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