What is so ‘effortful’ about handwriting?
Webb, A.
Henderson, S.E.
Stuart, K.M.
Institute of Education
London University
Background
It has long been recognised that children with
Developmental Coordination Disorder (DCD)
may experience difficulties with handwriting
(e.g. Henderson & Hall, 1982; Losse et al,
1991; Smits-Engelsmann & Van Galen, 1997).
It is one of the diagnostic criteria for DCD
listed in the DSM IV (APA, 2000).
Background 2
My own experience working with children
with DCD is that those with poor handwriting
also often experience difficulties with the
content of what they write.
Thus, the focus of my PhD thesis is the
relationship between the physical act of
handwriting and the composition quality of
handwritten work in this particular group.
Evidence
 The first three studies of the thesis found a clear
and consistent relationship between the ability to
handwrite and written composition quality.
 These studies compared written with oral
performance on a narrative task in verbally able,
literate children, with and without DCD.
 Overall, 176 scripts were rated blind to gender,
group (DCD vs TD), mode (written vs oral) and
order of production (written/oral vs oral/written).
Findings
Three main features characterised the
handwritten stories of the children with DCD:
1.They produced less text than the controls.
2.They sustained writing for less time.
3.Their handwritten compositions were weaker
in ‘the generation and development of ideas’.
Possible factors in compositional
weakness
The selection of verbally able, literate
children reduced the possibility that low
general ability or impairments of
language or literacy could account for
the compositional weakness.
‘Capacity theory’
Capacity theory
• Cognitive capacity is limited and finite. Different
cognitive processes compete for resources,
particularly on dual-tasks, such as writing (Hayes
& Flower, 1986; Kellogg 1995).
• The automation of certain processes (e.g.
handwriting) maximises the processing capacity
for others (e.g. composing).
• Where handwriting and spelling still make
undue demands of conscious control, essential
cognitive resources are diverted away from the
higher order processes of writing (McCutcheon,
1998; Torrance & Galbraith, 2007).
Aims of this study
In order to establish whether capacity theory
could explain the weak composition of poor
hand-writers with DCD, the demands of
handwriting and spelling needed to be tested.
To this end, two experiments were designed
to identify and then to measure the motor
and orthographic demands of writing.
Rationale
• Earlier research has examined handwriting
behaviours as indicators of ‘mental workload’
(Rosenblum et al, 2003; Luria & Rosenblum,
2010, 2011).
• As written composition can be conceptualised as
‘mental workload’ it is hypothesised that writing
tasks of differing levels of demand would yield
evidence of different handwriting characteristics.
• It would also follow that any negative impact of
this kind would be exaggerated in children with
DCD.
Experiment 1: Method
Participants
20 poorly coordinated boys (mean age 11.2 years;
range 9.10-14.2) were selected from mainstream
schools on the basis that they were considered to
be bright, verbally fluent and read well, but had
‘poor’ handwriting.
15 met the inclusion criteria and agreed to
participate.
15 controls matched for age, ability and literacy
were chosen on the basis of good motor
coordination and no handwriting problems.
Method 2
Testing
All were tested on the following standardised
measures:
 WISC-R UK – short form (Wechsler, 1992)
 WIAT II – word reading and spelling (Wechsler, …)
 Movement ABC-2 (Henderson, Sugden & Barnett,
2007)
 DASH (Barnett et al, 2007).
Standardised test results
DCD group
Mean (SD)
Controls
Mean (SD)
P value
Age
11.30 (1.43)
11.14 (1.47)
.771
VIQ
128.36 (9.58)
130.46 (7.78)
.539
PIQ
117.50 (9.18)
109.31 (15.87)
.023*
Reading SS
104.08 (17.52)
122.69 (5.66)
.092
Spelling SS
96.15 (3.95)
117.62 (9.27)
.021*
MABC-2 %
6.15 (3.95)
80.67 (13.81)
.000**
ManDex %
4.36 (1.60)
11.92 (1.89)
.000**
DASH %
26.85 (24.42)
71.25 (22.35
.000**
Tasks
• Children were given a two-sentence introduction
for a story to copy. The time taken was recorded.
• They were next asked to continue the story in
their own words for ten minutes. An electronic
marker was placed after the same period of time
which they had taken for the copying task.
• Comparisons could then be made between the
three tasks:
1. Copying
2. Freewriting 1 (FW1 = equal time )
3. Freewriting 2 (FW2 = up to ten minutes).
Procedures
• Tasks were performed
on A4 paper affixed to
a WACOM Intuos 4
digitiser tablet with a
WACOM Intuos Cinteq
sensitive inkpen.
• The tablet was
connected to a laptop
computer on to which
was installed the
software for analysis.
ComPET software
• The Computerized
Penmanship
Evaluation Tool
(ComPET) developed
by Rosenblum and
colleagues at Haifa
University was used to
provide data on
objective spatial,
temporal and pressure
measures
(Rosenblum, Parush &
Weiss, 2003a).
Experimental measures
Certain specific measures were chosen to indicate
handwriting demand based on the literature:
1. Total time on task (Smits-Engelsman et al, 2001)
2. Total time on paper (Luria & Rosenblum, 2011)
3. Total time in air (Luria & Rosenblum, 2011)
4. Velocity (Chang & Yu, 2010)
5. Pen pressure (Luria & Rosenblum, 2010)
6. Stroke variability (Parush et al, 1995a)
Results
• Comparisons were made first between the
copying task and the first free-writing task (FW1).
These were of equal time duration.
• Further comparisons were made between the
first sample of free-writing (FW1) and the
remaining free-writing task time to ten minutes
(FW2).
• ANOVAs were conducted with one betweensubject factor (group: DCD or control) and with
one within-subject factor (task: copying or FW1;
FW1 or FW2).
1. Total time:
Copying (and FW1)
An independent t
test showed there
was a significant
difference between
groups in copying
time (t = 3.902, p =
.001): the DCD
children took more
time than controls.
2. Time spent ‘in air’:
Copying vs FW1
• There was a significant
main effect of group (F
(1,24) = 4.445, p = .046)
and of task (F (1,24) =
4.185, p = .050) but no
group x task interaction:
DCD spent longer ‘in
air’ than the controls
and both groups spent
longer ‘in air’ for FW1
than when copying.
3.Time spent ‘on paper’:
Copying vs FW1
• There was a significant main
effect of group (F (1,24) =
5.003, p = .035) and of task
(F (1,24) = 16.9, p = .000)
and a significant group x
task interaction (F (1,24) =
4.744, p = .039): DCD spent
longer ‘on paper’ than
controls and both spent
longer ’on paper’ for
copying than for FW1 but
this was greater for the DCD
group.
4. Velocity:
Copying vs FW1
• There were no significant main effects of
group or task and no group x task
interaction. The DCD children wrote with
equal velocity to the controls on both
the copying and the short free-writing
task.
5. Pen pressure:
Copying vs FW1
There was a significant main
effect of group (F (1,24) =
5.414, p = .029) but no main
effect of task and no group x
task interaction: The DCD
children wrote with more
pen pressure than the
controls in both tasks. For
pen pressure variability
there was also a significant
main effect of group (F
(1,24) = 16.637,
p=
.000): the DCD children
showed greater variability
than the controls did.
6. Stroke efficiency:
Copying vs FW1
• There were no significant main effects of
group or task on stroke length, width or
height.
• However, there was a significant group x task
interaction on stroke length (F (1,24) = 8.05. p
= .009) and width (F (1,24) = 6.236, p = .02) :
when transferring from copying to free-writing
the DCD groups’ strokes increased in length
and width.
Summary:
Copying vs FW1
1. DCD took longer for copying than controls.
2. DCD spent longer ‘on paper’ than controls.
3. Both groups spent longer time ‘0n paper’ for copying
than for FW1, though the difference was greater for
the DCD.
4. DCD spent longer ‘in air’ than controls on both tasks.
5. There was no group difference in velocity of writing.
6. DCD exerted more pressure than controls for both
tasks and showed greater variability.
7. There was no group difference in stroke efficiency on
copying, but in FW1 the DCD strokes increased in
length and width.
Number of words: FW2
• An independent ttest showed that the
controls wrote
significantly more
than the DCD group.
1-3. Time on task
• There were no significant differences overall
between FW1 and FW2 on time spent ‘0n
paper’ or ‘in air’.
4. Velocity: FW1 vs FW2
• There was no significant main effect of group
but there was of task (F (1,24) = 8.421, p =
.000). There was no significant group x task
interaction: velocity increased for both groups
as they wrote more.
4. Velocity standard deviation
There was a
significant main
effect of task (F
(1,24) = 27.523, p =
.008) and a
significant group x
task interaction (F
(1,24) = 4.245, p =
.050: variability
increased for the
DCD group as they
wrote more.
5. Pen pressure:
FW1 vs FW2
There was a significant
main effect of group (F
(1,24) = 6.239, p = .020)
and of task (F (1,24) =
8.579, p = .000) and a
significant group x task
interaction (F (1,24) =
7.010, p = .014): the pen
pressure exerted by the
DCD group increased as
they wrote for longer but
it decreased for the
controls.
6. Stroke efficiency
• There were no significant differences between
FW1 and FW2 on stroke efficiency.
Summary:
FW1 vs FW2
• DCD produced less text overall than controls.
• There were no group or task differences on time spent
‘on paper’ or ‘in air’ or in stroke efficiency.
• There was no group difference on velocity but DCD
showed greater variability.
• As DCD wrote for longer their pen pressure increased.
• As controls wrote for longer their pen pressure
decreased.
Question: If the DCD group could write as fast on the
page as the controls why did they produce less text?
‘In air’ pathways: Control
copying – paper version
‘In air’ pathways: Control copying –
ComPET version
‘In air’ pathways: DCD FW1 – paper
version
‘In air’ pathways: DCD FW1 – ComPET
version
Conclusion
1. There is evidence on paper that supports an argument that
handwriting is more demanding for children with DCD:
- produced less text in all tasks,
- exerted greater pressure overall,
- showed greater variability,
- strokes were less efficient when FW than when copying.
2. There is visual evidence that their ‘in air’ movement is less
efficient (excess motor activity).
3. Controls seem able to make adjustments to their motor execution
when task demands increase (e.g. by reducing pen pressure).
4. As the generation and development of ideas requires processing
that cannot be automated, it might easily be compromised where
handwriting demanded the type of effort in evidence here.
For the future…
1. Software needs to be refined to measure and
analyse the in-air traces more acutely.
2. The effect on motor execution of handwriting
with different orthographic demand needs to
be examined.
3. Handwritten execution to be compared with
typed execution on similar tasks.