Predictors of handwriting in children with Autism Spectrum Disorder

Abstract

1During writing, perceptual, motor, and cognitive processes interact. This study 2 explored the predictive value of several factors on handwriting quality as well as on speed in 3 children with Autism Spectrum Disorder (ASD). Our results showed that, in this population, 4 age, gender, and visual-motor integration significantly predicted handwriting quality, whereas 5 age, reading abilities, and fine motor coordination had an impact on handwriting speed. These 6 results indicate that, although reading abilities are often overlooked, handwriting remediation 7 in children with ASD should tackle reading skills as well. Handwriting is a complex task in which perceptual, motor, and cognitive processes 3 interact (Berninger, Mizokawa, & Bragg, 1991; Graham & Weintraub, 1996; Tseng & 4 Cermak, 1993), implying that, when learning to write, skills in several domains need to be 5 mastered. Due to its complexity, a substantial part of children struggle to develop proficient 6 handwriting (Karlsdottir & Stefansson, 2002; Smits-Engelsman & Van Galen, 1997). In the 7 Dutch-speaking part of Belgium, Flanders, children must be able to copy texts in polished 8 handwriting at the end of primary school (Vlaams Ministerie van Onderwijs en Vorming, 9 2010) and the way this aim has to be reached is determined by each school board itself. 10In certain clinical syndromes, a higher prevalence of handwriting difficulties 11 compared to typically developing (TD) children has been reported. Lately, it has become 12 increasingly obvious that children with Autism Spectrum Disorder (ASD) encounter serious 13 writing difficulties. Several studies have found that, during a copy task, children and 14 adolescents with Asperger syndrome or ASD produce fewer legible letters and words, write 15 with an overall lower quality, and make more errors regarding letter alignment, size, and 16 formation than TD children and adolescents (Fuentes, Mostofsky, & Bastian, 2009, 2010 17 Myles et al., 2003). During free writing as well, just slightly more than half of the words 18 produced by two children with Asperger syndrome were legible (Henderson & Green, 2001). 19On the other hand, no significant difference in legibility was found between children with 20 ASD and TD children in the study of Cartmill, Boccthy, Rodger, and Medst (2009). With 21 respect to writing speed, children and adolescents with Asperger syndrome or ASD appeared 22 not to write slower than TD children (Cartmill et al., 2009; Fuentes et al., 2009 Fuentes et al., , 2010 although the two children with Asperger syndrome examined by Henderson and Green (2001) 24 did produce fewer letters in one minute than what was expected at their age. Keeling, & Tuck, 1983). In order to treat handwriting problems adequately, 5 practitioners need to know which factors contribute to handwriting difficulties. 6First of all, the handwriting of boys and girls differs substantially. In fact, the 7 dissimilarities are so prominent that one can easily predict a writer's gender by the written 8 o...

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