Role of Occupational Therapy in Prewriting Skills for Children with Special Need: A Clinical Study

Abstract

Background: Handwriting is a complex skill that develops over time, to learn handwriting children need to combine fine motor skills, language, memory and concentration. They also need to practice and follow instructions. The occupational therapists role is to determine underlying postural motor, sensory integrative or perceptual deficits that might interfere with the development of legible handwriting. Evaluation of the child with handwriting difficulties should begin with observation of the child’s attempts to write; several areas should be assessed. Sensory integrative problems frequently interfere with the development of handwriting skills; poor bilateral coordination could result in lack of stabilization of the paper with the non dominant hand and reluctance to cross the midline of the body. Poor kinesthetic awareness causes some children to grip the pencil that the point breaks piece. Physical disability may require specific adaptations to enable the child to learn handwriting skills. These include special pencil holders and device to stabilize paper; it is also imperative to position the child appropriate to achieve necessary stabilization for writing. Handwriting starts with scribbling and drawing then moves on to forming letters and words. Scribbling prepares young children to learn handwriting in school. This study enables occupational therapists to assess the handwriting difficulties in special need children. At future our work may facilitate the pre writing skills and improvement in handwriting of special need children to enhance their academic performance. These skills are taught to child early to achieve good handwriting skills. Aim: To analyze the role of occupational therapy in pre writing skills for children with special needs. Objectives: To evaluate hand writing skills of special need children, and to train pre writing skill for children with special need. Methods: Fourteen special need children with age group 9–14 (mean ages 10.92), including 6 male and 8 female children, were selected based on the inclusion and exclusion criteria. All the participants were screened by using Handwriting Legibility Scale (HLS) and were suggested prewriting activities. Result: The statistical analysis of Handwriting Legibility Scale (HLS) pre assessment mean value of legibility is 3.210, lay out on page is 2.435, and letter formation is 3.625. The post therapy mean value of legibility is 4.312, lay out on page is 3.476 and letter formation is 2.741. The results show that, there are significant changes between pre and post therapy value of Handwriting Legibility Scale (HLS) scores. Conclusion: A majority of children with special needs were not able to write and form letters and their hand writing were also not legible. Hence, we suggest that, the teaching and training of pre writing activities can be given with some fine motor activities along with our protocol will make them to overcome their difficulties in future.