A Geometric-Based Handwriting Intervention (GBHI) for Chinese Handwriting: Development,Feasibility,and Pilot Findings

Abstract

Objectives

Legible handwriting is crucial for academic success, especially among elementary school students. However, there is limited research on handwriting interventions for logographic languages. The purpose of this study was to develop a Geometric-Based Handwriting Intervention (GBHI) Program for improving Chinese handwriting and to investigate its feasibility and preliminary outcomes.

Methods

The intervention program was created using psycho-geometric, developmental, and motor learning theories, along with cognitive principles specific to Chinese character writing. Comprising 4 course modules, it was designed to systematically incorporate the geometric structure of Chinese characters into activities targeting fundamental handwriting skills. A two-phase feasibility study was conducted. In Phase 1, eight typically developing elementary students participated in a single 3-h course module to assess their satisfaction with the program. In Phase 2, four elementary students completed all four course modules to evaluate the feasibility and explore potential benefits, as measured by the Chinese Handwriting Evaluation Form (CHEF), the Chinese Handwriting Legibility Assessment for Children (CHLAC), and assessments of handwriting-related fundamental skills.

Results

In Phase 1, participants reported high satisfaction with the problem, with an average rating of 4.40 on the 5-point Likert-type satisfaction questionnaire. In Phase 2, participants demonstrated improvements in handwriting performance following completion of the GBHI program.

Conclusion

This study contributes to the growing body of research on handwriting interventions, particularly within the context of logographic language education. The program introduces a novel approach to teaching Chinese character writing, and the successful delivery of the 4-module intervention supports its feasibility for implementation.

Introduction

Developing proficient handwriting is crucial for achieving academic success. Despite the increasing use of technology in classrooms, mastering handwriting remains a primary focus for elementary school children (McMaster & Roberts, 2016). Failure to produce legible handwriting in a timely manner, even if the content is of high-quality, can result in lower grades from teachers, leading to frustration and decreased self-confidence (Feder & Majnemer, 2007; Taverna et al., 2020; van den Bos et al., 2022). Research has indicated that 5% to 25% of students struggle with handwriting, highlighting the necessity for intervention programs in educational institutions (Taverna et al., 2020; Tse et al., 2019). These handwriting intervention programs are essential for fostering the foundational skills required for effective handwriting during the early years of formal education.

Handwriting involves a complex interplay of sensorimotor skills, including visual perception, motor coordination, and visual-motor integration (Feder & Majnemer, 2007; Klein et al., 2011; Lu et al., 2024). Research on handwriting remediation demonstrates the effectiveness of interventions for children with various diagnoses, regardless of the diverse treatment approaches employed (Bray et al., 2021; Cole, 2023; Kadar et al., 2020). One prevalent approach is the visual-perceptual-motor approach, originating from developmental vision therapy (Keogh, 1974), which emphasizes the importance of visual-perceptual, motor coordination and visual-motor integration skills in handwriting proficiency (Howe et al., 2013; Tse et al., 2019). These skills are strongly correlated with handwriting legibility and are fundamental prerequisites for successful writing tasks, particularly among learners of logographic languages (Chang & Yu, 2017; Hwang et al., 2020; Tse et al., 2014).

Chinese operates as a logographic language where characters serve as the basic writing unit. Chinese characters are distinguished from alphabetic systems by their highly complex visual-spatial elements. They consist of intricate geometric configurations and multiple stroke directions organized within a square structure (Lai & Leung, 2012; Lee et al., 2016; Li-Tsang et al., 2012, 2023). Writing Chinese characters involves more lifting and sharp turns due to its orthographic nature. Children are tasked with not only reproducing the characters but also recalling the visual-spatial attributes and positioning the radicals within an imaginary square grid (Lam & McBride, 2018; McBride-Chang et al., 2005). Additionally, incorrect strokes or radical positions and spacing can alter the meaning of a word itself. For instance, “己” (self) versus “已” (already), or “刀” (knife) and “力” (force) may appear similar but carry different meanings. The complex geometric figuration and arrangement of strokes within a square area distinguish the Chinese writing system significantly from alphabetic systems in terms of visual configuration (visual perception), motor execution in writing processing (motor coordination), and graphic writing allocation (perceptual-motor integration). Considering these unique features is crucial when designing Chinese handwriting intervention programs.

Given the orthographic nature of Chinese characters, research supports the close association between Chinese handwriting and visual perceptual motor skills (Lu et al., 2024). Writing Chinese characters proficiently requires accurate visual discrimination of subtle variations in character forms, stroke placement, and components (Chang & Yu, 2009; Lam et al., 2011; Lee et al., 2016), as well as the capacity to organize visual-spatial information effectively to ensure clear and legible writing (Lai & Leung, 2012). Therefore, Chinese handwriting interventions are mostly sensorimotor-based, working on improving fine motor skills, visual perceptual skills, visual-motor integration skills, oculomotor skills through traditional tabletop activities (Chang & Yu, 2017; Li-Tsang et al., 2023), or computerized programs (Poon et al., 2010).

Few Chinese handwriting interventions have been specifically designed for elementary school children. While previous research has explored handwriting training programs aimed at improving sensorimotor skills- such as visual perception, visual-motor integration, and haptic perception (Chang & Yu, 2017; Poon et al., 2010)- these studies have primarily focus on enhancing skills such as visual perception, writing speed, and accuracy. Although such work underscores the importance of sensorimotor factors in Chinese handwriting, it largely overlooks the structural complexity inherent in Chinese orthography.

Specifically, existing interventions rarely address the hierarchical and geometric organization of Chinese characters, including the spatial arrangement of strokes and radicals within an imaginary square frame. These features are critical for achieving handwriting legibility - a key challenge for children learning to write Chinese. Many young learners struggle to replicate visually similar characters, often facing difficulties in arranging and proportioning radicals, organizing spatial elements, and providing a coherent visual structure.

The Geometric-Based Handwriting Intervention (GBHI) offers added value through its holistic and developmentally informed approach. It not only incorporates a sensorimotor-based training but also explicitly teaches the orthographic principles that govern stroke, radical, and character-level organization using cognitive and visual-spatial strategies. Unlike conventional interventions, GBHI addresses the geometric and spatial rules underlying Chinese character construction. By supporting children in understanding and applying these principles, GBHI aims to improve handwriting legibility through a more comprehensive and cognitively grounded framework.

The purpose of this study was to develop a Chinese handwriting intervention program specifically designed to align with the unique geometric structure of Chinese characters for elementary school children. The study focused on assessing the feasibility of implementing the program and investigating its preliminary outcomes.

Materials and Methods

Geometric-Based Handwriting Intervention Program

The development of the Chinese Geometric-Based Handwriting Intervention (GBHI) program, named “Go-Go Handwriting”, drew upon the psycho-geometric theory of Chinese character writing (Kao et al., 2002), alongside developmental and motor learning theories. The GBHI incorporates visual perception, motor coordination, and perceptual-motor integration into its training, focusing on organizing these visual spatial perception skills to match the intricate visual structure of Chinese characters. Learning is facilitated through principles stemming from developmental and motor learning theories such as repetitive task practice, just-right challenges, and timely feedback to enhance skill acquisition.

The training components of visual spatial perception skills in GBHI were designed based on the detailed visual structure of Chinese characters described in the psycho-geometric theory (Kao et al., 2002). Each Chinese character is constructed with three levels of hierarchical orthographic organization: stroke, radical, and Chinese character (Yeh et al., 2003). Strokes, simple features such as dots, lines and curves, serve as basic elements to form radicals. Various combinations and arrangements of different radicals in various positions form a Chinese character. Forming a Chinese character, the radicals can be arranged in different ways: left-right, as in the character 和 (禾+口), top-down, as in the character吉 (士+口), or one radical enclosed completely or partially by another, such as in the character 國 (或 completely enclosed by 口, or 這 (言partially enclosed by辶).

According to the three-tier hierarchical model of orthographic structure described above, the program emphasizes the visual spatial features of Chinese characters, progressing from the copying of strokes to radical formation and finally to a completed Chinese character through targeted training activities. In addition, the principles of practice and cognitive strategies are also used in this program.

Practice is widely recognized as a crucial element of learning and improving handwriting skills (Howe et al., 2013; Hoy et al., 2011), particularly in the context of Chinese handwriting, which involves complicated combinations. Unlike the alphabetic phonological system, the Chinese writing system comprises a vast number of characters. Research indicates that copying practice is the most effective strategy in facilitating Chinese handwriting proficiency (Wang et al., 2018). Furthermore, our approach integrates cognitive strategies, emphasizing instructions and feedbacks as well as encourage children to think critically about character formation and engage in self-guided correction during handwriting practice. This approach has been shown to significantly enhance children’s handwriting performance (Hoy et al., 2011).

Program Description

The Chinese GBHI program is a therapist-guided, paper-based intervention consists of 4 modules delivered over 4 weeks. Each module comprises three 60-min sessions, totaling 12 h of training (3 h per week). These modules are organized around four structural types of constituent radicals found in Chinese characters (Yeh et al., 2003). Each module incorporates activities designed to enhance visual-spatial perception, motor coordination, and visual-motor skills specific to the structural types of Chinese characters covered in that module. Within each module, activities are divided into two categories - those that emphasize the geometric features of character components and those that focus on complete character formation. These are implemented across the three skill domains—visual-spatial perception, motor coordination, and visual-motor integration—resulting in six distinct activity types per module (Appendix).

Module 1 focuses on constituent radicals arranged in a top-down vertical structure, such as in the character 吉 (士+口). Module 2 addresses constituent radicals arranged in a left-right position, exemplified by the character和 (禾+口). Module 3 includes characters where one radical is enclosed by another with a two-sided boundary, seen in characters like 疤 (巴is enclosed by 疒; P-shaped) or這 (言 is enclosed by辶; L-shaped). Module 4 includes characters where one radical is enclosed by a three- to four-sided boundary, such as風 enclosed by a 3-sided boundary, or國 enclosed by a 4-sided boundary. An example of a training module focusing on the top-down vertical structure is provided in the Appendix.

Guided by the three-tier hierarchical model of orthographic structure, all activities are systematically graded based on task complexity, including factors such as size, number of strokes and radicals, composite units, proportions, and discrimination difficulties. The practice sessions begin at the stroke level and progress to combining strokes into radicals and characters. The program’s organizational structure allocates the first 10 min of each session to preparatory activities for stroke practice. This is followed by a 50-min training session divided into 3 subsections: visual perception, motor coordination, and visual motor integration.

During program implementation, cognitive strategies – particularly instruction and feedback -- are delivered using a top-down processing approach. This begins with recognizing the whole Chinese character, followed by analysis of its radicals, and finally focusing on individual strokes. In visual motor integration activities, where participants are asked to copy a Chinese character from a provided sample, the therapist initially directs the child’s attention to the overall structure of the character, including its size and position within the designated task box. Subsequently, attention shifts to the internal organization of the character, such as the relative proportions and spatial relationships among its radicals and components. Finally, the child is guided to examine and refine the form and sequence of individual strokes. Feedback during this process is intentionally scaffolded: it begins as direct and explicit but gradually becomes more indirect. This gradual reduction in external support is designed to foster the participants’ ability for self-monitoring and independent error correction, ultimately promoting the development of self-correction skills.

Participants and Procedure

This study was conducted in two phases. Phase 1 focused on assessing the feasibility and acceptability of the GBHI. Specifically, it emphasized on evaluating students’ engagement, comprehension and overall receptivity to the program, rather than on handwriting performance outcomes. Phase 2 aimed to assess whether the program demonstrated preliminary outcomes on handwriting performance as well as handwriting fundamental skills in the targeted population. The study was approved by the university ethics committee and was registered in the ClinicalTrials.gov Protocol Registration and Results System under number NCT05035901.

Phase 1

A convenience sample of 8 typically developing elementary school children from the first and second grades was recruited for this phase. Children reported to have undiagnosed behavioral, emotional and sensory processing problem were excluded. The inclusion of typically developing children was essential at this stage to establish a baseline understanding of how the program is received by its intended age group under typical developmental conditions. Their participation allowed us to determine whether the program content was developmentally appropriate, engaging, and accessible—key considerations before introducing the intervention with students who have hand writing difficulties.

Participant received one of four modules (horizontal, vertical, P/L shaped and enclosed) over three 60-min session within one week. The modules were administered individually and face-to-face by a pediatric occupational therapist trained in the program protocol. Each participant received a single module, which was randomly assigned in a predetermined order to ensure that each of the four modules was tested on two participants.

Phase 2

Four elementary school children experiencing handwriting difficulties were recruited to participate in phase two of the study to examine the preliminary outcomes of the full version of the program. These participants were recruited conveniently through school systems or outpatient clinics. During this phase of the study, each participant completed the full program, which consisted of four module units - horizontal, vertical, P/L shaped and enclosed structures. The entire training program lasted for 12 h, delivered over a period of 4 weeks, 3 h per session each week (60 min per session, three times a week).

Measurements

Phase 1

In Phase 1 of the study, participants received a single module unit and completed a satisfaction questionnaire adapted from an existing measure (Engel-Yeger et al., 2009). This questionnaire was specifically tailored to assess participants’ acceptance of the treatment (e.g., I like the activities in this program; I look forward to the next session) and their self-perceived competence (e.g., I feel I now have a better understanding of how to write characters neatly). It consisted of 12 items rated on a 5-point Likert-type scale, divided into two categories: acceptance and self-perceived competence. Higher scores indicated greater acceptance and higher self-perceived competence. Additionally, the questionnaire included 5 open-ended questions to gather qualitative feedback and suggestions regarding the program.

Phase 2

Pre- and post-tests of handwriting performance and its fundamental skills were conducted for the participants in phase 2, who completed all 4 course units, comprising 12 sessions. Handwriting performance was measured with the Chinese Handwriting Evaluation Form (CHEF) (Chang & Yu, 2012) and the Chinese Handwriting Legibility Assessment for Children (CHLAC) (Wang et al., 2024). The CHEF is a 5-point Likert-type questionnaire which includes 25 questions for caregivers to evaluate the handwriting problems of the children regarding the dimensions of construction, accuracy, speed, pencil grasp and directionality. A higher score indicates a higher possibility of handwriting problems. The CHEF has been reported to have sound psychometric properties (Chang & Yu, 2012). The CHLAC is an assessment tool designed to measure handwriting legibility, including size, position, orientation, radical proportion, and radical space. The participants were requested to copy 10 Chinese characters without time limits. Higher scores indicated higher legibility of the written character. The CHLAC has demonstrated moderate to excellent intra-rater reliability (ICC >0.80) and test–retest reliability (r > 0.52) (Wang et al., 2024).

Fundamental handwriting skills, including visual perception and visual motor integration skills, were measured with the Developmental Test of Visual Perception – Third Edition (DTVP-3) and the Beery-Buktenica Developmental Test of Visual-Motor Integration – Fourth Edition (VMI-4). The DTVP-3 has five subscales, including eye-hand coordination, copying, figure-ground, visual closure, and form constancy, to measure both motor-enhanced and motor-reduced visual perception skills. The DTVP-3 is reported to have acceptable internal consistency (Cronbach’s α = 0.60–0.80) and a moderate level of convergent validity (Brown, 2016). The Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI-4) is a standardized, norm-referenced test. The participants were requested to copy 27 set of geometric designs, which were then graded using standardized criteria. The test demonstrated good to excellent internal consistency, good test–retest reliability (r = 0.91), and excellent inter-rater reliability (r = 0.96) (Beery et al., 2010).

Data Analysis

All statistical analyses were conducted in SPSS version 22. Descriptive statistics were used to summarize demographic characteristics and responses from the satisfaction questionnaire. In phase 2, the Wilcoxon signed-rank test and effect size were reported to compare the changes in handwriting performance and its fundamental skills between the pre- and post-test assessments.

Result

Phase 1

In Phase 1, a total of 8 typically developing children participated, comprising 4 boys and 4 girls. Among them, 2 were from the first grade and 6 were from the second grade (Table 1). No adverse events were reported during or after the program. The questionnaire used to assess the participants’ acceptance of the intervention program indicated high acceptance, with a mean item score of the entire questionnaire of 4.40 out of 5, with averages of 4.63 and 4.17 for the participants’ acceptance of the intervention program and their self-perceived competence in handwriting performance, respectively. Participants further expressed in open-ended questions that they found the program funny and interesting. They particularly enjoyed the visual perception activities, which did not require pencil-and-paper writing. In contrast, activities involving copying and writing Chinese characters were less preferred. Participants perceived these activities as similar to academic assignments and described them as less enjoyable.

Table 1.

Satisfaction Questionnaire for Phase 1

	Mean	Standard Deviation
Full form	4.40	0.93
Acceptance	4.63	0.70
Self-perceived competence	4.17	1.06

Phase 2

In Phase 2, a total of 4 boys with handwriting difficulties participated, with 3 from the first grade and 1 from the fifth grade. The Wilcoxon signed-rank test showed no significant differences between the pre- and post-evaluations of handwriting performance and fundamental skills (Table 2). However, both handwriting performance and fundamental skills demonstrated large effect sizes. For handwriting performance, the CHEF and CHLAC revealed large effect sizes of 0.92 and 1.29, respectively. For the handwriting fundamental skills, median to large effect sizes were also found for the DTVP-3 (0.80–0.91) and VMI-4 (0.55). Since effect sizes are independent of sample size, these findings highlight the preliminary benefits of the intervention.

Table 2.

Changes in handwriting Performance and Fundamental Skills

	Pre-test mean (SD)	Post-test mean (SD)	p value	Eeffect size
Handwriting performance
CHEF	88.75 (14.86)	75.25 (15.20)	0.07	0.92
CHLAC	39.75 (4.79)	45.75 (10.05)	0.20	1.29
Handwriting fundamental skills
DTVP-3
General VP	50.25 (8.22)	62.00 (8.52)	0.07	0.91
MRVP	20.50 (7.33)	26.75 (4.50)	0.11	0.80
VMI	29.75 (1.50)	34.00 (5.89)	0.07	0.91
VMI-4	15.00 (0.82)	17.25 (1.26)	0.27	0.55

Abbreviations: SD=Standard Deviation; CHEF=Chinese Handwriting Evaluation Form; CHLAC=Chinese Handwriting Legibility Assessment for Children; DTVP-3=Developmental Test of Visual Perception-third edition; VP=Visual Perception; MRVP=Motor-Reduced Visual Perception; VMI=Visual Motor Integration.

Discussion

Findings from Phase 1 support the feasibility of the proposed GBHI program. No adverse events were reported during or after its implementation, and participants demonstrated high levels of acceptance and self-perceived competence. Unlike commercial workbooks, GBHI uniquely integrates orthographic structure training with sensorimotor and cognitive strategies—addressing both what to write and how to write. While some commercially available paper-based handwriting workbooks, such as those from Kang Hsuan Educational Publishing Group (n.d.), incorporate orthographic principles in their layout, GBHI is distinct in its integration of sensorimotor strategies and its explicit alignment with the hierarchical stroke–radical–character structure of Chinese characters. Grounded in multiple theoretical frameworks, GBHI is designed to provide a structured, developmentally-informed approach that not only supports handwriting accuracy but also enhances learner engagement.

Positive participant attitudes and perceptions are likely due to the incorporation of playful and imaginative contexts within the intervention activities. These contexts align with the unique visual spatial structure of Chinese character, providing a contrast to traditional teaching methods that focus solely on instructional character formation. For instance, the program includes engaging activities such as “Mouse and Desserts” for vertical characters, “Peter Pan’s Train” for horizontal characters, “Jungle Music Party” for P/L shaped characters, and “Crocodiles’ Adventure” for enclosed characters. Each activity incorporates imaginative stories and figures designed to mitigate the frustrations often associated with writing tasks, helping to maintain participants’ interest and attention during the 3-h weekly sessions over the course of 4 weeks. Although participants showed a lower preference for engaging in visual-motor integration paper-and-pencil activities due to their similarity to academic assignments, they found these activities more tolerable than their usual school practices. A key goal for future program enhancements will be to further improve the engagement in practicing Chinese character handwriting.

For phase 2, the program was delivered to 4 elementary students with handwriting difficulties to assess its preliminary benefits. The results indicated that the program yielded improvements in both handwriting performance and fundamental skills after the students completed all 12 sessions. The results of the CHEF and CHLAC respectively showed average improvements of 13.5 and 5.5 points in handwriting performance. These improvements were accompanied by large effect sizes of 0.92 for the CHEF and 1.29 for the CHLAC, suggesting meaningful improvement for participants.

The benefits of the GBHI can be discussed from several key perspectives. First, its emphasis on the visual structure of the Chinese character, particularly the spatial relationships among strokes and radicals, draws on the psycho-geometric theory of Chinese handwriting (Kao et al., 2002). This approach provides participants with a holistic understanding of character composition, enabling them to differentiate subtle differences in radical proportion and position that significantly impact legibility. Unlike alphabetic writing systems, where legibility often depends on consistent sequential letter spacing, Chinese handwriting legibility relies more on the precise placement and proportion of radicals—making GBHI’s spatial emphasis especially pertinent. Second, the program incorporates activities specifically designed to improve motor coordination and visual-motor integration by embedding geometric elements that reflect the structural features of Chinese script. These include tasks such as tracing dotted lines and completing geometric figures resembling Chinese characters. By focusing on the spatial arrangement of geometric radicals within each character, the program aims to deepen learners’ understanding of character formation and improve handwriting legibility. This approach aims to enhance understanding of Chinese characters. In contrast to alphabetic writing systems—such as those evaluated using the Minnesota Handwriting Assessment, which emphasizes inter-letter interactions—Chinese handwriting legibility, as assessed in tools like the CHLAC, is more dependent on the internal arrangement of radicals within individual characters (Reisman et al., 1999; Wang et al., 2024). Third, the integration of the fundamental skills -- visual perception, motor coordination, and visual-motor integration -- into the program is supported by literature identifying these skills as crucial to Chinese handwriting performance (McBride-Chang et al., 2008; Tse et al., 2019). By systematically targeting these skills, the GBHI helps strengthen mastery of Chinese handwriting. Finally, the program uses cognitive strategies, such as self-guided correction technique. With support from the therapist’s verbal prompts, participants are encouraged to review their written characters, identify potential errors, and make modifications to improve their work. These reflective processes, combined with consistent, structured practice, likely contributed to the improvements in handwriting legibility observed in Phase 2 of the study.

While the study yields positive findings, several limitations should be noted. First, the use of convenience sampling may limit the generalizability of the results to the broader population. Second, the small sample size in both phases limits the strength of conclusions regarding program acceptability and potential outcomes. Third, the current implementation relied on intensive verbal instructions from therapists. To enhance consistency and delivery fidelity, future versions of the program will incorporate standardized script for all verbal instructions along with comprehensive training for therapists. We also acknowledge that the perceptions reported by typically developing students in Phase 1 may not fully reflect those of students with handwriting challenges. Students with handwriting difficulties may engage with the program differently due to varying levels of frustration, motivation, or cognitive and motor demands. Additionally, the Phase 2 sample was both small and gender-imbalanced, which may influence the interpretation of engagement and outcome data. Future studies should involve larger, more diverse, and representative sample—ideally with active control groups-- to more accurately assess the program’s acceptability and outcome across varied student populations. Such studies would offer more robust evidence of the program’s impact on handwriting performance and related fundamental skills.

Implications for Occupational Therapy Practice

Our study results have the following clinical implications for occupational therapy practice:

• Given the unique geometric and visual-spatial demands of Chinese handwriting, the study suggests that interventions should be specifically designed to address these complexities. Occupational therapists should customize handwriting programs to align with the orthographic nature of logographic languages, focusing on the distinctive visual-spatial features to improve proficiency.

• The research emphasizes the importance of fundamental handwriting skills in enhancing logographic handwriting. Occupational therapists should prioritize visual perception, motor coordination, and visual-motor integration skills in children, as these foundational abilities are essential for improving handwriting performance.

• The study supports the use of cognitive strategies, such as self-guided correction, in combination with repetitive practice to enhance handwriting skills. Occupational therapists can integrate these approaches into their intervention plans to encourage children to critically assess their writing and engage in meaningful practice, fostering long-term improvements in handwriting legibility.

Conclusion

This study affirms the feasibility and demonstrates a positive result in the outcomes of the Chinese GBHI Program for elementary students. It shows that the participants were satisfied with the program, and it suggests that the program may have potential to improve their handwriting legibility and related fundamental skills. To further solidify these findings and understand the program’s application more comprehensively, a larger sample size study with an active control group and follow-up tracking is recommended. This would allow for a more rigorous examination of the program’s effects over time, providing valuable insights into its potential benefits for a broader population of students.