Analyzing Occupational Performance of Children With Handwriting Difficulties: Parent and Teacher Experiences and...

Background: Handwriting is a crucial skill for elementary school students that involves complex subskills, including visual coordination, motor planning, cognitive abilities, and self-regulation. To inform intervention plans and support occupational performance and participation, occupational therapists use occupational profiles and performance analysis to assess children's strengths, weaknesses, handwriting performance, and school and personal contexts. Objective: This study is aimed at identifying and assessing the characteristics, as perceived by parents and teachers, that both facilitate and impede the improvement of children's handwriting. Methods: We employed a qualitative approach with inductive content analysis and collected data via semistructured individual interviews following purposive sampling of parents and teachers (N = 8) in Indonesia. The initial and subsequent interviews lasted 30-60 min and 20-40 min, respectively. Results: We analyzed the results based on two themes: (1) client factors that enhance handwriting abilities and (2) environmental factors that contribute to improving handwriting abilities. Psychological well-being, cognitive abilities, and motor performance significantly influenced handwriting skills. Children with poor emotional control, boredom, lack of age readiness, and memory difficulties often struggled with writing. Additionally, underdeveloped fine motor skills contributed to impaired handwriting abilities. Conclusions: Our findings have significant implications for occupational therapists. It highlights the impact of motor-related and external factors on handwriting abilities in children. The study suggests that occupational therapists can tailor interventions to children's needs by understanding parents' and teachers' perspectives. Additionally, it underscores the importance of collaboration between parents, therapists, and teachers in improving handwriting skills and emphasizes the critical role of siblings and peers in enhancing children's handwriting performance.