Are Visual-Motor Integration and Hand-Eye Coordination key predictors of the quality of a child’s handwriting?
Table 7: Author: Debra Bower, Jenna Patton, & Michelle TreadwayAuthor, Year / Study Objectives / Study Design / Level of Evidence / Sample Size / Intervention and Outcome Measures / Summary of Results / Study Limitations
Dankert, H., Davies, P., & Gavin, W. (2003) / Evaluate the assumption that preschool children who receive occupational therapy will demonstrate significant improvement in their visual-motor skills as measured on the Developmental Test of Visual-Motor Integration (VMI) and the two supplemental Visual Perception and Motor Coordination tests. / Experimental; Pretest and Postest. Control and treatment groups / II / 43 Preschool children / Preschool children with developmental delays (n = 12) received occupational therapy a minimum of one individual 30-minute session, and one group 30-minute session per week for 1 school year. Their performance was compared to two control groups; preschool students without disabilities who received occupational therapy (n = 16) for one 30-minute group session per week and preschool students without disabilities (n = 15) who received no occupational therapy. The VMI and two supplemental tests were administered three times to each student, at the beginning, middle, and end of school year. / Planned comparison tests showed that students with developmental delays demonstrated statistically significant improvement in visual-motor skills and developed skills at a rate faster than expected when compared to typically developing peers on the VMI. The results of this study demonstrate that intervention, including occupational therapy, can effectively improve visual-motor skills in preschool-aged children. / Small sample size; The person administering the assessments and providing therapywas not blinded to the study purpose or group membership; And although the amount and type of grouptherapyfocusing onvisual-motor skills was identical for the two treatment groups, the children with developmental delays received additional therapy to address needs other than visual-motor.
Kaiser, M.L.,., Albaret, J.M., & Doudin, P.A., (2009) / Analyze the relationship between quality of handwriting and visual-motor integration skills and analyze the predictive value of 4 items on the DVTP-2 in relation to the quality of handwriting / Experimental-type Research design was used with no random assignment / II / 75 Second-graders from a regular school in the French area of Switzerland, from multiple levels of the school with no known developmental delays. / Children were administered The Concise Assessment of Scale for Children’s Handwriting (BHK)
Two weeks later children’s handwriting quality was assessed individually using The “Manual Dexterity” section from the French version of the Movement Assessment Battery for Children (M-ABC) and Developmental Test of Visual Perception (DTVP-2) / The relationship between visual-motor integration and hand-eye coordination are keys predictors of the quality of a child’s handwriting / The research was administered to children with an mean age of 8 years old, results cannot be applied to older children because of the relationship decreased by age (as shown in previous studies)
Another test measuring visual motor integration should have been used to validate the results
Tseng, M. H. & Chow, S. M. K., (2000) / Analyzed the differences in perceptual-
motor measures and sustained attention between children
with slow and normal handwriting speed and the relationship between these factors. / Experimental-type Research design was used with no random assignment / II / 69 children ages 7-11 (34 slow speed hand writers and 35 normal speed handwrites) / Four measures, including three perceptual or motor tests and a vigilance test, were used in the present study. The Upper Limb Speed and Dexterity (ULSD) subtest of the
Bruininks - Oseretsky Test of Motor Proficiency was used to measure fine motor function.
The Test of Visual- Perceptual Skills — Non- Motor was also administered / A significant difference was found between
slow and normal hand writers in upper-limb coordination,
visual memory, spatial relation, form constancy, visual sequential memory, figure ground, visual-motor integration, and sustained attention. Age, visual sequential memory, and visual-motor integration were the three significant predictors of handwriting speed for the slow hand writers. For the normal speed hand writers, age and upper-limb speed and dexterity were the only two significant predictors. / This study was not an attempt to examine the relationship of quality or speed to handwriting performance, but examined the relationship of graphomotor output to perceptual-motor skills/proficiencies, and attention in children. Further studies should be conducted to examine the relationship of quality of handwriting to perceptual-motor skills
Summary:Based on the information provided from the research presented, visual-motor integration, perceptual-motor skills, and hand-eye coordination are key predictors of the quality and amount of output of children’s handwriting. Deficits in visual-motor integration and hand-eye coordination could lead to a decrease in the quality of children’s handwriting. Occupational therapists should address visual motor integration and hand-eye coordination to improve the quality of children’s handwriting.