The University of Queensland, School of Health and Rehabilitation Sciences/Division of Occupational Therapy
Abstract
Anecdotally it was found that Queensland occupational therapists reported a surprisingly high referral rate for handwriting problems amongst school aged children with Autistic Spectrum Disorder (ASD). A subsequent review of the literature revealed a number of anecdotal reports of disordered handwriting in this population but limited research in the area. This thesis presents a descriptive and exploratory study of the nature of handwriting in eight year old children with and without ASD. Issues of handwriting development and motor learning are canvassed followed by an examination of concepts of motor control. Next follows a review of current handwriting models. The Systems Model of Handwriting was proposed as a response to the evidence for both dynamic and motor programme aspects of handwriting. Using this model as an organizing structure, the literature on ASD and handwriting was then examined which led to the framing of three research questions: 1. Is the handwriting speed of children with ASD significantly different from that of children without ASD? 2. Is the handwriting legibility of children with ASD significantly different from that of children without ASD? 3. At what stage/s of the Sequential Handwriting Process, is the handwriting of children with ASD different from that of children without ASD? Twenty-eight eight year old children with ASD and a matched control group of twentyeight comparison children were recruited from state primary schools in Brisbane and surrounding areas. These fifty-six children were assessed on thirteen handwriting process variables and two handwriting outcome variables in order to answer the research questions. Data produced were analyzed primarily with t-tests for between group differences and by examination of correlations between process and outcome variables. Small but measurable differences were found in both speed and legibility between the two groups, with the handwriting of the children with ASD being both less legible (t=- 2.47, df=54, p=0.02) and slower (t=-2.47, df=54, p=0.02). Accuracy of letter formation was also found to be significantly worse for the children with ASD compared to children in the control group (t=3.53, df=54, p=0.001). Further, the two groups were found to differ in some aspects of the Sequential Handwriting Process. Specifically, the children with ASD showed significant correlations between legibility and Perceiving, Conceptualizing and Planning stages, while the comparison children showed significant correlations between legibility and Interpreting, Conceptualizing, Planning and Activating stages. Only one process variable (consistency of letter formation) showed a moderate correlation with handwriting speed all other variables were of only slight to fair strength. Finally, the implications of the research findings are discussed, limitations described and directions for future research canvassed. As a result of the present study, a revised Systems Model of Handwriting is proposed. Several recommendations for occupational therapy intervention in handwriting practices in the classroom are made, notably: clear and focussed initial tuition of letter formation and secondly, the development of automaticity of the handwriting skill