Motor Learning of Handwriting and Developmental Dysgraphia

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Global and Public Health".

Deadline for manuscript submissions: closed (1 November 2023) | Viewed by 16231

Special Issue Editors


E-Mail Website
Guest Editor
CNRS, University Grenoble Alpes, University Savoie Mont Blanc, LPNC, 38000 Grenoble, France
Interests: handwriting; child development; dysgraphia

E-Mail Website
Guest Editor
CLLE Laboratory, UMR CNRS 5263, Toulouse University, 31000 Toulouse, France
Interests: handwriting; dysgraphia; neurodevelopmental disorders and neuropathologies; digital; rehabilitation

Special Issue Information

Dear Colleagues,

Learning to write by hand is a complex activity which requires years of formal training before complete mastering, and which is essential for the acquisition of other skills, such as grammar. However, 5% to 10% of children have difficulties with and do not fully master handwriting. These handwriting deficits, characterized by poor quality and/or speed, are referred to as dysgraphia. Since handwriting deficits can seriously impact children’s academic achievement, it is important to identify and handle them early.

This Special Issue will focus on the motor aspects of handwriting learning in typically developing children, and of handwriting deficits in children with specificities and/or neurodevelopmental disorders.

We invite you to contribute to this Special Issue to increase the knowledge on dysgraphia and handwriting on fundamental, educational, and clinical aspects, and to improve the management of handwriting deficits, namely in the field of diagnosis and rehabilitation. Both original research articles and reviews will be considered for publication.

Dr. Caroline Jolly
Dr. Jérémy Danna
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • handwriting
  • motor learning
  • dysgraphia
  • diagnosis and rehabilitation
  • neurodevelopmental disorders

Published Papers (9 papers)

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Research

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12 pages, 603 KiB  
Article
From Scribbles to Script: Graphomotor Skills’ Impact on Spelling in Early Primary School
by Michelle N. Maurer, Lidia Truxius, Judith Sägesser Wyss and Michael Eckhart
Children 2023, 10(12), 1886; https://doi.org/10.3390/children10121886 - 01 Dec 2023
Cited by 1 | Viewed by 986
Abstract
The acquisition of handwriting skills is a crucial goal in early primary school. Yet our comprehension of handwriting development, encompassing graphomotor skills and spelling, remains fragmented. The identification of predictors for handwriting skills is essential for providing early support. This longitudinal study aimed [...] Read more.
The acquisition of handwriting skills is a crucial goal in early primary school. Yet our comprehension of handwriting development, encompassing graphomotor skills and spelling, remains fragmented. The identification of predictors for handwriting skills is essential for providing early support. This longitudinal study aimed to explore the predictive roles of gender, working memory, and motivation to handwrite for graphomotor skills six months later and spelling skills one year later. Paper-and-pencil tasks (graphomotor skills, spelling), a tablet task (working memory), and a questionnaire (teachers’ ratings of children’s handwriting motivation) were employed. This study included 363 first-grade children (49.8% girls) aged 6–9 years. Results from a structural equation model, controlling for age and socioeconomic background, revealed that girls exhibited superior performance in graphomotor skills, while boys tended to spell more accurately. Furthermore, working memory predicted graphomotor skills but not spelling. Additionally, motivation to handwrite predicted both first-grade graphomotor skills and second-grade spelling. This study extends contemporary evidence, demonstrating that graphomotor skills predict spelling while considering gender and motivation. The findings underscore the pivotal role of graphomotor skills in spelling acquisition and suggest their contribution to spelling difficulties. Full article
(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)
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17 pages, 1063 KiB  
Article
Exploratory Investigation of Handwriting Disorders in School-Aged Children from First to Fifth Grade
by Clémence Lopez and Laurence Vaivre-Douret
Children 2023, 10(9), 1512; https://doi.org/10.3390/children10091512 - 06 Sep 2023
Cited by 2 | Viewed by 1080
Abstract
Handwriting disorders (HDs) are prevalent in school-aged children, with significant interference with academic performances. The current study offers a transdisciplinary approach with the use of normed and standardized clinical assessments of neuropsychomotor, neuropsychological and oculomotor functions. The aim is to provide objective data [...] Read more.
Handwriting disorders (HDs) are prevalent in school-aged children, with significant interference with academic performances. The current study offers a transdisciplinary approach with the use of normed and standardized clinical assessments of neuropsychomotor, neuropsychological and oculomotor functions. The aim is to provide objective data for a better understanding of the nature and the etiology of HDs. Data from these clinical assessments were analyzed for 27 school-aged children with HD (first to fifth grade). The results underline a high heterogeneity of the children presenting HDs, with many co-occurrences often unknown. However, it was possible to highlight three levels of HDs based on BHK scores: mild HD not detected by the BHK test (26% of children), moderate HD (33%) and dysgraphia (41% of children). The mild nature of the HDs not detected by the BHK test appears to occur at a relatively low frequency of the associated disorders identified during clinical evaluations. On the contrary, dysgraphia appears to be associated with a high frequency of co-occurring disorders identified in the clinical assessment, with a predominance of oculomotor disorders (55% of children), leading to visual-perceptual difficulties and a high level of handwriting deterioration. Finally, children with moderate HD have fewer co-occurrences than children with dysgraphia, but have more difficulties than children with mild HD. This highlights the importance of differentiating between different degrees of HDs that do not respond to the same semiologies. Our findings support the interest in performing a transdisciplinary and standardized clinical examination with developmental standards (neuropsychomotor, neuropsychological and oculomotor) in children with HD. Indeed, HDs can therefore be associated with a multitude of disorders of different natures ranging from poor coordination of the graphomotor gesture to a more general and more complex impairment affecting perceptual-motor, cognitive and/or psycho-affective functions. Full article
(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)
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21 pages, 2211 KiB  
Article
Effectiveness of Psychomotor Therapy among Children with Graphomotor Impairment with and without DCD-Diagnosis
by Sibylle Hurschler Lichtsteiner, Melanie Nideröst, Carlo Di Brina, Christian Marquardt, Stefanie Wyss, Alois Buholzer and Werner Wicki
Children 2023, 10(6), 964; https://doi.org/10.3390/children10060964 - 29 May 2023
Cited by 1 | Viewed by 1652
Abstract
In Switzerland, psychomotor therapy (PMT) is a standard treatment for children with graphomotor impairments, but scientific evidence of its effectiveness is rare. To investigate the effectiveness of PMT, we conducted a randomised field trial (RFT). The sample consisted of 121 first and second [...] Read more.
In Switzerland, psychomotor therapy (PMT) is a standard treatment for children with graphomotor impairments, but scientific evidence of its effectiveness is rare. To investigate the effectiveness of PMT, we conducted a randomised field trial (RFT). The sample consisted of 121 first and second graders with graphomotor impairments, some of whom met the criteria of developmental coordination disorder, while the remaining suffered from developmental dysgraphia. The treatments lasted over 5 months. Handwriting fluency and consistency were measured five times on a digitising tablet. All participating children completed a self-concept interview, and a standardised fine motor performance test twice. Psychomotor therapy significantly improved the fine motor skills of the therapy group compared to those of the waiting group. However, there was no evidence that the treated children improved more than the waiting children in terms of their graphomotor skills such as frequency, automaticity, and consistency of forming letters. Finally, the children of the therapy group showed partial improvements in their handwriting self-concept, while those of the waiting group children remained stable. This short-term RFT demonstrated the effectiveness of PMT in terms of fine motor skills and some aspects of the handwriting self-concept but showed no effects on handwriting fluency and consistency. Full article
(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)
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17 pages, 5627 KiB  
Article
Muscle Activity during Handwriting on a Tablet: An Electromyographic Analysis of the Writing Process in Children and Adults
by Sabrina Gerth and Julia Festman
Children 2023, 10(4), 748; https://doi.org/10.3390/children10040748 - 20 Apr 2023
Viewed by 1372
Abstract
Handwriting is a complex task that includes planning the content and the execution of handwriting movements on paper or on a tool (e.g., a tablet). This execution depends on the involvement of specific muscles in the hand (distal) and arm (proximal). The present [...] Read more.
Handwriting is a complex task that includes planning the content and the execution of handwriting movements on paper or on a tool (e.g., a tablet). This execution depends on the involvement of specific muscles in the hand (distal) and arm (proximal). The present study combines the parallel recording of the writing process on tablets and the related muscle activity with electromyography to investigate the differences in handwriting movements in two groups. A total of 37 intermediate writers (third and fourth graders, mean age 9.6 years, SD 0.5) and 18 skilled adults (mean age 28.6 years, SD 5.5) participated in three handwriting tasks. The tablet data results replicate previous findings in handwriting research for the writing process. The muscle activity data reflected a differential relationship between distinct muscle activity and handwriting performance depending on the handwriting skill (intermediate or advanced writers). Furthermore, the combination of both methods revealed that skilled writers tend to involve rather distal muscles to control the pressure of the writing pen on the surface, whereas developing writers mainly use their proximal muscles to control the velocity of their handwriting movements. This research contributes to a deeper understanding of the underlying processes of handwriting and the development of efficient handwriting execution. Full article
(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)
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14 pages, 1207 KiB  
Article
Concurrent and Predictive Validity of a Cycloid Loops Copy Task to Assess Handwriting Disorders in Children
by Clémence Lopez and Laurence Vaivre-Douret
Children 2023, 10(2), 305; https://doi.org/10.3390/children10020305 - 05 Feb 2023
Cited by 4 | Viewed by 1478
Abstract
Handwriting disorders (HDs) are mainly assessed using script or cursive handwriting tasks. The most common is the scale for children’s handwriting, with a French adaptation (BHK). The present study aims to assess the concurrent validity of a pre-scriptural task (copying a line of [...] Read more.
Handwriting disorders (HDs) are mainly assessed using script or cursive handwriting tasks. The most common is the scale for children’s handwriting, with a French adaptation (BHK). The present study aims to assess the concurrent validity of a pre-scriptural task (copying a line of cycloid loops) with the BHK for the diagnosis of HDs. Thirty-five primary school children (7 females, 28 males) with HD aged 6–11 years were recruited and compared to 331 typically developing children (TDC). Spatial/temporal/kinematic measures were collected using a digital pen on a paper. Posture and inter-segmental writing arm coordination were video recorded. A logistic regression statistical method, including a receiver-operating characteristic curve, was used to assess the ability of the task to predict HD. Gestural patterns were significantly less mature in HDs than in TDC (p < 0.05), and associated with poorer quality, less fluid, and slower drawing (p < 0.001). Moreover, good correlations between temporal and kinematic measures and the BHK scale were found. Number of strokes, total drawing time, in-air pauses times, and number of velocity peaks showed very good sensitivity (88%) and specificity (74%) to diagnose HDs. Consequently, the cycloid loops task is an easy, robust, and predictive tool for clinicians to identify HDs before the alphabet is mastered. Full article
(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)
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10 pages, 429 KiB  
Article
Validation of the Concise Assessment Scale for Children’s Handwriting (BHK) in an Italian Population
by Annalivia Loizzo, Valerio Zaccaria, Barbara Caravale and Carlo Di Brina
Children 2023, 10(2), 223; https://doi.org/10.3390/children10020223 - 27 Jan 2023
Cited by 3 | Viewed by 1927
Abstract
Handwriting difficulties represent a common complaint among children and may cause a significant delay in motor skills achievement. The Concise Assessment Scale for Children’s Handwriting (BHK) assesses handwriting skill in clinical and experimental settings, providing a quick evaluation of handwriting quality and speed [...] Read more.
Handwriting difficulties represent a common complaint among children and may cause a significant delay in motor skills achievement. The Concise Assessment Scale for Children’s Handwriting (BHK) assesses handwriting skill in clinical and experimental settings, providing a quick evaluation of handwriting quality and speed through a copying text. The aim of the present study was to validate the Italian adaptation of the BHK in a representative primary school population. Overall, 562 children aged 7–11 from 16 public primary schools of Rome were included and asked to copy a text in 5 min using cursive handwriting. Handwriting quality and copying speed were measured. The included population followed a normal distribution for the BHK quality scores. Sex influenced the total quality scores, whereas school level influenced the copying speed. The BHK quality score was higher in girls (p < 0.05) and resulted as a stable parameter along the school years, without significant variations with regard to the years spent in handwriting exercise (p = 0.76). The handwriting speed was influenced by school level, and significant differences were found for each of the grades from the second to the fifth (p < 0.05), but not for gender (p = 0.47). Both BHK measures represent a helpful tool for the characterization and assessment of children with handwriting difficulties. The present study confirms that sex influences total BHK quality score, while school level influences handwriting speed. Full article
(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)
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Review

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27 pages, 3033 KiB  
Review
Is There a Deficit in Product and Process of Handwriting in Children with Attention Deficit Hyperactivity Disorder? A Systematic Review and Recommendations for Future Research
by Frédéric Puyjarinet, Yves Chaix and Maëlle Biotteau
Children 2024, 11(1), 31; https://doi.org/10.3390/children11010031 - 27 Dec 2023
Viewed by 1123
Abstract
Handwriting abnormalities in children with attention deficit hyperactivity disorder (ADHD) have sometimes been reported both (i) at the product level (i.e., quality/legibility of the written trace and speed of writing) and (ii) at the process level (i.e., dynamic and kinematic features, such as [...] Read more.
Handwriting abnormalities in children with attention deficit hyperactivity disorder (ADHD) have sometimes been reported both (i) at the product level (i.e., quality/legibility of the written trace and speed of writing) and (ii) at the process level (i.e., dynamic and kinematic features, such as on-paper and in-air durations, pen pressure and velocity peaks, etc.). Conversely, other works have failed to reveal any differences between ADHD and typically developing children. The question of the presence and nature of handwriting deficits in ADHD remains open and merits an in-depth examination. The aim of this systematic review was, therefore, to identify studies that have investigated the product and/or process of handwriting in children with ADHD compared to typically developing individuals. This review was conducted and reported in accordance with the PRISMA statement. A literature search was carried out using three electronic databases. The methodological quality of the studies was systematically assessed using the Critical Appraisal Skills Program (CASP) criteria. Twenty-one articles were identified. Of these, 17 described handwriting quality/legibility, 12 focused on speed and 14 analyzed the handwriting process. All the studies (100%) with satisfactory methodology procedures reported an impaired product (for quality/legibility) and 91.7% reported abnormalities in process, while only 25% evidenced a difference in the speed of production. Most importantly, the studies differed widely in their methodological approaches. Substantial gaps remain, particularly with regard to ascertaining comorbidities, ADHD subtypes and the medical status of the included children. The lack of overall homogeneity in the samples calls for higher quality studies. We conclude with recommendations for further studies. Full article
(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)
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Graphical abstract

16 pages, 662 KiB  
Review
Tools and Methods for Diagnosing Developmental Dysgraphia in the Digital Age: A State of the Art
by Jérémy Danna, Frédéric Puyjarinet and Caroline Jolly
Children 2023, 10(12), 1925; https://doi.org/10.3390/children10121925 - 14 Dec 2023
Viewed by 1573
Abstract
Handwriting is a complex perceptual motor task that requires years of training and practice before complete mastery. Its acquisition is crucial, since handwriting is the basis, together with reading, of the acquisition of higher-level skills such as spelling, grammar, syntax, and text composition. [...] Read more.
Handwriting is a complex perceptual motor task that requires years of training and practice before complete mastery. Its acquisition is crucial, since handwriting is the basis, together with reading, of the acquisition of higher-level skills such as spelling, grammar, syntax, and text composition. Despite the correct learning and practice of handwriting, some children never master this skill to a sufficient level. These handwriting deficits, referred to as developmental dysgraphia, can seriously impact the acquisition of other skills and thus the academic success of the child if they are not diagnosed and handled early. In this review, we present a non-exhaustive listing of the tools that are the most reported in the literature for the analysis of handwriting and the diagnosis of dysgraphia. A variety of tools focusing on either the final handwriting product or the handwriting process are described here. On one hand, paper-and-pen tools are widely used throughout the world to assess handwriting quality and/or speed, but no universal gold-standard diagnostic test exists. On the other hand, several very promising computerized tools for the diagnosis of dysgraphia have been developed in the last decade, but some improvements are required before they can be available to clinicians. Based on these observations, we will discuss the pros and cons of the existing tools and the perspectives related to the development of a universal, standardized test of dysgraphia combining both paper-and-pen and computerized approaches and including different graphomotor and writing tasks. Full article
(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)
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20 pages, 681 KiB  
Review
Teaching and Rehabilitation of Handwriting for Children in the Digital Age: Issues and Challenges
by Nathalie Bonneton-Botté, Ludovic Miramand, Rodolphe Bailly and Christelle Pons
Children 2023, 10(7), 1096; https://doi.org/10.3390/children10071096 - 22 Jun 2023
Viewed by 3794
Abstract
Handwriting is a determining factor for academic success and autonomy for all children. Making knowledge accessible to all is a challenge in the context of inclusive education. Given the neurodevelopmental diversity within a classroom of children, ensuring that the handwriting of all pupils [...] Read more.
Handwriting is a determining factor for academic success and autonomy for all children. Making knowledge accessible to all is a challenge in the context of inclusive education. Given the neurodevelopmental diversity within a classroom of children, ensuring that the handwriting of all pupils progresses is very demanding for education professionals. The development of tools that can take into account the variability of the profiles and learning abilities of children with handwriting difficulties offers a new potential for the development of specific and adapted remediation strategies. This narrative review aims to present and discuss the challenges of handwriting learning and the opportunities offered by new technologies involving AI for school and health professionals to successfully improve the handwriting skills of all children. Full article
(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)
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