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Q. Is handwriting really as important now that computers are so widely used?
A. Most educators feel that the keyboard has not totally replaced the pen. In fact, in addition to the practical purposes of handwritten signatures, we must realize that many new devices require entering information with a stylus.

Q. Is there a link between poor handwriting and lower academic grades?
A. Some studies have indicated that regardless of content, teachers are more likely to give lower grades when they have difficulty reading students' papers.

Q. Who is the appropriate professional to help children with handwriting problems?
A. The teaching of handwriting is truly a function of children's teachers. However, some children, usually by the third grade, have ongoing problems with letter formation, size and shape, letter/word spacing, alignment, and/or legibility. If extra help by the teacher does not result in improvement, occupational therapists are qualified to evaluate these children to determine if handwriting is the problem or actually the symptom of other issues (motor, perceptual, and/or organizational skills), which may require the intervention of others (physical therapists, psychologists, and/or optometrists).

Q. What foundation skills are required for handwriting?
A. Postural control, integrity of the shoulder joint for accurate arm and hand control, eye-hand coordination, and pencil grip are all important foundation skills for handwriting.
* Postural control depends on gross motor skills of alignment, muscle strength, and balance reactions.
* Shoulder girdle integrity normally develops during weight-bearing in the prone position in early infancy. When the Back to Sleep program to prevent Sudden Infant Death (SIDS) began, many parents became afraid to place their infants in prone even during waking hours.
* Eye-hand coordination requires (a) fine motor skills of dissociation, grading, timing, force, and spatial awareness (tool/surface), and (b) oculomotor skills of muscle control and visual perception.
* According to many researchers, pencil grip develops in a sequential pattern during the preschool years, but deviation from those expected patterns do not necessarily impact negatively on handwriting, evidence by the multitude of adults who use a variety of pencil grips efficiently.

Q. Should therapists try to change a child's pencil grip?
A. It depends on the child's age, motivation, and the product (manuscript) quality. The younger child who has not yet reached the automatic stage of learning to write may benefit from suggestions to use a more appropriate grip, which will then be accepted if it works more efficiently. The older child who has been using a certain grip for years may resist a new grip because it is not an automatic skill, thus interferes with his ability to focus on academic content. Logically, if the product quality is acceptable, there is no reason to change.

Q. What is the best approach for helping children with handwriting problems?
A. Because of the complex issues involved, most interventionists are drawn toward eclectic and multidisciplinary solutions, depending on children's needs, e.g. either or both direct (top-down, academic skill training) and indirect (bottom-up, sensorimotor training).

Q. What are the reasons for using both top-down and bottom-up approaches for children with handwriting problems?
A. Since many of these children appear disorganized in several aspects of their lives, they need imposed structure and guidance in planning each task cognitively (top-down), with that structure gradually reduced as they assume responsibility. They also need activities that allow for repetitive exploration to master missing sensorimotor developmental components (bottom-up).

Adapted from: Erhardt, R. P. & Meade, V. (2005). Handwriting: Anatomy of a collaborative assessment/intervention model. Stillwater, MN: PDP Press.

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* Hand Function

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