Handwriting and other fine motor tasks demand strength in the core body muscles to provide stability to the upper body and head so that the hands and fingers can engage with the eyes in the performance of precision tasks. An efficient analysis of handwriting development skills and the development of an effective remediation plan to address handwriting needs should begin with the assessment of the writer’s seating arrangements. Chair and desk sizes and heights are critical measurements that can provide the most basic and fundamental information about handwriting performance: How is the seating supporting or hindering handwriting success. In my book, Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists, I discuss this topic in detail. In my post, “5 Reasons Why Handwriting Needs a Good Seat,” I share guidelines that can assist in the assessment of seating, as well as adaptations that can provide stability for your young writer.
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 understands the link between handwriting skills and writing. 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.
Well, folks, today is the big day! My new work, Handwriting Assessment and Remediation: A Practice Model for Occupational Therapists, will be officially launched at the #AOTA16 Convention in Chicago! I am honored to have worked with Universal Publishing toward sharing my book with you and look forward to chatting with my peers at Booth #5015 in the Expo Hall! This is a very exciting time for me and, as always, I think you for reading and sharing my work.
If you could not make it to the convention this year, you can still pre-order my book by clicking on the picture below!
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 understands the link between handwriting skills and writing. She can be contacted via her website, Handwriting With Katherine.
I’ll be boarding the plane bright and early today heading for Chicago and the 2016 AOTA Convention! This will be a very exciting journey for me as I share my new book with my peers. It will be an honor to discuss handwriting assessment and remediation and chat about the concerns and challenges we have all faced in this area of occupational therapy. I look forward to meeting many of you at the Universal Publishing Booth #5015. Please join me there!
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 understands the link between handwriting skills and writing. She can be contacted via her website, Handwriting With Katherine.
My new book, The Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists, will be offered for the first time in Chicago at the 2016 AOTA Conference. It’s very exciting to be sharing my work with my peers! But, I know that many of you will not be able to attend the conference, so I wanted to let you know that the book will be offered through a link here and on my website after the conference. Please look for it! And, as always, thank you for reading and sharing my work.
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 understands the link between handwriting skills and writing. She can be contacted via her website, Handwriting With Katherine.
Hand Dominance – a key factor in handwriting success
by Katherine J. Collmer, M.Ed., OTR/L
Hand 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
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.
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).
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.
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:
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.
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.
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.
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.
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
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:
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.
“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>.
“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/>.
Handwriting mastery has been determined to be a leading factor in literacy. Research has proven that early handwriting instruction, if done right, improves students’ handwriting and that poor handwriting skills place the earliest constraints on writing development. (1) Writing* instruction, and its favorable effect on improving reading fluency, has been given the rating of “strong confidence” among research experts. (2) This is significant in the light that reading skills lie “at the heart of education,” with learning to read and write providing the foundation for both academic and economic success. (3) Such as that is, handwriting mastery continues to remain a skill that 10%-34% of school-age children continue to fail to achieve, (4, qtd. in 5) with handwriting problems being prevalent in up to 25% of typically developing children. (6) That may explain why results from a survey of 167 occupational therapists revealed that 98% reported problems with handwriting to be the most common reasons for referrals from teachers. (7, 8)
Handwriting is a complex skill that involves sensory, perceptual, motor, cognitive, and language functions and encompasses many layers of prerequisite skills. These include the ability to
balance without use of the hands,
grasp and release an object voluntarily,
use of the hands in a led-and-assist fashion,
interact with the environment in the stage of constructive play,
hold utensils and writing tools and to form basic strokes smoothly, and
perceive letter and orientation to printed language. (9)
It is the role of the occupational therapist to evaluate these underlying skill areas to determine the student’s strengths and weaknesses and to develop a remedial treatment plan to address those needs that are preventing him from achieving handwriting mastery. Among the ergonomic mechanisms that affect the production of handwriting are body positioning, pencil positioning, pencil grip positioning, and pencil grip type. (10) Each of these factors has been considered to be a significant factor in determining handwriting mastery and, hence, an assessment of each has been included in the traditional occupational therapy evaluation of handwriting development skills. Pencil grip efficiency has been the long-established benchmark for “good handwriting,” with the dynamic tripod grasp encouraged by teachers and occupational therapists. Therefore, when a student fails to achieve that level of mastery, his pencil grip is the first factor that gains attention and at times claims the lion’s share of time, energy, and resources. If he is not using the “optimal” pencil grasp, then changes are implemented. Pencil grip adaptations can be easily and inexpensively obtained and sent into the classroom or to home as quick remedies for illegible and incorrect handwritten work. And hours of extra practice with a grip or a “better pencil grasp” are often prescribed as a plan to fix handwriting problems. But, is the pencil grip the most advantageous aspect to review when a student presents with a poor handwriting style? Should that be the first place to start when he is referred to us for services or the teacher asks us to suggest classroom adaptations? Does pencil grasp, or the dynamic tripod grasp in particular, have a major impact on handwriting mastery?
Not according to the research. In fact, research suggests that 50% – 70% of children in a given sample use the dynamic tripod grasp (11), with more than half of second grade children surveyed using the dynamic quadrupod grasp. (12, qtd in 13). The results of a study conducted with 4th grade students determined that there were four mature handwriting grasps that were equally functional for children of that age:
Dynamic Tripod
Dynamic Quadrupod
Lateral Tripod
Lateral Quadrupod. (14)
Most importantly, the researchers also found that “no relationship was found between grasp and handwriting legibility or sped when children used of the mature grasp patterns” (Collmer, p. 29) below:
Grasp Patterns for Functional Writing. Adapted from “Effect of pencil grasp on the speed and legibility of handwriting after a 10-minute copy task in Grade 4 children,” by H. Schwellnus et al. (2012). Australian Occupational Therapy Journal, 59(3), 180-187. (PHOTO PROPERTY OF COLLMER, K., REF. 18)
In another study conducted to discover the “Effect of Pencil Grasp on the Speed and Legibility of Handwriting in Children,” (15) it was found that although the fourth-grade participants utilized the dynamic tripod and lateral quadruped grasping patterns equally, they also displayed the use of the other two mature grasps identified in the study above. In addition, this study found that 20% of the participants switched grasp patterns during the writing, with an equal percentage switching between the dynamic and lateral tripod and between the dynamic and lateral quadrupod. Analysis of the results indicted that grasping patterns did not have an effect on legibility or speed. This study used a 2-minute writing task for assessment. The authors of the study indicated that alternating between two grasping patterns with the thumb position switching from opposition to adduction across the top of the pencil may indicate the need to cope with pain or discomfort during a longer-writing task. This would presume to result in a slower writing speed accompanied with periods of rest. However, in an additional study of fourth graders who participated in a 10-minute writing task, it was found that while the quality of the legibility of the handwriting decreased after the copy task, the speed of writing actually increased. After analyzing the results, the researchers concluded that there was no difference in the quality or speed scores among the different pencil grasps before and after the task and questioned the practice of having students adopt the dynamic tripod grasp. (13)
Photo is property of Handwriting With Katherine.
Although 40% of teachers surveyed identified “uncorrect” pencil grasp as a common handwriting difficulty” (16 qtd in 13), researchers found that pencil grasp played a significantly less role then is perceived in a child’s ability to master handwritten tasks. Instead, it was revealed that body positioning, pencil positioning, and consistency of pencil grip presented a significantly higher correlation with the measure of handwriting efficiency – legibility and speed. (10) The implication of the findings of these studies for pediatric occupational therapy is that we must look beyond the seemingly obvious and traditionally accepted cause for handwriting problems. Handwriting development skills can lie deeper than pencil grasp and their needs can be uncovered only with an assessment that targets them.
* Handwriting vs Writing: Handwriting is the process through which the writer uses his hand to produce letters, words, and sentences on the page in order to create, whereas writing is the skill that “enables him to express his knowledge and thoughts.” (Clark, Gloria Jean, “The relationship between handwriting, reading, fine motor and visual-motor skills in kindergarteners” (2010). Graduate Thesis and Dissertations. Paper 11399. p. 1)
Katherine J. Collmer, M.Ed., OTR/L, owner, Handwriting With Katherine
Photos are the property of Handwriting With Katherine and are not to be used in any fashion except as links to the appropriate blog or the Handwriting With Katherine website without the expressed, written permission of Katherine Collmer. Photos that include links to an outside site are the property of those sites and should not be used in any fashion excepts when they include links to those sites.
References:
Graham, Steve. “Want to Improve Children’s Writing? Don’t Neglect Their Handwriting.” American Educator Winter.2009-2010 (n.d.): 20-25. Web. 26 June 2015.
Graham, Steve, and Michael Hebert. “Writing to Read: A Meta-Analysis of the Impact of Writing and Writing Instruction on Reading.” Harvard Educational Review 81.4 (2011): 710-44. Web. 7 Oct. 2015.
Gentry, J. Richard, Ph.D., and Steve Graham, Ed.D. Creating Better Readers and Writers: The Importance of Direct, Systematic Spelling and Handwriting Instruction in Improving Academic Performance. Saperstein Associates. Saperstein Associates, 2010. Web. 24 June 2015. <http://www.sapersteinassociates.com/downloads/Color%20National%20Whitepaper%20Executive%20Summary.pdf>.
Smits-Engelsman, B.c.m., A.s. Niemeijer, and G.p. Van Galen. “Fine Motor Deficiencies in Children Diagnosed as DCD Based on Poor Grapho-motor Ability.” Human Movement Science 20.1-2 (2001): 161-82. Web. 7 Oct. 2015.
Schwellnus, Heidi, PhD, Heather Carnahan, PhD, Azadeh Kushki, PhD, Helene Polatajko, PhD, Cheryl Missiuna, PhD, and Tom Chau, PhD. “Effect of Pencil Grasp on the Speed and Legibility of Handwriting in Children.” The American Journal of Occupational Therapy 66.6 (2012): 718-26. Web. 11 July 2015.
vanderMerwe, Joanne, BScOT, M OT, Neeltje Smit, B OT, B Hons OT, MBA, and Betsie Vlok, M OT. “A Survey to Investigate How South African Occupational Therapists in Private Practice Are Assessing and Treating Poor Handwriting in Foundation Phase Learners: Part I Demographics and Assessment Practices.” South African Journal of Occupational Therapy December 41.3 (2011): 3-11. South African Journal of Occupational Therapy. Web. 7 Oct. 2015. <http://www.sajot.co.za>.
Case-Smith, J., (2002). Effectiveness of school-based occupational therapy intervention on handwriting. American Journal of Occupational Therapy, 56, 17-25.
Hammerschmidt, S. L., and P. Sudsawad. “Teachers’ Survey on Problems With Handwriting: Referral, Evaluation, and Outcomes.” American Journal of Occupational Therapy 58.2 (2004): 185-92. Web. 15 Aug. 2015.
Chu, S. “Occupational Therapy for Children with Handwriting Difficulties: A Framework for Evaluation and Treatment.” The British Journal of Occupational Therapy 60.12 (1997): 514-20. Web. 5 Oct. 2015.
Rosenblum, S., S. Goldstand, and S. Parush. “Relationships Among Biomechanical Ergonomic Factors, Handwriting Product Quality, Handwriting Efficiency, and Computerized Handwriting Process Measures in Children With and Without Handwriting Difficulties.” American Journal of Occupational Therapy 60.1 (2006): 28-39. Web.
Zivani, Jenny, and Margaret Wallen. “The Development of Graphomotor Skills.” Hand Function in the Child: Foundations for Remediation. 2006 ed. St. Louis, MO: Mosby/Elsevier, 2006. 217-36. Print.
Benbow, M. (1987). Sensory and motor measurements of dynamic tripod skill. Unpublished Thesis, Boston University.
Schwellnus, Heidi D. “Pencil Grasp Pattern: How Critical Is It to Functional Handwriting?” Thesis. University of Toronto, 2012. Print.
Koziatek, S. M., and N. J. Powell. “Pencil Grips, Legibility, and Speed of Fourth-Graders’ Writing in Cursive.” American Journal of Occupational Therapy 57.3 (2003): 284-88. Web. 7 Oct. 2015.
Schwellnus, Heidi, PhD, Heather Carnahan, PhD, Azadeh Kushki, PhD, Helene Polatajko, PhD, Cheryl Missiuna, PhD, and Tom Chau, PhD. “Effect of Pencil Grasp on the Speed and Legibility of Handwriting in Children.” The American Journal of Occupational Therapy 66.6 (2012): 718-26. Web. 11 July 2015.
Graham, S., Harris, K. R., Mason, L., Fink-Chorzempa, B., Moran, S., & Saddler, B. (2008). How do primary grade teachers teach handwriting? A national survey. Reading and Writing, 21(1), 49-69.
Sudsawad, P., C. A. Trombly, A. Henderson, and L. Tickle-Degnen. “The Relationship Between the Evaluation Tool of Children’s Handwriting and Teachers’ Perceptions of Handwriting Legibility.” American Journal of Occupational Therapy 55.5 (2001): 518-23. Web. 7 Oct. 2015.
Collmer, K. Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists. 2016 ed. Waymart, PA: Universal Publishing, 2016. Print.
This summer, I was honored and humbled by the thoughtfulness of eight inspiring and knowledgeable Occupational Therapists who so lovingly shared their time and expertise with my readers on the Handwriting is Fun! Blog. Their willingness to jump in and give me a hand when I needed it most won’t ever be forgotten, for sure.
Most importantly, however, their words of wisdom in the 10 blogs they shared will help so many readers for years to come.
In that light, I wanted to take a moment to thank them personally and to share their work with you once again. And, as always, thank you to my readers. You are the foundation upon which the success of the Handwriting is Fun! Blog is built.
Thank you so much
Spaghetti and Meatball Spacing by Jaime Spencer, MA, OTR/L, Miss Jaime OT
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 understands the link between handwriting skills and writing. She can be contacted via her website, Handwriting With Katherine.
Handwriting and Posture: Revisiting Good Seating
Handwriting mastery has been determined to be a leading factor in literacy. Research has proven that early handwriting instruction, if done right, improves students’ handwriting and that poor handwriting skills place the earliest constraints on writing development. (1) Writing* instruction, and its favorable effect on improving reading fluency, has been given the rating of “strong confidence” among research experts. (2) This is significant in the light that reading skills lie “at the heart of education,” with learning to read and write providing the foundation for both academic and economic success. (3) Such as that is, handwriting mastery continues to remain a skill that 10%-34% of school-age children continue to fail to achieve, (4, qtd. in 5) with handwriting problems being prevalent in up to 25% of typically developing children. (6) That may explain why results from a survey of 167 occupational therapists revealed that 98% reported problems with handwriting to be the most common reasons for referrals from teachers. (7, 8)
You must be logged in to post a comment.