A Review of Handwriting Assessments

1

• A Review of Handwriting Assessments
• Presented by
• Rachel Kirk
• Shannon Munford
• Selena Mehr, BCABA
• Caldwell College

2
Handwriting

• Why focus heavily on handwriting
  skills/remediation?
• Record and communicate information
• Compete in the regular education classroom
• Personal use (class notes, shopping lists)
• Written communication to others (letters, memos)
• Writing related to seeking employment and
  job-related skills (applications)
• To obtain information from others
• (Stowitschek et. al., 1989)

3
Handwriting

• Poor Handwriting can cause
• Teachers place importance on clear, concise, good
  handwriting. Poor handwriting in the early grades
  linked to poor academic performance in the
  future. (Harvey and Henderson 1997)
• Some develop mind-set that they cannot write and
  give up. (Berninger 1998)
• Lack of confidence then leads to stress, poor
  self-esteem, poor career prospects. (Sassoon 1997)

4
Handwriting

• Reason for Assessment
• Standardized or systematic procedures are seldom
  used
• Poor letter formation skills are evident in the
  handwriting of many students
• Few special or general educators have been
  trained to teach and remediate handwriting
• Distinguish between student ability and actual
  handwriting performance
• (Stowitschek et. al., 1989)

5
MHA

• The Minnesota Handwriting
• Assessment
• Developed by
• Judith Reisman (1993)

6
Development of MHT

• MHA is a way
• to assist school-based occupational therapists in
  the identification of children with writing
  difficulties/assess treatment.
• A more sophisticated alternative to the rating
  scales.
• MHA can determine
• Speed, accuracy, letter size, spacing, and can
  show where students difficulties are.
• (Reisman 1993)

7
MHA

• Designed for
• 1st and 2nd graders
• Age Range(5 to 7 years)
• AdministrationIndividual or Group- 5 to 10
  minutes 10 to 30 minutes to score
• Test is used to identify how students are
  performing in relationship to their peers.
• (Reisman 1993)

8
MHA Materials

• Complete kit
• Includes manual, 1 manuscript and 1 D'Nealian
  Pad, 25 sheets
• Additional copies of materials
• Manuscript Print Pads, pack of 4 pads (25 sheets
  per pad) D'Nealian Print Pads, pack of 4 pads (25
  sheets per pad)

9
MHA Format

• Rate score (writing speed) of letters
  completed during the timed portion.
• More time given
• Legibility
• Form
• Alignment
• Size
• Spacing
• The total maximum point scored on the test is
  170.
• (Reisman 1993)

10
MHA

• Procedure
• Sentence is given in jumbled form
• Ex the quick brown fox jumped over the lazy
  dog
• Small triangles starting point.
• Write for a timed period (2 ½ minutes)
• (Reisman 1991) used 2.5 minutes made after pilot
  test with 1st and 2nd graders
• timed for 1.0, 1.5, 2.0, 2.5, 4.0 and 5.0
  minutes.
• 67 of the 2nd graders finished at least 31 of
  the 34 sample letters in 2.5 minutes.
• Stop and circle last letter written
• Then finish the sentence
• (Feder Majnemer 2003)

11
MHA

• Legibility/Scoring
• Letter is recognizable out of context (dots on
  letters i/j)
• Complete with all strokes present
• Contains no reversals (letter k)
• 34 maximum points
• Scoring is discontinued if the students writing
  is illegible.
• This rule was adopted b/c
• It is impossible to obtain reliable measurements
  for the other categories if a letter is illegible
• (Reisman 1993)

12
MHA

• Form/Scoring
• Measures letter quality
• Lines curved or pointed in certain parts of the
  letter.
• no gaps or overlaps greater than 1/16 between
  letter parts
• Maximum 34 points

• Alignment/Scoring
• Position of the letters on the line.
• Letters within 1/16 of the solid baseline.
• Maximum 34 points

13
MHA

• Size/Scoring
• Measures all other parts of the letter to the
  midline, upper and lower lines.
• Maximum points 34

• Spacing/Scoring
• Correct letter and word spacing
• daylight between letters.
• Maximum points 34

14
Research

• Reisman, J.E., (1993). Development and
  Reliability of the Research Version of the
  Minnesota Handwriting Test. Physical and
  Occupational Therapy in Pediatrics, 13(2), 41-55.
• 6 raters trained in 3 sessions
• 1st session Brief explanation of the scoring
  rules.
• Took an average of 2 hours to score
• After 1st session discussion b/w Reisman and the
  raters.
• 2nd session repeated the process.
• After 2nd session errors made raters was very
  small.
• 3rd session repeated the process.
• Took an average of 25 minutes to score
• Reliability increased to 95.
• Manual for the MHA 3 sets of 10 handwriting
  samples, can be compared to Reismans grading of
  the samples.
• Explains scoring procedure as in the study.

15
Research cont

• Cornhill, H., Case-Smith, J. (1996). Factors that
  relate to good and poor handwriting. American
  Journal of Occupational Therapy, 56(3), 305-312.
• 48 typical 1st graders identified as either good
  or poor handwriters.
• Motor accuracy test, visual-motor integration
  test and 2 in-hand manipulation tests.
• All test scores significantly higher for students
  with good handwriting.
• Then given the MHA.
• Results
• Eye-hand coordination, visual-motor integration
  and in-hand manipulation have a direct
  association to handwriting skills
• MHA is a valid tool that accurately shows a
  students current handwriting skills

16
Research cont

• Owens, L.L (2004). The Effects of the Handwriting
  Without Tears Program on the Handwriting of
  Students in Inclusion Classrooms. Masters
  Thesis. Virginia Commonwealth University,
  Richmond, Virginia.
• 2 Experimental groups(41 students)- received HWT
  method
• 2 Comparison groups(40 students)- general
  handwriting instruction.
• Handwriting performance measured using MHA.
• Pretest scores no difference b/w both groups
• Posttest scores experimental classes showed
  improvement in the areas of size (.008) and
  spacing (.014).

17
MHA Individualization/Modification

• The initial MHA evaluation shows handwriting
  illegibility.
• The teacher could customizes the MHA test by
• Teaching specific commonly used letters.
• Example e, a, h, f, t, i, r, d, s, y.
• Combining these letters into words.
• Example The first day.
• Practice writing these words.
• Take MHA using the learned letters, words and
  phrases.
• Contriving this procedure until all the letters
  have been used and evaluated.

18
MHA

• Pros
• Reinforce/teach hand dexterity (kinesthetic)
• knowledge (cognitive) is motivational
• Helps with perception/motor skills
• Easy to score
• Easy to administer
• Clear, easy to understand manual
• Reisman MHA can be administered to children
  with a variety of disabilities.

19
MHA

• Cons
• Test is relatively new
• No extensive clinical trials or research
• Children who can not read are at a disadvantage
  in the timing portion.
• Write letter by letter
• Some pre-req hold a pencil, see, concentrate and
  understand.
• Can be difficult for many developmentally
  disabled children

20
DRHP

• The Diagnosis and Remediation of
• Handwriting Problems
• Authors
• Denis H. Stott, Fred A. Moyes, and
• Sheila E. Henderson (1985)

21
DRHP

• According to Stott et. al. (1987)
• Purpose
• Systematically identify and classify handwriting
  problems
• To be used as a clinical tool
• Advance research in handwriting
• Provide remedial materials for teacher education

22
DRHP

• According to Stott et. al. (1987)
• Population Intended to Assess
• Children with two years experience handwriting
• (3rd grade)
• Adults who have loss skill of handwriting due to
  brain injury

23
DRHP

• Materials
• Manual
• Scoring templates for size and slant
• 3 pictures/comic strips
• Students Writing Sheet
• Diagnostic Record Form

24
DRHP

• Manual Content
• Sections on direction use
• Directions for Scoring
• Scorer training
• Single reliability study
• Issues relative to the measurement of handwriting

• Handwriting in left-handers
• Monitoring handwriting standards in the classroom
• Guidelines for remediation
• Remedial programs

25
DRHP

• Categories of Assessment
• Part 1. Faults of Concept and Style
• (poor teaching or failure to benefit from
  teaching)
• Section A. Letters incorrectly formed and/or
  joined
• Section B. Spacing Errors
• Section C. Stylistic Distractors
• Section D. Slurring

26
DRHP

• Categories of Assessment
• Part 2. Faults of Motor Control
• Inconsistency of slant
• Inconsistency of letter size
• Irregular word alignment
• Random Letter Distortion
• Tremor

27
DRHP

• Categories of Assessment
• Part 3. Concurrent Observations
• Section A. Posture of handling paper and pen
• Section B. Faulty ways of addressing task
• Section C. Physical Disadvantages
• (poor motor control)

28
DRHP

• Administration
• Individually or in a group
• Student is given a comic book style series of 3
  pictures with word cues provided in balloons in
  each picture
• Student is given Students Writing Sheet
  containing ten lines to write on
• Test is not timed but authors suggest no more
  than 20 minutes

29
DRHP

• Scoring
• Only Part 1 and 2 are numerically scored
• Quantitative measures
• Scoring templates or mechanical aids for
  consistency of slant, spacing, and letter size
  difference are used
• These transparent diagnostic templates are
  applied to writing slant and alignment or
  deviation from the writing base line
• Measurement of word spacing is taken but
  dependent on the scorers accuracy and decision
  when making numerical awards

30
DRHP

• Scoring
• Qualitative measures
• Examiners determination of whether an error
  occurred
• When examiner judgment needed refer to the
  operationally defined terms
• All of Section 3 (Observations)
• Higher Scores high number of errors and higher
  writing impairment

31
DRHP

• Scoring
• Use scores from part 1 2 with observations from
  part 3 (not scored) to provide basis for
  diagnostic analysis
• Overall score/sum were not intended to be used
  but you can total the scores if needed for
  research purposes
• Use of a two-scorer system provided for
  reliability

32
DRHP

• Limitations
• Complex to Score
• No scores or score range guidelines for
  interpretation necessary for development
  generalizability
• IOA 61-65 for 150 samples (Stott et. al., 1987)
• Scores are dependent on examiners accuracy and
  judgment
• No demographic information regarding the samples
• No descriptive data for scorer reliability
  training provided in the study (Alston Taylor,
  87)
• No validity studies done
• Authors do identify need for validity and further
  reliability studies (Alston Taylor, 87)

33
DRHP

• Limitations
• Learner must have prerequisite of writing
  complete sentences and writing/reading
  comprehension.
• Suggests no room for individualization/modificatio
  n
• Could change the pictures/balloons to accommodate
  the learners academic repetiore
• Remedial materials and teacher education aspects
  are limited to brief sections
• A brief review or introduction to an area is not
  sufficient information to plan and carry out
  handwriting programming (Daniels, 1988)
• Advantages
• Easy to administer (Daniels, 1988)

34
DRHP

• Conclusion
• Not a valid/reliable tool in assessing
  handwriting problems
• With clarification in scoring methods DRHP could
  be
• Useful tool for occupational therapists and
  behavioral therapists in assessing/teaching
  handwriting problems
• Not a useful approach to assessing handwriting
  for lower skilled individuals since there is a
  need for writing/reading comprehension.

35
ETCH

• Evaluation Tool of Childrens Handwriting
• Author
• Susan J. Amudson Ph.D. OTR/L, FAOTA
• Publication-1995

36
ETCH

• Who is using it?
• Public Schools
• Pediatric occupational therapy agencies
• Childrens Hospitals
• Child Specialists

37
ETCH

• Purpose
• Evaluate
• Global legibility
• Speed
• Target Population
• Mild developmental delays
• Learning disabilities
• Mild muscular impairment

38
ETCH

• Prerequisite Skills
• First or Second grade level
• Composition

39
ETCH

• Design
• Task 1- Alphabet
• Task 2- Numbers
• Task 3- Near point
• Task 4- Far point
• Task 5- Dictation
• Task 6- Sentence composition

40
ETCH

• Example

41
ETCH

• How is the test scored?
• Legibility
• subtract the illegible letter, word or numbers
  from the possible total.
• Speed-Tasks 3, 4 6
• Minutes are divided by the number of letters
  written within the time given.

42
ETCH

• Diekema et al. (1998)
• Test-retest reliability of the ETCH-M
• Examined the test-retest reliability with
• 31 First and second graders
• Tested twice with one week between testing
• Results
• total letter legibility .77
• total word legibility .71
• Individual letter legibility ranged from .20-.76

43
ETCH

• Sudsawad et al. (2000)
• The Relationship Between the ETCH and
• teachers perception of handwriting
• Legibility
• 45 first grade students
• Teacher rated students
• ETCH
• Compared the ETCH scores to the teacher
  questionnaire

44
ETCH
Results
45
ETCH

• Pros
• Examiner is proficient
• Scoring criteria
• Score sheets
• Includes diagrams
• Total score reliability
• Tasks are relevant
• Cons
• Individual score reliability
• Insufficient validity studies
• Variability
• Writing Quality

46
ETCH

• Limitations
• Subjective
• Handwriting changes
• Combined with other methods
• Unable to account for the differences in
• handwriting quality

47
ETCH

• How can this be modified?
• Latency and duration
• Operational definition
• legibility
• speed
• Pretest/Post-test

48
References

• Alston, J., Taylor, J. (1987). Handwriting
  Theory, research and practice. London, UK Croom
  Helm.
• Berninger, V., Graham, S. (1998). Language by
  hand A synthesis of a decade of research on
  handwriting. Handwriting Review 12 11-25.
• Cornhill, H., Case-Smith, J. (1996). Factors
  that relate to good and poor handwriting.
  American Journal of Occupational Therapy, 56(3),
  305-312.
• Daniels, L.E. (1988). The diagnosis and
  remediation of handwriting problems An analysis.
  Physical Occupational Therapy in Pediatrics,
  8(1), 61-67.
• Diekema, S.M., Deitz, L., Amundson, S.J.
  (1998). Test-retest reliability of the Evaluation
  Tool of ChildrensHandwrting-Manuscript. American
  Journal of Occupational Therapy, 52, 248-255.
• Feder, K., Majnemer, A. (2003). Childrens
  Handwriting Evaluation Tools and Their
  Psychometric Properties. Physical and
  Occupational Therapy in Pediatrics, 23(3), 65-83.

49
References

• Harvey, C. Henderson, S. (1997). Childrens
  handwriting in the first three years of school
  Consistency over time and its relationship to
  academic achievement. Handwriting Review 11
  8-25.
• Owens, L.L (2004). The Effects of the Handwriting
  Without Tears Program on the Handwriting of
  Students in Inclusion Classrooms. Masters
  Thesis. Virginia Commonwealth University,
  Richmond, Virginia.
• Reisman, J.E., (1991). Poor handwriting Who is
  referred? American Journal of Occupational
  Therapy, 45, 849-852.
• Reisman, J.E., (1993). Development and
  Reliability of the Research Version of the
  Minnesota Handwriting Test. Physical and
  Occupational Therapy in Pediatrics, 13(2), 41-55.
• Sassoon, R. (1997). Dealing with adult
  handwriting problems. Handwriting Review 11
  69-74.

50
References

• Stott, D.H., Henderson, S.E., Moyes, F.A.
  (1987). Diagnosis and remediation of handwriting
  problems. Adapted Physical Education Quarterly,
  4, 134-147.
• Stott, D.H., Moyes, F.A., Henderson, S.E.
  (1985). Diagnosis and Remediation of Handwriting
  Problems. Fairwater, Cardiff, Whales. DRAKE
  Educational Associates.
• Stowitschek, C.E., Stowitschek, J.J.,
  Hendrickson, J.M., Gable, R.A. (1989). Diagnosis
  and remediation of handwriting errors.
  Multidisciplinary Diagnostic and Training
  Program, 22.
• Sudsawad, P.,Trombly, C.A., Henderson, A.,
  Tickle-Degnen, L (2000). The relationship between
  the Evaluation Tool of Childrens Handwriting and
  teachers perceptions of handwriting legibility.
  American Journal of Occupational Therapy, 55
  518-523.