Poor handwriting is a diagnostic criterion for developmental coordination disorder. Typical of poor handwriting is its low overall quality and the high variability of the spatial characteristics of the letters, usually assessed with a subjective handwriting scale. Recently, Dynamic Time Warping (DTW), a technique originally developed for speech recognition, was introduced for pattern recognition in handwriting. The present study evaluates its application to analyze poor handwriting. Forty children attending Dutch mainstream primary schools were recruited and based on their scores on the Concise Evaluation Scale for Children's Handwriting (Dutch abbreviation: BHK), 20 good and 20 poor writers (of whom 13 were scheduled for handwriting intervention) were identified. The groups were matched for age (7-9 years), school grade (grades 2 and 3) and handedness. The children subsequently wrote sequences of the letter 'a' on a graphics tablet in three conditions (normal, fast, and accurate). Classical kinematics were obtained and for each individual letter DTW was used to calculate the distance from the mean shape. The DTW data revealed much higher variability in the letter forms of the poor writers that was independent of the kinematic results of larger trajectories, faster movements, and higher pen pressure. The current results suggest that DTW is a valid and objective technique for letter-form analysis in handwriting and may hence be useful to evaluate the rehabilitation treatments of children suffering from poor handwriting. In education research it may be exploited to explore how children (should) learn to write.

This pilot study is to investigate the influence of a developmental coordination disorder (DCD) comorbidity in a group of children with learning disability (LD). Reading and writing were assessed to investigate if the coexistence of a motor impairment can worsen writing quality, speed, and reading accuracy. A sample of 33 LD children (aged 7-11 years) was divided in two subgroups, on the base of their scores on the Movement Assessment Battery for Children: LD-only (n = 14) and LD with a comorbidity for DCD (LD-DCD, n = 19). No differences were found in handwriting speed, but significant differences were found in handwriting quality: LD-DCD children showed a worst performance. Reading words and nonwords accuracy was more impaired in LD-only children than in LD-DCD children. Group differences suggest a poorer phonological decoding of the LD-only sample, whereas worst cursive handwriting legibility scores are typical of the motor-impaired subgroup.

Evidence suggests that task-based training approaches can improve the performance of children with handwriting difficulties. The present case study tests the efficacy of the Handwriting Task Program (HTP). Three male children (9-10 yr. old) with poor handwriting skills and different developmental disorders participated in the HTP, twice per week, for 13 wk. Handwriting legibility was assessed through the Concise Evaluation Scale for Children's Handwriting, and fine motor performance and handwriting speed were evaluated at pre- and post-treatment with the Visual Motor Integration Test and the Battery for the assessment of writing skills of children from 7 to 13 yr. old. The results showed that motor efficiency and global handwriting quality improved in all the children, although some handwriting difficulties still persisted in one child with Developmental Coordination Disorder (DCD). Further study may confirm on a larger sample that a visual-spatially based training may improve the handwriting legibility of children with DCD.

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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.

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