SENSORY CONSIDERATIONS AND STRATEGIES FOR HELPING KIDS WITH

HANDWRITING

When teaching a child to write, there are many sensory processing to consider.
Today, I'm sharing sensory considerations and strategies to help children in
handwriting tasks. This post is part of my new year-long series with 9 other
Occupational Therapy and Physical Therapy bloggers as we discuss Functional Skills
of Childhood.

Pick up a pencil. Hold it correctly. Write a letter. Copy a word. Fill in a worksheet.
Write down the day's homework assignment in the correct space with a noisy
classroom full of talking kids while the teacher chats to someone at the door. The
open windows alert you of another class playing on a playground. Bouncing balls,
laughing students, buzzing pencil sharpener, bright sunshine, and that homework
assignment that needs to be written legibly so you and your parents can read it an
hour from now.

One of a child's occupations are to perform educational activities like

handwriting. Holding a pencil, forming letters, writing on lines, and copying from a
chalkboard is a multi-sensorial function of childhood.

Handwriting depends on accuracy and legibility. Letters must be formed correctly

and with appropriate pencil pressure, on the lines, and with attention to details. To
complete these skills, handwriting and sensory processing are naturally
associated. All components of handwriting require integration of our senses for
accuracy, legibility, and performance. In a classroom environment, we are constantly
bombarded with an input of sensory information. We receive sensory information
from our eyes, ears, skin, muscles, and joints and our brain has the job of organizing
the information, selecting the important parts, and disregarding the rest. When our
body's sensory systems are functioning appropriately, we are able to manage tasks
like writing with a pencil. When there is a deficit in one of these areas, there are
sensory integration problems and activities that we are required to perform are
affected.

Sensory Processing and Handwriting

What is sensory processing?

Sensory processing, or sensory integration requires the body's central nervous

system to effectively register sensory information, filter the parts that are not
necessary, organize and interpret what to do with that information, and modulate the
attention level of our nervous system. Ineffective accommodation to this process
leads to distractability and disorganization. There are seven sensory systems in our
bodies:

 Tactile System (touch)

 Vestibular System
 Proprioceptive System
 Olfactory System
 Visual System
 Auditory System
 Gustatory System

Sensory integration is what turns sensations from these systems into perception. We
perceive our bodies, and our interactions in our environment because our brain has
integrated the sensory information into something meaningful, organized, and useful
(Ayres, 1979).

An Explanation of the Sensory Systems related to Handwriting

The proprioceptive, vestibular, and touch senses are primary influences on the
integration of our senses. This happens from infancy as we are swaddled, carried in a
flexed position, and swung in a baby swing or our mother's arms. If these sensory
systems are poorly functioning, a child will have trouble developing in all
areas. Integration of the vestibular and proproceptive systems gives the child
control over eye movements at infancy. Without integration of these two systems,
the baby will be slow to develop postural reactions and have a poor foundation of
movement.

If the proprioceptive, vestibular, and touch sensory systems are not functioning
adequately, the child will have a poor reaction to his environment. He may withdraw or
over-respond to auditory and visual stimuli. The child can not focus on tasks and may
feel insecure in his environment. These problems can lead to a poor body perception.

A child with proproception dysfunction may seek out sensory feedback from
his environment. You might see these children bumping into their desks, stomping
their feet on the ground, kicking their chair or their neighbors chair. They might rub
their hands on the desk, bight their hands, shirt, or pencils, or write with heavy
pencil pressure. Students seeking proprioceptive input often crack their knuckles
and chew on shirt cuffs or collars.

An inefficient grading of movement might result in students holding their pencils too
tightly, writing so heavily that the pencil point breaks, or producing messy work with
large erasure holes.

A child with vestibular dysfunction may present as a hyperactive child or a

hypersensitive child. Some students might have an intolerance for movement and will
seem willful and uncooperative, while demanding physical support. A problem with the
vestibular system sometimes presents with gravitational insecurity. These kids might
be fearful when moved such as when a teacher pushes in their chair. The hypo-
sensitive student will have an increased tolerance for movement. These kids need to
keep moving in order to function. They might fidget, wiggle, and bounce in their
seat. You will see these students jumping up and down in their chair, sitting on their
feet and swaying, hanging upside down at their desk, and falling out of their seat.

Children with vestibular, tactile, and proprioception difficulties will have trouble
with eye-hand coordination. Writing on lines and coloring between lines is
difficult. There will also usually be difficulties with depth perception. In order for a
child to develop visual perception, they need adequately integrated vestibular and
proprioception systems.

Many times, children have auditory and tactile dysfunctions that interfere with
handwriting:

The child with auditory processing concerns will seem unaware of where sounds
are coming from. When a teacher directs the class to write down items or copy
specific information, these directions are lost. They are unable to pay attention to
one voice or sound without being distracted by other sounds in the classroom. They
may even be distressed by the sounds of pencils making marks as they or other
students write. They have trouble attending to and understanding and remembering
directions related to letter formation in words and sentences. These kids might have
difficulty putting their thoughts onto paper and trouble revising or correcting what
they have written. Additionally, students with oor auditory processing often times
have a weak vocabulary so when they are writing words and sentences, they struggle
with words and sentence structure and therefore lose focus on the letter formation
and line placement that they need to attend to.
The child with tactile dysfunction may be either hypersensitive or hypo-sensitive to
touch. A student who has tactile defensiveness (hypersensitivity) may overly
react to light touch. When teachers are up close as in handwriting instruction, the
student might become fearful or irritable. These kids can become overly focused on
neatness in handwriting and their desk space. They might need to brush off every
eraser bit or clear their paper and desk of every stray mark. The child with under-
responsiveness to touch (hypo-sensitivity) might seem unaware of pencil pressure
and write with very heavy or very dark pressure on his pencil. These children fail
to realize that they've dropped their pencil or that they've got pencil smears all over
their palms.

Sensory Processing and Motor Planning needed for Handwriting

When our body understands sensations from our skin, muscles, and joints, we are able
to feel and know what our body is doing without looking at it. This poor perception
can lead to difficulty coordinating the two sides of the body as they perform
different tasks. The child might have trouble holding his paper with one hand while
writing with his dominant hand. The child will need to think through his actions
without them happening automatically.

Most students learn to form letters and numbers automatically given

practice. Children with a poor motor plan must think out the way a letter is
made. Motor planning is the sensory process that allows us to complete and adapt to
an unfamiliar task (like a worksheet), using what we already know. The key to motor
planning is a body perception that can accommodate to tactile, proprioceptive, and
vestibular information.

Also related to the sensory system is a child's attention span. If the sensory
information is not registered, filtered, organized, selected, and discarded
appropriately, the child will not be able to focus his attention on an activity like
handwriting.
Handwriting Difficulties due to poor Sensory Processing

Children with difficulties modulating sensory input face a big challenge in the
classroom. The school environment is overstimulating and asking a child with sensory
integration difficulties to filter out irrelevant sensory input while attending to
academic work is very difficult. Problems in handwriting might include (but not be
limited to):

Handwriting Issues Related to Poor registration of sensory input with an Under-

reactive response

 The child may be unaware that he drops his pencil.

 Shows a weak grasp.
 Difficulty maintaining an effective writing posture.
 Tires easily in writing tasks.
 Does not notice details (Misses letters when copying words or sentences)
 Desk and writing area are disorganized and sloppy.

Handwriting Issues Related to Poor registration of sensory input with a

Hyperactive or Over-reactive Response

 Avoids smells (pencil or paper) in the classroom.

 Easily distracted during writing tasks.
 Difficulty paying attention to a writing task.
 Cannot work silently.
 Visually distracted by others, including noises, scents.
 Difficulty focusing on one section of a chalkboard or one part of a worksheet.

Handwriting Issues Related to Sensory Seeking

 Seeks movements by moving the chair, wiggling in the seat, bouncing legs and
arms and distracts other students with the movements.
 Overly excited after recess and is difficult to settle down.
 Always touching the desk or parts of the chair during writing tasks.
 Craves scents or tastes: chews the pencil for it's task, smells the paper or
pencil shavings.
 Chews the pencil or eraser and clothing.
 Bites hair/shirt/nails when writing.
 Writes with heavy pencil pressure.
Handwriting Issues Related to Sensory Avoiding

 Difficulty with changes in the routine of writing: new paper or type of

worksheets
 Low frustration level with errors in letter formation
 Anxiety: wants to make letters and numbers correctly the first time
 Stubborn in handwriting concerns
 Avoids touching pencil shavings, the wooden part of the pencil tip, or the
eraser.
 Avoids erasing mistakes

How to Help: Sensory Strategies and Modifications to help with Handwriting

Problems

Many times, sensory integration can help with handwriting problems related to
handwriting. Children who demonstrate proprioceptive issues may benefit from heavy
work activities in the classroom.
Heavy Work Sensory Activities to Help with Handwriting

 At the beginning of the day, take down chairs from desks and push them to
correct places in the room
 Erase the chalkboard
 Wash desks/dry erase board
 Sharpen pencils with a manual pencil sharpener
 Chewy food breaks (fruit leather, licorice)
 Crunchy food breaks (vegetables, popcorn, pretzels, dry cereal)
 Cut materials from oak-tag or heavy paper
 Carry books with both hands, hugging the books to their chest
 Weight down the student's chair by taping weights to the chair legs
 Pad the feet of the chair to add extra resistance
 Climb playground equipment
 Carry books and supplies to other classrooms
 Hand fidget toy and squeeze toys
 Brain Breaks
 Wall push-ups
 Chair push-ups
 Animal walk breaks
Possible Modifications and Strategies to Help with Handwriting Problems

 Try a variety of pencil grips.

 Wrap the tip of the pencil in clay and tell the child that if the clay is
misshaped, then he is pressing too hard on the pencil.
 Try various proprioception in handwriting modifications.
 Tilt the child's writing surface to a slightly included position using a 3 ring
binder. This positioning provides improved wrist positioning and will decrease
the force the child presses through his wrist.
 Try writing with carbon paper under the paper to show the child that he needs
to press harder or lighter through the pencil.
 Copy written work from a his desk instead of from the chalkboard or
overhead.
 Write with a grease pencil to provide more resistance and feedback.
 Remove distractions from the classroom and seat the child away from windows
and doors.
 Provide the child with written and verbal instructions.
 Provide a quiet space in the classroom.
 Provide movement breaks.

Typically, the sensory systems and sensory integration is developed by the time a
child enters school. The ability to concentrate while managing sensory input is very
much needed for the classroom that is multi-sensorial, like described above.

Problems seen with handwriting, like heavy pencil pressure, sloppy letter formation,
difficulty with letter size and form, fast or very slow speed of writing, and
inattention to writing tasks are often times an end product of an inefficient and
irregular sensory processing system.

A sensory integrative approach to teaching handwriting can be successful for the

child with sensory processing concerns. Occupational Therapists can analyze sensory
processing skills during the performance of handwriting (and other school-day
tasks). An OT uses formal evaluations, screening tools, standardized tests,
observation of classroom behaviors, parent/teacher checklists, and observation of
classroom behaviors and play activities to identify handwriting issues related to
sensory processing.
HANDWRITING ACCOMMODATIONS FOR THE CLASSROOM

Handwriting accommodations for the classroom can help the child who has tried many
handwriting strategies for improving legibility and written work. Try these classroom
accommodations to help with spacing, line awareness, and letter formation in written
work. These handwriting ideas can be used by educators, therapists, and parents
across the curriculum in everyday writing tasks. Try using one or more of the
strategies at a time and combining techniques to meet the individual needs of the
child.

Handwriting Accommodations for the Classroom--Writing Strategies, Cheats, and

Hacks

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 Trace the baseline or worksheet lines with a bold marker.

 Trace the baseline or worksheet with glue. Allow it to dry for a DIY raised
line.
 Try raised line paper. Available in narrow rule or double rule.
 Mechanical pencil for weak fine motor skills or proprioception issues.
 Remove handwriting grade from requirements.
 Don't require a handwriting grade.
 Set appropriate lengths of time for completing written work.
 Allow more time for completing written work.
 Reduce written work requirements.
 Allow dictation of written work.
 Writing strip on the desk.
 Erasable pen to provide less resistance on paper.
 Graph paper for written work, spelling tests, and math problems.
 Allow the student to type their spelling test answers.
 Bold lined paper. Available in single rule or double rule.
 Try a variety of pencil grips. Universal writing aide, the Crossover Grip, or
the Claw may help.
 Sky/ground paper. Try a DIY version.
 Box and dot paper. Read about this paper here.
 Green dot at left margin and red dot at right margin of the paper.
 Flexibility with written work: use all capital letters or use printed work
instead of requiring cursive.
 Highlight answers on tests instead of writing the answer out.
 Use a stamp or highlighter to mark multiple choice answers.
 Divide tests into smaller writing portions.
 Dictation/note taking app on tablet/iPad. Google Chrome's Read and Write
extension is one idea.
 Laminate worksheets or slide them into a sheet protector. Student can use a
dry erase marker for answers.
 Provide larder space for filling in worksheets. Try enlarging the page.
 Use letter tiles to spell spelling words.
 Handwriting checkpoints. Throughout the day, the students and teacher
should encourage a self-check using a handwriting checklist.
 Tape guide on the desk to help with paper position and consistent tilt or slant
of written work.
WHEN EXECUTIVE FUNCTION SKILLS IMPAIR HANDWRITING

Handwriting is a complex task. To write a sentence, a child needs to process

information, recall important information, plan what he wants to write, initiate the
writing task, perform the motor tasks to move the pencil to form letters, organize
motor output on the page, manage paper/posture/pencil mechanics, realize errors,
and be flexible enough to accept and correct mistakes.
All of these "parts" of handwriting might sound familiar to the parent, teacher, or
therapist of a child with executive function defects. Executive function is our ability
to "get things done". It is a set of skills that allow us to organize information, plan,
learn, multi-task, remember things, prioritize, pay attention, and act on information.

Handwriting for a child with executive functioning problems can be quite challenging.
Handwriting requires visual perception, sensory processing, cognitive components,
motoric output, awareness of mistakes, and the ability to correct them just to
complete written work.

Now, image asking a child with executive function difficulties to write a 5 sentence
writing prompt. After an 8 hour day of school. In the environment that the child
feels most comfortable to exhibit behaviors (home with his loved ones)...it can be a
messy scenario leading to a homework breakdown.
What is Executive Functioning?

One issue that may be causing a child to write well at school and produce completely
illegible or totally sloppy written work at home is a deficit in executive functioning
skills.
Kids who have trouble managing their executive functioning skills might have trouble
with:

 attention
 focus
 problem solving
 impulse control
 emotional control
 organization
 task initiation
 prioritizing and planning
 self-awareness
 working memory
 flexibility in thinking

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Handwriting and Executive Function Skills

When asked to complete written work, a lack of executive functions or a inability to

utilize executive functioning skills may occur. The child may show resistance to the
writing topic, trouble initiating, and difficulties with written work output. Here are
signs of executive function problems in handwriting:
 Difficulty generating ideas
 Trouble articulating ideas
 Problems putting their ideas onto paper
 Difficulty forming the letters to produce written text
 Simple or minimized written output despite verbally responding to writing
prompts
 Inappropriate pencil grasp
 Trouble initiating writing prompt
 Difficulty organizing work space
 Crumbled paper
 Tearing paper when writing or erasing
 Poor letter formation
 Difficulty with line and spatial awareness on the paper
 Slow writing speed
 Complaints of mechanics of writing (pencil needs sharpened, need better
eraser, uncomfortable seat)
 Slow writing speed
 Written work does not answer the question or answers only part of the
question despite verbally stating a full response.
 Repeats self in written work (in an open ended writing prompt type of task)