I often get asked the question if handwriting is really important anymore. After all, aren’t we all writing a little sloppier in the age of email and texting? This is certainly a valid question. However, there is still so much we can get out of handwriting-related activities, far beyond the actual printing of words. I will first bore you with a little background info about Occupational Therapy. There are two types of activities: an “occupation as an end” (i.e. learning to perform an actual task for the sake of completing the task) and an “occupation as a means” (i.e. learning to perform a task for the skill development needed for other tasks). For example, learning how to sort laundry is functional and would qualify as an “occupation as an end.” Picking up pom poms with a clothespin, however, is an “occupation as a means” because it is not functional standing alone but develops important skills. Some of our clients will learn how to print their name and to print more advanced things as well. Some will not, but by working on handwriting-related activities, they will still build functional skills.
A study by the University of Washington found that the skills learned in handwriting practice translate to other areas of life. So, when your brain tells your hand to make a certain letter, stroke, or even scribble, a neurological relay response is happening and our clients are learning to use their brain to generate ideas to then be executed into movements (which is called ideational praxis). This can then help with gross motor tasks (like moving their arms to put in their sleeves) as well as fine motor tasks (like using their fingers to manipulate the zipper on their coat).
The starting point in the developmental progression depends on the individual client, but I will quickly go through a typical chain of development. When in doubt, we always err on the side of an easier step for the client to build confidence. Development occurs proximally to distally (or inner/outer), meaning the torso should be stable first, then the shoulders should be stable before focusing on the arm, hand, etc. This is where the term “core development” comes in, and is developed from activities such as sitting on a therapy ball, swinging on a swing, lying on the stomach propped up on elbows, etc. Shoulders can be strengthened from activities such as wall push-ups, wheelbarrow races, or hanging from monkey bars.
The next step is to really work towards getting the clients to use their hands cooperatively in a variety of activities to promote grasp development. One of my favorite activities to do with the clients is to play in a toy bin. This is a really motivating activity, but so many skills are being addressed in the process. The toys come in all sizes and shapes, which requires them to adjust their grasp as needed to hold each toy. They may “press buttons” (which addresses index finger isolation), “spin the dial” (rotation of the wrist), “flip it over and see what is underneath” (for forearm movement).
After the clients are effectively using their hands and grasping items with ease for general play, I really work on refining grasps and making them stronger. It’s important that the muscles in the fingers are strengthened as well as the muscles in the palm, which are called intrinsic hand muscles. Examples of activities that strengthen the fingers are clipping clothespins on to a ruler, stretching rubber bands to place on a tube, or placing plastic chips into a slot on the top of the coffee can, which creates resistance that you have to push through to get the chip inside. Examples of activities working on intrinsic palmar muscles include using a hole puncher to punch holes in paper, squeezing a hand strengthen, and squishing Play-Doh.
After grasp is becoming precise and consistent, we can really begin to work towards handwriting. There are so many factors involved in teaching handwriting that would take too much time for this article, but the OT department at Grafton would be happy to assist! The main take-home points of this post are 1) the skills developed from working towards handwriting translate far beyond the actual task of handwriting to help clients in their daily lives and 2) we can all help clients move through the developmental progression by encouraging play with engaging toys and activities using their hands (feel free to give some of the activities mentioned in this post a shot). Everyone has fun, and a few skills may be developed in the process!