By Darlene A. Robertson, OTR/L
Having been an occupational therapist for nearly 18 years, I have had my fair share of referrals for "just handwriting". It is rarely "just handwriting". All too often a child will be referred to occupational therapy after some quick fix attempts by teachers such as a pencil grip or change in paper have proved unsuccessful. Although having the age appropriate hand grasp on the writing instrument and using age appropriate paper for the child is important, these aspects are small components of the complex task of handwriting.
As an occupational therapist, we look at the child as a whole. We begin by looking at the child's ability to attend to the task and their ability to maintain a state of arousal that is alert and focused. If attention and arousal state are not optimal, handwriting skills will suffer. Also important, there is the ole' adage of the wrist bone is connected to the shoulder bone; the shoulder bone is connected to the spine... The child's overall strength and endurance must be addressed. Also the simple act of sitting correctly must not be ignored. Chair size in relation to the table, along with the type of writing surface must be addressed. Is the child's handwriting improved with a vertical or horizontal writing surface, i.e. slant board? Then we return to the importance of muscles, strength and endurance in the seated position. Lastly, we have visual perceptual and visual motor skills. These skills working together are defined visual motor integration or the ability of the eyes, brain and hands to work together as a team. The visual skills need to be in their team work role.
A skilled occupational therapist must evaluate and address these components of handwriting before finally putting pencil to paper. and assess the sum of the above mentioned skill areas to see what final product is produced. So, I can confidently state rarely it is "just handwriting".
Written by Darlene A Robertson, OTR/L who is a pediatric OT in private practice in Roswell, GA DARlingOT@msn.com.
