Concurrent and Predictive Validity of a Cycloid Loops Copy Task to Assess Handwriting Disorders in Children

Handwriting disorders (HDs) are mainly assessed using script or cursive handwriting tasks. The most common is the scale for children's handwriting, with a French adaptation (BHK). The present study aims to assess the concurrent validity of a pre-scriptural task (copying a line of cycloid loops) with the BHK for the diagnosis of HDs. Thirty-five primary school children (7 females, 28 males) with HD aged 6-11 years were recruited and compared to 331 typically developing children (TDC). Spatial/temporal/kinematic measures were collected using a digital pen on a paper. Posture and inter-segmental writing arm coordination were video recorded. A logistic regression statistical method, including a receiver-operating characteristic curve, was used to assess the ability of the task to predict HD. Gestural patterns were significantly less mature in HDs than in TDC (p < 0.05), and associated with poorer quality, less fluid, and slower drawing (p < 0.001). Moreover, good correlations between temporal and kinematic measures and the BHK scale were found. Number of strokes, total drawing time, in-air pauses times, and number of velocity peaks showed very good sensitivity (88%) and specificity (74%) to diagnose HDs. Consequently, the cycloid loops task is an easy, robust, and predictive tool for clinicians to identify HDs before the alphabet is mastered.