Date of Award

5-2023

Degree Name

Master of Science in Occupational Therapy

Department

Occupational Therapy

Project Chairperson

Sheryl Zylstra

Second Advisor

Renee Watling

Third Advisor

Maggie Hayes

Keywords

handwriting, legibility, occupational therapy, intervention, school-aged, K-5, pediatric

Abstract

Four occupational therapy students collaborated with 360 Pediatric Therapy, a Seattle based pediatric occupational therapy practice. The collaborating practitioners, Catherine (Cate), Heather, and Miriam, were interested in the current and relevant evidence surrounding factors impacting handwriting legibility with children. Student researchers systematically reviewed the literature from 2007-2023 to address the question, "What are the main factors that affect or correlate with handwriting legibility for school- aged children K-5?” Out of the 936 articles screened, researchers found 36 articles that met the inclusion criteria. Research demonstrates that handwriting interventions (in and out of the classroom) involving multiple skills (cognition, visual motor, fine motor, etc.) have been shown to be, in general, effective for improving handwriting legibility. Selecting an intervention may be dependent upon specific circumstances and client needs; so the researchers advise practitioners to use clinical reasoning in addition to the evidence-based research when making handwriting legibility intervention decisions.

A Handwriting Education Packet was created to synthesize information surrounding factors associated with legibility, populations at high risk for poor legibility, curricular and non-curricular legibility interventions, as well as a condensed presentation on developmental patterns and pencil-grasp styles. The packet was designed to be a simple, evidence-based resource for occupational therapists to use in practice to better support their clients needs. Outcomes were monitored through in-depth feedback in the form of a meeting after several drafts were exchanged and edited. Future resources targeted toward families, educators, and administrators could be beneficial and should be explored through additional research. Subsequent topics such as fatigue, endurance, handwriting speed, and specific diagnoses should also be addressed.

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