How can an occupational therapist help children with handwriting difficulties?

Occupational therapists are trained in the detailed mechanics of hand function as well as all other aspects that relate to the task of handwriting. The skill of handwriting requires several underlying skills before a child can effectively write. The skills that are needed for handwriting are: Body & Spatial Awareness, Laterality, Directionality, Visual Perception, Visual Motor, Integration, Postural Stability, In Hand Manipulation, Hand Separation, Hand Strength, Movement & Position Awareness, Motor Planning, Ocular Motor Control, Bilateral Integration, Eye Hand Coordination, Sensory Integration, Tactile Discrimination, Memory, Attention, Orientation to Letters, and Sequencing. It is hard to know exactly what is at the root of a handwriting problem without a thorough assessment from an occupational therapist.

What is proprioception and body awareness?

Proprioception is the sense that allows us to know what position our body parts are in without looking at them. This sense also tells us about the force of our movements. So if we see a cup and want to reach for it, we can judge how much force and speed we are reaching with so we can accurately get our hand to the cup without knocking it over or missing it. We can also tell how hard we need to hold on to lift the cup without squashing it or dropping it. Proprioception is extremely important for body awareness and coordinated movements.

Body awareness is the internal body “map” each of us has that allows us to know where we are, what position we are in, and how we are moving at any given moment. The body map allows us to move without relying on our visual system to guide each movement. Via repeated accurate sensory inputs produced from our motion through space, the body map is created over time as we develop from infancy throughout childhood. Inaccurate sensory perceptions do not allow for the creation of accurate body maps. Children with inaccurate body maps typically rely heavily on their visual systems and have significant difficulty with many aspects of motor skill.

How do I know if my child has sensory processing issues?

Some signs of sensory processing difficulties are:
• Overly sensitive or under reactive to sight, sounds, movement, or touch.
• Can’t get “enough” sensory input: moving, bouncing, squeezing, or mouthing.
• Difficulty with behavioral and/or emotional regulation. Easily overwhelmed (may result in overexcitement, meltdowns or shutting down.)
• Has poor muscle tone, fatigues easily, leans on people, or slumps in a chair. Uses an inappropriate amount of force when handling objects, coloring, writing, or interacting with siblings or pets
• Is clumsy, falls frequently, bumps into furniture or people, and has trouble judging position of body in relation to surrounding space.
• Has difficulty learning new motor tasks; experiences frustration when attempting to follow instructions or sequence steps for an activity.
• Avoids playground activities, physical education class, and/or sports
• Difficulty learning how to play or get along with other children
• Difficulty with everyday activities like eating, sleeping, brushing teeth or getting dressed
• Problems learning to color, cut, draw or write
• Difficulty transitioning from one activity or place to another
• Challenges in school, including attention, organizational perception and listening skills.

What is the vestibular system?

This sense allows us to maintain our balance and upright posture. It is also closely involved with the visual system, allowing us to judge our motion in relation to the objects around us. This sense allows us to feel secure with gravity and is a way of knowing where we are in relation to gravity e.g. if we are upside-down or sideways.

What is Pediatric Occupational Therapy?

For children and youth, occupations are activities that enable them to learn and develop life skills (school activities), be creative and/or derive enjoyment (play), and thrive (self-care and care for others). Play is the media most often used in the Occupational therapist’s treatment of children. The act of playing is an important tool that influences a child’s life. The primary goals of childhood are to grow, learn, and play. It is often through play that children learn to make sense of the world around them. It is a child’s “job” or “occupation” to play to develop physical coordination, emotional maturity, social skills to interact with other children, and self-confidence to try new experiences and explore new environments. Recommended interventions are based on a thorough understanding of typical development and the impact of disability, illness, and impairment on the individual child’s development, play, learning, and overall occupational performance.