What is a common problem that occupational therapists face?
Written by Cheri Dotterer
It is a well-known fact that most of the school-based occupational therapy (SBOT) referrals are for handwriting problems. Transforming a child to write legibly is a challenge. Legibility is not the only issue. Handwriting speed is also a challenge.
I have had numerous referrals for students with impeccable handwriting. However, watching them write is worse than watching a sloth in slow motion. Ok, so I exaggerate. However, I bet you can picture a student right now.
Increasing their speed is complicated. First, we need to understand why, then we need to challenge it.
Go back to the evaluation report. Look at the Wechsler Intelligence Scale for Children, fifth edition (WISC-V) scores in the following categories: Verbal Reasoning, Visual Speed, Fluid Reasoning, Working Memory, and Processing Speed. Compare them to the visual perception and visual-motor integration scores that you have received. Is there a similarity or difference?
Processing speed is looking at the speed of visual interpretation and working memory is examining the speed at which a student interprets auditory materials. School psychologists look at visual-perceptual and visual-motor as one concept in the WISC-V. It is included in the visual-spatial subtest. This subtest evaluates “seeing visual details, understanding spatial relationships and construction ability, understanding the relationship between parts and a whole, and integrating visual and motor skills.” (Eckerd, n.d.) The school psychologist is looking to occupational therapy expertise to break down the parts of visual-spatial awareness to help them differentiate the educational classification. If the motor component of their processing speed is below average, this could be a reason for their decreased handwriting speed.
Now compare the Verbal Reasoning score. According to Eckerd, “Verbal Reasoning: Knowledge of words and being able to apply them – verbal concept formation, reasoning, and expression” (n.d.) This score reflects their visual perceptual skills. A student with good handwriting skills will probably test high in this category.
Eckerd also states that
- Fluid Reasoning: Seeing the meaningful relationship between visual objects and applying that knowledge using the concept
- Working Memory: Demonstrating attention, concentration, holding information in mind and being able to work with information held in mind; this includes one visual and one auditory subtest
- Processing Speed: Speed and accuracy of visual scanning and identifying visual objects, short-term memory, and visual-motor coordination
Use your clinical reasoning skills to differentiate what you have assessed in visual perceptual skills and visual motor skills plus the functional components of everyday activities. Does this picture give you a better understanding of the student?
Take this knowledge and design treatment interventions to build those neurological pathways to promote these categories. I bet their handwriting speed increases too.
Let’s keep the discussion going. What treatments have you used to increase processing speed and motor speed? What impact have you seen on handwriting?
Eckerd, M. (n.d.) Evaluating your child: Understanding IQ test scores. Smartkidswithld.org Retrieved from https://www.smartkidswithld.org/first-steps/evaluating-your-child/understanding-iq-test-scores/