Conceptual Model for Performance in Handwriting

  • The Conceptual Model for Performance in Handwriting views that handwriting is important for one’s work and/or education domains of occupations. It considers the performance components, performance areas (functional performance), performance contexts, and the interactive relationship among them. Prerequisites to handwriting include performance components in sensory, perceptual, motor cognitive, and language functions, as well as integrations of these components. During evaluation, therapists can consider the three areas including biomechanical and ergonomic factors (e.g., sitting posture, pencil grip), quality of writing (e.g., leveling, directionality, spacing), and observation/other consideration (e.g., associated reactions and behavioral responses). This model illustrates that the interaction between performance components and functional performance in handwriting. For example, a child’s difficulty in quality of writing (functional performance) could be related to underlying cognitive function (performance components). Assessments include examining work samples, discussing with teachers and parents, reviewing educational record, directly observation, evaluating functional performance, and assessing any suspected interfering performance components. Standardized assessments including handwriting profile is used. Interventions with various treatment approaches can be used for individuals with handwriting difficulties; they are remedial (e.g., sensory integrative therapy), functional (e.g., biomechanical and ergonomic interventions), compensatory (e.g., use of audio-tape), adaptive (e.g., reduce amount of coping task), management (e.g., motivational approach), and maintenance (e.g., high power information technology appliance), to address the underlying deficits that interfere with successful handwriting.

Summarized by

  • Macey Cho

Type

  • Model (conceptual)

Population

  • Child

Disability

  • Handwriting difficulty

Domain of occupation

  • Work
  • Education

Application Note

  • Collaboration with teacher should be established at early stage of evaluation and intervention.

Key Reference

  • Chu, S. (1997). Occupational therapy for children with handwriting difficulties: A framework for evaluation and treatment. British Journal of Occupational Therapy, 60, 514-520.

Year Published

  • 1997

Primary Developer

  • Sidney Chu

Primary Developer Email

  • kid.power@btinternet.com

Related Models

Frame of Reference for Development of Handwriting Skills

  • This frame of reference identifies functions and dysfunctions in five areas of handwriting for children, including proximal posture, components, use of writing tools, grasp, and handwriting. Good proximal control is required for functional and effective distal control of the writing tools. Either excessive postural stability or lack of postural stability during writing tasks is considered as dysfunctions. Components including ocular-motor skills, attention, and memory are considered as essential.

Neuro-Developmental Treatment Frame of Reference

  • The Neuro-Developmental Treatment (NDT) frame of reference is used to analyze and treat posture and movement impairments based on kinesiology and biomechanics. To identify difficulties and plan for intervention, the following concepts are to be considered in NDT, including planes of movement, alignment, range of motion, base of support, muscle strength, postural control, weight shifts, and mobility. NDT assumes that posture and movement impairments are changeable. Thus, it utilizes movement analysis to identify missing or atypical elements.

Biomechanical Frame of Reference for Positioning Children for Function

  • The Biomechanical frame of reference for positioning children for function is applied to individuals who are unable to maintain posture from appropriate automatic muscle activity caused by neuromuscular or musculoskeletal dysfunction. The goals of this frame of reference are (1) to enhance development of postural reactions, which can be done by reducing the demands of gravity and aligning the body, and (2) to improve functional performance by providing external support for proximal stability to improve distal function.

Hand Function Evaluation Model (HFEM)

  • The Hand Function Evaluation Model (HFEM) aims to guide assessment of the impairment and disabilities for preschool-age children presenting hand dysfunction. In the HFEM, hand function is evaluated at three levels: 1) sensorimotor performance, 2) developmental progress, and 3) hand function performance. At the first level, assessment of sensorimotor performance includes grip strength, dexterity, and stereognosis of the child. In particular, the evaluation of the grip strength includes four subtypes: power, tip pinch, three point chuck, and lateral pinch grip.

Compensatory Frame of Reference

  • The compensatory frame of reference (FOR) aims to increase occupational performance and facilitate independence by utilizing compensatory techniques. It is used to compensate dysfunction in desired occupations, e.g., using assistive device or equipment such as Ergonon/Reflex knife during meal preparation, to compensate difficulty with using traditional knife. This FOR also includes environmental change, e.g., altering layout of living environment or using splints.

Model Type

Population

Disability

Domain of Occupation

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