Sara Rosenblum

Product and Process Evaluation of Handwriting Difficulties

Handwriting is a complex human activity that entails an intricate blend of cognitive, kinesthetic, and perceptual-motor components. Children are expected to acquire a level of handwriting proficiency that enables them to make skillful use of handwriting as a tool to carry out their work at school. Poor handwriters have difficulty developing their writing skills and, as a result, often suffer in their educational and emotional development. This article highlights the importance of handwriting and reviews the development of methods used to evaluate handwriting difficulties. Included also is a discussion of methodological aspects of current handwriting evaluations and a presentation of research on the use of a computerized system that may be helpful in better understanding the handwriting process of poor writers. The article concludes by outlining future directions in handwriting evaluation that combine the assessment of the handwriting product with computerized analysis of the handwriting process.

THE IN AIR PHENOMENON: TEMPORAL AND SPATIAL CORRELATES OF THE HANDWRITING PROCESS

From 10 to 30% of elementary school-aged children have handwriting difficulties. Examination of such difficulties is important given the variety of academic, emotional, and social consequences that they can impose. One such common problem is the tendency of children to pause while writing. Thus the objective of this study was to use a computerized digitizer system to examine the tendency of poor writers to pause while writing. Handwriting samples of varying type and length were collected from Grade 3 students, 50 of whom were proficient writers and 50 of whom were poor writers as judged by a questionnaire completed by the classroom teachers and verified by the Hebrew Handwriting Evaluation. Analysts indicated that the so-called pauses are not stationary breaks between the writing of successive segments because letters and words were usually associated with considerable movement of the pen above the writing surface. This In Air writing occurred with significantly greater frequency for poor writers than for the proficient writers in most handwriting tasks. The results, suggest possible underlying perceptual-motor difficulties, which could be considered when planning effective handwriting interventions.

The development and standardization of the Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (ADC).

Developmental Co-ordination Disorder (DCD), also known as Dyspraxia in the United Kingdom (U.K.), is a developmental disorder affecting motor co-ordination. In the past this was regarded as a childhood disorder, however there is increasing evidence that a significant number of children will continue to have persistent difficulties into adulthood. Despite this, there remains little information as to how the difficulties might present at this stage, and additionally the impact on every day functioning. As young people move into further and higher education there is a need for screening and assessment tools. Such tools allow for identification of these difficulties, access to support, and clarification of areas where appropriate support needs to be targeted. This paper describes the first adult screening tool for DCD. The development and the results from testing this tool in two countries, Israel and the U.K. are outlined and the implications for its use in further and higher education discussed.

Handwriting evaluation for developmental dysgraphia: Process versus product

The act of writing presents difficulties for10–30% of elementary school children. Thisstudys objectives were to compare theabilities of digitizer-based evaluation of thehandwriting process and conventional evaluationof the handwriting product to discriminatebetween children with proficient and dysgraphichandwriting. Copied and dictated writingsamples were collected from 3rd grade students,50 with proficient and 50 with dysgraphichandwriting. Results indicated that bothdigitizer-based and conventional evaluationsdifferentiated between children with proficientand dysgraphic handwriting, and that togetherthey provided an improved understanding ofwriting difficulties. Moreover, copying anddictated writing task results differed significantly.The results demonstrate theadvantages of combining both handwritingprocess and product testing, and utilizing bothcopying and dictation tasks, in order toachieve a more comprehensive understanding andsuperior evaluation of developmentaldysgraphia.

Using data visualization and signal processing to characterize the handwriting process

Introduction: Disturbances in handwriting legibility and speed are found among elementary school-aged children. The aim of this paper is to present a set of sophisticated analytical tools suitable for visualization and evaluation of handwriting disturbances. Methods: Handwriting samples from 30 children, 15 proficient and 15 non-proficient handwriters, aged 8–9 years were collected with the aid of a digitizing tablet. Temporal and spatial measures of the handwriting process dynamics based on signal processing methods were developed and visually presented. Results: Significant differences between proficient and non-proficient handwriters were found in handwriting characteristics such as the standard deviations of letter width (t = 2.96, p = 0.008), letter height (t = 3.24, p = 0.005) and pen elevation (t = 2.91, p = 0.008). Significant differences were also found for the number of pen lifts (t = 2.27, p = 0.03), for the value of the correlation coefficients between letter length and time (t = −6.62, p = 0.000) and between the actual and computed number of words (t = 2.79, p = 0.01). Conclusions: The techniques described in this paper provide objective measures for handwriting performance presented in a way designed to help clinicians and educators visualize handwriting difficulties during clinical evaluation and intervention. Data visualization and analysis appear to enhance information concerning the spatial and temporal dynamics of handwriting. Introducción: En los niños en edad escolar que asisten a la escuela primaria se encuentran alteraciones en la legibilidad y la velocidad de la escritura. El objetivo de este artículo es presentar un conjunto de herramientas analíticas sofisticadas para visualizar y evaluar las alteraciones en la escritura. Métodos: Se recogieron muestras de escritura de 30 niños, 15 escritores experimentados y 15 no experimentados, con edades entre los 8 y 9 años, con la ayuda de una tablilla digital. Las mediciones temporales y espaciales del proceso de las dinámicas de la escritura fueron desarrolladas y presentadas visualmente en base a métodos de procesamiento de las señales. Resultados: Se encontraron diferencias significativas en las características de la escritura entre los escritores experimentados y los no experimentados, tales como las desviaciones estándar del ancho de las letras (t = 2.96, p = 0.08), altura de las letras (t = 3.24, p = 0.005) y la elevación de la pluma (t = 2.91, p = 0.008). También se encontraron diferencias significativas en relación al número de elevaciones de la pluma (t = 2.27, p = 0.03), en relación al valor de los coeficientes de correlación entre la longitud de la letra y el tiempo(t = 6.62, p = 0.000), y entre el número actual y el computado de las palabras(t = 2.79, p = 0.01). Conclusiones: Las técnicas descritas en este artículo proveen de mediciones objetivas en la realización de la escritura, presentadas de una manera diseñada para ayudar a los médicos y educadores a visualizar las dificultades de la escritura durante la evaluación e intervención clínica. El análisis y la visualización de los datos parecen realzar la información relacionada con las dinámicas espaciales y temporales de la escritura. Palabras Clave: Escritura, evaluación, digitalizador, visualización.

Movement Assessment Battery for Children (M-ABC): Establishing construct validity for Israeli children

The Movement Assessment Battery for Children (M-ABC) is one of the most accepted tools, both in clinical practice and in research, for the diagnosis of Developmental Coordination Disorders (DCDs) in children. The present study aimed to: (1) establish the construct validity of M-ABC in Israel by comparing the motor performance of typically developed children in four age groups (ranging from 6 to 12 years) and (2) examine the impact of socio-demographic parameters on childrens motor performance. Participants were 249 typical children, between 4.1 and 12.08 years old, whose motor performance was evaluated by the M-ABC. The results showed that age, gender, mothers education level, and socioeconomic status had an impact on childrens motor performance. Thus, the M-ABC may serve as a suitable tool for examining the motor performance of children in Israel. This examination should also refer to socio-demographic factors in order to shed light on the contribution of environmental disadvantages to childrens motor performance.

Handwriting Performance of Children with Attention Deficit Hyperactive Disorders: A Pilot Study

Objective. The aim of this study was to compare the handwriting characteristics of children diagnosed with attention deficit hyperactive disorder (ADHD), while on and off medication, as well as with a control group. Methods. Twelve children with ADHD and 12 control children, aged 8–10, performed a paragraph-copying task using a computerized system. The children with ADHD performed the task both while on and off medication. The handwriting product of both groups was then evaluated with the Hebrew Handwriting Evaluation tool. Conclusion. Results provide evidence for poorer performance of children with ADHD in comparison to children without ADHD on most handwriting process and product measures. Children with ADHD demonstrated significantly more total time including in-air time spent in handwriting performance when off medication. The possible implications of these results regarding the future use of handwriting process and product evaluations for children with ADHD in school settings are discussed.

Assessing the handwriting process in healthy elderly persons using a computerized system.

Background and aims: Despite the importance of handwriting in everyday life, virtually no literature can be found documenting the extent and range of everyday handwriting performance and ability among healthy elderly persons. The aim of this pilot study was to examine the kinematic characteristics of the handwriting process of healthy elderly persons and its correlates. Methods: Fifty-three healthy participants (aged 60 to 94) living in the community, performed five functional writing tasks using a computerized system which documented the handwriting process. Results: In air time (i.e., the time of non-writing while writing) accounted for approximately half to two-thirds of total writing time. Higher age was consistently associated with longer on paper and in air time, as well as with lower speed and lower pressure. Conclusions: The results of this pilot study indicate that kinematic analysis of handwriting provides important information about the handwriting process among elderly people.

Handwriting measures as reflectors of executive functions among adults with Developmental Coordination Disorders (DCD)

Planning ahead and organizational abilities in time and space are ingredients of high-level cognitive functions labeled as ‘Executive Functions’ (EF) required for daily activities such as writing or home management. EF deficits are considered a possible underlying brain mechanism involved in Developmental Coordination Disorders (DCD). The aim: of the study was to compare the handwriting process measures and the planning and organizational abilities in space and time of students with DCD with those of matched controls and to find whether handwriting measures can predict daily planning and organizational abilities among students with DCD. Method: 30 students diagnosed with DCD, between the ages of 24–41, and 30 age- and gender-matched controls participated in the study. They filled out the Handwriting Proficiency Screening Questionnaire (HPSQ) and the Adult Developmental Co-ordination Disorders Checklist (ADC). Furthermore, they copied a paragraph on a digitizer that is part of a computerized system Computerised Penmanship Evaluation Toll (ComPET). Results: Significant group differences were found for the HPSQ subscales scores as well as for the temporal and spatial measures of the paragraph copy task. Significant group differences were also found for the planning and organizational abilities in space and time as reflected through the ADC subscales. Significant medium correlations were found in both groups between the mean HPSQ time subscale and the ADC-B subscale mean score (r = 0.50/0.58, p < 0.05). Series of regression analyses indicated that two handwriting performance measures (mean HPSQ time subscale and mean stroke duration) predicted 19% of planning and organizational abilities as reflected through daily functions (ADC-B) [F(3, 54) = 38.37, β = 0.40, p < 0.0001]. Conclusion: The results support previous evidence about EF deficits as an underlying brain mechanism involved in motor coordination disorders, their significance as related to theoretical models of handwriting and daily function among DCD will be examined.

The handwriting performance of children with NF1

The objective of this study was to analyze the process and product of handwriting among children with Neurofibromatosis Type 1 (NF1) in comparison to those of Typically Developing (TD) children. Children with NF1 are at risk for some cognitive deficits, a wide range of deficits in perceptual skills and, motor and visual-motor integration skills which may interfere with handwriting competency, which is an essential ingredient for success at school. Participants were 30 NF1 children and 30 age and gender matched TD children, between the ages 8 and 16.08. The handwriting performance of children with NF1 was evaluated with the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), for copying text and free style writing tasks, using: (1) Computerized Penmanship Evaluation Tool (ComPET) to assess mechanical aspects of the writing process. (2) The Hebrew Handwriting Evaluation (HHE) to examine product legibility. (3) The Six-Trait Writing Model to judge the quality of the written product. Significant differences between the NF1 children and the control group were found in the process and product measures. Significant correlations were found between the VMI, the ComPET, the HHE and the Six-Trait Writing Model variables for both groups. We suggest a possible relationship between executive dysfunction and poor performance in handwriting.