Development of handwriting skill in children with unilateral cerebral palsy (CP)
Şermin Tükel Kavak1, Ann-Christin Eliasson
1Neuropediatric Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden. sermin.tukel-kavak@ki.se
Insights
Children with unilateral cerebral palsy (CP) showed continued development in handwriting quality and fine motor skills over 16 months. Age and IQ were key predictors of handwriting improvement in these children.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Occupational Therapy
Background:
- Unilateral cerebral palsy (CP) often impacts fine motor skills, affecting handwriting and academic performance.
- Understanding the developmental trajectory of handwriting and fine motor skills in children with CP is crucial for targeted interventions.
- Previous research highlights challenges in academic achievement for children with CP, necessitating further investigation into specific skill development.
Purpose of the Study:
- To examine the progression of handwriting, fine motor skills, and school marks in children with unilateral CP over a 16-month period.
- To determine the relationship between handwriting skill development and factors such as age and intelligence quotient (IQ) in this population.
- To assess if school performance changes in response to evolving academic demands.
Main Methods:
- Longitudinal study involving 16 children (mean age 11 years 4 months) with left-sided hemiplegia.
- Utilized the Minnesota Handwriting Assessment (MHA) for handwriting, Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) for fine motor skills, and Wechsler Intelligence Scale for Children Revised (WISC-R) for IQ.
- Included Manual Ability Classification System (MACS) and school marks for comprehensive assessment.
Main Results:
- Significant improvements were observed in handwriting quality, handwriting speed, and fine motor skills over 16 months.
- Despite improvements, children with unilateral CP continued to perform below their peers in handwriting and fine motor skills.
- Age and IQ were significant negative predictors of handwriting quality improvement, explaining a substantial portion of the variance (Adj. R(2) = 0.76).
- No correlation was found between handwriting speed and age or IQ.
Conclusions:
- Children with unilateral CP demonstrate a prolonged developmental period for handwriting skills beyond typical expectations.
- Age and IQ are critical factors influencing the rate of improvement in handwriting quality for children with unilateral CP.
- School marks remained stable, indicating children with unilateral CP can maintain academic performance despite increasing grade-level challenges.
Aim:
To investigate the development of handwriting, fine motor skills and school marks in children with unilateral cerebral palsy (CP) and relate the performance in handwriting skill to age and IQ at a 16-month follow-up.
Method:
Data from 16 children (5 females, 11 males; mean age 11 years 4 months, SD 1 year 6 months, range 8-13 years) with left-sided hemiplegia were collected. The Minnesota Handwriting Assessment (MHA) for handwriting skill, the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) for fine motor skills, the Wechsler Intelligence Scale for Children Revised (WISC-R) for IQ, the Manual Ability Classification System (MACS) and school marks of children were used.
Results:
Handwriting quality, handwriting speed and fine motor skills improved over 16 months but the children with unilateral CP still performed below their peers. School marks did not change. The regression model (Adj. R(2) = 0.76) revealed that age and IQ were negatively correlated and good predictors for the improvement in handwriting quality. No relationship was found between handwriting speed and age or IQ.
Conclusion:
Children with unilateral CP continued to develop handwriting skill over a longer time period than expected. Age and IQ predicted the rate of development in handwriting quality. Children kept up school marks despite the increasing demands of the succeeding grade.
