Rachel Goode, MS, Occupational Therapist

When families ask if it is time to seek help to improve their child’s fine motor skills, I advise that if their child’s poor handwriting is affecting their academic performance or if they get frustrated with fine motor activities to the point where they avoid them, they should refer to an occupational therapist. In the occupational therapy evaluation, we are able to dig deeper into the issues behind poor handwriting and attempt to determine the causes. Poor handwriting can be caused by difficulty with hand strength and endurance, fine motor coordination, visual motor integration, impulsivity or lack of motivation. 

An indicator of decreased hand strength or endurance can be an inefficient pencil grasp or alternating grasps while writing. Examples of typical handwriting development include:

• 1-1.5 years old, they use a fisted grasp on writing utensils, wrapping all of their fingers around the utensil to fully stabilize it.
• By 2-3 years, they rotate their hand so their index finger and thumb are pointing downwards towards the tip of the writing utensil.
• By 3-4 years, you should be able to see their thumb on one side of the writing utensil and two or three fingers on the other side with a nice open web space. Their fingers should form an oval or circle with the writing utensil resting in the middle. They typically still move their entire hand as one unit at this age and tend to use more shoulder or elbow movement while coloring.
• By 5-6 years, children should be able to utilize a dynamic tripod grasp, where they are utilizing more dynamic movements in their fingers and wrist to control the pencil while coloring or writing.
• By 7 years, if handwriting is still challenging, then an occupational therapy evaluation is recommended.

With all clients that demonstrate poor handwriting, I recommend hand and upper body strengthening activities. These strengthening tasks help improve the strength and endurance needed to hold writing utensils properly and to have the endurance to participate in the fine motor activity for the duration of the task. 

Hand strengthening activities can include pinching, rolling and cutting Play-Doh, clothespin activities, playing with spray bottles, stringing beads, playing with Legos, working with tongs or tweezers and using scissors to cut thick paper or Play-Doh.

Upper body strengthening activities could include wheelbarrow walks, climbing, swimming, animal walks and coloring on an upright surface such as an easel.

Practicing forming letters through multi-sensory learning is also very helpful to promote proper letter formation, which leads to improved handwriting legibility. Forming letters or words on a cookie sheet filled with salt, sand or rice gives them more tactile input while practicing forming their letters and takes off the pressure of writing on paper where they are worrying about holding their pencil. They can also make letters out of Play-Doh or things found in nature. 

When working on letter formation, I also recommend a “wet, dry, try” method which is a Handwriting Without Tears technique where you first use a small wet sponge to draw the letter on a slate board, then use a dry sponge to go over the wet letter to “dry” the letter, and finally use a piece of chalk to write the letter. This provides a chance to write the letter three times in a proper formation to help improve the motor planning of writing the letter properly. The Handwriting without Tears curriculum also has songs that teach children about how to form letters correctly which can be helpful for kids to sing while writing. Once children are forming their letters correctly, working on letter alignment on the lines, letter spacing for words and spacing between words is important to help improve legibility of their handwriting.

Integrated Pediatric Therapies occupational therapists can help guide you and your child through fun and structured programs to improve handwriting. To schedule a consultation, email IPI@JCFS.org or call 847.412.4370.