INTRODUCTION: While most children have developed effective handwriting by secondary school age, some have handwriting difficulties that hamper academic progress. Occupational therapists play a role in assessment and planning support, which may include introducing typing as an alternative. However, there is limited understanding regarding how decisions are made about recommending typing. This study explored the support provided to adolescents with handwriting difficulties by occupational therapists, and the contextual factors that influence their decision-making. METHOD: Semi-structured interviews were conducted with 13 occupational therapists and analysed using thematic analysis. FINDINGS: Although there was shared practice underpinned by occupational therapy philosophy, there was also divergent practice due to different approaches. Roles and responsibilities, resources, and evidence and experience influenced occupational therapists’ practice. Understanding the adolescent’s motivation, the effect of handwriting difficulties on well-being and the need for a functional method to record schoolwork, was central to occupational therapists’ decision-making to recommend typing. CONCLUSION: Strategies are needed to address the knowledge-practice gap, including evidence-based guidelines. Closer collaboration between occupational therapists and school staff could increase understanding of roles and highlight the unique occupational therapy contribution. Further research examining whether, when and how to introduce typing as an alternative to handwriting would support best practice
