Handwriting: When it’s More Than Fine Motor

Handwriting is often a common concern among parents.  Recently I talked to a mother about her pre-kindergartener who when asked to write his name, would simply scribble on the paper.  She would go into her son’s classroom and note that all of the other children could not only write their name but other letters of the alphabet – “perfectly”.   We talked further and she noted that he enjoyed activities such as Lego’s, crafts, and playing on the playground.  In fact, his fine motor skills were age appropriate.  He struggled, though, with tasks such coloring, completing simple mazes and any written output. 

As an occupational therapist, this is a story I hear often.  Handwriting is often seen as a fine motor skill.  Indeed, fine motor is a component of handwriting that allows us to grasp our pencil/marker/crayon appropriately and then have adequate control to use it.  But there are many other skills that go into successful handwriting and many of them start before a child even picks up a pencil or a crayon.  To have adequate control over a tool in your hand, such as a pencil, requires a stable base.  Having adequate core strength and stability at the shoulder and arm musculature ensures that the child can maintain an upright posture during tabletop tasks and allows for distal control of the wrist and hand to perform small movements needed for writing.  Young children begin with large movements of their whole arm when first coloring or writing but this moves to smaller movements of the wrist and hand.  Families can encourage children to develop core strength in a variety of way including animal walks, playing in a prone position, pulling and pushing items around the home, and even helping with chores.

Visual motor skills are the coordination of the visual system with the motor system.  The visual system takes in the information and communicates it to the motor system to output it in the form of writing, using scissors, kicking and ball and even tying your shoes.  In regards to handwriting, visual motor skills would be the ability to copy and form letters.  Children first learn to imitate, then copy, then independently write.  Further, children are able to form basic strokes such as a horizontal and vertical line (between age 2 and 3), and then move onto intersecting lines and diagonals (around age 4) and finally more complex shapes such as a square or triangle (between age 4 and 5).  Therefore a child who has a letter or letters in his or her name that contain diagonal lines (X, V, K, etc.) may not be developmentally ready to write their name as well as their peers that may not have those same letters within their name. 

Visual perceptual skills are essentially taking in information from the environment through the eyes, organizing it and then allowing the brain to process the information.  Visual perceptual skills include visual memory, figure ground, spatial organization, visual closure and matching.  Children begin with the simplest task of finding things that are the same, matching, and then move on to noticing differences.  Games such as ” Memory”  and insert puzzles help build these skills.  Spatial organization includes parts to whole tasks such as interlocking puzzles.  Understanding the basis of how pieces of a picture come together to form a whole picture is the basis for letter formation and the notion that a letter “E” is actually 4 different lines versus an “S”, which is one continuous line. 

Visual skills are the basis for both visual perceptual and visual motor skills.  How our eyes move from left to right to scan across the page of a book and then return to the left side for the next line is a building block for handwriting.  Other basic skills include convergence and the ability to cross midline with your eyes.  In many cases children who are having handwriting and reading difficulty may actually have underlying visual issues that need more extensive evaluation.

These are still many other facets to handwriting.  Below is a summary:

• Hand and finger strength: An ability to exert force against resistance using the hands and fingers that allows the necessary muscle power for controlled movement of the pencil.
• Crossing mid-line: The ability to cross the imaginary line running from a person’s nose to pelvis that divides the body into left and right sides.
• Pencil grasp: The efficiency of how the pencil is held, allowing age appropriate pencil movement generation.
• Hand eye coordination: The ability to process information received from the eyes to control, guide and direct the hands in the performance of a task such as handwriting.
• Bilateral integration: Using two hands together with one hand leading (e.g. holding and moving the pencil with the dominant hand while the other hand helps by holding the writing paper).
• Upper body strength: The strength and stability provided by the shoulder to allow controlled hand movement for good pencil control.
• Object manipulation: The ability to skillfully manipulate tools (including holding and moving pencils and scissors) and controlled use of everyday tools (such as a toothbrush, hairbrush, cutlery).
• Visual perception: The brain’s ability to interpret and make sense of visual images seen by the eyes, such as letters and numbers.
• Hand dominance: The consistent use of one (usually the same) hand for task performance, which allows refined skills to develop.
• Hand division: Using just the thumb, index and middle finger for manipulation, leaving the fourth and little finger tucked into the palm stabilizing the other fingers but not participating.
• Visual motor skills: Your body's ability to produce output from information received from the brain and sensory systems; ie..cutting and handwriting
• Visual perceptual skills:  Your brains ability to interpret what your visual system takes in

If your child continues to struggle with pre-writing and writing tasks, it may be beneficial to consult an occupational therapist, who can evaluate the prerequisite skills necessary for successful handwriting.