Handwriting Difficulties 3f3r38

MANAGING STUDENTS WITH

HANDWRITING DIFFICULTIES NUR THAQQIFAH MD SANI OCCUPATIONAL THERAPIST U29 KLINIK KESIHATAN UJONG PASIR

Enhance client ability to engage in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better their occupational engagement.

Let’s start with

BILATERAL MOTOR INTEGRATION ACTIVITIES

DRINKING WATER Activates the brain for : Efficient action between the brain and the nervous system Efficient storage and retrieval of information

BRAIN BUTTONS Improves academic skills such as : Crossing the visual midline for reading The correction of letter and number reversals Consonant blending Keeping one’s place while reading

CROSS CRAWL Improves academic skills such as : Spelling Writing Listening reading and comprehension

THINKING CAPS Activates the brain for: Short term working memory Silent speech and thinking skills Hearing with both ears together

LAZY 8’s Improves academic skills in: Mechanics of reading Decoding of written language Reading comprehension

HOOK UPS Improves academic skills in: Clear listening and speaking Test talking and similar challenges Work at keyboard

HOW DO YOU FEELS ?

TEACHER

is primarily for handwriting instruction…......

determine underlying postural, motor, sensory integrative or perceptual deficits that might interfere with the development of legible handwriting

THERAPIST

TEACHER

THERAPIST

+ When the teacher and the therapist work together, combining medical and educational knowledge, the result are often very POSITIVE in achieving legible handwriting.

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Let’s experience it… By using your in-dominant hand, write the sentence from the screen. You have 5 minutes to complete the task. Pen & Paper

“Most people do not realize that good handwriting is a direct result from good upper body strength. Crawling is a natural milestone that children need to learn. Crawling develops power in the shoulders, arms, wrists, and hands. Have you heard or personally ever stated “My child skipped crawling and went straight to walking!” While walking skills may be advancing quickly, it is also a good indication that the child will have poor fine motor skills”-Wiggins.

How do you feel?

What will you get when your student success? video

STAGE 1 Student’s readiness for writing

CHECK YOUR STUDENT’S READINESS 1.Sitting Behavior A good position at the table will help the child to be stable and be able to concentrate and use their hand effectively. Arm forward symmetrically Feet flat on the floor

Hip 90 degree Knee flex 90 degree Feet flat on the floor Ankle 90 degree Prevent foot hanging: Provide a stool to rest feet Important for all desk work!

CHECK YOUR STUDENT’S READINESS 2. Pincer Grip Ability to grasp small objects with thumb and forefinger. It is an important part of the child’s fine motor development and necessary for holding and manipulating the pencil.

SUGGESTION ACTIVITIES

Cloth peg open with tripod pinch (thumb, index and middle finger)

Pick up small object with tripod pinch

Play with play dough/ putty

CHECK YOUR STUDENT’S READINESS 3. Attention A crucial step in learning process.

Find beads in the putty

Jigsaw puzzles

SUGGESTION ACTIVITIES

Lacing beads

Sequencing alphabets/numbers foam

Question……

Question……

CHECK YOUR STUDENT’S READINESS 4. Eye Hand Coordination Uses the eyes to direct attention and the hands to execute a task. SUGGESTION ACTIVITIES

Nuts and bolts

Scissor activities

Ball activities

Dot to dot

Mazes

CHECK YOUR STUDENT’S READINESS 5. Visual Perception Ability to recognize forms, notice likeness and differences SUGGESTION ACTIVITIES

Visual Discrimination

Visual Form Constancy

Visual Memory Figure Ground

Visual Closure

Handwriting readiness can be developed by:  Activities

to improve stability of proximal t

 Activities

to improve children's fine motor control and isolated finger movements

 Activities

to improve ability to hold writing tools

 Activities

to enhance right-left discrimination

ACTIVITIES TO IMPROVE STABILITY OF PROXIMAL T

Games such as tug-of-war, wheelbarrow walking, animal walks

Tug of war

Heavy work: Pushing furniture, carrying shopping bags, carrying chair, etc Scooter board

Wall/floor push up

Commando crawl

Tummy-lying on the floor to color or do puzzles

Use the playground equipment, such as the climbers and monkey bars

ACTIVITIES TO IMPROVE CHILDREN'S FINE MOTOR CONTROL AND ISOLATED FINGER MOVEMENTS

Rolling tiny balls of clay or therapy-putty between the tip of the thumb and tips of the index and middle fingers Picking up small objects with tweezers/ adapted chopsticks

Find hidden beads in putty

Lace beads with strings

Stretching rubber band onto cylindrical object

Tug of war with fingers using coffee stirrer and/or tongue depressor TRY IT WITH YOUR PARTNER

ACTIVITIES TO IMPROVE CHILDREN’S ABILITY TO HOLD WRITING TOOLS

Linking chain

Pick up small objects (toys, sweets etc.) with thumb and first finger rather than whole hand, or thumb and middle finger

While doing pincer grip activities place a small object (e.g. a rubber) in the child’s palm to be held in place by the middle, index and little finger. This will help with pincer isolation i.e. only using thumb and first finger

Clothes pegs opened with the thumb and index finger help to strengthen pincer grip

ACTIVITIES TO ENHANCE RIGHT-LEFT DISCRIMINATION

Lacing activities Screwing nuts and bolt

STAGE 2 Student will be able to color using dominant hand with proper grasping pattern with appropriate force.

Pencil Grasp:

Radial cross palmar

Cross thumb

Palmar supinate

Static tripod

Digital pronate, only finger extended

Four fingers

Brush

Lateral tripod

(Schneck & Henderson, 1990)

Grasp with extended fingers

Dynamic tripod

Colouring : Scribble STAGE 1

Palmar grasp

Light pressure Hand not leaning on the table

Strategies / activities Play dough/ putty

Play tennis ball

Fold paper

Tear the paper

Use crayon-down flat

Manipulating small objects

Colour on the wall

Trace on the sand

Colouring : Part by parts Problem Student colour the whole picture as they do not understand that they have to colour part by parts yet.

BALLOON S

Student has grasped the understanding to colour part by parts, but waiting for teacher’s cue to proceed to the next.(orientate skill not establish yet).

BALLOON S

Example of cues

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To emphasize student to colour within line

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BALLOO Number cue NS

BALLOO Arrow NS

BALLOO Bold the balloon NS with different colour

COLOUR : Follow border line

STAGE 3 Student should be able to do the pre-writing task.

Pre-writing

Children needs to be able to draw prewriting shapes/lines before they are able to form letters/numbers correctly.

Vertical line

Example of pre-writing activity

Curve line

Circle

Horizontal line

slanting line

Pre-writing : Tracing steps Step 1

Step 2

Step 3

Step 4

Cue fading

Starting point

Pre-writing : Tracing between 2 lines

Pre-writing : Tracing between 2 lines

FREE DRAWING

ACTIVITIES TO PROMOTE PREWRITING SKILLS

Drawing lines and copying shapes using shaving cream, sand trays or finger paints

Drawing and colouring pictures of people, houses, trees, cars or animals

Tracing on simple dot-to-dot pictures/lines

Completing mazes

Tracing on lines or shapes using buttons or any other tiny objects Tracing on lines or shapes using stickers

Copy and construct blocks according to cue cards to encourage constructional skills

STAGE 4 Student should be able to trace and write alphabets and numbers

Letter formation: The ability to make a letter on a page/paper using eye-hand coordination, correct posture, directionality, and visual motor memory.

STRATEGIES Free drawing

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Tracing alphabets (Capital letter)

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Get faster result in writing alphabets

Letter formation :Tracing Tracing steps:

Step 3

Step 1 Step 2

Step 4

Step 5

STAGE 5 Student should be able to copy words and sentences from ; • book ( up to down ) • book ( copy from left or right ) • board ( into book )

Writing: Copy one word

Copy two words

Copy three words

Copy 4-6 words in 2 lines

3-4 letters 4-6 letters Promote spacing between words

Copy from the book (up to down, left or right side) and from the board

ASSESSMENT Pre Academic skill assessment / School readiness assessment  Pre-School Visual Motor Integration Assessment (PVMIA) Miller Assessment for Preschooler  Minnesota Handwriting Assessment  Test of Handwriting Skills – Revised  Miller Assessment for Preschooler  Shore Handwriting Assessment  Beery VMI  Assessment on Client Needs  Canadian Occupational Performance Measure(COPM) (parents questionnaire)  

QUESTION? PRACTICAL SESSION

LAZY 8s

Pen & Paper