ABCs of Handwriting

Core stability or postural/body control affects a child's ability to maintain upright posture for tabletop activities. Postural control refers to a good base of support in sitting, with hips at 90° and feet on the floor, good pelvic and spinal alignment, neck control for forward visual gaze and shoulder strength for arm and hand control.

Upper limbs stability plays an important role in handwriting. A stable shoulder girdle will help fixation on the elbow and the wrist which allows refined finger movements for writing. This shoulder girdle begins developing very early in life (even from tummy time), whereby the weight through the arms starts strengthening those muscles. As a baby gets stronger they begin lifting their arms in the air against gravity and developing shoulder stability further. A stable shoulder girdle will help a child to cut with scissors and write without getting tired.

When it comes to fine motor movements for handwriting, wrist stability is essential to promote functional handwriting. Wrist extension (back of hand lifted towards forearm) is important for positioning of fingers during writing. A flexed wrist (hand bent towards the inside of the forearm) is more stable but less functional for writing. A stable wrist means holding the wrist position without constantly lifting up from the table and hooking. Many children with low muscle tone, or with poor fine motor skills, may lack good wrist stability. They often lift their wrist up from the table while writing, and may also write with movement from their wrists instead of their fingers. This is very tiring, and usually leads to messy work.

Visual -motor skills, also referred to as “eye hand coordination”, are the skills that emerge from the integration of visual skills, visual perceptual skills and motor skills that allow us to use our eyes and hands in a coordinated and efficient way. Besides handwriting, visual-motor skills are the foundation for many of a child’s day to day activities — including feeding, cutting, tying shoelaces, and catching. When the visual and motor systems are efficiently communicating with one another, these activities are easy for children to complete. A child may not have any visual issues with acuity or perception or with hand strength or dexterity, however, if the connection between visual and the motor system is not organized it can result in difficulties with visual motor skills. 

The building blocks to develop a functional pencil grip include:

i) Web Space: The space between thumb and index finger. Imagine forming an ‘o’ with your thumb and index finger. This opposition naturally forms an arch in the palm of your hand. This allows for more controlled manipulation and strength. A closed web space results in an inefficient grip.

ii) Finger Isolation: The ability to move each finger one at a time. This skill is essential to allow for manipulation. Think about buttoning your shirt, zipping your bag or taking a price tag off. How many times do you use 2 or 3 fingers instead of all 5 together? If you think about how you hold a pencil, you are gripping the pencil with 3 fingers while the other two are tucked in to support your hand while writing.

iii) Dexterity: The ability to coordinate precise hand and finger movements in order to grab and manipulate objects. Aside from writing, this can include actions like opening a jar or bottle, putting on your socks and shoes, using a key, holding a fork and spoon, putting on your watch and tying/untying a rubber band etc.

Handwriting difficulties are common among children with neurological conditions, such as ASD, ADHD, dyspraxia and others. However, if children spend time and effort performing fine motor related tasks at school, alongside the guidance of trained occupational therapists, they can overcome their handwriting difficulties over time.