Background. Developmental coordination disorder (DCD), is the term used to refer to children who present with motor coordination difficulties, unexplained by a general-medical condition, intellectual disability or known neurological impairment. Difficulties with handwriting are often included in descriptions of DCD, including that provided in DSM-5 (APA, 2013). However, surprisingly few studies have examined handwriting in DCD in a systematic way. Those that are available, have been conducted outside of the UK, in alphabets other than the Latin based alphabet. In order to gain a better understanding of the nature of 'slowness' so commonly reported in children with DCD, this thesis aimed to examine the handwriting of children with DCD in detail by considering the handwriting product, the process, the child's perspective, the teacher's perspective and some popular clinical measures including strength, visual perception and force variability. Compositional quality was also evaluated to examine the impact of poor handwriting on the wider task of writing. Method. Twenty-eight 8-14 year-old children with a diagnosis of DCD participated in the study, with 28 typically developing age and gender matched controls. Participants completed the four handwriting tasks from the Detailed Assessment of Speed of Handwriting (DASH) and wrote their own name; all on a digitising writing tablet. The number of words written, speed of pen movements and the time spent pausing during the tasks were calculated. Participants were also assessed in spelling, reading, receptive vocabulary, visual perception, visual motor integration, grip strength and the quality of their composition. Results. The findings confirmed what many professionals report, that children with DCD produce less text than their peers. However, this was not due to slow movement execution, but rather a higher percentage of time spent pausing, in particular, pauses over 10 seconds. The location of the pauses within words indicated a lack of automaticity in the handwriting of children with DCD. The DCD group scored below their peers on legibility, grip strength, measures of visual perception and had poorer compositional quality. Individual data highlighted heterogeneous performance profiles in children with DCD and there was little agreement/no significant association between teacher and therapist's measures of handwriting. Conclusions. A new model incorporating handwriting within the broader context of writing was proposed as a lens through which therapists can consider handwriting in children with DCD. The model incorporates the findings from this thesis and discusses avenues for future research in this area.
Prunty, M
Department of Sport and Health SciencesFaculty of Health and Life Sciences
Year: 2013
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