Handwriting The ‘Write’ Way

Handwriting is a complex process that involves the coordination of eyes, body posture, arms, hands, and fingers to produce written language. While a teacher may provide handwriting instruction, occupational therapists can evaluate any underlying sensory, motor, postural or perceptual deficits that may be interfering with a child’s handwriting performance. In therapy, there is often greater emphasis on addressing issues in the handwriting process than the actual handwriting product. Focusing on the process can ultimately generate a more legible handwriting product that is supported throughout the stages of development.


The first step is to evaluate the underlying cause of handwriting difficulties by assessing:

  • Visual Motor Integration – The coordinated ability to visually perceive and interpret information from the environment and then direct movements of the body to produce a motor expression (i.e., copying lines, shapes, letters, numbers).
  • Visual Perception – The brain’s ability to receive, process, and make sense of the information from the visual system (i.e., letter/word spacing, discrimination between similar numbers or letters)
  • Fine Motor Skills – The ability to perform controlled small movements in the wrist, hands, and fingers (i.e., in-hand manipulation, grasp/grip, strength, hand dominance).
  • Sensory Processing – The ability to process and organize sensory information received from the environment (i.e., pencil pressure, tight grasp).
  • Postural Stability – Controlling or regulating the orientation of the body’s position. (i.e., core strength, chair/desk size).

These areas can be analyzed using an assessment battery selected based on a child’s stage of development and the presentation of their handwriting issues. After a formal and informal evaluation of the child’s handwriting skills, an intervention plan can be created to address and accommodate for any deficits.

This may include implementing some of the following strategies, programs, or equipment:

  • Grasp
    • Early grasps: As a child develops physically, the type of grasp they use begins to mature.
      • Radial cross palmar grasp (0-2 years)
      • Palmar supinate grasp (1-2 years)
      • Digital pronate grasp (2-3 years)
    • Inefficient grasps: An inefficient pencil grasp tends to restrict finger movements which results in movements generated from the wrist or arm. Pencil grips can be helpful in correcting positioning of fingers and providing control when writing.
      • Four finger grasp
        • Grip – Handi-writer (promote hand separation and control)
      • Thumb tuck grasp
        • Grip – Crossover grip (designed to keep fingers from crossing)
      • Thumb wrap grasp
        • Grip – Original pencil grip (molded to keep fingers in the correct placement and prevent thumb from wrapping)
    • Efficient/Functional grasps: A functional grasp of the writing utensil enables controlled finger movements.
      • Dynamic Quadripod Grasp
      • Lateral Quadripod Grasp
      • Lateral Tripod Grasp
      • Dynamic Tripod Grasp
  • Programs
    • Handwriting Without Tears
      • This program teaches children handwriting by grouping letters based on their similar formation to help facilitate motor learning.
  • Posture
    • In order to have functional mobility in the wrist, hands, and fingers there must first be stability in the core and midline. When seated the hips are the base of support and should be positioned at 90 degrees. The legs should be parallel to the floor with knees bent at 90 degrees and feet resting flat on the floor. The 90-90-90 degree rule for positioning at the hips, knees, and feet (with slight lean at hips toward the desk/table) is the most functional position.
  • Other Tips and Tricks to Support Handwriting Development
    • Use connect the dots worksheets using left to right strokes to enhance left-right discrimination
    • Provide a variety of writing utensils to allow the child to explore their properties (i.e., felt tip pens, crayons, pencils, chalk, paint brushes, weighted pens/pencils)
    • Use grid paper to promote letter and word spacing.
    • Use adaptive paper with raised or highlighted lines to encourage proper sizing and spacing.
    • Pick up small objects using tweezers to isolate finger movements and strengthen finger muscles
    • Draw lines, shapes, letters, or words in various elements (i.e., shaving cream, sand, paint)
    • Create a DIY slant board using a large binder and clipboard to help place the hand in wrist in the optimal position and prevent hunched posture when sitting.
    • Use weighted writing utensils to help stabilize uncontrollable movements and provide more sensory feedback to the hand when writing.