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How Can OT Help with Handwriting Difficulties?

Updated: Feb 23



Handwriting Difficulties:

Children spend approximately 30-60% of their day performing fine motor activities, with handwriting tasks accounting for most of this time. Therefore, handwriting is an essential life skill for a child to have to achieve success in school. Handwriting in itself is a very complex task that involves the successful coordination of many different skills, including cognitive, motor, visual and sensory skills. Over time with practice, a child will start to coordinate all of these skills to allow them to correctly form letters, words, and sentences. A child will start by scribbling and drawing simple shapes and then move on to writing familiar letters such as letters in their name, then onto sentences, essays, and stories as they progress through school.

Your child’s teacher or yourself may flag that they are struggling with handwriting in class. Whether that be with letter formations, getting information on the page, or completing their spelling lists. It is important to remember that handwriting is a very complex task and difficulties in the foundation areas may be the main reason the child is struggling.


Here are some examples of foundation skills and difficulties that may present:

Visual Skills:

· Difficulty with letter identification and recall (knowing the alphabet and sequence)

· Incorrect letter formation

· Inconsistent or incorrect spacing and positioning of letters

· Difficulties with copying from paper or from the board

Fine Motor Skills:

· Non-functional or awkward pencil grip

· Hand pain and fatigue when writing

· Difficulty controlling and manipulating the pencil

· Difficulties with bilateral hand coordination (using two hands at once)

Gross Motor Skills:

· Weak upper limb stability

· Difficulty maintaining correct posture when seated during writing tasks

Cognitive Skills:

· Difficulty planning and organising written tasks to form sentences and paragraphs

· Difficulty maintaining concentration

· Difficulty following verbal or written instructions during handwriting tasks

Sensory Skills:

· Difficulty maintaining attention to tasks

· Difficulty maintaining posture when seated or standing

As well as these difficulties with foundation skills; diagnoses such as dyslexia or motor dysgraphia can cause handwriting difficulties for a child. Dyslexia is a learning disorder that impacts a child’s ability to read and spell. Children with dyslexia have difficulty with phonemic awareness and reading which can impact handwriting by causing difficulties with the child’s ability to learn the alphabet sequence, recognize similar-sounding letters, and spelling words when writing. Motor dysgraphia is a disorder that impacts a child’s motor skills which are needed to produce written work. A child with motor dysgraphia can see and interpret letters and numbers however has difficulty creating the motor movements required to form the shape.

How Can OT Help?

One of the most common reasons a child is referred to an occupational therapist is due to difficulties with handwriting flagged by the child’s teacher or parent. Occupational therapy for children with handwriting difficulties is much like building a house. Without a stable and secure foundation, the house will not be able to stand. Therefore, an occupational therapist will begin by conducting a thorough assessment of all of the child’s skills such as visual perception, letter formation, gross motor coordination and sensory processing. This will allow the occupational therapist to truly understand the specific difficulty that the child may be having which is impacting their ability to produce written work. For example, a child may be referred by their teacher with concerns that they are unable to produce sentences in the classroom however upon assessment and investigation the child has sensory processing difficulties which is impacting their ability to pay attention and listen to instructions in class.

Following assessment, the occupational therapist will then target the child’s specific difficulties to lay that secure and set foundation for further learning and improvements in handwriting. As handwriting is often a boring task for most school-aged children occupational therapy for children with handwriting difficulties will include lots of fun games and easy home practice activities to keep the children engaged and having fun without even thinking they are working on their handwriting.

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