Related Experiment Video
Updated: Mar 22, 2026
A Tablet-Based Curriculum-Based Measurement Protocol for Kindergarten Writing
Published on: February 7, 2025
Effectiveness of a Handwriting Intervention With At-Risk Kindergarteners
Sheryl Eckberg Zylstra1, Beth Pfeiffer2
1Sheryl Eckberg Zylstra, DOT, MS, OTR/L, is Clinical Assistant Professor, Department of Occupational Therapy, University of Puget Sound, Tacoma, WA. At the time of this study, she was a doctoral student at Temple University, Philadelphia, PA; szylstra@pugetsound.edu.
Objective:
We examined the effectiveness of an occupational therapist-led handwriting intervention for special education and at-risk kindergarteners.
Method:
We incorporated a two-group, pretest-posttest design. Both groups consisted of kindergarteners receiving individualized education program (IEP) or Response to Intervention (RtI) support. An occupational therapist provided biweekly group handwriting instruction using the Size Matters Handwriting Program to students in the intervention group (n = 23). The control group (n = 12) received the standard handwriting instruction.
Results:
Students in the intervention group demonstrated significantly greater gains in handwriting legibility than students in the control group. Students in the intervention group also demonstrated significantly greater gains in the prereading skills of uppercase letter recognition, lowercase letter recognition, and letter sound recognition.
Conclusion:
This study provides preliminary support for an occupational therapist-led handwriting intervention to improve writing legibility and letter recognition in kindergarteners receiving RtI and IEP supports.
