How Handwriting Difficulties Could Signal An Underlying Problem

Debra Fenton: My name’s Debra Fenton. I am a Speech Language Pathologist in Denver, Colorado. I own a pediatric speech and occupational therapy practice called Lowry Speech and Occupational Therapy. Today I’m here with our Clinical Director, Erin Heighway.

Erin Heighway: Morning Deb. I’m also a speech pathologist and here at Lowry Speech and Occupational Therapy. We support many academic issues that kids are having and one of those is handwriting difficulties. We get a lot of phone calls and questions about handwriting and it’s actually quite a complex process. Deb, what are some of the things that parents are reporting they’re seeing or observing as far as their kid’s handwriting?

Debra Fenton: Sure. I think some of the most common concerns with handwriting are mainly related to the content;  the students writing is really not matching up with their verbal abilities. Their writing is very simplistic. They’re not using a lot of vocabulary. It’s very very short and more typical of a much younger child. Other things that parents report is that their child really dislikes handwriting. They avoid it. Homework is a terrible time at home. There’s a lot of fighting to get things done. Homework takes a long time and generally the quality of the work is not commensurate with the child’s other abilities. The handwriting is sloppy, the spacing is poor, the grammar’s poor, they’re not capitalizing, using periods, all of those kinds of things.

Erin Heighway: So it is a whole spectrum of difficulties kids can have as far as their handwriting and writing goes. Because of that, it is kind of a complicated assessment process. We’re very fortunate here that we have both speech and occupational therapists and have a multidisciplinary model because we’re able to then look at all of the aspects of handwriting to figure out exactly what’s going on and how to support it best.

Debra Fenton: That’s right. Oftentimes I think a lot of teachers and parents have a very simplistic view and automatically assume that the difficulty with writing is just related to fine motor difficulty and they may suggest a pencil grasp or just more practice. But when we take a closer look at the whole writing process, it’s one of the most difficult processes for students because it really taps into a student’s attention,  motor planning, language skills, and everything is kind of being taxed at one time. We often see that they just kind of fall apart in the writing process.

Erin Heighway: So where we typically start is by asking some questions to see specifically where parents concerns are lying so that we can help determine treatment. Do we start with an occupational therapy evaluation, looking at those fine motor abilities, looking at something like posture or core stability, the motor planning pieces of it, whether they’re attending well enough and regulated well enough to be able to sit and complete this complicated task.

Debra Fenton: The other side is, we look to see if it is related to an underlying language difficulty, particularly if the child is demonstrating poor spelling abilities or maybe they’re lagging behind in their reading. It would be expected that writing would be a more difficult process for them if they struggle in these areas.. So one of the things that we would like to rule out is an underlying reading disability that’s contributing to the writing difficulty. So that’s really getting into a much bigger assessment process where we’re looking at the processing speed, a child’s ability to see and remember words, spellings of words, how fluently they’re able to read, how long it takes them to acquire sight words into their vocabulary. If they’re struggling in those areas, then you know a lot of times that handwriting is probably related to more of a language based difficulty as opposed to a motor based issue.

Erin Heighway: After we do the evaluation, we have to begin a treatment process.  Depending on a student’s age and the level of severity of their difficulties, intervention varies a lot. As writing becomes more and more a piece of their everyday academics, we have to also start looking at accommodating that with some technology. So whether that’s building some keyboarding skills, using some voice to text technology, all of those sorts of things can really help your child be able to demonstrate their knowledge without their handwriting or spelling hindering that process.

Debra Fenton: One of the things that an occupational therapist will also look at is that visual-motor integration, how well the eyes and hands are working together. They’ll also want to rule out that there’s not a visual scanning or tracking problem that is underlying and causing some of the difficulties. In most cases of language-based learning disabilities, a child may have symptoms of some scanning or tracking difficulty, but that’s really just a symptom, it’s not the problem. In some cases, we do have students where they do need support for that visual piece.

Erin Heighway: So feel free if your child has some difficulties with handwriting to give us a call at 303-360-0727 and we’d be happy to help problem solve what evaluation would be the most appropriate to start with and get some help for your student.