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Why Is A Full Occupational Therapy Evaluation Beneficial When My Child’s Only Difficulty is Handwriting?

Child practicing handwriting

Handwriting is a complex task that involves many prerequisite skills, including visual skills, ocular motor control, body awareness, fine motor planning, shoulder stability, and hand and finger strength. Each prerequisite skill contributes to efficient and fluid handwriting:

  • Visual skills are needed to accurately distinguish and interpret letters and shapes on a page, essential for writing. Ocular motor control is needed to move one’s eyes across the paper to write in an organized manner.
  • Body awareness is required to accurately move the hands for writing, as well as knowing how much force is needed to make marks on the paper with the pencil or pen.
  • Fine motor planning is needed so that your child can easily identify, plan and execute the task of writing letters, words and sentences.
  • Shoulder stability is required to control the pencil.
  • Hand and finger strength is required for endurance that is needed to write many letters to form words and sentences. Hand strength is also needed for an appropriate grasp on the pencil.

In order to address handwriting in therapy, it is imperative for the occupational therapist to assess your child’s current level of functioning in each of the above areas. The root cause of your child’s handwriting difficulties may be his or her struggle in either one area or multiple areas. A full occupational therapy evaluation is very comprehensive; it allows the therapist to get a baseline level of performance to identify your child’s strengths and weaknesses in the prerequisite skill areas, and unveil the source of your child’s difficulty with handwriting.

Following the evaluation, your therapist will develop goals based on your child’s performance and design a treatment program that concentrates on improving these foundational skills, and ultimately improve his or her handwriting organization and legibility.

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Speech and Language: What is the Difference?

At a time when families are seeking treatment for their children, they may hear terms like “speech” or “language” and wonder, what’s mother and daughter talkingthe difference?  Many children will struggle with both speech and language aspects of communication, and it is important that families understand the distinction.

Speech:

“Speech” can be thought of as verbal communication. It is the set of sounds that we make (using our voice and our articulators) that comprise syllables, words, and sentences. Speech alone carries no meaning; it is merely sound.

There are three main components of speech:

  • Articulation (how we make each sound)
  • Voicing (using our “vocal cords”)
  • Fluency (intonation and rhythm)

Speech sounds emerge at different ages, and most children have all sounds mastered by age 9. Common speech errors occur when a child omits sounds (ex. “ba” for “ball”)  or substitutes one sound for another (ex. “wabbit” for “rabbit”). If you have questions about typical speech milestones, please see this blog

Language:

“Language” encompasses how we use speech to formulate sentences in order to communicate.  Language also consists of three parts:

Children may have difficulty with one or more components of language, as indicated by children choosing the wrong word, having a difficult time understanding ideas and concepts, and struggling with appropriate grammar when speaking or writing. Many older children may have difficulty decoding social language such as irony, sarcasm, or hidden meanings, which can negatively affect their ability to make and maintain friendships.

Communication is comprised of speech and language. Children struggling in one or more areas of communication may have difficulty being understood by both familiar and unfamiliar communication partners, making it more difficult for their wants and needs to be met. These difficulties may also create problems in school, both academically and socially.

Intervention can help children with difficulties in these areas. Speech-language pathologists can conduct evaluations and create plans that help to reduce both short-term and long-term effects of speech and/or language disorders. At NSPT, we want to see your children blossom, so please contact us if you have any questions about your child’s speech and/or language development!




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What do Occupational Therapists Look for During your Child’s Handwriting Sample?

Handwriting is a lifelong skill. It begins as young as 3 years of age, when children start identifying shapes, letters, and numbers.  Handwriting and letter recognition are important for communicating (e.g. sending cards and emails) and for completing age-appropriate tasks (e.g. homework assignments; writing grocery lists).child pencil grasp

Below are many of the components your child’s occupational therapist looks for during a handwriting sample in order to work towards a clear and legible final product:

  • Sizing: Are the letters all relatively the same size (e.g. all upper case the same size and all lower case the same size)?
  • Spacing: Are the letters and/or words too close together?  Or is there at least a finger or pencil width between each word?
  • Mixing of upper case and lower case:  Is there inconsistency between the use of upper case and lower case letters?  Are upper case letters used correctly (e.g. start of a sentence or for a name/title)?  Mixing of upper case and lower case letters is appropriate until 6 years of age.
  • Capitalization: Are names, titles, and beginning letters of a sentence appropriately capitalized?
  • Formation of letters Does the child form each letter in the right direction?  (e.g. ‘b’, ‘d’)  Does the child use the correct number of lines and curves? (e.g. ‘m’, ‘n’)  Letter reversals are appropriate until 7 years of age.
  • Complete sentences Are there clear and complete thoughts?  Is the correct punctuation used at the end of the sentence?
  • Floating letters: Do all of the letters sit clearly on the line?
  • Pencil grasp:  Does the child hold the pencil or marker age appropriately?  The static tripod grasp is expected around 3 ½ – 4 years of age.  This is when the pencil is held between the thumb and index finger, with the pencil resting on the middle finger and the child uses and moves his wrist/arm to make movements with the pencil.  The dynamic tripod grasp is expected around 4 ½ – 6 years of age.  This is when the pencil is held between the thumb and index finger with the pencil resting on the middle finger, and the child uses and moves his fingers to make movements with the pencil.
  • Posture in chair:  Is the child slouching or falling out of the chair?  Is the child propped or leaning?  Are his feet flat on the floor?  Is the table the appropriate size?
  • Pressure used:  Is the child’s writing legible?  Or does he press down too hard or too lightly with the pencil, causing the writing to be hard to read or his hands to fatigue more easily?

This list of handwriting aspects may give you ideas of what to look for in your child’s handwriting during activities/assignments at home.   If you notice that your child is having trouble in any of these areas, encourage him to focus on one of those aspects each time he practices writing (to break down the task).  Your child will work on these aspects of handwriting during his occupational therapy sessions, but it is also very important to provide your child with similar learning opportunities and feedback at home.

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