By Dan Waldron, Occupational Therapist with Communicate 2U and Selly Oak Trust School

“I know what I want to say. I just can’t write it down. It’s so annoying!” This is one pupil’s reflection on why he walked out of class earlier this week. But this is one of many similar stories and a story, I’m sure, that resonates with many children, parents, carers and teachers. Indeed, between 10% and 30% of school-aged children experience handwriting difficulties. When considering that up to 60% of a child’s school day comprises fine motor tasks, with the majority of these being writing-based, it is no wonder that children with handwriting difficulties find school incredibly challenging.

So why is handwriting so challenging? Handwriting is a complex task, involving a blend of motor and visual-perceptual skills; balance, body awareness, core stability, eye-hand coordination, in-hand manipulation, to name a few. And this is before we layer the cognitive demand of letter formation, sentence construction, creative writing etc. on top! When you are a novice writer, that’s a lot to focus on!

To draw on an analogy: being a novice writer is very much like being a novice driver. If you’re a driver, think about your first driving lesson. Everything requires conscious effort: How hard do I apply the accelerator? Where is the bite on the clutch? Which lever is the indicator? This leaves very little capacity for cognitive demands like having a conversation with your driving instructor or listening to music. It’s a similar experience for many of our children. The demands of sitting still, maintaining a comfortable posture and holding the pen in a functional grip might leave very little capacity for the child to remember how to form the letter ‘a’ that you’ve been practicing all week!

But what can we do to support these children to become expert – or, at least, satisfied – writers? Does practice make perfect? Well, kind of, but not quite! I practice singing every day. I sing in the car. I sing in the shower. I probably sing in my sleep. But would you like to hear my rendition of Nessun Dorma? Not without some industrial ear defenders! That’s because I have about as much knowledge of how I should warm-up my voice and control my breaths as I do about fine wine. And that’s not much! A better headline would be: appropriate practice makes permanent.

So what does appropriate practice look like? Is it massed practice? Daily fine motor programmes? Sensory-motor play? Fortunately, the evidence is quite clear about how we can support appropriate practice:

Fine motor programmes do not improve handwriting.

Fine motor programmes develop fine motor skills, but the evidence is clear that this alone does not translate to improvements in handwriting performance. And, when we think about it, it makes sense, doesn’t it? Imagine you have tickets to see a pianist at the Royal Albert Hall this evening. The pianist has been practicing daily since September for this big occasion. Finger isolation. Grip strength. Range of movement exercises. He’s done it all! But he’s never played the piano in his life… What are you expecting from the show? It’s the same for our children. If our aim is to develop handwriting, we need to practice handwriting!

So, should we scrap all of our fine motor programmes tomorrow? Well, maybe not. The evidence is unclear at this stage about whether fine motor programmes enhance handwriting practice versus handwriting practice alone. So, don’t put away your High Five Jive or your Dough Disco yet; just make sure that if your aim is to develop handwriting, you’re practicing handwriting as well!

Appropriate practice makes permanent!

20 sessions. That’s what the evidence tells us is the minimum necessary to make significant improvements in handwriting performance. That’s a lot! And, in reality, that might be impractical for a school to embed into a child’s timetable or for a parent to commit to in evenings and weekends. The reality is that the most effective handwriting interventions are when school and home work collaboratively and have honest conversations about how, who and when they can hit that 20-session target.

But what should these sessions include? Many of the strategies that have been used in schools for years are effective. Motor imitation, where the child copies the adult ‘sky writing’. Memory retrieval, where the child looks at a letter, the adult covers the letter, then the child writes it. And visual cueing, where the child overwrites dot-to-dot letters or follows arrows (although, interestingly, evidence tells us this is only effective when supported by memory retrieval).

Repetition, fun and evaluation

I still remember the first time I attempted writing letters in shaving foam with a small group of Key Stage 1 pupils. I clearly underestimated how much shaving foam expands. The marks might well still be on the sensory room carpet! But this was a fun, engaging (albeit messy!) way of delivering motor imitation. And the possibilities are endless! What about asking the child to use a wet cotton bud to erase your letters on a chalk board (visual cueing)? Or playing hide-and-seek letters, where they have to turn over the letter cards that they find and copy the letter on the reverse (memory retrieval)? Learning handwriting should be fun, otherwise it becomes just another lesson learning about yet another thing that the child is no good at!

The process of learning doesn’t end when the child finishes writing, though. The final piece of the jigsaw is evaluation. Which is your best letter? Does your letter look like mine? Did you keep your sentence on the line? The evidence is clear that learning is embedded faster when evaluation is incorporated into the sessions.

So to summarise, handwriting is a complex task, but it is well worth investing the time to support children to develop this skill. If your aim is to develop a child’s handwriting, it is important to plan your intervention to maximise success: What is the specific aim of the intervention (to write a letter, a word, a sentence)? Who will facilitate the 20 sessions and when? How will we make motor imitation, memory retrieval and visual cueing meaningful and fun for the child? And if you’re still having difficulties, don’t forget that your friendly neighbourhood Occupational Therapy team is always available for advice and support!

Thank you for reading and I hope you’ve found this useful.

Written by Guest Blog

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