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Updated: May 15, 2026

A Tablet-Based Curriculum-Based Measurement Protocol for Kindergarten Writing
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Assessing handwriting intervention effectiveness in elementary school students: a two-group controlled study.

Tsu-Hsin Howe1, Karen Laurie Roston, Ching-Fan Sheu

  • 1Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, 35 West Fourth Street, 11th Floor, New York, NY 10012, USA. tsuhsin.howe@nyu.edu

The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association
|December 19, 2012
PubMed
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Intensive handwriting practice significantly improved legibility in young students. This approach, delivered via a Handwriting Club, offers an effective, short-term intervention for elementary schools.

Area of Science:

  • Pediatrics
  • Educational Psychology
  • Occupational Therapy

Background:

  • Handwriting is a fundamental skill for academic success in elementary education.
  • Developing effective handwriting interventions is crucial for supporting young learners.
  • Previous research indicates a need for evidence-based handwriting programs in schools.

Purpose of the Study:

  • To compare the effectiveness of intensive handwriting practice versus visual-perceptual-motor activities for improving children's handwriting.
  • To evaluate the impact of a 12-week Handwriting Club intervention on handwriting speed, legibility, and visual-motor skills.
  • To determine the suitability of the Handwriting Club model as a short-term, Tier II intervention within school curricula.

Main Methods:

  • A nonequivalent pretest-posttest group design was employed with 72 first and second-grade students in New York City public schools.

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  • Participants were divided into two groups, engaging in either intensive handwriting practice or visual-perceptual-motor activities.
  • Multivariate analysis of variance (MANOVA) was used to analyze changes in handwriting speed, legibility, and visual-motor skills after the 12-week intervention.

    • Main Results:

    • Students participating in intensive handwriting practice showed statistically significant improvements in handwriting legibility compared to the visual-perceptual-motor activity group.
    • No significant differences were observed in handwriting speed between the two intervention groups.
    • No significant differences were found in visual-motor skills between the intensive handwriting practice and visual-perceptual-motor activities groups.

    Conclusions:

    • Intensive handwriting practice is an effective method for enhancing handwriting legibility in elementary school students.
    • The Handwriting Club model provides a practical and effective short-term intervention that can be integrated into existing school programs.
    • This intervention aligns with a Response to Intervention (RTI) Tier II framework, offering targeted support for students needing handwriting improvement.