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PubMed1982

The relationship between birth stress and writing hand posture.

Variations in handwriting posture (inverted versus noninverted) were measured in 1203 individuals for whom birth histories, based upon retrospective maternal reports, were available. A history of birth complications was associated with an increased incidence of inverted handwriting posture. Effects interacted with sex and hand preference; the largest difference in handwriting posture between the birth-stressed and non-birth-stressed groups occurred in left-handers and in males.

Cesarean Section↗

PubMedDate not supplied

A study and review of developmental dysgraphia in relation to acquired dysgraphia.

A survey of developmental dysgraphia in a population of 259 normal 13- and 14-year-old schoolchildren has been carried out. The neurological characteristics of handwriting impairments in the 25 children with the poorest handwriting skills are described. These data form the basis of a clinical classification of developmental dysgraphia. A group of simple clinical tests of handwriting and associated functions are offered for routine use. Because they are based on neurological principles relating to acquired dysgraphia, the classification and testing format may be used for correlation with neuro-imaging in research studies. More importantly, they may also facilitate both counselling and remediation for a particular child. The test battery could be modified for use in epidemiological surveys of neurodevelopmental disorders.

Adolescent↗

PubMed1979

Normative data on hand position during writing.

It has been suggested that inverted versus upright handwriting position is an indicator of cerebral lateralization and the pattern of neuromotor control. Normative data on the prevalence of these handwriting positions was collected from 1758 subjects ranging in age from 10 to 75 years. Both age and sex differences in the prevalence of inverted handwriting positions were found.

Adolescent↗

PubMed2006

Fine motor skills and effects of methylphenidate in children with attention-deficit-hyperactivity disorder and developmental coordination disorder.

The aims of this study were to investigate fine motor skills of children with both attention-deficit-hyperactivity disorder (ADHD) and developmental coordination disorder (DCD) and those of a control group, and to examine the effects of methylphenidate on these skills. A group of 12 children with ADHD-DCD (11 males, one female; mean age 9y 8mo [SD 1y 7mo]) and 12 age- and sex-matched controls (mean age 9y 7mo [SD 1y 2 mo]) participated. The manual dexterity subtests of the Movement Assessment Battery for Children, the concise assessment method for children's handwriting, and a computerized graphomotor task were used. Results demonstrated that children with ADHD-DCD performed more poorly on the manual dexterity subtests, had poorer quality of handwriting, and drew more rapidly, more fluently, but less accurately than controls on the graphomotor task. On methylphenidate, manual dexterity and quality of handwriting improved, and strokes on the graphomotor task became less fluent but more accurate. ADHD is characterized by persistent symptoms of inattention, impulsivity, and hyperactivity, affecting 3 to 5% of school-age children. Up to 50% of children with ADHD also have motor coordination problems that are severe enough to meet criteria for DCD. In DCD, children demonstrate functional motor performance deficits not explained by the child's (chronological) age or intellect, or by other neurological or psychiatric disorders.

Attention Deficit Disorder with Hyperactivity↗

PubMed2001

Brief report: macrographia in high-functioning adults with autism spectrum disorder.

The initial description of Asperger syndrome commented on the poor handwriting and motor coordination difficulties of individuals with this condition. Early descriptions of autism do not remark upon such difficulties. Recent evidence, however, suggests that individuals with both conditions have a similar motor control impairment. Handwriting has not been formally assessed in this context. Our study compared handwriting size between individuals with autism spectrum disorder and age- and IQ-matched control subjects. Macrographia was observed among subjects with autism spectrum disorder which remained statistically significant when covaried with educational level. This finding may correlate with the anatomical abnormalities present in the cerebellum of individuals with autism spectrum disorder.

Adolescent↗

PubMed2006

Discontinuity in the fall of left-handedness in a French population: a May '68 effect?

The fall in the prevalence of left-handedness with age has been attributed to the effect of forced dextrality on handwriting. The purpose of this study was to assess handwriting preference in a cohort of children and adult participants in order to study the correlation between age and incidence of sinistrality. A strong preference for right handwriting across all ages with a decrease in sinistrality with age (18% in those under 20 versus 3% in those over 60) was observed. This phenomenon was not continuous, and a dramatic drop at age 30-40 years might be attributed to changes in educational management during the 1960s, especially after the events of May 1968 in France.

Adolescent↗

PubMed2005

Effects of ethanol on kinaesthetic perception.

In normal subjects, alcohol increases handwriting size, but the mechanism is not understood. Here we show that the alcohol effect on handwriting can be explained by a selective impairment of kinaesthetic perception. Thirty volunteers (15 male, aged 18-29 years) took part in an open study. They were tested before and after a drink containing vodka intended to produce a blood alcohol concentration of about 80mg/100ml. Tests included kinaesthetic distance estimation, in which volunteers worked with preferred hand and arm behind a screen which hid their movements; visual distance estimation; and measures of handwriting and drawing. Blood alcohol concentration at 55min, based on breathalyser measurements, was 76.7mg/100ml (SD 9.8). When asked to move the hand and mark a distance of 10cm from a starting point, distances estimates increased by 7-10% (p 0.01). Similar increases were seen for writing words and drawing characters. Signatures were increased in height but not in length. Distances estimated visually were increased much less, by 3-4% (p 0.05). Tests of psychomotor performance indicated the expected effects of ethanol. These results suggest that ethanol affects writing size by reducing kinaesthetically perceived distances.

Adolescent↗

PubMed2004

Relationship between orthographic-motor integration and computer use for the production of creative and well-structured written text.

BACKGROUND: Orthographic-motor integration refers to the way in which orthographic knowledge is integrated with fine-motor demands of handwriting. A strong relationship has shown to exist between orthographic-motor integration and students' ability to produce creative and well-structured written text (De La Paz & Graham, 1995). This relationship is thought to be due to the cognitive load resulting from lack of automaticity in orthographic-motor integration so that writers do not have sufficient resources to accomplish the more demanding aspects of writing. Interventions to improve children's orthographic-motor integration result in improved written text (Jones & Christensen, 1999). AIM: This study first extended findings related to handwritten text to the relationship between typing and the length and quality of computer-based written text. Second, it examined the efficacy of an intervention to develop proficiency in typing skills on the length and quality of students' written language. SAMPLE: Participants in the first study were 276 Grade 8 and 9 students. In the second study 35 students in Grades 8 and 9 who exhibited very low levels of proficiency in typing were the participants. METHODS: In Study 1, orthographic-motor integration related to typing as well as handwriting was assessed for all students. They were asked to complete a piece of handwritten and computer-based text. Students in the intervention study completed the same measures as Study 1, at pre- and post-test. During the intervention half the students completed a daily typed journal and half completed a program designed to facilitate their typing skills. RESULTS: There was a significant relationship between orthographic-motor integration -- handwriting and the length and quality of handwritten text, and a stronger relationship between orthographic-motor integration -- typing and length and quality of computer-based text. Both intervention groups in the second study showed significant differences in writing skills from pre- to post-test. However, the typing skills group showed significantly better scores on typing and quality of typewritten text than the journal group at post-test. The impact of the intervention was specific to typewritten text. There was no difference in length or quality of handwritten text. CONCLUSION: It is suggested that developing proficiency in orthographic-motor integration related to typing allows writers to employ their cognitive resources more flexibly when working on a computer, so that they can devote attention to higher-order processes involved in ideation, syntactic and semantic monitoring and pragmatic awareness.

Adolescent↗

PubMed1977

Validation of graphoanalysis by "global" or "holistic" method.

Graphoanalysis is the most systematically developed and best researched of all methods of handwriting analysis (genetically called graphology). This is a projective expressive movement that is neither better nor more poorly validated than most projective techniques as a means of personality assessment, which is inadequate because their subjectivity makes statistical study difficult. With all projective techniques "sign" or trait validation has been minimal, and the best validation has come from "global" or "holistic" methods. The present study presents a paradigm for the latter type of approach to handwriting analysis, using a matching technique with probabilities of 1/5, wherein five subjects were matched by people who knew them to one of five blind Graphoanalyses of the subjects' writing. This design is herein replicated five times, with total data significantly different from chance expectation (p less than .001), supporting the hypothesis that it is possible to evaluate personality through analysis of handwriting.

Female↗

PubMed2005

D2 dopamine receptor occupancy, risperidone plasma level and extrapyramidal motor symptoms in previously drug-free schizophrenic patients.

RATIONALE: A relationship between high D2 occupancy (above 80%) and extrapyramidal-motor symptoms under neuroleptic treatment has been observed in several neuroimaging studies. OBJECTIVES: We investigated the striatal dopamine D2 receptor occupancy, risperidone plasma level and extrapyramidal-motor symptoms in drug-free schizophrenic patients. METHODS: Ten schizophrenic patients were treated with 3 - 6 mg risperidone daily. After four weeks administration, a [(123)I]iodobenzamide ([(123)I]IBZM)-single photon emission tomography (SPET) scan for determination of D2 receptor occupancy was carried out (in eight responders) and compared to a control group. Plasma concentrations of risperidone and its active metabolite 9-hydroxyrisperidone (active moiety) were determined by high performance liquid chromatography and electrochemical detection. Extrapyramidal-motor symptoms were assessed by means of the Simpson-Angus-Scale and a handwriting test before treatment and coincident with the scan. RESULTS: The D2 receptor occupancy (Mean 62%, SD 13%) positively correlated with the plasma level of the risperidone active moiety as well as with the reduction in handwriting area. Multiple linear regression revealed an inherent relationship with a coefficient of determination of r = 0.956 (p = 0.02). No clinical relevant extrapyramidal-motor symptoms were observed. CONCLUSIONS: In drug-free schizophrenic responders, the simultaneous assessment of both plasma level and reduction in handwriting area may be a useful clinical tool for a surrogate estimate of D2 receptor occupancy under risperidone treatment. This may help to minimize or even prevent extrapyramidal-motor symptoms.

Adult↗

PubMed2005

Motor training as treatment in focal hand dystonia.

Focal hand dystonia may arise as a result of aberrant plasticity from excessive repetitive use. Improvement might be possible with appropriate motor training. Focusing on trying to decrease abnormal overflow of movement to fingers not involved in a task, we developed a motor training program for individualized finger movements. Ten patients with writer's cramp participated in the motor training program. Evaluation was done with the Fahn dystonia scale, kinematic analysis of handwriting, transcranial magnetic stimulation (TMS), and electroencephalography (EEG). Clinical improvement of dystonia was significant using the Fahn dystonia scale, and 6 patients reported an improvement in writing. The handwriting analysis showed a trend for improvement after training in simple exercises. There were no changes in cortical excitability measured by TMS and EEG. Whereas this method of motor training for 4 weeks led to mild subjective improvement and some improvement in handwriting, it is not sufficient to reverse motor cortex abnormalities measured by TMS and EEG.

Cerebral Cortex↗

PubMed2006

Effects of transcutaneous electrical nerve stimulation on motor cortex excitability in writer's cramp: neurophysiological and clinical correlations.

We recently reported that transcutaneous electrical nerve stimulation (TENS) applied over forearm flexor muscles, a paradigm producing in physiological conditions transient changes in corticomotoneuronal excitability of forearm muscles, may improve motor symptoms in writer's cramp (WC). In the present study, we explored the possibility that one or repeated sessions of TENS might have beneficial effects on handwriting in WC by remodulating cortical excitability of forearm agonist and antagonist muscles. Motor evoked potentials (MEPs) after transcranial magnetic stimulation of the left motor cortex were recorded from the right flexor carpi radialis (FCR) and extensor carpi radialis (ECR) muscles, before and after 1 and 15 sessions of TENS applied over flexor muscles in patients and in a control group. One session of TENS induced a significant smaller reduction of MEPs from the FCR and a smaller increase of the MEPs from the ECR in patients than in normal subjects. In WC, repeated sessions of TENS had the effect to decrease MEP amplitude in the FCR and to increase it in the ECR. This modulation was paralleled by a handwriting improvement. In conclusion, repeated TENS sessions may have the effect to re-modulate excitability of the motor cortex in WC and this modulation might partially play a role in temporarily improving the handwriting.

Adult↗

PubMed2005

Electroencephalographic spectral power in writer's cramp patients: evidence for motor cortex malfunctioning during the cramp.

We investigated cortical activation as reflected in task-related spectral power (TRPow) changes in 8 writer's cramp patients during writing on a digital board and during isometric contraction and compared them to those of 8 age-matched healthy subjects. Scalp EEG was recorded over the contralateral primary sensorimotor area (SM1(c)), and from the ipsilateral sensorimotor area (SM1(i)). The electromyogram (EMG) was recorded from the Extensor Digitorum Communis (Extensor), Flexor Digitorum Superficialis (Flexor), and First Dorsal Interosseous (FDI) muscles. We analyzed (1) handwriting performance, (2) changes in the TRPow confined to alpha and beta band, and (3) the EMG spectral power during both tasks, writing and isometric contraction. During writing, all patients developed writer's cramp. The handwriting in writer's cramp patients was associated with significantly less reduction of the beta-range TRPow and lower frequency of the TRPow reduction compared to controls. No significant differences between patients and controls for the alpha band TRPow reduction during handwriting were observed. During writing, the patients showed higher EMG spectral power than the controls but this difference was at the border of significance. The present results indicate disorder in the motor execution system, in writer's cramp patients, associated with impaired functional beta-network state of the contra- and ipsilateral sensorimotor cortices, most probably due to inadequate modulation of the intracortical inhibition associated with writing.

Adult↗

PubMed1989

Skill, strength, handedness, and fatigue.

Thirty male subjects, 20 of whom were self-classified left-handers and 10 right-handers, were tested on a grip-strength task and a handwriting task with each hand, both under normal conditions and in a situation of induced experimental fatigue. On the basis of questionnaire scores, the left-handers were sub-divided into two groups comprising the 10 most left-handed and the 10 least left-handed subjects. The test of grip strength showed a small but significant deterioration in performance of both hands from fatigue. With the handwriting task, a similar significantly adverse effect of fatigue was recorded for all groups as well as a large significant difference in performance between the preferred and nonpreferred hands under normal conditions, which decreased under fatigue. An explanation of these differential effects is discussed in terms of the greater efficiency of the preferred hand in the highly developed skill of handwriting.

Journal Article↗

PubMed2004

Online recognition of Chinese characters: the state-of-the-art.

Online handwriting recognition is gaining renewed interest owing to the increase of pen computing applications and new pen input devices. The recognition of Chinese characters is different from western handwriting recognition and poses a special challenge. To provide an overview of the technical status and inspire future research, this paper reviews the advances in online Chinese character recognition (OLCCR), with emphasis on the research works from the 1990s. Compared to the research in the 1980s, the research efforts in the 1990s aimed to further relax the constraints of handwriting, namely, the adherence to standard stroke orders and stroke numbers and the restriction of recognition to isolated characters only. The target of recognition has shifted from regular script to fluent script in order to better meet the requirements of practical applications. The research works are reviewed in terms of pattern representation, character classification, learning/adaptation, and contextual processing. We compare important results and discuss possible directions of future research.

Algorithms↗

PubMed2000

Evaluation of three different ways of assessing tremor in multiple sclerosis.

OBJECTIVES: To examine the comparative reliability and validity of three simple ways of rating upper limb tremor in patients with multiple sclerosis. METHODS: Three examiners independently rated severity of upper limb tremor in patients with multiple sclerosis on a 0-10 scale by studying videotape recordings of patients' examinations, spiral drawings, and handwriting samples. The correlations of the tremor severity scores with scores from arm dexterity tests and a tremor related disability scale were also assessed. RESULTS: Rating tremor on posture had a good intrarater and interrater reliability. However, these reliabilities decreased when kinetic tremor was assessed, in part because dysmetria was a confounding factor. The intrarater reliabilities of rating tremor from spirals and handwriting were also good but the interrater reliabilities were only fair to moderate. Tremor severity scored by all three methods correlated highly with scores obtained from the nine hole peg test, finger tapping test, and a tremor related activities of daily living (ADL) questionnaire, indicating that all three methods were valid ways of assessing tremor in multiple sclerosis. CONCLUSION: Multiple sclerosis tremors in posture can be scored using a clinical rating scale in a valid and reliable way, and from spirals and handwriting samples if the ratings are carried out by the same examiner. However, scoring kinetic tremor was less reliable. In addition, the nine hole peg and finger tapping tests provide useful objective assessments of upper limb function in tremulous patients with multiple sclerosis.

Activities of Daily Living↗

PubMed1976

Validity and student acceptance of a graphoanalytic approach to personality.

Forty-eight handwriting specimens were rated by 6 handwriting analysts on 16 personality variables. Correlations of analysts ratings and personality inventory scores were nonsignificant. Analysis of variance showed that there were significant differences between the analysts on their judgments of 10 of the 15 traits. Subjects were also given the reports prepared for them and a bogus report and asked to rate the analysts' assessments for accuracy. Subjects were able to choose 2 of the 15 traits with significant accuracy on the real report when considering individual traits. There were no significant differences between the accuracy ratings on the real and bogus reports on overall rating. It was concluded that the analysts could not accurately predict personality from handwriting.

Journal Article↗

PubMed1987

Neuroelectric correlates of a neuropsychological model of word decoding and semantic processing in reading disabled children.

The purpose of this study was to distinguish the characteristics and components of event related potentials (ERPs) correlated with word decoding and semantic processing in a subgroup of children with specific reading disabilities related to visual processing deficiencies. The results were compared with those obtained from a group of normal readers previously studied (Ostrosky et al. in press). Visual ERPs were recorded to four stimuli: three physically different but with the same semantic content: a frequently used noun written in capitals (COCHE), the same noun in handwriting, the pictorial representation of the noun (drawing), and a neutral stimulus consisting of a checkerboard. Four derivations were used: occipital (O1-O2) and parietal (P3-P4) with reference to linked mastoids. Data were analyzed using multivariate procedures. A Principal Component Analysis with Varimax rotation of the solution was applied. In the normal readers, we found some components in the occipital derivations which identified the words presented in different styles of handwriting and others which seemed to identify these words with the pictorial representation (and not with the neutral stimuli). The first "verbal" components were situated around the 156-256 ms latency range and the second "semantic" components were observed at over 380 ms. In the disabled readers, there was no "verbal" or "semantic" recognition grouping of these physically different stimuli. As opposed to the normal readers, interhemispheric responses were symmetrical. At the left parietal leads in the normal readers, the morphology of the verbal stimuli (capitals and handwriting) were very similar throughout the sweep and both were very different from the nonverbal stimuli. At 376 ms the four stimuli elicited a prominent negative peak in which the verbal stimuli elicited significantly higher amplitude than the nonverbal stimuli. In the disabled group, the morphologies of the four stimuli were very similar and no significant differences were observed. The results are discussed in accordance with a hypothetical model of the neural bases underlying reading. The model takes into account the complexity of the reading process and the various cognitive skills required for its adequate performance, and emphasizes a complex, dynamic interplay between occipital, parietal and temporal areas.

Cerebral Cortex↗