OTOtherJournal of neuroengineering and rehabilitation2021

Proximal and distal movement patterns during a graphomotor task in typically developing children and children with handwriting problems.

Shoshana Steinhart, Patrice L Weiss, Jason Friedman

PMID 34930334

WHAT IT FOUND

Children with handwriting problems drew shapes less accurately and moved their shoulders and upper backs differently than peers.

However, the amount of movement did not predict writing quality. Accuracy errors, not joint dynamics, were the strongest predictors of legibility and speed.

Key findings

01Children with handwriting problems made significantly more errors when drawing shapes than typically developing children.

02The shoulder and upper back movements of children with handwriting problems were less similar to the shape being drawn compared to controls, suggesting different proximal joint control.

03Drawing error was a significant predictor of writing speed and legibility, whereas the magnitude of joint movement was not.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The study used copying and tracing of basic geometric shapes, not actual handwriting tasks, so findings may not directly translate to letter formation. The sample was small (41 children) and recruited from a convenience sample (summer camp) and a waiting list, which may not represent the general population. The study was cross-sectional and descriptive; it cannot prove that proximal movement issues cause handwriting problems. The Hebrew handwriting test and specific cultural context may limit generalizability to other populations.

Declared interests

The authors declared no competing interests. The study was supported by the Israel Science Foundation.

The easy way to misread this

Do not conclude that proximal joint instability causes handwriting problems. The study found differences in how proximal joints moved, but the amount of movement did not predict writing quality. The primary deficit associated with poor handwriting was the accuracy of the shape drawn, not the stability of the shoulder or trunk.

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