The Relationship Between Linguistic Skills, Visual–Motor Functions, and Handwriting Performance at Various Developmental Stages

PURPOSE: To examine the relationship between linguistic and visual–motor functions and handwriting performance at different stages of handwriting development.

RATIONALE: Handwriting is an important skill for participation in daily school life. It requires linguistic and visual–motor skills. Effective occupational therapy assessment and intervention among students with handwriting difficulties requires an understanding of the factors underlying handwriting performance. Few studies examined the relationship between linguistic functions and handwriting performance (in English). These studies showed that the linguistic skills associated with handwriting performance were different at the various stages of handwriting development. This issue was not examined in other languages, nor was the association between visual–motor functions and handwriting performance at the different developmental stages.

DESIGN: A correlational study design was employed.

PARTICIPANTS: The study included 114 normally achieving students in second (n = 54, mean [M] age = 7.80, standard deviation [SD] = .31) and fourth (n = 60, M age = 9.9, SD = .30) grades, whose mother tongue is Arabic. Students with neurodevelopmental, sensory, or physical disabilities were excluded. Using convenience sampling, students were recruited from three schools in Israel.

METHOD: Handwriting performance was assessed using the Arabic Handwriting Assessment Test. Linguistic functions included orthographic–motor integration (OMI; evaluating the integration between orthographic knowledge and handwriting execution) and speed and accuracy of reading texts (Diagnostic Reading Texts in Arabic). Assessment of visual–motor functions included Visual Motor Integration (Beery) and the Visual Motor Speed subtest of the Developmental Test of Visual Perception 2nd Edition. After obtaining approval and consent, students were administered the assessment battery by two occupational therapists

ANALYSIS: Data analyses included descriptive statistics and Pearson correlation.

RESULTS: Grade-level differences were found in relation to handwriting performance and in the underlying skills, supporting the developmental trends in each of these domains. Results also showed that both language and visual–motor functions were related to handwriting performance, but these associations were more prominent in fourth grade. In both grade levels, OMI was related to the speed of handwriting, and reading speed was associated with both handwriting legibility and speed. Finally, in both grade levels visual–motor functions were related to legibility, yet in fourth grade it was also related to handwriting speed. No correlations were found with visual–motor integration.

DISCUSSION: The relationship between OMI and Arabic handwriting speed in both grade levels supports results of previous handwriting studies in different languages, showing that the integration between orthographic knowledge and motor execution is an important underlying skill of handwriting speed. Similar to findings in other languages, the results also suggest that as children grow older and are expected to write faster, speed of processing information and motor execution, as seen in reading and in drawing shapes accurately, seem to have a greater contribution to handwriting performance. These findings suggest that in assessing skills related to handwriting performance, the stage of students’ handwriting development should be considered.

IMPACT STATEMENT: The study highlights the association between OMI, reading speed, visual–motor control, and handwriting performance. The findings indicate that at different stages of handwriting development, focus of assessment and intervention related to these underlying skills may differ.