Standardized tests of handwriting readiness: a systematic review of the literature

Preliminary Psychometric Properties of the Letter Form Assessment Version 2 (LFA-2) Scale

IMPORTANCE

Because handwriting is fundamental to academic success and early literacy development, it is crucial to identify letter formation difficulties. The Letter Form Assessment Version 2 (LFA-2) was developed to measure letter formation fluency but requires validation.

OBJECTIVE

To examine the LFA-2's interrater reliability, construct validity (factor structure), and concurrent validity.

DESIGN

Observational cross-sectional analysis of data from a longitudinal study.

SETTING

School.

PARTICIPANTS

Seventy-eight kindergarten students in Australia (41 boys, 37 girls; M age = 68.5 mo, SD = 4.2) were recruited for construct and concurrent validity studies. A subgroup (n = 16) was used for interrater reliability testing.

RESULTS

Interrater reliability for LFA-2 total was excellent (interclass correlation coefficient = .96, 95% confidence interval [.90, .98]). Interrater agreement coefficients for individual letters scores were good to excellent (Cohen's κ = .71 to 1.00; Gwet's AC1 = .79 to 1.00). Factor analysis established unidimensionality with good total score reliability (ω = .92). Correlations of the LFA-2 total score were moderate to strong with timed and untimed alphabet writing (rs = .32 and rs = .36, respectively), visual-motor integration (rs = .55), fine motor precision (rs = .35), and manual dexterity (rs = .34; all ps < .01).

CONCLUSIONS AND RELEVANCE

Preliminary findings support the LFA-2's reliability and validity for assessing letter formation fluency among beginning writers. Multiple raters using the LFA-2 were reliable in their use of the tool (interrater reliability), and item structure was confirmed to be unidimensional (construct validity). The LFA-2 performed as expected compared with other measures (concurrent validity). Research on larger samples is required to verify these results. Plain-Language Summary: Handwriting is an important skill in early education and supports the development of reading and writing skills. To write by hand efficiently, children need to develop movement patterns that allow them to form letters correctly and from memory. Children can advance their literacy skills once they can perform these letter formation patterns automatically. There are limited assessments of beginning writers' letter formation patterns, making it difficult for occupational therapists and teachers to identify children who need more help with their early handwriting. A new tool, the Letter Form Assessment Version 2 (LFA-2), has been developed to address this need. This study presents the first results of the development and validation of the LFA-2.

Development and Validation of a Tool for Assessing Pre-Writing Skills of 2-5 y old Children

OBJECTIVES

To develop a tool to assess pre-writing skills of 2-5 y old children in India.

METHODS

The tool development process followed the recommendations by Fitzpatrick et al. and the Consensus based Standards for the selection of health Measurement Instruments (COSMIN), and included 4 phases. In Phase I, an initial 35-item draft tool was developed by an expert panel for the tool-development. In Phase II, the 35-item draft tool was prevalidated through peer and expert reviews, pilot-study to assess the tool-comprehensibility, and assessment of test-retest and inter-rater reliability. In Phase III, the 35-item draft tool was administered on the 575 typically developing children aged 2-5 y, recruited from rural, urban, slum, and coastal areas through stratified random sampling. In Phase IV, the normative age-range for development of each item was generated by calculating the age-percentiles (10th, 25th, 50th, 75th, 90th). Factor analysis and item reduction was done for items in 2-3, 3-4, and 4-5 y age-groups. The final tool was converted to graphic format with 10th-90th age-percentile bars.

RESULTS

The final tool had 26 items with a three-factor structure. Cronbach's alpha was within acceptable limits for all three age-groups (0.723, 0.778, and 0.823 in 2-3 y, 3-4 y, and 4-5 y respectively). Kappa coefficients of the items ranged from 0.6-1 in interrater reliability and 0.64-1 test-retest reliability analysis reflecting substantial agreement between ratings.

CONCLUSIONS

A 26-item screening tool "Prewriting skills Assessment Tool" (PAT) to assess writing readiness of 2-5 y old children was developed. Tool reliability and construct validity have been established.

Evaluating the Experiences of Occupational Therapists and Children Using the SensoGrip Pressure-Sensitive Pen in a Handwriting Intervention: Multimethods Study

BACKGROUND

The acquisition of handwriting skills is essential for a child's academic success, self-confidence, and general school performance. Nevertheless, an estimated 5% to 27% of children face handwriting challenges, where the ability to modulate pressure on the pencil and lead on the paper is a key motor component.

OBJECTIVE

We aimed to investigate the experience with and usability of the SensoGrip system, a pressure-measuring pen system with personalized real-time feedback about pressure modulation, in a clinical setting with children and occupational therapists (OTs).

METHODS

A multimethods study was conducted, incorporating qualitative interviews and questionnaires with children, user diaries, focus group discussions, and a usability questionnaire with OTs, along with a questionnaire for parents.

RESULTS

The study involved OTs (n=8), children with handwriting difficulties (n=16), and their parents (n=16), each of whom used the SensoGrip system in up to 5 therapy sessions. OTs reported that the SensoGrip system helped to focus the child's awareness on handwriting pressure and to measure it objectively. The system received high acceptance and usability ratings from the OTs-usefulness: median score of 4 out of 7; ease of use and ease of learning: median score of 6 out of 7; and satisfaction: median score of 6 out of 7. Participants appreciated that it fosters pressure awareness and motivation to draw and write.

CONCLUSIONS

The SensoGrip pressure-sensing system with real-time feedback is a promising tool for pediatric occupational therapy. It supports children with handwriting difficulties to adjust their pressure application during the task. In the future, controlled quantitative trials are warranted to further examine the system's impact.

Teaching and Rehabilitation of Handwriting for Children in the Digital Age: Issues and Challenges

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.

Cognitive Orientation to Daily Occupational Performance: A Randomized Controlled Trial Examining Intervention Effects on Children with Developmental Coordination Disorder Traits

Children with traits of developmental coordination disorder (DCD-t) may experience occupational performance problems that go unrecognized and therefore may not be adequately supported. The cognitive orientation to daily occupational performance (CO-OP) approach has been effective in interventions for developmental coordination disorder (DCD). Based on an open-label, randomized controlled trial design, this study evaluated the effects of CO-OP on the occupational performance and motor skills of older kindergarten children with DCD-t using the School Assessment of Motor and Process Skills (S-AMPS) and the Movement Assessment Battery for Children, Second Edition. Children with a total DCDQ score of less than 40 or M-ABC2 scores in the 5th to 16th percentile were considered to have DCD-t. Furthermore, children with DCD-t and S-AMPS process skills less than 0.7 were considered to have DAMP (Deficits in Attention, Motor control and Perception)-t. After 3 months of CO-OP intervention, the performance and motor skills of children with DCD-t improved significantly. However, there were no significant changes noted in the motor skills of children with DAMP-t, although their occupational performance improved. These results suggest that CO-OP is effective even for older kindergarten children with DCD-t. However, further improvement of the CO-OP approach or a different strategy is required for children with ADHD comorbidity.

Ready for handwriting? A reference data study on handwriting readiness assessments

INTRODUCTION

Early evaluation of writing readiness is essential to predict and prevent handwriting difficulties and its negative influences on school occupations. An occupation-based measurement for kindergarten children has been previously developed: Writing Readiness Inventory Tool In Context (WRITIC). In addition, to assess fine motor coordination two tests are frequently used in children with handwriting difficulties: the modified Timed Test of In-Hand Manipulation (Timed TIHM) and the Nine-Hole Peg Test (9-HPT). However, no Dutch reference data are available.

AIM

To provide reference data for (1) WRITIC, (2) Timed-TIHM and (3) 9-HPT for handwriting readiness assessment in kindergarten children.

METHODS

Three hundred and seventy-four children from Dutch kindergartens in the age of 5 to 6.5 years (5.6±0.4 years, 190 boys/184 girls) participated in the study. Children were recruited at Dutch kindergartens. Full classes of the last year were tested, children were excluded if there was a medical diagnosis such as a visual, auditory, motor or intellectual impairment that hinder handwriting performance. Descriptive statistics and percentiles scores were calculated. The score of the WRITIC (possible score 0-48 points) and the performance time on the Timed-TIHM and 9-HPT are classified as percentile scores lower than the 15th percentile to distinguish low performance from adequate performance. The percentile scores can be used to identify children that are possibly at risk developing handwriting difficulties in first grade.

RESULTS

WRITIC scores ranged from 23 to 48 (41±4.4), Timed-TIHM ranged from 17.9 to 64.5 seconds (31.4± 7.4 seconds) and 9-HPT ranged from 18.2 to 48.3 seconds (28.4± 5.4). A WRITIC score between 0-36, a performance time of more than 39.6 seconds on the Timed-TIHM and more than 33.8 seconds on the 9-HPT were classified as low performance.

CONCLUSION

The reference data of the WRITIC allow to assess which children are possibly at risk developing handwriting difficulties.

Handwriting and typing: Occupational therapy practice when supporting adolescents with handwriting difficulties

Introduction

While most children have developed effective handwriting by secondary school age, some have handwriting difficulties that hamper academic progress. Occupational therapists play a role in assessment and planning support, which may include introducing typing as an alternative. However, there is limited understanding regarding how decisions are made about recommending typing. This study explored the support provided to adolescents with handwriting difficulties by occupational therapists, and the contextual factors that influence their decision-making.

Method

Semi-structured interviews were conducted with 13 occupational therapists and analysed using thematic analysis.

Findings

Although there was shared practice underpinned by occupational therapy philosophy, there was also divergent practice due to different approaches. Roles and responsibilities, resources, and evidence and experience influenced occupational therapists' practice. Understanding the adolescent's motivation, the effect of handwriting difficulties on well-being and the need for a functional method to record schoolwork, was central to occupational therapists' decision-making to recommend typing.

Conclusion

Strategies are needed to address the knowledge-practice gap, including evidence-based guidelines. Closer collaboration between occupational therapists and school staff could increase understanding of roles and highlight the unique occupational therapy contribution. Further research examining whether, when and how to introduce typing as an alternative to handwriting would support best practice.

Neurofeedback for the Education of Children with ADHD and Specific Learning Disorders: A Review

Neurofeedback (NF) is a type of biofeedback in which an individual’s brain activity is measured and presented to them to support self-regulation of ongoing brain oscillations and achieve specific behavioral and neurophysiological outcomes. NF training induces changes in neurophysiological circuits that are associated with behavioral changes. Recent evidence suggests that the NF technique can be used to train electrical brain activity and facilitate learning among children with learning disorders. Toward this aim, this review first presents a generalized model for NF systems, and then studies involving NF training for children with disorders such as dyslexia, attention-deficit/hyperactivity disorder (ADHD), and other specific learning disorders such as dyscalculia and dysgraphia are reviewed. The discussion elaborates on the potential for translational applications of NF in educational and learning settings with details. This review also addresses some issues concerning the role of NF in education, and it concludes with some solutions and future directions. In order to provide the best learning environment for children with ADHD and other learning disorders, it is critical to better understand the role of NF in educational settings. The review provides the potential challenges of the current systems to aid in highlighting the issues undermining the efficacy of current systems and identifying solutions to address them. The review focuses on the use of NF technology in education for the development of adaptive teaching methods and the best learning environment for children with learning disabilities.

In-hand manipulation assessment instruments for children: A scoping review

Aim

Accurate assessment of in-hand manipulation is imperative when treating children with fine motor delays. A clinically suitable instrument for in-hand manipulation is required to inform the paediatric developmental and rehabilitation context. Critical evaluation of the available instrument is required to make an informed decision and direct future research. The aim of the study was to assess the available literature with a view to writing a scoping review on in-hand manipulation assessment instruments for children.

Methods

The Arskey and O'Malley six-stage scoping review was applied. Fifteen databases were sourced for articles published between 1 January 1990 and 31 December 2020. After identifying 33 eligible articles that met the inclusion criteria, the data obtained from the articles were charted.

Results

Eleven in-hand manipulation assessment instruments were identified and summarised according to (i) the constructs of in-hand manipulation included; (ii) clinical utility aspects of applicability and practicality and (iii) psychometric properties.

Conclusion

At the time of the review, none of the instruments had comprehensively completed the instrument development process to the point of standardisation with evaluated psychometric properties. Further research is recommended for the development of a gold standard in-hand manipulation assessment instrument.

The Development and Preliminary Psychometric Properties of the TeleWrite: A Telehealth-Based Handwriting Assessment for School-Aged Children

This article describes the development and preliminary psychometric properties of the TeleWrite, a handwriting assessment tool designed to measure the rate, accuracy, and fluency of children's handwriting for children in first through third grade administered via telehealth. A series of three pilot studies were completed to determine initial interrater reliability, content validity, and clinical utility of the TeleWrite. A study with eight children was used to determine preliminary interrater reliability testing using a beta version of the TeleWrite with (n = 9) raters. The reliability coefficient was obtained using intraclass correlation (ICC) and yielded α = 0.92 for total scores, CI [0.815, 0.983] and the Cronbach's α measure for internal consistency was α = 0.95 (excellent). A clinical utility survey of (n = 55) pediatric occupational therapists was used to obtain their clinical impression regarding the usefulness and accuracy. Representing twelve different countries and twenty-two U.S. states, the respondents indicated that 61% (n = 33) are quite or extremely likely to use the TeleWrite in their practice and most participants (64%; n = 35) indicated that TeleWrite was quite/extremely accurate in measuring handwriting performance. Third, a content validity study with nine handwriting experts reviewed and concluded that all ten subtests of the TeleWrite tool are considered essential. All preliminary studies strengthen the development of the TeleWrite assessment to advance to construct validation of the tool.

Handwriting in Children with Developmental Coordination Disorder: Is Legibility the Only Indicator of a Poor Performance?

Research on the use of speed, as an indicator of motor handwriting problems, is controversial and the legibility of the text is the measure mostly examined in children. This case-control study compared handwriting legibility and speed in 25 children with Developmental Coordination Disorder (DCD) and 75 typically developing peers matched by school grade (third and fourth grade). Children with DCD achieved significantly lower scores than their peers in both legibility and speed measures, overall and in the third and in the fourth grade independently. These measures represent a good insight into children's writing abilities and could be both used to screen and monitor.

Initial psychometric evaluation of the Hartley Knows Writing Shapes Assessment Version 2 with typically developing children between the ages of 4 and 8

INTRODUCTION

Despite advances in technology, handwriting still remains an important part of the school curriculum. Especially during the early years of schooling, handwriting difficulties have been shown to negatively affect academic success. Consequently, occupational therapists rely on sound psychometric tools to assess a child's visual motor abilities and implement appropriate strategies to facilitate their handwriting outcomes. The Hartley Knows Writing Shapes Assessment Version 2 (HKWSA-V2) evaluates knowledge of writing shapes, ability to replicate writing shapes and knowledge of handwriting concepts used in the Hartley Knows Writing Program (HKWP). The current study describes the initial development and psychometric evaluation of the HKWSA-V2.

METHOD

Typically developing children (N = 50) between 4 and 8 years old, completed two visual motor assessments: the HKWSA-V2 and the Beery Buktenica Developmental Test of Visual Motor Integration 6th Ed. (Beery VMI). Guided by the COnsensus-based standards for the Selection of health Measurement INstruments, statistical analysis was conducted using various non-parametric tests to assess the internal consistency, construct, and criterion validity of the HKWSA-V2.

RESULTS

The internal consistency of the HKWSA-V2 ranged between adequate and excellent (Cronbach's α = 0.61-0.88). Construct validity as hypothesised, was supported with strong correlations found between groups of children who had and had not been involved in the HKWP. Statistically significant differences were also found in HKWSA-V2 scores based on the child's chronological age (r = .51, p < .01; r = .34, p < .05) and year level (p = .00). Criterion validity was substantiated with moderate to strong correlations found between all HKWSA-V2 scales and subscales and the Beery VMI subscales (ρ = 0.06-0.53).

CONCLUSION

Evaluation of the tool provides promising initial psychometric findings. The tool allows professionals and clinicians to evaluate a child's visual motor abilities according to concepts learnt within the HKWP. Further development of the HKWSA-V2 is warranted.

Reliability and validity of Handwriting Test for Preschool Children (HT-PRE): A new tool to assess the handwriting ability of preschool children aged 5-6 years old in Mainland China

BACKGROUND

Handwriting ability is related to many neuronal functions, such as visual-perceptual skills, orthographic coding, motor planning and execution, kinesthetic feedback and visual-motor coordination. To date, there is no specific assessment tool for to assess preschool children's handwriting ability in Mainland China. Our study aimed to develop a tool to assess the handwriting ability of children aged 5-6 years old in Mainland China and to analyze its reliability and validity.

METHODS

The investigation comprised three phases: 1) original tool generation, 2) tool revision, 3) reliability analysis (i.e., interrater, test-retest) and validity analysis (i.e., content, criterion).

RESULTS

The sample included a total of 482 children. The internal consistency (Cronbach alpha) was 0.74. The test-retest correlation coefficients ranged from 0.38 to 0.80. As expected, our data showed an improving trend in handwriting, and differences in respect to age and gender. When compared with the 'handwriting difficulty' group, each subtest score of children in the 'normal' group showed significant differences (p < 0.05). The correlation validity, compared with the visual-motor integration development test (VMI), was 0.17-0.52.

CONCLUSION

The Handwriting Test for Preschool Children (HT-PRE), which is a newly developed handwriting screening tool for preschool children aged 5-6 years old in Mainland China, has displayed a very good internal consistency, acceptable test-retest reproducibility, and good criterion-based validity, and has also shown good application prospects for handwriting difficulty screening in a clinical setting.

A systematic review of occupational therapy intervention for handwriting skills in 4-6 year old children

INTRODUCTION

Handwriting skills play a significant role in all stages of an individual's life. Writing interventions should be considered at a younger age to ensure proper development of writing skills. Hence, the aims of this study is to evaluate the current evidence of occupational therapy interventions in handwriting skills for 4-6 year old children.

METHODS

Published literature was systematically searched according to PRISMA guidelines using specific key terms. Initial search identified 785 studies; however only seven met the inclusion criteria and were assessed for final review. Studies were methodologically appraised using the McMaster Critical Review Form-Quantitative Studies.

RESULTS

The review found no randomised control trial study design pertaining to the reviewed area. However, it can be seen that occupational therapy interventions for writing skills in 4-6 year old children managed to increase the targeted skills. The results were similar across samples with or without disabilities. An effective integration of occupational therapy interventions into educational curriculum was found to save both time and cost.

CONCLUSION

The long-term benefit from these interventions and the effects of these interventions on a broader spectrum of fine motor abilities need to be explored further with stronger research designs. However, the lack of studies adopting high level study designs, i.e., RCT designs means, results need to be approached with caution by occupational therapists when implementing handwriting skills intervention in practice.

Understanding handwriting difficulties: A comparison of children with and without motor impairment

The nature of handwriting difficulties have been explored in children with specific developmental disorders. The aim of this study was to investigate the nature of handwriting difficulties in children with dysgraphia, a less studied group who have significant handwriting difficulties in the absence of motor control or cognitive difficulties. The performance of a dysgraphia group aged 8-14 years was compared to a group with Developmental Coordination Disorder and to typically developing (TD) controls. Participants completed two handwriting tasks on a digitizing writing tablet. The amount and accuracy of the handwriting product was measured, plus various temporal and spatial features of the writing process. There were no significant differences in performance between the two groups with handwriting difficulties but both performed more poorly than the TD group. Individual differences in the type and severity of handwriting impairments suggest the need for a range of classroom assessments to tailor intervention appropriately.

Evaluation of Standardized Instruments for Use in Universal Screening of Very Early School-Age Children: Suitability, Technical Adequacy, and Usability

Universal screening of very early school-age children (age 4-7 years) is important for early identification of learning problems that may require enhanced learning opportunity. In this context, use of standardized instruments is critical to obtain valid, reliable, and comparable assessment outcomes. A wide variety of standardized instruments is available for screening and assessment purposes, though previous reviews have revealed some technical inadequacies. Suitability and usability of instruments should be considered as well as technical adequacy, making instrument selection a challenge for education professionals. This review used a systematic search to identify 48 instruments that measured development and early academic skills in very early school-age children. Instruments were evaluated and mapped against established psychometric and usability criteria, and rated as good, adequate, or not adequate. The results provide education professionals with a guide to selection of standardized instruments suitable for this age group and assessment purpose.

Child-Report Measures of Occupational Performance: A Systematic Review

Introduction

Improving occupational performance is a key service of occupational therapists and client-centred approach to care is central to clinical practice. As such it is important to comprehensively evaluate the quality of psychometric properties reported across measures of occupational performance; in order to guide assessment and treatment planning.

Objective

To systematically review the literature on the psychometric properties of child-report measures of occupational performance for children ages 2–18 years.

Methods

A systematic search of the following six electronic databases was conducted: CINAHL; PsycINFO; EMBASE; PubMed; the Health and Psychosocial Instruments (HAPI) database; and Google Scholar. The quality of the studies was evaluated against the COSMIN taxonomy of measurement properties and the overall quality of psychometric properties was evaluated using pre-set psychometric criteria.

Results

Fifteen articles and one manual were reviewed to assess the psychometric properties of the six measures–the PEGS, MMD, CAPE, PAC, COSA, and OSA- which met the inclusion criteria. Most of the measures had conducted good quality studies to evaluate the psychometric properties of measures (PEGS, CAPE, PAC, OSA); however, the quality of the studies for two of these measures was relatively weak (MMD, COSA). When integrating the quality of the psychometric properties of the measures with the quality of the studies, the PAC stood out as having superior psychometric qualities.

Conclusions

The overall quality of the psychometric properties of most measures was limited. There is a need for continuing research into the psychometric properties of child-report measures of occupational performance, and to revise and improve the psychometric properties of existing measures.

Evaluating fine motor coordination in children who are not ready for handwriting: which test should we take?

When children are not ready to write, assessment of fine motor coordination may be indicated. The purpose of this study was to evaluate which fine motor test, the Nine-Hole Peg Test (9-HPT) or the newly developed Timed Test of In-Hand Manipulation (Timed-TIHM), correlates best with handwriting readiness as measured by the Writing Readiness Inventory Tool In Context-Task Performance (WRITIC-TP). From the 119 participating children, 43 were poor performers. Convergent validity of the 9-HPT and Timed-TIHM with WRITIC-TP was determined, and test-retest reliability of the Timed-TIHM was examined in 59 children. The results showed that correlations of the 9-HPT and Timed-TIHM with the WRITIC-TP were similar (rs = -0.40). The 9-HPT and the complex rotation subtask of the Timed-TIHM had a low correlation with the WRITIC-TP in poor performers (rs = -0.30 and -0.32 respectively). Test-retest reliability of the Timed-TIHM was significant (Intraclass Correlation Coefficient = 0.71). Neither of these two fine motor tests is appeared superior. They both relate to different aspects of fine motor performance. One of the limitations of the methodology was unequal numbers of children in subgroups. It is recommended that further research is indicated to evaluate the relation between development of fine motor coordination and handwriting proficiency, on the Timed-TIHM in different age groups.

Predictive validity of kindergarten assessments on handwriting readiness

We investigated the predictive value of a new kindergarten assessment of handwriting readiness on handwriting performance in first grade as evaluated by the Systematic Screening for Handwriting Difficulties (Dutch abbreviation: SOS). The kindergarten assessment consisted of the Writing Readiness Inventory Tool In Context (WRITIC), the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery™VMI) and the Nine-Hole Peg Test (9-HPT). The WRITIC evaluates in kindergarten children (aged 5-6 years) prewriting skills, the Beery™VMI and 9-HPT evaluate visual motor integration and fine-motor coordination, all elements important for handwriting readiness. In kindergarten, 109 children (55 boys; mean age 70 months, SD 4.8 months) were tested with the WRITIC, Beery™VMI and 9-HPT and one year later in first grade (mean age 85 months, SD 4.5 months) with the SOS. A multivariable linear mixed model was used to identify variables that independently predict outcomes in first grade (SOS): baseline scores on WRITIC-TP, Beery™VMI, 9-HPT, 'sustained attention,' 'gender,' 'age' and 'intervention' in the intermediate period. The results showed that WRITIC-TP, Beery™VMI, and 9-HPT, 'sustained attention,' 'gender' and 'intervention' had all predictive value on the handwriting outcome. Thereby WRITIC-TP was the main predictor for outcome of SOS-Quality, and Beery™VMI and 9-HPT were the main predictors of SOS-Speed. This kindergarten assessment of WRITIC-TP, Beery™VMI, and 9-HPT contributes to the detection of children at risk for developing handwriting problems.

Development of the writing readiness inventory tool in context (WRITIC)

This article describes the development of the Writing Readiness Inventory Tool in Context (WRITIC), a measurement evaluating writing readiness in Dutch kindergarten children (5 and 6 years old). Content validity was established through 10 expert evaluations in three rounds. Construct validity was established with 251 children following regular education. To identify scale constructs, factor analysis was performed. Discriminative validity was established by examining contrast groups with good (n = 142) and poor (n = 109) performers in paper-and-pencil tasks. Content validity was high with 94.4% agreement among the experts. Two reliable factors were found in the performance of paper-and-pencil tasks with Cronbach's alphas of 0.82 and 0.69 respectively. The contrast groups differed significantly in two WRITIC subdomains: "Sustained attention" and "Task performance". Our findings indicated that the WRITIC is feasible for use in the classroom.

Content and Construct Validity of Here’s How I Write (HHIW): A Child’s Self-Assessment and Goal Setting Tool

OBJECTIVE. We examined content and construct validity of Here’s How I Write: A Child’s Self-Assessment and Goal Setting Tool, to assess children’s perception of their handwriting and set child-directed goals.

METHOD. In Study 1, a content validity study, 6 occupational therapists and 2 educators assessed the need for this type of measure and examined the proposed items. Thirty-four occupational therapists and educators then completed an online survey examining the items. Study 2, a construct validity study, compared the self-ratings of 20 children with poor handwriting and 20 children with good handwriting in Grades 2–5 with their teachers’ ratings.

RESULTS. Results supported test content and indicated freedom from culture and gender bias. The assessment discriminated between good and poor writers. The relationship between teacher and student ratings was significant, although teachers of poor writers rated the children lower than the children rated themselves.

CONCLUSION. These studies provide support for the tool’s validity.

Neural correlates of paediatric dysgraphia

Writing is an important skill that is related both to school performance and to psychosocial outcomes such as the child's self-esteem. Deficits in handwriting performance are frequently encountered in children with developmental coordination disorder. This review focuses on what is known about the neural correlates of atypical handwriting in children. Knowledge of the neural correlates is derived from studies using clinical case designs (e.g. lesion studies), studies using neuroimaging, and assessment of minor neurological dysfunction. The two functional imaging studies suggest a contribution of cortical areas and the cerebellum. The largest study indicated that cortical areas in all regions of the brain are involved (frontal, temporal, parietal, and occipital). The two lesion studies confirmed cerebellar involvement. The findings of the study on minor neurological dysfunction in children with writing problems correspond to the imaging results. The limited data on the neural substrate of paediatric dysgraphia suggest that at least a subset of the children with dysgraphia have dysfunctions in extensive supraspinal networks. In others, dysfunction may be restricted to either the cerebellum or specific cortical sites.