults: A Pilot Study.” The Journal of Rehabilitation Research and Development JRRD 48.1 (2011): 59. Web. 28 Oct. 2015.
  2. “Texas Child Care: Back Issues.” Texas Child Care: Back Issues. Texas Child Care Quarterly, n.d. Web. 30 Oct. 2015. <http://www.childcarequarterly.com/spring07_story3.html>.
  3. “Occupational Therapy for Children.” Occupational Therapy for Children. Occupational Therapy for Children, 08 Sept. 2015. Web. 30 Oct. 2015. <http://www.occupationaltherapychildren.com.au/blog/dominance-hand-dominance/>.

Crossing the Midline – an important handwriting skill

Crossing the Midline

by Katherine J. Collmer, M.Ed., OTR/L

on The Handwriting is Fun! Blog

 

baseball ruthclark pixabayChildren who experience difficulty with the mastery of handwriting skills are often struggling with crossing their body midline.   During the performance of handwriting tasks, the arm, hand, and eyes travel from the writer’s left side to his right, crossing the body’s center many times.  Letter formations also rely upon the writer’s ability to cross from left to right to cross a “t” or produce an “x.”  A developmental skill need that limits the fluid movement across midline prevents a child from mastering the basic facets of handwriting mastery.

 

What is Crossing the Midline?

Crossing the midline is a bilateral skill demonstrated by the ability to spontaneously move one hand, foot, or eye into the space of the other hand, foot, or eye.  This happens when we sit cross-legged on the floor, scratch our elbow, read or write from left to right, draw a horizontal line from one side of the paper to the other, or connect intersecting lines to draw a cross without switching hands.  Crossing the midline is a coordinated movement that is developed as a child experiences activities that include cross-lateral motions, such as reaching across the body to retrieve a toy.  These movements help to build pathways in the brain that facilitate the development of various motor and cognitive skills involved in completing self-care tasks, participating in sports, reading, and writing.

Crossing the midline is an integral skill related to bilateral coordination.  Bilateral coordination is defined as the ability to use both sides of the body together in a coordinated, controlled, and organized manner during tasks that require the use of one hand to stabilize and the other to perform simultaneously.   These activities include crawling or climbing stairs, catching or throwing a ball, manipulating clothing fasteners, tying shoes, stringing beads, cutting, and handwriting.  In addition to the foundational skills of eye-hand coordination and muscular strength, the development of bilateral coordination is dependent upon an accurate body awareness.  This perceptual skill represents the ability to know where the body and its parts are positioned in space without using vision allowing for the spontaneous and efficient completion of tasks.  The development of bilateral coordination indicates that both sides of the brain are communicating effectively in the sharing of information.  The development of a “helper” and a “worker” hand to facilitate bilateral movements is a sign that the brain is maturating and that brain lateralization is occurring.  The lateralization process is strongly correlated with the ability to cross midline.

Brain lateralization is defined by the ongoing process that is thought to begin in the prenatal period and continue throughout early childhood. The brain OpenClipartVectors pixabaycerebrum consists of two hemispheres (or halves) that specialize in different functions which control different areas of the body.  The left hemisphere controls the right side of the body and contains the centers for the understanding and use of language (listening, reading, speaking, and writing), memory for spoken and written language, analysis of information in detail, and motor control of the right side of the body.  The right hemisphere controls the motor movements of the left side of the body and contains the centers for processing visual-spatial information, comprehending and remembering things you see and do, and using pieces of information to form a complete picture.  The two halves are connected by a band of fibers called the corpus callosum which plays an important role in integrating their respective functions.  Lateralization becomes specialized to serve particular functions and involves a preference for using one hand or side of the body more than another.  Hand dominance is a result of brain lateralization.  (1, p. 176-7)

 

What are the behaviors that indicate difficulty with Bilateral Coordination and Crossing the Midline Skills?

Children who have difficulty with these skills may display decreased coordination and motor control, tend to avoid crossing their midline by using alternate hands for performing tasks on each side of their body, and have difficulty establishing hand dominance.  These children may appear to be ambidextrous because they use both hands alternately during and among tasks.  However, they may actually be doing that because they have two unskilled hands.  In addition, children who experience problems with crossing the midline can have difficulty with higher level skills such as reading and writing as they both involve left-to-right eye and hand movements.   This may be observed as stopping in the middle of the page to blink or rub their eyes, losing their place frequently during close work tasks, being unable to master letter formations that include diagonal lines, or stopping in the middle of the page to switch hands during handwriting assignments.  For children who have an inaccurate sense of body awareness, they may appear clumsy and cautious with movement especially when it involves having their feet of the ground.  They may seek or avoid deep sensory input or have difficulty coordinating both sides of their body to complete bilateral activities of daily living.  These behaviors also can result from inefficient eye-hand coordination and muscular strength.

 

What are some activities to promote the development of Crossing the Midline Skills?

The activities listed below are some examples of easy-to-implement tasks or games that will enhance the underlying skills that promote the development of crossing the midline skills.

 

obstacle course Hezsa pixabayFor younger children:

  • Obstacle course activities performed inside or outside that encourage crawling and climbing using verbal commands for directional concepts such as over and under, back and front, and up and down promote gross- and fine-motor muscle strengthening, the understanding of directional concepts, body awareness, and bilateral coordination skills.
  • Floor games such as bean bag toss or ball rolling can be designed to encourage crossing the midline by having children catch or stop the bean bag or ball on the sides of their body versus the middle (e.g., using the right hand to perform the task on the left and vice versa).   Have the child call out the side of his body where he has caught or stopped the object.  These activities encourage body awareness, balance skill development, and midline crossing as the child reaches with one or both hands across the body to perform the task and identifies the sides of his body.
  • Sitting or standing games such as bean bag toss can encourage the child to reach for and pick up an object on the opposite side of the body and throw it at a target on the reverse side (e.g., picking up a bean bag located on the left side with the right hand and then throwing it at a target on the right side and vice versa.)  Provide verbal directions to direct which hand the child will use or have him call out which hand he intends to use before he begins each toss.  This activity encourages balance, midline crossing, and visual attention skills.
  • Push and pull toys or activities that are performed at midline such as pop beads, connecting blocks, lacing, hand exercises (pushing palms together at chest level), or rolling putty into a long snake encourage bilateral coordination, crossing the midline, and upper extremity muscle strengthening skills.
  • Pretending to drive a car using a ball promotes midline crossing as the child holds the ball in both hands and turns it like a steering wheel by crossing his arms over each other as he drives. This can be adapted for children who have sufficient upper extremity strength by having them perform the activity without the ball.  This activity promotes upper extremity muscle strengthening, bilateral coordination, and crossing the midline skills.
  • Clapping and popping bubbles performed in either sitting or standing can encourage engagement in the left, center, and right space in front of the popping bubbles seomyungjuk pixabay-766535_1920child.  This activity promotes visual attention, bilateral coordination, midline crossing, and upper extremity muscle strengthening skills.
  • Keeping time to music by clapping hands, alternating clapping hands and patting knees, tapping sticks together, or marching in place promote crossing the midline skills.  These activities as well as playing games that include following directions such as Simons Says or Hokey Pokey promote balance, body awareness, bilateral coordination, and visual attention skills.
  • Batting a balloon back and forth in sitting or standing promotes balance, visual attention, and crossing the midline skills.
  • Upper extremity exercises performed in either sitting or standing can promote midline crossing skill development.  Exercises can include touching toes with the opposite hand, performing windmills above the head or windshield washers in front of the body (crossing arms back and forth over each other), tapping opposite shoulders with the hands, hugging the body, or swinging lowered arms back and forth slowly across and behind the body.  Provide verbal directions or have the child call out the directions for each hand or side being addressed.  These activities promote balance, body awareness, bilateral coordination, crossing the midline, visual attention, and upper extremity muscle strengthening skills.
  • Large arm movement activities in the air that cross from the child’s left side to his right side and reverse, such as drawing large crosses or figure 8’s (an 8 turned on its side or the infinity symbol) promote midline crossing development.   Activities that include practice for letter formation strokes (circle, up/down, or left/right strokes) can be adapted to address midline skills by first producing the letter on the left side, then in the middle, and finally on the right side using the child’s preferred hand.  Large arm movements in the air promote balance, upper extremity muscle strengthening, bilateral coordination, and midline crossing skills as well as visualization skills for automatic motor memory patterns.
  • Lazy 8s 1296Large movement activities performed on the floor on a large piece of paper or on a sidewalk can encourage crossing the midline.  Have the child trace large crosses or figure 8’s (drawn on their side) using different colors of chalk to create rainbow tracings, drive a toy car through a figure eight driveway, or complete a large simple maze with chalk or colored pencils.  These activities promote visual attention, bilateral coordination, and crossing the midline skills as well as upper extremity muscle strengthening with crawling and movement on all four’s.  The use of chalk provides tactile input to promote handedness and writing/drawing tool control.
  • Tracing activities on a vertical surface that use large arm movements that cross from the child’s left side to his right side and reverse, such as drawing large crosses or figure 8’s (drawn on their side), driving a small car through a roadway system, completing a simple maze, or drawing lines on which to practice letter strokes. These activities promote bilateral coordination and crossing the midline skills.  In addition, activities that are performed on a vertical surface promote upper extremity muscle strengthening and visual attention skills.

 

For older children:  While some of the activities listed below were also listed for younger children, they can be enhanced for the older ones by increasing the challenges with time or speed elements or the inclusion of academic tasks.

  • Large arm movement activities in the air that cross from the child’s left side to his right side and reverse, such as drawing large crosses or figure 8’s (an 8 turned on its side or the infinity symbol) promote midline crossing skills.  This activity can include practicing letter formations or spelling words in the air using his preferred hand, first on the left side, then in the middle, and finally on the right side.  Large arm movements in the air promote upper extremity muscle strengthening, bilateral coordination, midline crossing skill as well as visualization skills for automatic motor memory patterns.
  • Large movement activities that combine arm and leg movements such as drawing or writing on a large piece of paper or a sidewalk promote crossing the body midline.  Have the child trace large crosses or figure 8’s using different colors of chalk to create rainbow tracings, use a pencil to “drive” through a figure 8 pathway, copy a drawing, or complete a large maze with chalk or colored pencils.  These activities promote visual attention, bilateral coordination, and crossing the midline skills as well as upper extremity muscle strength with crawling and movement on all four’s.  The use of chalk provides tactile input to promote handedness and writing/drawing tool control.
  • Tracing activities on a vertical surface that provide large arm movements that cross from the child’s left side to his right side promotes midline crossing.  These activities can include copying a drawing, completing an age-appropriate maze or word search, or drawing lines on which to practice spelling words.  These activities promote bilateral coordination as well.  In addition, activities that are performed on a vertical surface promote upper extremity muscle strengthening and visual attention skills.
  • Keeping time to music by clapping hands, alternating clapping hands and patting knees, tapping sticks together, or marching in place promote playing ball clip art clkerFreeVectorImages Pixabaybalance, body awareness, bilateral coordination, and visual attention skills.
  • Batting a balloon back and forth in sitting or standing promotes balance, visual attention, and crossing the midline skills.  Using a balloon instead of a ball increases the challenge and enhances the development of these skills.  Adding a verbal task such as reciting the alphabet or answering questions further increases the activity’s challenge.
  • Upper extremity exercises performed in sitting or standing can include touching toes with the opposite hand, crossing the right hand to touch the raised left knee and alternating sides in a rhythmic fashion, jumping jacks, or running in place with exaggerated arm movements.   These activities promote balance, body awareness, bilateral coordination, crossing the midline, visual attention, and upper extremity muscle strengthening skills.  Adding small, light weights or a verbal task, such as reciting the directions aloud during the task will further enhance development of visual attention, crossing the midline, and bilateral coordination skills.
  • Ball toss, catch, or kick games in standing or sitting promote visual attention, body awareness, balance, midline crossing, and upper extremity strengthening skills.
  • Construction toys and crafts that encourage the use of two hands to construct a product promote bilateral coordination, crossing the midline, fine motor strengthening, and visual attention skills.
  • Board or card games such as strategy games or solitaire can encourage visual scanning from left-to-right. These activities, as well as most board or card games, promote visual attention, bilateral coordination, and crossing the midline skills.
  • Mazes, word search, hidden picture, and tangrams performed on a vertical or horizontal surface promote visual attention and crossing the midline skills.  Activities performed on a vertical surface promote upper extremity strengthening skills.
  • Yoga postures. These activities promote body awareness, balance, bilateral coordination, crossing the midline, visual attention, and muscle strengthening skills.
  • Playing sports or tug-of-war.  These activities promote balance, visual attention, bilateral coordination, crossing the midline, and muscle strengthening skills.

 

Crossing the midline skills are developmental and should appear by the age of 3-4 years.  This article is meant to provide information about its development and the symptoms that indicate a need in this area.  If you find that your child has not achieved this milestone by the age of 4, it would be wise to consult with his or her pediatrician to determine if there is an actual need that would benefit from intervention.

 

(Blog edited May 2018.)

The Handwriting is Fun! Blog is published by and is the property of Handwriting With Katherine.

 

Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine

Katherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and remediation of handwriting skills. In her current book, Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists, she shares a comprehensive guide and consistent tool for addressing handwriting development needs. She can be contacted via her website, Handwriting With Katherine.

Collmer Handwriting Development Assessment and Remediation

http://www.handwritingwithkatherine.com/handwriting-development-assessment-and-remediation-book.html

 

 

 

The Handwriting is Fun! Blog is published by and is the property of Handwriting With Katherine.

 

Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine

Katherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and remediation of handwriting skills. In her current book, Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists, she shares a comprehensive guide and consistent tool for addressing handwriting development needs. She can be contacted via her website, Handwriting With Katherine.

Collmer Handwriting Development Assessment and Remediation

http://www.handwritingwithkatherine.com/handwriting-development-assessment-and-remediation-book.html

 

 

 

 

Photos are the property of the  photographers at Pixabay where indicated.    Their use should include the link provided with the pictures.  All other photographs are property of the author and are not to be used without her written permission.

Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.

 

 

References:
  1. Shaffer, David R., and Katherine Kipp. Developmental Psychology: Childhood and Adolescence. 9th ed. Belmont, CA: Wadsworth, 2013. Print.
  2. Edwards, Marissa, M.S., OTR/L. “Help Your Child Develop the “Crossing the Midline” Skill.” Nspt4kids.com. North Shore Pediatric Therapy, 18 Apr. 2011. Web. 28 Oct. 2015. <http://nspt4kids.com/parenting/help-your-child-develop-the-crossing-the-midline-skill/>.
  3. “What Is Brain Lateralization?” Nspt4kids.com. North Shore Pediatric Therapy, n.d. Web. 28 Oct. 2015. <http://nspt4kids.com/healthtopics-and-conditions-database/brain-lateralization/>.

 

Dyspraxia: Is it the hidden handicap?

Dyspraxia:  Is it the hidden handicap?

by Katherine J. Collmer, M.Ed., OTR/L

Dyspraxia, most concisely described, is a learning difficulty that “possesses the most interesting ‘melting pot’ mix of physical and mental characteristics.” (Patrick 2015 p. 11)  Once called a “disorder of sensory integration by Jean Ayes in 1972 and then labeled as “Clumsy Child Syndrome” in 1975, dyspraxia continues to be a confusing condition to classify.   The terms “Dyspraxia” and “Developmental Coordination Disorder” are commonly used interchangeably, however, it is felt by some professionals that they are not the same condition.  Dyspraxia is defined by the Dyspraxia Foundation USA as “a neurological disorder throughout the brain” that often comes with a variety of comorbidities, the most common [of these being] Developmental Co-ordination Disorder (also known as DCD). (“1 in 10 Odds”)  The UK branch further explains that “while DCD is often regarded as an umbrella term to cover motor coordination difficulties, dyspraxia refers to those people who have additional problems planning, organising and carrying out movements in the right order in everyday situations” and can also experience difficulties with “articulation and speech, perception and thought.” (“What is Dyspraxia,” Section “What is Dyspraxia?”)   Alison Patrick, in her book “The Dyspraxic Learner,” stresses that “the significant role that the mind plays in this condition cannot be underestimated.” (Patrick 2015 p. 17)

Developmental Dyspraxia, the term more commonly used to describe the developmental problems observed in children who are clumsy, describes the condition as “a failure to learn or perform voluntary motor activities despite adequate strength, sensation, attention, and volition (Missiuna & Polatajko, p. 620)”  It is felt that the term was chosen as a result of the belief that a link existed between apraxia and dyspraxia.  Due to the lack of empirical data that shows a causative link between apraxia – the condition that involves “the loss of ability to perform previously acquired movements” most commonly observed in adults who have experienced a cerebrovascular accident resulting in brain damage – and the problems of children who have the symptoms described above, the condition is often labeled simply as “Dyspraxia.” (Missiuna & Polatajko 1995 p. 620)  The roots of this confusion over labelling stem from two facts:  first, that there is no internationally agreed upon definition for the term “dyspraxia” and second, that the DSM-V does not list it among diagnosable conditions.  Instead, it is felt that dyspraxia would most suitably fall under the new reclassification of “Neurodevelopmental Disorders-Motor,” as some consider it a developmental coordination disorder (“Highlights of Changes”).  Steinman, et. al. make a further distinction that developmental dyspraxia should be considered in terms of praxis “rather than a diagnostic label” and referred to instead as “a specific neurologic sign of impaired execution of skilled learned movements. (p. 5)”  The authors stress that it can exist in children who demonstrate no other signs of neurological impairments, as well as in conjunction with other neurodevelopmental disorders such as autism and language disorders.  After all the discussions have been heard, it is not difficult to imagine a more fitting label than “the hidden handicap.” (Udoh & Okoro 2013, Kirby 1999)

It is difficult to estimate exactly how many children are affected by DCD/Dyspraxia due to the lack of an official diagnosis and consistent use of behavioral information to identify them.   However, 2009 study results out of the UK “suggested that up to one in every 20 children between seven and eight years of age may be affected by the condition to some degree.  It is felt that the disorder occurs three or four times more in boys than girls and that the condition “sometimes runs in families.”  (Developmental Co-ordination, Section “Who is affected).

Despite the confusion, understanding developmental dyspraxia remains an important concern for occupational therapists who are often presented with referrals for children who have handwriting difficulties, problems with self-care management, and social isolation that results from their clumsiness and uncoordinated behaviors (Missiuna & Polatajko 1995).  Without a clear definition for dyspraxia nor a diagnosis that outlines the symptoms associated with it, our assessment will be based upon our knowledge of the condition itself.  Children who present with these school-, home-, and socially based needs will appear physically capable, will not have intellectual needs, and often will not have any identifiable disease or medical condition.  Since dyspraxia is a developmental condition, it can present itself in the early years as children meet the prescribed developmental gross-motor milestones late and experience difficulty with fine-motor activities of daily living, such as tying their shoes or fastening buttons, very much like developmental coordination disorder.  From an occupational therapy standpoint, then, dyspraxia and the behaviors associated with it must be differentiated from those same behaviors that exist with a motor coordination condition.  Dyspraxia, in our practice area, is not viewed as a primary problem in motor coordination and the child must present with difficulties with ideation and planning to be regarded as dyspraxic from our point of view. (9)  Rather than be the result of a problem with motor execution, dyspraxic behaviors are felt to be a difficulty in formulating a plan of action, the problem presenting itself as the inability to efficiently plan and carry out skilled non-habitual motor acts in the correct sequence.   Although children with dyspraxia may have difficulty learning a new task, once they are able to master the skills that it demands, they can use those skills to repeat the task.  (9)  Their ability to use their skill development in the mastery of other similar activities is limited, however, as they are not able to effectively plan and execute new motor actions or generalize motor actions in a new situation.  (9)  From an occupational therapy standpoint, the child with dyspraxia will present with the following behaviors (10) that can be fall into four categories: (7)

Dyspraxic Behaviors Chart
Dyspraxic Behaviors

Categories of Dyspraxia

The appearance of “clumsiness” stems from their difficulty in transitioning from one body position to another, their poor discrimination of tactile input, an overall difficulty in relating their bodies to physical objects and space, and challenges with imitating actions or perceiving the direction of movement.  They are slower to develop both gross- and fine-motor skills and are often referred to occupational therapy for these reasons, particularly handwriting.  They may tend to prefer talking rather than performing and will often avoid new tasks altogether.  Their social behaviors result from their becoming frustrated with new situations because they are unable to approach these activities in an organized manner. The culmination of these symptoms and behaviors can be low self-esteem or self-concept.  (9)

Patten, in her newsletter article, “Dyspraxia from an Occupational Therapy Perspective,” suggests a battery of standardized assessments that will assist in the assessment process.  Goodgold-Edwards and Cermak, (10) stress that we must also have an understanding of the motor, sensory integrative, and cognitive and conceptual components of movement as we observe the children in both standardized testing environments and the performance of everyday activities.  Treatment strategies we select can include sensory integrative, perceptual motor, sensorimotor, cognitive goal-directed, and compensatory skill development approaches. (9)  These will most likely be combined in a remedial plan that addresses each child’s individual needs and will include skill areas such as rule learning as it applies to motor planning and motor learning; planning for managing movements as they occur that include goal-directed activities with performance expectations; the use of tasks that have a clear, functional identification within the practicing environment; the inclusion of cognitive strategies that allow for the child’s learning abilities and styles; and, perhaps most importantly, will be fun as well as challenging.  (10)  Of course, the complex nature of dyspraxia and the multiple needs that a child may experience will necessitate the development of a team approach. (7)

The implications of dyspraxic behaviors for the school-based occupational therapist are that we must consider the “whole child” in our development of a remedial plan or recommendations for adaptations.  Although the child may have been referred to therapy because of handwriting difficulties, it is vital that we look below the surface and develop the overall picture of his behaviors, from home, to school, to the playground, and the community.  With or without an official diagnosis, dyspraxia exists and will continue to present itself in our therapy rooms and clinics.

Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine

occupational therapist who specializes in the assessment and remediation of handwriting skills. In her current book, Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists, she shares a comprehensive guide and consistent tool for addressing handwriting development needs. She can be contacted via her website, Handwriting With Katherine.

Collmer Handwriting Development Assessment and Remediation

 
 
 
 
 Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.
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  1. Patrick, Alison. “Introduction and Chapters 1 and 2.” The Dyspraxic Learner: Strategies for Success. 2015 ed. London: Jessica Kingsley Pub., 2015. 11-54. Print.
  2. “1 in 10 Odds Are That You Know Someone With Dyspraxia.” Dyspraxia Foundation USA. Dyspraxia Foundation USA, n.d. Web. 08 Oct. 2015. <http://www.dyspraxiausa.org/>.
  3. “What is Dyspraxia?” Dyspraxia Foundation.org.uk. Dyspraxia Foundation UK, n.d. Web. 8 Oct. 2015. <https://www.dyspraxiafoundation.org.uk/about-dyspraxia/>.
  4. Missiuna, C., and H. Polatajko. “Developmental Dyspraxia by Any Other Name: Are They All Just Clumsy Children?” American Journal of Occupational Therapy 49.7 (1995): 619-27. Web. 8 Oct. 2015.
  5. “Highlights of Changes From DSM-IV to DSM-5.” Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (2013): n. pag. DSM5.org. American Psychiatric Publishing. Web. 8 Oct. 2015. <http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf>.
  6. Steinman, K. J., S. H. Mostofsky, and M. B. Denckla. “Toward a Narrower, More Pragmatic View of Developmental Dyspraxia.” Journal of Child Neurology 25.1 (2009): 71-81. Web. 8 Oct. 2015.
  7. Udoh, Nsisong A., and Cornelius C. Okoro. “Developmental Dyspraxia—Implications for the Child, Family and School.” International Journal of Academic Research in Progressive Education and Development IJARPED 2.4 (2013): 200-14. Web. 9 Oct. 2015.Caroline Lacey. London:
  8. Caroline Lacey, 1997. Ludlowlearning.com. OAASIS, Cambian Education Services. Web. 8 Oct. 2015. <http://www.ludlowlearning.com/downloads-icpa/Oaasis-Dyspraxia.pdf>. OAASIS website: www.oaasis.co.uk Cambian Education Services website: cambianeducation.com
  9. Patten, Natasha, Bcc OT. Dyspraxia from an Occupational Therapy Perspective (n.d.): n. pag. Dyspraxia Foundation.org.uk. Dyspraxia Foundation UK. Web. 8 Oct. 2015. <http://dyspraxiafoundation.org.uk/wp-content/uploads/2013/10/dyspraxia_and_Occupational_Therapy.pdf>.
  10. Goodgold-Edwards, S. A., and S. A. Cermak. “Integrating Motor Control and Motor Learning Concepts With Neuropsychological Perspectives on Apraxia and Developmental Dyspraxia.” American Journal of Occupational Therapy 44.5 (1990): 431-39. Web. 8 Oct. 2015.
  11. Kirby, Amanda. Dyspraxia: The Hidden Handicap. 2002 ed. London: Souvenir, 1999. Print.
  12. “Developmental Co-ordination Disorder (dyspraxia) in Children .” NHS Choices. National Health Services UK, n.d. Web. 09 Oct. 2015. <http://www.nhs.uk/Conditions/Dyspraxia-(childhood)/Pages/Introduction.aspx>.
 
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