Efficacy of a prewriting intervention: A pilot randomised control trial.

The study had only 18 participants and was explicitly underpowered to detect between-group differences, so a real effect could easily have been missed. All participants had average or above-average visual-motor integration scores, so the findings may not apply to children with below-average VMI who are more likely to need prewriting support. The school still provided prewriting instruction as part of standard classroom practice, so it is unclear how much of the improvement came from the intervention versus everyday classroom exposure. Only six sessions were delivered, which the authors note may have been insufficient for children still in the cognitive or associative phase of motor learning. No long-term follow-up was conducted, so the effect on later handwriting and letter formation is unknown.

No conflicts of interest were declared. The study was funded by Developmental Occupational Therapy WA.

Do not read the improvement in the intervention group as proof the programme works. The waitlist group improved just as much, the between-group difference was not significant (p = 0.406), and the study was underpowered to detect a real effect.