Date Presented 4/9/2016

A retrospective study identified the efficacy of Connect Experience Write, a music- and movement-based multisensory handwriting program for children who are nonwriters. Eight of 10 children with autism spectrum disorder participated in a 9-wk program and improved in forming at least two of three letters taught.

Primary Author and Speaker: Mary Falzarano

Additional Authors and Speakers: Thais Petrocelli, Mackenzie Kruger

PURPOSE: The Connect Experience Write (CEW; n.d.), a music- and movement-based handwriting program provided 3 times a wk for 9 wk, was investigated to identify the efficacy for 10 children with autism spectrum disorder (ASD) who were considered nonwriters.

RATIONALE: Occupational therapy handwriting intervention often uses a multisensory approach to target performance areas of visual–motor integration and praxis skills. The CEW program offers the child a development, relation-based program focusing on visual–spatial concepts and sensorimotor, auditory, and executive functions needed for writing through use of movement activities set to musical sounds beginning with whole-body movements prior to writing on paper. To date, there is no research about the efficacy of music- and movement-based handwriting programs for nonwriters.

DESIGN: An exploratory retrospective study with a pre- and posttest design examined the efficacy of the CEW program.

PARTICIPANTS: The school occupational therapist (OT; creator of CEW) recruited ten 5- to 14-yr-old children to participate in the 3×/wk, 9-wk CEW program provided by the school OT.

METHOD: After the CEW intervention was completed, secondary data analysis was conducted to analyze the deidentified pre- and posttest Beery Developmental Test of Visual–Motor Integration (VMI) and CEW checklist for each of the 10 children.

ANALYSIS: The Beery VMI requires the person to copy a developmental sequence of geometric forms. The CEW is a subjective measurement tool developed by the creator of the CEW program that requires the test taker to write the letters L, F, and E. The school OT provided the 15 sessions of CEW. Ten children completed 10–15 of the 3×/wk 30-min sessions. The Wilcoxon signed-rank nonparametric test was performed for the Beery VMI and CEW pre–post scores. A bootstrapping technique was used (BCa 2000) to construct a confidence interval due to the small sample size.

RESULTS: A significant difference was found for the identification of the letters L (p = .087), F (p = .027), and E (p = .002). Raw post scores from the Beery VMI Visual Perceptual portion were significant (p = .002).

DISCUSSION: Before CEW intervention, the 10 children were unable to form identifiable letters. By the end of the 9 wk, 8 of the 10 children formed two of three identifiable letters. Despite the limitation of the small sample size, which limits generalizability, results suggest that CEW may be a viable handwriting intervention program for children with ASD who are classified as nonwriters.

IMPACT STATEMENT: This research study of the CEW program was a pilot study and the first of its kind. CEW offers a novel movement and music approach to help nonwriters learn how to write. Children of all ages who have not responded to traditional handwriting instruction or other handwriting instruction may benefit from CEW given its multisensory approach and the initial findings of improvement for the 8 of 10 children in this research study. Further research could be used to develop psychometric properties for the CEW pretest and posttest to determine if this is a reliable and valid tool.

References

Connect Experience Write (CEW)®. (n.d.). About CEW. Retrieved June 3, 2014, from http://www.connectexperiencewrite.com/about-cew.html

Denton, P. L., Cope, S., & Moser, C. (2006). The effects of sensorimotor-based intervention versus therapeutic practice on improving handwriting performance in 6- to 11-year-old children. American Journal of Occupational Therapy, 60, 16–27. http://dx.doi.org/10.5014/ajot.60.1.16

Howe, T., Roston, K. L., Sheu, C., & Hinojosa, J. (2013). Assessing handwriting intervention effectiveness in elementary school students: A two-group controlled study. American Journal of Occupational Therapy, 67, 19–26. http://dx.doi.org/10.5014/ajot.2013.005470

Kushki, A., Chau, T., & Anagnostou, E. (2011). Handwriting difficulties in children with autism spectrum disorders: A scoping review. Journal of Autism and Developmental Disorders, 41, 1706–1716. http://dx.doi.org/10.1007/s10803-011-1206-0

Standley, J. M., & Hughes, J. E. (1997). Evaluation of an early intervention music curriculum for enhancing pre-reading/writing skills. Music Therapy Perspectives, 15, 79–86. http://dx.doi.org/10.1093/mtp/15.2.79

Sudsawad, P., Trombly, C. A., Henderson, A., & Tickle-Degnen, L. (2002). Testing the effect of kinesthetic training on handwriting performance in first-grade students. American Journal of Occupational Therapy, 56, 26–33. http://dx.doi.org/10.5014/ajot.56.1.26