Appendix B

Foundational Skills in Handwriting

for Kindergarten Classrooms

Maria Fiela Paje-Delos Reyes, OTR/L

Foundational Skills in Handwriting for Kindergarten Classrooms

Maria Fiela Paje-Delos Reyes, OTR/L

Permission is granted to reproduce and distribute copies of the instructions, illustrations, forms, and diagrams contained in this manual in limited quantities for non-commercial, educational use only.

OBJECTIVES:

Foundational Skills in Handwriting Program is designed to provide kindergarten teachers classroom support to improve the students’ handwriting performance by means of engaging in a structured program that utilizes an eclectic approach (cognitive and multisensory techniques) in handwriting instruction. Students using this program will participate in classroom centers or activities utilizing different sensorimotor components such as visual perception, visual-motor integration, proprioception/kinesthesia, body awareness skills, and in-hand manipulation skills. The main goal of the program is to enable at-risk students with fine motor delays to improve their fine motor and visual skills to the point where they can succeed in school and develop their writing skills that will prepare them for succeeding years in academic tasks. Objectives have been developed for all those participating in the program:

1. Provide a structured program for teachers to increase their understanding of their students’ hand functioning and developmental progression in teaching handwriting.

2. Provide additional knowledge for teachers in modifying classroom environment and develop remediation activities to improve hand skills.

3. Increase awareness of teachers and administrators of occupational therapy as a resource service.

4. Enable at-risk students with fine motor delays to increase their knowledge of hand function and become more actively involved of their own skills.

INTRODUCTION:

Handwriting is an important skill for children to develop in primary years. It is a primary way to communicate with and necessary to complete assignments, seatwork, homework, and many tests. “Children in elementary school spend 31 to 60% of each academic day on fine motor tasks including handwriting” (McHale & Cermak, 1992). As such, difficulty on this area may pose a significant risk in the child’s academic success.

Studies by Oliver and Reisman (as cited in Hammerschmidt & Sudsawad, 2004) show that problems with handwriting have been identified as one of the most common reasons for referrals for occupational therapy services. Occupational therapy practitioners work with students and teachers through direct therapy and consultation services on the goals of improving student’s abilities and skills needed for academic success, including handwriting.

As with any skill, teaching handwriting requires many prerequisite skills necessary for the skill acquisition. By providing a solid foundation in handwriting, students will be able to improve their hand functioning in the classroom and become more actively involved in the development of their own hand skills. Therefore, it is important for the teachers to gain understanding of what constitutes an effective handwriting instruction.

FINE MOTOR MILESTONES:

>Grasping Skills according to Erhardt Prehension Developmental Levels

1. Grasp of the pellet (prone or sitting)

Age Milestonenatal No grasp or visual attention to the object

3 months No attempt to grasp, but visually attends to the object6 months Raking and contacting objects7 months Inferior scissors grasp: raking object into palm with adducted

totally flexed thumb and all flexed fingers, or two partially extended fingers

8 months Scissors grasp: between thumb and side of curled indexed finger, distal thumb joint slightly flexed, proximal thumb joint extended

9 months Inferior pincer grasp: between ventral surfaces of thumb and index finger, distal thumb joint extended, beginning of thumb opposition

10 months Pincer grasp: between distal pads of thumb and index finger, distal thumb joint slightly flexed, thumb opposed

12 months Fine Pincer grasp: between fingertips or fingernails, distal thumb joint flexed

2. Grasp of the cube

Age Milestonenatal Visually attends to object, grasp is reflexive

3 months Visually attends to object and may swipe. Sustained voluntary grasp possible only upon contact, ulnar side used, no thumb involvement, wrist flexed

4 months Primitive squeeze grasp: visually attends to object, approaches if within 1 inch, contact results in hand pulling object back to squeeze precariously against the other hand or body, no thumb involvement

5 months Palmar grasp: fingers on top of surface of object press it into center of palm with thumb adducted

6 months Radial palmar grasp: fingers on far side of object-press it against opposed thumb and radial side of palm

7 months Radial palmar grasp: fingers on far side of object-press it against opposed thumb and radial side of palm, with wrist straight

8 months Radial digital grasp: object held with the opposed thumb and fingertips, space visible between

9 months Radial digital grasp, with wrist extended

Source: Cottrell, R.F. (2006). National occupational therapy certification exam: Review and study guide. Evanston, Illinois: International Education Resources, Ltd.

3. Releasing skills

Age Milestone0-1 month No release; grasp reflex is strong1-4 months Involuntary release4 months Mutual fingering in midline

4-8 months Transfers objects from hand to hand5-6 months Two-stage transfer; taking hand grasps before releasing hand

lets go6-7 months One-stage transfer; taking hand and releasing hand perform

actions simultaneously7-9 months Volitional release7-10 months Presses down on surface to release

8 months Releases above a surface with wrist flexion9-10 months Releases into a container with wrist straight10-14 months Clumsy release into small container; hand rests on edge of

container12-15 months Precise, controlled release into small container with wrist

extended3. Bilateral hand use

Age Milestone0-3 months Asymmetric movements

4-10 months Symmetric movements12-18 months Uses both hands for different functions18-24 months Manipulation skills emerge

2 1/2 The ability to use different hands for two very different functions emerges

4. Manipulating skills according to Exner’s Classification system

Age Milestone12-15 months Finger to palm translation: a linear movement of an object

from the fingers to the palm of the hand2 – 2 ½ years Palm to finger translation: with stabilization, a liner movement

of an object from the palm of the hand to the fingers3 – 3 ½ years Shift: a linear movement of an object on the finger surfaces to

allow for repositioning of the object relative to the finger pads2-2 ½ years Simple rotation: the turning or rolling of an object held at the

finger pads approximately 90 degrees or les6-7 years Complex rotation: the rotation of an object 360 degrees6-7 years In-hand manipulation with stabilization: several objects are

held in the hand and manipulation of one object occurs, while simultaneously stabilizing the others

5. Pre-writing skills

Age Milestone1- 1 ½ years Palmar supinate grasp: held with fisted hand, wrist slightly

flexed and slightly supinated away from mid-position; arm moves as a unit

2 – 3 years Digital-pronate grasp: held with fingers, wrist neutral with slight ulnar deviation and forearm pronated; arms moves as a unit

3 1/2– 4 years Static tripod posture: held with crude approximation of thumb, index and middle fingers, ring and little fingers only slightly flexed, grasped proximally with continual adjustments by other hand, no fine localized movements of digit components; hands moves as a unit

4 1/2- 6 years Dynamic tripod posture: held with precise opposition of distal phalanges of thumb, index, and middle fingers, ring and little fingers flexed to form a stable arch, wrist slightly extended, grasped distally, MCP joints stabilized during fine, localized movements of PIP joints

6-7 years Complex rotation: the rotation of an object 360 degrees6-7 years In-hand manipulation with stabilization: several objects are

held in the hand and manipulation of one object occurs, while simultaneously stabilizing the others

6. Scissor use skills>Prerequisite skills for scissors use include the ability to:a. Open and close a hand.b. Isolate or combine the movements of the thumb, index and middle fingers.c. Use hands bilaterally; one hand to use the scissors, one to stabilize the item being cutd. Coordinate arm, hand, and eye movements.e. Stabilize the wrist, elbow, and shoulder joint so that movement can occur at distal joints.f. Interact with the environment in the constructive developmental play stage

>Stages of development in scissor use, the child sequentially:

Age Milestone2- 3 years Shows an interest in scissors2 – 3 years Holds and snips with scissors2-3 years Opens and closes scissors in a controlled fashion3-4 years Manipulates scissors in a forward motion3-4 years Coordinates the lateral direction of the scissors3-4 years Cuts a straight forward line

3-4 years Cuts simple geometric shapes3 ½- 4 1/2 years Cuts circles

4-6 years Cuts simple figure shapes6-7 years Cuts complex figure shapes

Source: Cottrell, R.F. (2006). National occupational therapy certification exam: Review and study guide. Evanston, Illinois: International Education Resources, Ltd.

PATTERNS OF PREHENSION:

Below are examples of types of grasps used during drawing and writing activities. Common maladaptive grasps are also described with remediation recommendations. Intervention needs are outlined beside the inefficient prehension patterns.

© Therapro (1999) PERMISSION TO USE GRANTED IF CREDITS ARE MAINTAINED.PERMISSION IS GRANTED TO REPRODUCE AND DISTRIBUTE COPIES FOR NON-COMMERCIAL OR EDUCATIONAL USE ONLY.

CLASSROOM REMEDIATION IDEAS:

1. Check the height of the student tables. Check if the student’s feet are flat on floor, with knees bent to around 90 degrees with hips slightly above the level of knees. The upper body or torso should be more or less vertical and head as upright as possible.

2. Teach the students correct paper positioning for a writing task. Make sure the paper is tilted about 45 degrees angle. If the student is left handed, the top left corner should be closer to the body than the top right corner. If the student is right handed, the top right corner should be closer to the body than the left corner. The child’s forearm should be perpendicular to the bottom edge of the paper, this will naturally create a 30 degree angle from his upper body or torso.

3. Give the students proper tools for writing. Use small pieces of chalk, crayon, etc. Be explicit about proper finger placement. Teach the concepts of “writing hand” and “helping hand.”

4. Before students are instructed in correct letter formation, students should have developed skills that are pre-requisites for handwriting. These skills include:

a. Ability to cross the midlineb. Ability to use two handsc. Understanding of directional termsd. Ability to recognize similarities and differences in formse. Hand dominancef. Functional pencil graspg. Ability to copy lines and shapes

(Please refer to Fine Motor Centers for suggested classroom activities)

OCCUPATIONAL THERAPY ACCOMMODATIONS FOR THE CLASSROOM:

A. For students who have difficulty forming letters:1. You demonstrate and have the child imitate you.2. Give the student a letter strip to use at his/her desk and at home. Have parents work

on correct letter formation.

3. Provide explicit verbal directions as you form the letter and have the students follow along, repeating the directions using the same words as they make the letter.

4. Using the “Handwriting Without Tears” format, re-teach the correct stroke sequence for problem letters. Teach the concept that letters start at the top (either at the corner or at the center.

B. For students who reverses letters or numbers:1. Choose one reversal per assignment to work on. If the child reverses many numbers,

work on them one at a time, beginning with the lowest number.2. When using the slate chalkboard, use the “starting corner” and the child will quickly

learn to form the letter the right way.3. You demonstrate and have the child imitate.4. Allow the student to keep a letter strip at his/her desk for quick reference.5. Some students may benefit from a “green” (go) hand on the upper left hand corner of

the desk and a red (stop) hand on the upper right corner.C. For students who hold pencils too lightly:

1. Have the child practice coloring shapes light gray, medium gray, dark gray, and black to increase awareness of different degrees of pressure on the pencil.

2. Try a weighted pencil to give the child more awareness of the pencil.3. Try using pencil grippers.4. Do warm up activities before writing.5. Have the student write on paper over a grainy surface.6. Try a soft-lead pencil.

D. For students who hold pencil too tight and writes with too much pressure:1. Correcting the pencil grasp might help. Experiment with various pencil grips.2. Increase the child’s awareness of pencil pressure by having the student color shapes

in either light gray, medium gray, dark gray, or black.3. Have the student write on a soft surface such as blotters, layers of paper, a mouse pad,

phone book, or a piece of Styrofoam.4. Modify the pencil.5. Try a mechanical pencil so the student has to learn to control the amount of pressure

used.6. Cue the student to write faster (if legibility is not compromised too much).

E. For students who have difficulty spacing letters and keeping the letters on the line:1. Try popsicle sticks or placing a finger down between words.2. Try using a stamp pad and have the student stamp his/her fingerprint between each

word.3. Use the concept of exaggerating the spacing by putting “nothing” between words.4. Have student place dashes between words.5. Experiment with different kinds of paper such as bi-color, raised line, Sky-Grass-

Earth, Handwriting Without Tears paper6. Skip lines (using regular notebook paper)

7. Highlight or darken baseline8. Highlight margins9. Try teaching the student cursive.

F. For a student who has tremors:1. Use weighted cuff.2. Use weighted pencil.3. Use alternative writing techniques.

G. For a student who has difficulty holding a pencil:1. If a child has developed poor habits, try an adaptive grip to position the fingers

(pencil grip, stetro grip,try wrapping the pencil with a silly putty or play dough to help relax a tense grip.

2. Check to see that the hips , knees and ankles are all at 90 degrees for optimal posture.3. When modifying the pencil grasp, have the child use the adaptive grip for only short

time each day. This will help the child get used to the feel of a new grasp.4. If the child has a difficult time manipulating a large or regular size pencil, try using

pencil stubs. 5. If the child moves his entire arm when writing, try having the student write on a

vertical surface such as a slat board or a large 3 ring binder or use an easel.6. If the child holds the pencil too close or too far from the tip, try wrapping a small

rubber band around the area where the fingers should be placed. 7. Provide frequent breaks.

Source: Korenstein, B. J. (2002). Occupational therapy accommodations for the classroom. Retrieved from http://www.venturacountyselpa.com/Portals/45/Users/Teacher%20Res/OT%20Accom%204%20Classroom.pdf

HANDWRITING INSTRUCTION:

The following standards of learning (SOLs), issued by the Virginia Department of Education, illustrate the writing accomplishments that students must meet by the end of kindergarten. (Please see Appendix A for details):

1. The student will print his/her name.2. The student will draw pictures and/or use letters and phonetically spelled words to write

about experiences, stories, people, objects, or events.3. The student will explore the uses of available technology for reading and writing.4. Using multisensory and cognitive approaches as adapted in studies conducted by

In order to meet the above expectations, the following are suggested classroom centers that utilize cognitive and multisensory approaches in handwriting. By engaging the students in visual and fine motor activities as part of daily classroom experience, students will be able to increase their knowledge of hand function and become more actively involved of their own skills.

Fine Motor Center # 1

1. Finger Muscles Warm-up: This center will focus on activities that develop pre-requisite skills in handwriting such as crossing the midline, promoting bilateral integration, understanding directional terms, developing hand dominance, and promoting functional grasp. Examples of activities include:

a. Ability to cross the midline1. Practice tying shoes.2. Handwriting exercises:

2.1 Windshield wipers: arms above head, cross straight arms ten times like scissors then put bottom arm over top hand and do ten more.

2.2 Scissor cuts: same as windshield wipers only arms are pointed straight down with palm up

3. Daily experiences: Students zipper their coat, button their pants or tie their shoes.4. Balancing: Students build blocks and use both hands to balance their structure.5. Lacing cards.

Sources: http://www.doe.virginia.gov/testing/sol/standards_docs/english/index.shtml#expectationsPre-K and Kindergarten Handwriting Resource by Frederick County Public Schools. Retrieved from http://fcps.org/boez.htm#board April 2012

6. Cross-crawling obstacle course: The teacher creates an obstacle course with things for students to crawl in and out of, over and under, up and down.

7. Mini-movements: Roll out paper on the floor and tape in place. Tell students to lie on their stomachs to paint. Using finger paint, students will make a variety of tiny movements with their fingers that matches the rhythm of music being played.

8. The cross-crawl limbo: Play the traditional game “The Limbo,” holding a stick in the air. Ask students to form a line and find a way to go under the stick without bumping it. Each time through, lower the stick. Eventually, the students will have to crawl forward on their stomachs to get beneath the pole.

9. What a racquet: The teacher will help students make a racquet by stretching a wire hanger to form a diamond shape. Stretch stockings across the diamond and tape at the bottom. Use the racquets to play a game like badminton where students hit a ball or birdie back and forth to a partner. Have students start out close together and then move farther and farther apart.

10. Turtle crawl: Challenge students to crawl like turtles around an open space.

b. Ability to use two hands:

1. Tearing paper instead of using scissors.2. Cutting with scissors.3. Tracing letters by using stencils4. Making letters using yarn, shoestrings, or wax-coated string5. Gluing objects using small manipulatives to a letters6. Stapling paper while making books or packets to encourage use of both hands7. Punching holes to make designs on paper8. Wringing out sponges to increase muscle development.9. Sewing and lacing10. Stringing beads11. Performing finger plays12. Clapping13. Constructing with blocks14. Handwriting exercises:

14.1 Mickey Mouse Ears: Place fist next to ears, squeeze, and then open and close the fingers. Complete the activity 10 to 15 times.

14.2 Door knob turns: Arms in front of you, elbows slightly bent, move wrists from side to side as if you are opening a doorknob. Move wrists to the right and then to the left.

Source: Pre-K and Kindergarten Handwriting Resource by Frederick County Public Schools. Retrieved from http://fcps.org/boez.htm#board April 2012

14.3Finger opposition: Hold fingers next to ears and have the students touch their thumb to each finger and back again. Complete 10 to 15 sets.

14.4Butterflies: Hold arms straight in front of your body and make an X with thumbs, palms facing down to resemble a butterfly. Make small circles 10 times to the right and then 10 times to the left.

c. Understanding of directional terms and the ability to recognize similarities and differences in forms:

Incorporate the following activities in their daily routines:1. Play Simon Says2. Establish classroom routines throughout the year3. Read aloud: Model left to right progression so students understand and

visualize left to right directionality4. Follow directions in a sequence by completing step-by-step recipes5. Choral read: Students read along with the teacher, following a pointer to focus

on print read from left to right6. Build puzzles7. Discriminate objects according to size, shape, color, etc.8. Straight line/curved line exploration: Students manipulate commercially-made

wooden, plastic or foam pieces, cut into big and small lines and curves, to form letters

d. Hand dominance: In order to develop hand dominance, teachers need to provide students with opportunities to explore hand preference. As a precursor, students must develop their small muscles, which aid fine motor skills.

The following activities will improve hand strength:1. Tearing paper to make art projects.2. Using plant sprayers to water classroom plants.3. Use tweezers or tongs to place small items or objects (buttons, beads, beans)

into the container.4. Using eye droppers to transfer water from one container to another.5. Finger painting with Jello on a paper plate.6. Stringing popcorn, buttons, and beads to make necklaces.

Source: Pre-K and Kindergarten Handwriting Resource by Frederick County Public Schools. Retrieved from http://fcps.org/boez.htm#board April 2012

The following activities will improve hand dominance:

1. Playing Simon Says.2. Sequencing items.3. Cutting with scissors.4. Drawing with stencils, templates, or a ruler.5. Using a pencil sharpener.6. Opening containers with lids.7. Using wind-up toys.8. Wearing a bracelet or ring as a reminder.

e. Having a functional pencil grasp:

1. Using manipulatives (Jigsaw puzzles, legos, snap beads)2. Playing with small toys3. Molding with clay, sand, play dough, silly putty.4. Using daily experience activities (zipping, buttoning, sewing, screwing lids,

tying knots and bows, playing a piano)5. Practicing art skills (coloring, drawing, sketching, tearing paper, folding paper)

f. The ability to copy lines and shapes/basic strokes:

>The following are examples of basic strokes: vertical lines, horizontal lines, diagonal lines, circles, partial circle strokes.

>The following activities give students an opportunity to practice using basic strokes:

1. Drawing2. Painting3. Stirring4. Sand play5. Water play6. Finger painting7. Connecting dots8. Tracing9. Drawing lines to connect matching pictures on paper/chalkboard

Source: Pre-K and Kindergarten Handwriting Resource by Frederick County Public Schools. Retrieved from http://fcps.org/boez.htm#board April 2012

Fine Motor Center # 2

Structured worksheets of visual motor activities: This center will focus on activities that include a series of sample mazes, visual memory activities, visuomotor integration, and visual form perception.

Please see Appendix B.

Fine Motor Center # 3

Alphabet warm-up: This center will focus on naming of each letter, matching the letter with the appropriate letter (i.e. matching uppercase letter to uppercase letter, upper case to lower case, lower case to lower case), and practicing producing letters in the context of developmental progression (Asher, 2006). During letter introduction, the teacher will model writing the letter on a whiteboard and describe the steps. The students will imitate by writing in the air using large arm movements and repeating steps aloud. The students will then continue to say the steps while writing on the table with pointer finger.

***Introduce the uppercase letters in the following order:Rationale: According to Benbow (1990) (as cited in Zwicker & Hadwin, 2007), introducing letters with similar stroke patterns is thought to reinforce correct motor patterns for letter formation and reduce problems of reversals, rotations, and inversions (Alston & Taylor, 1987).

1. Vertical and horizontal lines- E,F,H,I,L,T2. Oblique lines- A, K, M, N,V,W,X,Y,Z3. Curved lines- B,C,D,G,J,O, P,Q,R,S,U

***Introduce the lowercase letters in the following order:

4. c, a, d5. g, q,o6. b, h, n7. m, p, r8. f, i, j9. k, t, x10. y, v, w11. e, l, s12. u, z

Fine Motor Center # 4

Alphabet practice using a multisensory approach: This center will focus on modeling and imitating of letter strokes using multisensory modalities (Woodward & Swinth, 2002). During guided practice activities, students will write with scented markers, color change markers, finger paint, pudding, shaving cream, clay tray, salt, rice, or sand tray. Students will

also write in their handwriting books or worksheet with the teacher or therapist monitoring for semi-independent practice.

References

Asher, A. (2006). Handwriting instruction in elementary schools. American Journal of

Occupational Therapy, 60, 461-470.

Berry, J. (1993). Fine motor skills in the classroom: Screening & remediation strategies.

Framingham, MA: Therapro Inc.

Cottrell, R.F. (2006). National occupational therapy certification exam: Review and study

guide. Evanston, Illinois: International Education Resources, Ltd.

Frederick County Public Schools (2003). Pre-k and kindergarten handwriting resource.

Retrieved from http://fcps.org/boez.htm#board April 2012

Hammerschmidt, S. L., & Sudsawad, P. (2004). Teachers’ survey on problems with handwriting:

Referral, evaluation, and outcomes. American Journal of Occupational Therapy, 58,

185–192.

Korenstein, B. J. (2002). Occupational therapy accommodations for the classroom. Retrieved

from http://www.venturacountyselpa.com/Portals/45/Users/Teacher%20Res/OT

%20Accom%204%20Classroom.pdf

Virginia Department of Education (2011). English Standards of Learning. Retrieved from:

http://www.doe.virginia.gov/testing/sol/standards_docs/english/index.shtml#expectations

Woodward, S., & Swinth, Y. (2002). Multisensory approach to handwriting intervention:

perceptions of school-based occupational therapists. American Journal of Occupational

Therapy, 56(3), 305-12.

Zwicker, J., & Hadwin, A. (2009). Cognitive versus multisensory approaches to handwriting

intervention: A randomized controlled trial. Occupational Therapy Journal of Resources,

29(1), 40-48.