This blog, written by Emily Wormald is the second in our series in which students who were awarded masters studentships by the SF-DDARIN discuss their experiences of practice based research.
This blog is the work of the author and does not necessarily reflect the views of the SF-DDARIN or its management team.
For my Masters thesis project I was lucky enough to work alongside an established behaviour support team in a special needs school, overseeing an intervention to teach handwriting to three children with Learning Disabilities (LDs). I was supervised by Dr Corinna Grindle and Professor Carl Hughes (Bangor University), and received a grant from SF-DDARIN to conduct the research.
Handwriting is an important life skill that is often overlooked in children with learning disabilities (LDs). Children with a diagnosis of LD are particularly at-risk for delays in handwriting development –up to 90% of those with a LD have handwriting and/or fine motor difficulties (Tarnopol & Tarnopol, 1977).
Many professionals recommend keyboarding as an alternative writing strategy for children with handwriting difficulties; however, there are several benefits associated with handwriting that aren’t seen with typing. Children who practise spelling using handwriting may acquire spellings faster than those using typing (Cunningham & Stanovich, 1990). Also, teaching children to spell through handwriting may support letter recognition and subsequent reading skills; this has not been seen in those taught through typing (Longcamp, Zerbato-Poudou, & Velay, 2005). Furthermore, children may improve in word reading (Berninger et al., 2006), writing fluency (Berninger et al., 1997), and general self-confidence (Erhardt & Meade, 2005) after specific instruction on letter formation. So, despite the increasing prevalence of typing and technology, handwriting is still an important skill to teach children with LDs.
Handwriting Without Tears® (HWT) is a comprehensive handwriting curriculum, designed by an occupational therapist, that covers foundation level to Year 6. Stages of the curriculum follow a developmental sequence of fine motor skills, beginning with scribbling and colouring, then simple lines and shapes, followed by capital then lower-case letters. Capital letters are introduced first since these are easier to write – they are all the same size, all sit above the line, and are mainly formed of straight lines and curves. Also, letters are grouped by their formation, so ‘F’ ‘E’ and ‘D’ are taught first as they all start with a “big line down, frog jump up [to the top]” – as children practice this sequence, subsequent letters in the group become easier to learn. Simple, repetitive instructions help children remember how to form their letters.
During my project the intervention followed an adapted HWT manual, initially developed by Grindle et al. (2017). The manual has been tailored to incorporate evidence-based teaching strategies for children with LDs. Many core elements of the original HWT curriculum were still included, such as the instructions for each letter. The adapted manual was more condensed, to promote more rapid learning as children with LDs are likely to be using it as a ‘catch-up’, and recommended prompting and generalisation strategies.
Three children aged 9-11 were selected for the study, who were identified as having specific deficits in their handwriting skills. Initially the children’s regular TA received training in how to deliver lessons following the adapted manual, and how to take data. Next, the children were assessed using a range of measures, including a standardised assessment (the Minnesota Handwriting Assessment) and measures of related skills. For the next 8 weeks the TA delivered four 15-minute lessons per week, which I regularly oversaw to provide training. I also reviewed the children’s handwriting sheets after each lesson to check when a letter was mastered, and set the children new targets (a letter was considered mastered if the child wrote it correctly and independently for two lessons).
The primary aim was to establish the feasibility and acceptability of the intervention, and I carried out interviews with the TA and children’s class teacher to explore this. Overall they were very positive about the intervention:
“David’s (pseudonym) doing really well...At the beginning he wouldn’t use his right-hand to secure the paper, but he’s doing that a lot more now”
“They seem a bit more focused, you know after we’ve come back from Handwriting Without Tears and they get on with their work”
“I think the boys have got a lot from it. Um they seem to be really enjoying it, looking forward to it in fact.”
“I think it’s a really good programme. I think it should be rolled out as standard for all [children in] primary”
The secondary aim was to see whether there were any improvements in the boys’ handwriting after an 8-week intervention. Results from all assessments reflected improvements in the boys’ handwriting, for example sizing on the Minnesota Handwriting Assessment:
and better formation of ‘Frog Jump Capitals’ on the Screener of Handwriting Proficiency:
Also, children improved their drawings of people; on the Goodenough Draw-a-Person test, which gives an age-equivalent score for drawings, one boy increased his age score by a full year:
This was an exciting project for the future development of the adapted HWT manual, as we obtained great results by training regular school staff to deliver the intervention. Using this model, there is great potential for the widespread use of the HWT programme as an evidence-based intervention for teaching handwriting across special needs schools.
Further readings / references
Handwriting Without Tears: https://www.lwtears.com/hwt
Grindle, C., Cianfaglione, R., Corbel, L., Wormald, E., Brown, F. J., Hastings, R. P., & Hughes, C. J. (2017). Teaching handwriting skills to children with learning disabilities using an adapted Handwriting Without Tears® program. Manuscript submitted for publication.
Tarnopol, L., & Tarnopol, M. (1977). Brain function and reading disabilities. Baltimore, Maryland: University Park Press.
Cunningham, A. E., & Stanovich, K. E. (1990). Early spelling acquisition: Writing beats the computer. Journal of Educational Psychology, 82, 159. doi:10.1037/0022-0622.214.171.124
Longcamp, M., Zerbato-Poudou, M. T., & Velay, J. L. (2005). The influence of writing practice on letter recognition in preschool children: A comparison between handwriting and typing. Acta psychologica, 119, 67-79. doi:10.1016/j.actpsy.2004.10.019
Berninger, V. W., Rutberg, J. E., Abbott, R. D., Garcia, N., Anderson-Youngstrom, M., Brooks, A., & Fulton, C. (2006). Tier 1 and tier 2 early intervention for handwriting and composing. Journal of School Psychology, 44, 3-30. doi:10.1016/j.jsp.2005.12.003
Berninger, V. W., Vaughan, K. B., Abbott, R. D., Abbott, S. P., Rogan, L. W., Brooks, A., Reed, E., & Graham, S. (1997). Treatment of handwriting problems in beginning writers: Transfer from handwriting to composition. Journal of Educational Psychology, 89, 652-666. doi:10.1037/0022-06126.96.36.1992
Erhardt, R. P., & Meade, V. (2005). Improving handwriting without teaching handwriting: The consultative clinical reasoning process. Australian Occupational Therapy Journal, 52, 199-210. doi:10.1111/j.1440-1630.2005.00505.x