Validation of the Concise Assessment Scale for Children's Handwriting (BHK) in an Italian Population

Handwriting difficulties represent a common complaint among children and may cause a significant delay in motor skills achievement. The Concise Assessment Scale for Children's Handwriting (BHK) assesses handwriting skill in clinical and experimental settings, providing a quick evaluation of handwriting quality and speed through a copying text. The aim of the present study was to validate the Italian adaptation of the BHK in a representative primary school population. Overall, 562 children aged 7-11 from 16 public primary schools of Rome were included and asked to copy a text in 5 min using cursive handwriting. Handwriting quality and copying speed were measured. The included population followed a normal distribution for the BHK quality scores. Sex influenced the total quality scores, whereas school level influenced the copying speed. The BHK quality score was higher in girls (p < 0.05) and resulted as a stable parameter along the school years, without significant variations with regard to the years spent in handwriting exercise (p = 0.76). The handwriting speed was influenced by school level, and significant differences were found for each of the grades from the second to the fifth (p < 0.05), but not for gender (p = 0.47). Both BHK measures represent a helpful tool for the characterization and assessment of children with handwriting difficulties. The present study confirms that sex influences total BHK quality score, while school level influences handwriting speed.