1. Somatosensory Processing &
Handwriting Proficiency
BACKGROUND
‣ Proficient handwriting correlates with increased motivation,
self-esteem, and memory retention for school-aged children
(Donica et al., 2012).
‣ Handwriting facilitates neuronal pathway development in
areas of the brain associated with fine motor control,
neuromuscular coordination and balance, and reception of
sensory stimuli (Kalat, 2015).
‣ Somatosensory development provides important
information to children, such as body awareness and skilled
motor planning (Kramer & Hinojosa, 2010).
‣ 80-85% of school-based referrals for OT are for handwriting
and fine motor deficits that affect school-related tasks
(Schneck & Amundson, 2010).
‣ 90% of surveyed OTs in the United States listed multisensory
approach as a main approach to handwriting intervention
(Feder, Majnemer, & Synnes, 2000). Somatosensory
intervention is often used in the multisensory approach.
‣ Although multisensory interventions are used frequently, it’s
efficacy has not been well researched (Zwicker & Hadwin,
2009) and the lack of evidence regarding the contribution of
somatosensory processing to effective handwriting indicates
the necessity for further research.
Hillary E. Colby, OTS | Ani K. Courville, OTS | Salwa S.Yaser, OTS | Sherin Thomas, OTS | Melisa Kaye, MS, OTR/L
Objective:
The objective of this study was to examine the relationship
between somatosensory processing and handwriting
proficiency in typically developing second grade children.
The hypotheses of this study stated there would be a
positive correlation between somatosensory processing and
proficient handwriting.
O C C U P AT I O N A L T H E R A P Y D E PA R T M E N T D O M I N I C A N U N I V E R S I T Y O F C A L I F O R N I A
Discussion
‣ Somatosensory processing is a necessary component for
developing handwriting proficiency.
‣ Our research suggests that there is a link between
somatosensory processing to handwriting proficiency,
which provides insight on the skills required to produce
legible handwriting.
‣ Somatosensory skill components are essential for kids to
develop, as they may contribute to handwriting
proficiency. However, this does not suggest that children
with well developed somatosensory skills have adequate
handwriting abilities.
‣ By identifying specific components of somatosensation to
handwriting proficiency, it narrows the scope of skills
needed to improve handwriting.
‣ OTs can evaluate specific somatosensory components in
children having difficulties and potentially take
remediation measures to improve handwriting
proficiency.
Methods
Research Design: Exploratory correlational
Setting: The Friends School in San Francisco, California &
Bacich Elementary School in Kentfield, California
Participants: 74 typically developing second grade students
between the ages of 7.0-8.11 years
Independent Variable: Somatosensory Processing
Dependent Variable: Handwriting Skill
Data Administration: One hour of testing; interrater reliability
established prior to test administration; teacher consultation
and parent guardian questionnaire were included
Data Analysis: SPSS Version 22.0, Descriptive Statistics, Means
& SD,T-Tests (p<.05), Pearson Product Moment Correlation
Assessment Measures
Minnesota Handwriting Assessment (MHA): Measures size,
form, alignment, legibility, and spacing in handwriting.All
letters of the alphabet used.Test age range: 1st - 2nd graders.
Buktenica Developmental Test of Visual Motor Integration,
Sixth Edition (VMI- MC): A subtest of the VMI measuring
motor coordination; this includes tactile discrimination,
proprioception, and refined motor output. Test age range:
2-100 years.
Quick Neurological Screening Test, 3rd Edition (QNST-3):
Measures haptic skill, proprioception, tactile sensation, and
kinesthesia. Subtest components that measure somatosensory
processing were included.Test age range: 4-80 years.
Results
‣ Sample Size: N=74
‣ There is a statistically significant correlation between the
QNST Nose Discrimination subtest (QNST-ND) and MHA3
Components: Form, Size, and Alignment (MHAcomp3) (r
= .257, p = .05).
‣ This indicated as the child’s precision to touch the tip of his
or her nose becomes more accurate, handwriting
proficiency is higher.
‣ The results imply that with more accurate nose
discrimination, the more accurate handwriting is; thus
demonstrating a relationship between somatosensory
processing and proficient handwriting.As one develops
efficient somatosensory processing one’s handwriting
becomes more proficient.
‣ There is a statically significant correlation between the
QNST-ND and MHA Size component ( r = .267, p = .05).
‣ This indicated that as the child's accuracy to complete the
nose discrimination test was more precise, handwriting
size became more accurate.
‣ MHA Size is the most significant contributing factor to the
relationship between handwriting proficiency and
somatosensory processing.
‣ As one is able to control and manipulate the pencil to the
adequate letter size through somatosensensation, more
proficient handwriting is produced.
IMPLICATIONS
‣ Additional research is suggested to examine the links between
somatosensory intervention and handwriting proficiency.
‣ Future research should examine if somatosensory remediation
to multisensory intervention is effective in handwriting
proficiency intervention.
‣ Further research is needed to determine if somatosensory
remediation affects handwriting performance in specific areas
(legibility, form, size, spacing).
‣ Research that explores the aforementioned interventions will
lead to future ways to facilitate handwriting remediation
effectively using somatosensory skills.
‣ Future assessment tools designed and developed to
specifically measure each somatosensory component is
indicated.
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