Relationships between handwriting and keyboarding performance of sixth-grade students.

OBJECTIVES: This study examined the relationships between sixth-grade students' handwriting speed and legibility and their keyboarding speed and error rate. A second purpose was to examine how well handwriting performance discriminates students as slow or fast in computer keyboarding. METHOD: After participation in a school-required keyboarding class, 40 sixth-grade students were asked to copy a familiar poem using handwriting and keyboarding. Handwriting legibility and speed and keyboarding speed and errors were measured. Relationships among these variables were analyzed using Pearson product-moment correlations and discriminant analysis. RESULTS: Keyboarding speed correlated with handwriting legibility (n = 38, r = .361, p = .026), suggesting that handwriting performance accounts for 12% to 13% of the variance in keyboarding performance. Handwriting speed and legibility together accurately categorized 71% of students as slow or fast in keyboarding. On average, students were able to keyboard faster than handwrite. Of the 20 slowest handwriters, 75% achieved more text production with keyboarding than with handwriting. CONCLUSION: Keyboarding performance demonstrated low to moderate correlation with handwriting performance, suggesting that these forms of written expression require distinctly different skills. Most students who were slow at handwriting or had poor legibility increased the quantity and overall legibility of text they produced with a keyboard. These results suggest that keyboarding has the potential to increase and improve a student's written output.     

Effectiveness of school-based occupational therapy intervention on handwriting.

OBJECTIVE: This study investigated the effects of school-based occupational therapy services on students' handwriting. METHOD: Students 7 to 10 years of age with poor handwriting legibility who received direct occupational therapy services (n = 29) were compared with students who did not receive services (n = 9) on handwriting legibility and speed and associated performance components. Visual-motor, visual-perception, in-hand manipulation, and handwriting legibility and speed were measured at the beginning and end of the academic year. The intervention group received a mean of 16.4 sessions and 528 min of direct occupational therapy services during the school year. According to the therapists, visual-motor skills and handwriting practice were emphasized most in intervention. RESULTS: Students in the intervention group showed significant increases in in-hand manipulation and position in space scores. They also improved more in handwriting legibility scores than the students in the comparison group. Fifteen students in the intervention group demonstrated greater than 90% legibility at the end of the school year. On average, legibility increased by 14.2% in the students who received services and by 5.8% in the students who did not receive services. Speed increased slightly more in the students who did not receive services. CONCLUSION: Students who received occupational therapy services demonstrated improved letter legibility, but speed and numeral legibility did not demonstrate positive intervention effects.     

The effects of sensorimotor-based intervention versus therapeutic practice on improving handwriting performance in 6- to 11-year-old children.

OBJECTIVE: The aim of this study was to investigate the effects of two interventions (sensorimotor and therapeutic practice) on handwriting and selected sensorimotor components in elementary-age children. METHOD: Thirty-eight children 6 to 11 years of age with handwriting dysfunction but no identified educational need were randomly assigned to one of the two intervention groups or a control group. Intervention groups met four times per week over 5 weeks. Handwriting was measured pre- and postintervention using the Test of Handwriting Skills. Visual perception (motor-reduced), visual-motor integration, proprioception, and in-hand manipulation were also measured. RESULTS: Children receiving therapeutic practice moderately improved handwriting whereas children receiving sensorimotor intervention declined in handwriting performance. The control group did not change significantly. Sensorimotor impairment was noted at pretest in three or four components and selected sensorimotor component function improved with intervention. CONCLUSION: Therapeutic practice was more effective than sensorimotor-based intervention at improving handwriting performance. Children who received sensorimotor intervention improved in some sensorimotor components but also experienced a clinically meaningful decline in handwriting performance.     

Enabling occupational performance: optimal experiences in therapy.

Occupational therapists believe that engagement in occupation contributes to health through an individually balanced use of time, a positive focus for one's physical and mental energy, and the provision of a sense of purpose. Flow is a construct which describes optimal experiences or enjoyment in everyday activities. A review of the literature suggests that the theory of optimal experience is complementary to occupational therapy beliefs and that an understanding of the flow experience may contribute to our understanding of human occupation. Specifically, flow may be useful in understanding those aspects of the occupation, environment and person that contribute to a "just right" challenge, and to enabling occupational performance through enjoyable, structured and purposeful activity. Occupational therapists are encouraged to explore whether optimal experiences facilitate occupational performance for individuals with a disability. Future research could explore whether the occupational opportunities available to persons with a disability provide the degree of challenge required to elicit the optimal experience. Finally, research could explore whether the client-driven selection of meaningful occupation, and therapist enablement of the "just right" challenge, influences optimal experience, occupational performance, and life satisfaction for those with a disability.     

The Canadian occupational performance measure: an outcome measure for occupational therapy

The Canadian Association of Occupational Therapists, in collaboration with Health and Welfare Canada have developed and published a conceptual model for occupational therapy, the Occupational Performance model. This paper describes the development of an outcome measure, The Canadian Occupational Performance Measure (COPM), which is designed to be used with these guidelines for client-centred clinical practice. The COPM is an outcome measure designed for use by occupational therapists to assess client outcomes in the areas of self-care, productivity and leisure. Using a semi-structured interview, the COPM is a five step process which measures individual, client-identified problem areas in daily function. Two scores, for performance and satisfaction with performance are obtained. This paper describes the rationale and development of the COPM as well as information about its use for therapists.     

Stability of handwriting performance following injury-induced hand-dominance transfer in adults: a pilot study

The aim of this study was to quantify stability of nondominant handwriting kinematics and legibility in participants with functional loss of the previously dominant hand. Twelve adult volunteers provided two handwriting samples 6 weeks apart. Handwriting tasks (Compose a Sentence, Copy Alphabet, Copy Date, Copy Sentence, and Draw Circles) were performed in cursive writing on standard white, lined paper taped to a digitizer to record kinematic and kinetic variables of velocity, displacement, force, and on-paper time. Results showed minimal performance variability within subjects and marked variability between subjects, as well as variability between tasks for all participants. Stylistic stability of the handwriting samples was assessed by two independent evaluators. These evaluators matched all handwriting samples at test to retest times with 89%-100% accuracy, suggesting value in the "whole" handwriting sample and emphasizing the idiosyncratic nature of handwriting. Results suggest that handwriting skill stability in the previously nondominant hand varies across subjects and task demands.     

Relationships among biomechanical ergonomic factors, handwriting product quality, handwriting efficiency, and computerized handwriting process measures in children with and without handwriting difficulties.

OBJECTIVES: Handwriting is a work activity for children, hence it may be evaluated based on ergonomic factors. This study investigated whether nonproficient handwriters could be distinguished by biomechanical ergonomic factors during handwriting, as well as by measures of handwriting efficiency. Furthermore, the relationships among ergonomic factors, handwriting quality, efficiency, and measures of the handwriting process were examined. METHODS: Fifty proficient and 50 nonproficient third-grade handwriters performed a handwriting task on an electronic tablet. Biomechanical ergonomic factors, measures of handwriting quality, and efficiency were rated using the Hebrew Handwriting Evaluation. Handwriting process measures were obtained from a computerized system. RESULTS: Biomechanical ergonomic factors and handwriting efficiency measures significantly differentiated between the study groups. Significant correlations were found among ergonomic factors and handwriting quality, efficiency, and process measures. CONCLUSION: Nonproficient handwriting is a work activity that is often characterized by inferior biomechanical ergonomics, handwriting quality, efficiency, and significantly different handwriting process measures. Results provide insights that can assist in planning intervention.     

A child's occupational performance: considerations of sensory processing and family context.

Sensory processing problems can be serious enough to affect a child's performance in school and home environments but often go undetected or are misunderstood. Poor sensory processing can affect a child's ability to successfully perform daily activities because of its effect on cognitive, sensory, and motor development. The relationship of sensory processing to children's occupational performance in their daily lives is an important consideration.     

Feeding the infant with congenital heart disease: an occupational performance challenge.

This review article uses the Canadian Model of Occupational Performance (CMOP) as a theoretical framework to organize a discussion of the complexities of infant feeding when the infant has congenital heart disease (CHD). Literature from many fields indicates that feeding supports the physical, cognitive, and affective development of infants within their various environmental contexts. Many infants with CHD, who are now surviving in increasing numbers, experience feeding difficulties that affect their growth and development and that challenge their caregivers. The feeding experiences of infants with CHD illustrate the clinical applicability of the CMOP and the need for further research. Research using the framework of the CMOP will enable the development and implementation of evidence-based interventions that support the occupation of feeding from both the infant and the caregiver perspective.     

Predicting performance from functional imaging data: methods matter

In the standard approach to functional imaging studies, brain-behavior relationships are studied by contrasting data obtained during different behavioral states. It is generally assumed that relative change yields meaningful data about relevant brain processes, and that the magnitude of the change reflects the extent of a region's involvement in the behavior being studied. The present study takes a different approach by asking the question, Can functional imaging data predict performance? Regional cerebral blood flow was measured using positron emission tomography in a group of 13 right-handed, normal volunteers during speech production and quiet baseline. A number of methodological assumptions were addressed by examining the relationships between different imaging measures derived from the same raw data and performance on the speech task. The results demonstrate that several common assumptions are not necessarily true. First, although measures based on "activated" scans alone had predictive value with respect to speech rate, measures based on contrasts between "baseline" and "activated" states did not. This was true regardless of whether the contrast was based on subtraction or covariance analyses. Second, while many regions demonstrated large signal increases during speech, speech rate could be predicted by a linear combination of data from two regions, neither of which had the highest "activation" peak, and one of which had a negative relationship with performance. The results demonstrate that contrasting experimental conditions do not necessarily isolate or enhance brain activity related to performance, and that the current assumptions about activation in functional imaging need to be reconsidered.     

Semantic priming of motor task performance in young adults: implications for occupational therapy.

OBJECTIVE: To investigate whether the performance of a multisegment motor task is influenced by reading a segment-specific action word. METHOD: Twenty-four participants performed tasks that involved reaching for a bottle, grasping it, lifting and placing it on a shelf, and returning their hand to the starting position. At the initiation of each task, participants read either aloud or silently five randomly provided, task-related words (reach, grasp, lift, place, and return). RESULTS: Reading task-related words significantly affected the reach and lift/place segments in the direction of the hypothesis (p < 0.05) but not the return segments. Grasp times were shorter and grasp velocities were higher when participants read aloud or silently the words grasp and place for the grasp segment (p < 0.05). CONCLUSIONS: The results suggest that in young adults, motor performance may be influenced by precuing or priming the brain with performance-related words. A meaning of a motor performance can be manipulated by contextually relevant language, which can facilitate performance.     

Outcomes of an occupational therapy program for mothers of children with disabilities: impact on satisfaction with time use and occupational performance.

OBJECTIVE: This experimental research study evaluated the impact of an 8-week psychosocial occupational therapy intervention program for mothers who have children with disabilities. METHOD: Thirty-eight mothers of children with disabilities were randomly assigned to participate either in the treatment or the control group (19 in each). The occupational therapy intervention was designed to facilitate increased perceptions of satisfaction with time use and occupational performance, thereby positively affecting maternal and family well-being. The Canadian Occupational Performance Measure (COPM) was administered to measure self-perceptions of occupational performance and satisfaction over time. RESULTS: No significant differences were found between the two groups on time use perceptions. Although no significant differences were found between the two groups on the COPM Performance subscale, the treatment group demonstrated significantly greater score increases (p < .05) on the COPM Satisfaction subscale. CONCLUSION: This preliminary study suggests that attending to the time use and occupational concerns of mothers of children with disabilities can have a positive impact on their satisfaction with occupational performance.     

Consistency of handwriting in early elementary students.

OBJECTIVE: The purpose of this longitudinal study was to examine the consistency of handwriting in children from the beginning of kindergarten to the middle of the first-grade year. Consistency was defined as retaining the same qualitative performance and relative ranking over time. METHOD: Ninety-three children were tested at the beginning of the kindergarten year and again in the middle of the first-grade year on the Scale of Children's Readiness In PrinTing (SCRIPT). Data were analyzed with a repeated measures analysis of variance (ANOVA) (3 performance groups [lower, middle, upper] x 2 grades) followed by a Tukey's HSD post hoc analysis. An analysis of the change in performance of individual children also was conducted. RESULTS: The main effects and the interaction in the ANOVA were significant. Post hoc analysis for grade demonstrated that both the middle and the lower performing groups showed a significant improvement from kindergarten to first grade, whereas the upper performing group remained unchanged. Post hoc analysis found significant differences among all three performance groups in kindergarten. In first grade, the lower performing group continued to score significantly lower than the middle and upper performing groups, whereas the middle and upper performing groups were not significantly different. Analysis of individual data revealed that 60% of the students were consistent in their performance from kindergarten to first grade. CONCLUSION: The correlation between kindergarten SCRIPT scores and first-grade SCRIPT scores provides initial evidence that a moderately consistent pattern of handwriting performance exists. Students with low- and middle-ranked handwriting skills show relatively similar improvement over time, whereas change for students ranked high is limited.