The role of Occupational Therapy practitioners in the school setting is to help students access their education and to become as independent as possible.
Occupational Therapy is best known for addressing fine motor deficits, especially handwriting.
Fine motor skills are needed for:
This may be a controversial opinion, but I rarely write handwriting goals for middle school and high school students on my caseload. Unless they are super motivated to improve or have outside support like parents and Therapy, they will unlikely progress. So instead, I like to shift to using assistive technology to complete lengthy written assignments.
That’s not to say I don’t find handwriting valuable at all. On the contrary, handwriting should be the focus for elementary O.T. practitioners since that’s the prime age to address these skills and see substantial progress. On that note, if handwriting is appropriate, I would establish specific underlying skills.
Various underlying skills need to be established before addressing handwriting. Humans develop proximal to distal, so these are the skills Occupational Therapists should observe for:
If these skills are not established, don’t read any further. It’s unfair to start addressing a complex fine motor demand like handwriting. This is only making things more complicated for the student and yourself. Instead, I’d recommend first creating a goal for the underlying deficit and working towards writing.
When writing IEP handwriting goals, you will want to assess the following performance skills:
Legibility is the overall neatness of the handwriting that the writer and others can read.
Speed is the rate of how fast the writer can handwrite and is measured in words per minute (WPM).
To calculate handwriting speed, you would count the number of letters written and divide by five. Take this number and multiply by 60. Divide this number by the time in seconds to calculate words per minute.
Here is the formula I use to calculate handwriting speed into words per minute (WPM):
Letters Written/5 = __________ X 60 = _________/ seconds = WPM
Letter Formation means that upper and lowercase letters were created top-down and left to right.
Word Spacing should be a finger-width distance between each word unit. Words should not be too close or far apart to enhance reading flow.
Letter Spacing refers to the upper and lowercase letters not overlapping or spaced excessively far apart.
Line Adherence accurately places letters, words, and numbers on the corresponding line. They shouldn’t float above or fall below the line.
Letter Sizing is determined by the location of the upper and lower case letters to the top solid line, middle dotted line, and bottom solid line. For example, upper case “N” would reach the top solid line, and lower case “n” would reach the middle dotted line.
Casing is the distinction between uppercase and lowercase letters. For example, the start of every sentence begins with a capital letter.
Reversals occur when letters (most commonly “b,” “d,” “q,” and “p.”) or numbers (most commonly “5,” “7,” and “9”) are formed backward or upside down.
During your observation, it’s essential to note the difference between how the handwriting sample was obtained under these specific conditions:
As stated in my previous goal-setting post, I found the COAST method to be the most effective.
The best part about motor skills is that they are easy to measure progress. For example, here are the handwriting goals I would create for a student:
If I were to focus on handwriting for my older students, I would focus on legibility and speed, but every therapist is different. So I added the other handwriting goals for OTRs that they would find more relevant to their practice. Let me know in the comments if you found this post helpful for writing handwriting goals.
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