MANAGING STUDENTS WITH
HANDWRITING
DIFFICULTIES
NUR THAQQIFAH MD SANI
OCCUPATIONAL THERAPIST U29
KLINIK KESIHATAN UJONG PASIR
Enhance client ability to engage in the
occupations they want to, need to, or are
expected to do, or by modifying the occupation or
the environment to better support their
occupational engagement.
Lets start with
BILATERAL MOTOR
INTEGRATION
ACTIVITIES
DRINKING WATER
Activates the brain for :
Efficient action between
the brain and the nervous
system
Efficient storage and
retrieval of information
BRAIN BUTTONS
Improves academic skills
such as :
Crossing the visual midline
for reading
The correction of letter and
number reversals
Consonant blending
Keeping ones place while
reading
CROSS CRAWL
Improves academic skills
such as :
Spelling
Writing
Listening reading and
comprehension
THINKING CAPS
Activates the brain for:
Short term working
memory
Silent speech and thinking
skills
Hearing with both ears
together
LAZY 8s
Improves academic
skills in:
Mechanics of reading
Decoding of written
language
Reading
comprehension
HOOK UPS
Improves academic skills
in:
Clear listening and
speaking
Test talking and similar
challenges
Work at keyboard
HOW DO YOU
FEELS ?
TEACHER
is primarily for handwriting instruction......
determine underlying postural, motor, sensory
integrative or perceptual deficits that might interfere
with the development of legible handwriting
THERAPIST
TEACHER
THERAPIST
+
When the teacher and the therapist work together,
combining medical and educational knowledge, the
result are often very POSITIVE in achieving legible
handwriting.
Example of handwriting difficulties:
C
1.
2.
3.
4.
5.
Lets experience it
By using your in-dominant hand, write
the sentence from the screen.
You have 5 minutes to complete the
task.
Pen & Paper
Most people do not realize that good
handwriting is a direct result from good upper
body strength. Crawling is a natural milestone
that children need to learn. Crawling develops
power in the shoulders, arms, wrists, and
hands. Have you heard or personally ever
stated My child skipped crawling and went
straight to walking! While walking skills may
be advancing quickly, it is also a good
indication that the child will have poor fine
motor skills-Wiggins.
How do you
feel?
What will you get
when your
student success?
video
STAGE 1
Students
readiness for
writing
CHECK YOUR
STUDENTS READINESS
1.Sitting Behavior
A good position at the table will help the child to be
stable and be able to concentrate and use their
hand effectively.
Arm forward
symmetrically
Feet flat on
the floor
Hip 90 degree
Knee flex 90 degree
Feet flat on the floor
Ankle 90 degree
Prevent foot hanging:
Provide a stool to rest feet
Important for all desk work!
CHECK YOUR
STUDENTS READINESS
2. Pincer Grip
Ability to grasp small objects with thumb and
forefinger. It is an important part of the childs fine
motor development and necessary for holding and
manipulating the pencil.
SUGGESTION
ACTIVITIES
Cloth peg open with tripod
pinch (thumb, index and
middle finger)
Pick up small object
with tripod pinch
Play with play
dough/ putty
CHECK YOUR
STUDENTS READINESS
3. Attention
A crucial step in learning process.
Find beads in the putty
Jigsaw puzzles
SUGGESTION
ACTIVITIES
Lacing beads
Sequencing alphabets/numbers foam
Question
Question
CHECK YOUR
STUDENTS READINESS
4. Eye Hand Coordination
Uses the eyes to direct attention and the hands to
execute a task.
SUGGESTION
ACTIVITIES
Nuts and bolts
Scissor
activities
Ball activities
Dot to dot
Mazes
CHECK YOUR
STUDENTS READINESS
5. Visual Perception
Ability to recognize forms, notice likeness and
differences
SUGGESTION
ACTIVITIES
Visual
Discrimination
Visual Form
Constancy
Visual Memory
Figure Ground
Visual Closure
Handwriting readiness can be developed
by:
Activities
to improve stability of proximal joint
Activities
to improve children's fine motor
control and isolated finger movements
Activities
to improve ability to hold writing tools
Activities
to enhance right-left discrimination
ACTIVITIES TO IMPROVE
STABILITY OF PROXIMAL JOINT
Games such as tug-of-war, wheelbarrow walking,
animal walks
Tug of war
Heavy work:
Pushing furniture, carrying
shopping bags, carrying chair,
etc
Scooter board
Wall/floor push up
Commando crawl
Tummy-lying on the floor
to color or do puzzles
Use the playground
equipment, such as the
climbers and monkey bars
ACTIVITIES TO IMPROVE
CHILDREN'S FINE MOTOR
CONTROL
AND ISOLATED FINGER
MOVEMENTS
Rolling tiny balls of clay or
therapy-putty between the tip
of the thumb and tips of the
index and middle fingers
Picking up small objects
with tweezers/
adapted chopsticks
Find hidden beads in putty
Lace beads with strings
Stretching rubber
band onto
cylindrical object
Tug of war with fingers
using coffee stirrer
and/or tongue depressor
TRY IT WITH YOUR PARTNER
ACTIVITIES TO IMPROVE
CHILDRENS ABILITY
TO HOLD WRITING
TOOLS
Linking chain
Pick up small objects
(toys, sweets etc.) with
thumb and first finger
rather than whole hand, or
thumb and middle finger
While doing pincer grip activities place a small object
(e.g. a rubber) in the childs palm to be held in place by
the middle, index and little finger. This will help with
pincer isolation i.e. only using thumb and first finger
Clothes pegs opened with the thumb and
index finger help to strengthen pincer grip
ACTIVITIES TO ENHANCE
RIGHT-LEFT
DISCRIMINATION
Lacing
activities
Screwing nuts and bolt
STAGE 2
Student will be able to
color using dominant
hand with proper
grasping pattern with
appropriate force.
Pencil Grasp:
Radial cross
palmar
Cross thumb
Palmar
supinate
Static tripod
Digital pronate,
only finger
extended
Four fingers
Brush
Lateral tripod
(Schneck & Henderson, 1990)
Grasp with
extended
fingers
Dynamic tripod
Colouring : Scribble
STAGE 1
Palmar grasp
Light pressure
Hand not leaning
on the table
Strategies / activities
Play dough/ putty
Play tennis ball
Fold paper
Tear the paper
Use crayon-down
flat
Manipulating
small objects
Colour on the
wall
Trace on the
sand
Colouring : Part by parts
Problem
Student colour the whole
picture as they do not
understand that they have to
colour part by parts yet.
BALLOON
S
Student has grasped the
understanding to colour part
by parts, but waiting for
teachers cue to proceed to
the next.(orientate skill not
establish yet).
BALLOON
S
Example of cues
To
emphasize
student to
colour
within line
BALLOO
Number cue
NS
BALLOO
Arrow
NS
BALLOO
Bold the balloon
NS
with
different
colour
COLOUR : Follow border line
STAGE 3
Student should be able
to do the pre-writing
task.
Pre-writing
Children needs to be able to draw prewriting shapes/lines before they are able
to form letters/numbers correctly.
Vertical line
Example of
pre-writing activity
Curve line
Circle
Horizontal line
slanting line
Pre-writing : Tracing steps
Step 1
Step 2
Step 3
Step 4
Cue fading
Starting
point
Pre-writing :
Tracing between 2 lines
Pre-writing :
Tracing between 2
lines
FREE
DRAWING
ACTIVITIES TO
PROMOTE
PREWRITING
SKILLS
Drawing lines and copying
shapes using shaving
cream, sand trays or finger
paints
Drawing and colouring
pictures of people,
houses, trees, cars or
animals
Tracing on simple
dot-to-dot
pictures/lines
Completing mazes
Tracing on lines or shapes using
buttons or any other tiny
objects
Tracing on lines or shapes
using stickers
Copy and construct blocks
according to cue cards to
encourage constructional skills
STAGE 4
Student should be able
to trace and write
alphabets and numbers
Letter formation:
The ability to make a letter on a page/paper using
eye-hand coordination, correct posture,
directionality, and visual motor memory.
STRATEGIES
Free
drawing
Tracing alphabets
(Capital letter)
Get faster result
in writing
alphabets
Letter formation :Tracing
Tracing steps:
Step 3
Step 1
Step 2
Step 4
Step 5
STAGE 5
Student should be able to
copy words and
sentences from ;
book ( up to down )
book ( copy from left or
right )
board ( into book )
Writing:
Copy one word
Copy two words
Copy three words
Copy 4-6 words
in 2 lines
3-4 letters
4-6 letters
Promote spacing
between words
Copy from the
book (up to
down, left or
right side) and
from the board
ASSESSMENT
Pre Academic skill assessment / School readiness
assessment
Pre-School Visual Motor Integration Assessment (PVMIA)
Miller Assessment for Preschooler
Minnesota Handwriting Assessment
Test of Handwriting Skills Revised
Miller Assessment for Preschooler
Shore Handwriting Assessment
Beery VMI
Assessment on Client Needs
Canadian Occupational Performance Measure(COPM)
(parents questionnaire)
QUESTION?
PRACTICAL SESSION
LAZY 8s
Pen & Paper
