When compared to their peers without an autism spectrum disorder (ASD), children with high-functioning autism have unique handwriting patterns. In academic progress, activities related to writing account for 30 to 60 percent of a student’s daily school activity. If a child with an ASD has difficulty writing, he or she becomes fatigued. This fatigue frequently leads to problems coping with the cognitive, social and functional challenges he or she faces on a daily basis. Researchers state that a child who has to finish copying text from the board may miss recess, which impacts his or her ability to practice social skills: When assigning tasks to students with high-functioning ASD, teachers should take these differences into account.
Satisfactory Handwriting Skills Are Crucial for Academic Development and Communication
The American Academy of Neurology states that if a child is to be successful throughout his or her school career as well as when communicating with others, handwriting skills are vital; furthermore, if a child is experiencing difficulty in this area, his or her self-esteem may also begin to suffer. In addition, handwriting skills increase the likelihood that a child with autism will eventually become independent.
Numerous Studies Find Children with Autism Have Difficulty with Handwriting Skills
Researchers at the Kennedy Krieger Institute conducted the first study (2009) dedicated to examining the quality of handwriting in children with autism spectrum disorders. The researchers find that children with ASD consistently show poor handwriting capabilities due to their difficulty with fine motor control.
Christina Fuentes led this study, she states that handwriting is necessary to convey ideas and keep pace in class: Determining the reasons children with an autism spectrum disorder are experiencing these difficulties allows for the strategic identification of techniques to help them improve their handwriting skills. This study suggests that the best way to improve the handwriting skills of children with autism is to teach them letter formation in conjunction with fine motor skills training using techniques including arm stabilization and proper use of writing utensils.
Handwriting Issues Continue into Teenage Years
Another study conducted by the Kennedy Krieger Institute finds that children with autism are unlikely to ‘outgrow’ the problems they are experiencing related to handwriting skills.
Amy Bastian, Ph.D., is Kennedy Krieger Institute’s Director of the Motion Analysis Laboratory and author of this study. Dr. Bastian states that this research is not intended to determine if children and adolescents with an ASD struggle with handwriting skills, but instead to document the degree of the challenge and attempt to determine why these difficulties are being experienced. Although it is more likely for adolescents with an ASD to have handwriting problems, several techniques can improve handwriting quality.
These techniques include:
- Using the opposite hand to stabilize the writing hand
- Making adjustments as to how the individual with autism is holding/gripping the writing utensil
- Encouraging slow letter formation
Adolescents (ages 12 to 16) with autism continue to have poor handwriting quality due to motor skill impairments; however, unlike younger children with autism, perceptual reasoning seems to be the main predictor of an adolescent's handwriting performance. Perceptual reasoning refers to an individual’s ability to solve problems using nonverbal material.
According to Dr. Bastian, adolescents with an ASD may be able to compensate for their motor impairments by using compensatory strategies involving reasoning skills.
Study to Investigate Hand Strength Development Trends
This study aimed to establish trends related to hand strength development in children with an ASD, as well as to investigate associations between pinch and grip strength, functional activities and handwriting components in children with and without an autism spectrum disorder. Study results conclude that typically developing children and children with autism follow the same strength development trends. In both of these groups, grip strength and pencil control were linked; however, while grip strength and control affected the legibility of a typically developing child’s handwriting, these factors did not affect the handwriting legibility of a child with an ASD. In both groups, grip and pinch strength were linked with their ability to work independently on functional activities.
Common Difficulties Related to Handwriting
Children with low muscle tone frequently use and adapted grip: This adaptation inhibits the ability of the fingers to move freely and places additional stress on hypermobile joints.
Dysfunctional Writing Grasps
Thumb tuck – the individual wraps his or her thumb around the writing utensil, tucking it into the web-space.
Palmar supinate – the writing utensil is placed into a fist positioned with the thumb facing up.
Digital pronate – the writing utensil is held within the hand itself (not the web-space) and movement is primarily achieved from using the forearm and/or shoulder.
Radial cross palmar – the writing utensil is placed into a fist positioned with the thumb facing down.
5 Therapeutic Intervention Methods to Promote a Functional Grasp
1. Proper Writing Surface and Tools
To promote a functional grasp, caregivers and teachers should provide students with a vertical writing surface and short writing tool.
2. Improve Hand Strength to Shape Grasp
Pencil grips can separate the fingers used in writing to promote a functional grasp. Caregivers and teachers who do choose to provide adaptive equipment must create a systematic plan for the eventual elimination of the tools.
3. Wrist Extension Activities
- Using window markers/clings on a window
- Drawing on a chalkboard or an easel
4. Functional Grasp Activities
- Coloring with short, broad crayons
- Using a short stylus with a tablet
5. Improve Posture
Supporting distal mobility requires stability:
- Are his or her ankles, knees and hips at 90 to 120 degrees?
- Is the chair’s height and writing surface adequate?
- Is the child’s forearm stable on the writing surface?
- Is his or her wrist extended?
Other issues that could contribute to handwriting difficulty for children with autism include:
- Not enough pressure
- Too much pressure
- A flexed wrist
- Instability of the dominant forearm
- The non-dominant hand neglects to stabilize the paper
Caregivers and teachers who help children with autism improve their handwriting skills increase the likelihood that these children will one day achieve independence.