Date Presented 04/05/19
Handwriting is a critical functional skill that impacts academic participation and progress. OT practitioners address components of grasp in their handwriting intervention as it is commonly assumed that grasp affects legibility, fluency, and endurance. This study used scoping review methodology to explore the relationship between grasp and handwriting performance. Findings suggest a lack of consensus regarding this relationship and a need for additional research.
Primary Author and Speaker: Marcia Schneider
Additional Authors and Speakers: Christine Myers, Jane Morgan-Daniel
Contributing Authors: Orit Shechtman
PURPOSE: Handwriting is a critical functional skill that impacts academic participation and progress. Children are often referred for school-based occupational therapy due to handwriting difficulties. There are a number of underlying skills required to perform the task of handwriting including motor processes and cognitive processes. Grasp is important because it allows the fine motor movements needed for handwriting and affects the crucial components of legibility, fluency, and endurance. It is a common assumption among occupational therapists that a causal relationship exists between handwriting performance and the underlying cognitive and motor processes such as grasp and that intervention in these areas will result in improved handwriting outcomes, yet research studies examining this relationship are limited. The purpose of this scoping review was to map the existing research on the relationship between grasp and handwriting performance in school-age children and identify the gaps in the literature.
DESIGN AND METHOD: The current scoping review was completed in accordance with the Joanna Briggs Institute (2015) and Arksey and O’Malley frameworks (2005). Seventeen bibliographic databases were searched using a combination of keywords (grasp, grip, child, children, handwriting) and subject headings. Information sources included peer-reviewed, non-peer-reviewed, and grey literature as well as an ancestry search of all full-text articles assessed. It was determined that primary studies printed in English which included the relationship between grasp and handwriting as outcome variables in school-age children grades Pre-K through 12 would be included in the review. Inclusion and exclusion criteria were developed post hoc.
RESULTS: The search generated a total of 127 articles with 12 articles meeting the search criteria for inclusion in the scoping review. The significance of the results in the 12 studies was widely inconsistent with no apparent consensus regarding the relationship between grasp and handwriting performance. The results were categorized according to the outcomes with respect to a significant relationship between grasp and handwriting performance. Six studies found a significant relationship, four found mixed results, and two did not find a significant relationship.
CONCLUSION: The results of this study indicate that grasp may impact handwriting performance. Some studies found the use of an inefficient grasp during handwriting tasks can result in decreased legibility as well as fatigue while other studies found mixed results or no significant difference. The studies with mixed results found inconsistencies within their findings which resulted in the inability to draw a firm conclusion. Such inconsistencies included differences across age groups, gender, grasp patterns, grasp force, and task length. Thus, additional research needs to be completed with lengthier handwriting tasks representative of a typical school day. The results also suggest the use of an inefficient grasp may impact participation more significantly for a child with special needs as compared to a typically developing child. A number of studies further suggest interventions should not focus solely on changing grasp but on the assessment of the underlying motor processes as well as sensorimotor-based interventions.
IMPACT STATEMENT: This study impacts occupational therapy practice as therapists make a unique contribution by facilitating not only increased handwriting outcomes but classroom participation through interventions targeting needed underlying cognitive and motor processes such as grasp.
References
Alhusaini, A. A., Melam, G. R., & Buragadda, S. (2016). Short-term sensorimotor-based intervention for handwriting performance in elementary school children. Pediatrics International, 58(11), 1118-1123. doi:10.1111/ped.13004
Arksey, H., & O'Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. doi:10.1080/1364557032000119616
Lin, Y. C., Chao, Y. L., Wu, S. K., Lin, H. H., Hsu, C. H., Hsu, H. M., & Kuo, L. C. (2017). Comprehension of handwriting development: Pen-grip kinetics in handwriting tasks and its relation to fine motor skills among school-age children. Australian Occupational Therapy Journal, 64(5), 369-380. doi:10.1111/1440-1630.12393
The Joanna Briggs Institute. (2015). Joanna Briggs Institute Reviewers’ Manual: Methodology for JBI Scoping Reviews. Adelaide: The Joanna Briggs Institute. Retrieved from https://joannabriggs.org/assets/docs/sumari/Reviewers-Manual_Methodology-for-JBI-Scoping-Reviews_2015_v2.pdf
