Julie Anderson, DrOT, OTR/L, is an occupational therapist in the Puyallup School District who works with elementary aged students. For this project, Dr. Anderson worked as the primary collaborator with occupational therapy students to answer the question: What is the evidence that occupational therapy interventions at a systems-level improve student's academic performance and skill development outcomes, such as handwriting, in elementary age students with and without disabilities? The results of this descriptive study indicate strong evidence that systems-level interventions, involving an occupational therapist, in a school setting improve at least one area of a student’s skill development. Additionally, any consistent handwriting curriculum improved handwriting skills in elementary school children compared to no handwriting curriculum. Finally, when teachers and occupational therapists collaborate, systems-level interventions can be implemented to best fit the needs of individual classrooms. Future research in this area should work to define the terms “systems-level” and “collaboration.” This would allow consistent results when comparing various studies performed at a systems-level and involving collaboration, as currently studies use multiple terms to describe the same approaches.

Knowledge translation for this project included compiling the systematic review, as well as other handwriting research, into a PowerPoint to be presented to administrators at the Puyallup School District. The aim of this presentation was to educate administrators on the benefits of a districtwide handwriting curriculum for kindergarten and first grade classrooms, provide details on specific curricula and provide a possible implementation plan. Pre- and post-survey results, gathered at the presentation, indicate that administrators within the Puyallup School District believe they should have a districtwide handwriting curriculum. All administrators picked TV Teacher as the top choice at the end of the presentation. As a result of the presentation, the administrator for the kindergarten academy in the Puyallup School District will be using TV Teacher as the kindergarten academy’s curriculum. Future recommendations regarding this knowledge translation include recording data on handwriting for either pre- and post-handwriting curriculum or utilizing a between group design that compares half the Puyallup School District using a handwriting curriculum to half not using a handwriting curriculum.

Publication Place

Tacoma, Washington


University of Puget Sound

Project Chairperson

Yvonne Swinth, PhD, OTR/L, FAOTA

Publication Date



Capstone Project





Degree Program

Occupational Therapy

Degree Level

Master of Science


Occupational Therapy


University of Puget Sound