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Computerized temporal handwriting characteristics of proficient and non-proficient handwriters.

OBJECTIVE: The purpose of this study was to use computerized temporal measures to examine and compare the writing process of proficient and non-proficient third-grade handwriters. METHOD: A computerized digitizer system was used to compare the temporal handwriting measures of two groups of 8-9-year-old students. Classroom teachers used a questionnaire to identify 50 students who were non-proficient handwriters and 50 students who were proficient handwriters. Multivariate analysis of variance (MANOVA) analyses were used to test for the group differences across tasks for each dependent variable. Total time, "on paper" time, "in air" time, speed, and number of characters per minute were recorded as the participants performed graded writing tasks. RESULTS: Non-proficient handwriters required significantly more time to perform handwriting tasks [F(4,91) = 14.83, p < .0001]; their "in air" time, was especially longer as compared to the proficient handwriters [F(4,91) = 13.63, p < .0001]. Their handwriting speed was slower [F(4,91) = 5.99, p < .0002], and they wrote fewer characters per minute (F(4,91) = 14.63, p < .0001). CONCLUSION: The use of a computerized handwriting system provides objective temporal measures of handwriting performance, and may lead to the development of additional tools for the evaluation and treatment of handwriting difficulties.

Agraphia↗

Relationships between handwriting and keyboarding performance of sixth-grade students.

OBJECTIVES: This study examined the relationships between sixth-grade students' handwriting speed and legibility and their keyboarding speed and error rate. A second purpose was to examine how well handwriting performance discriminates students as slow or fast in computer keyboarding. METHOD: After participation in a school-required keyboarding class, 40 sixth-grade students were asked to copy a familiar poem using handwriting and keyboarding. Handwriting legibility and speed and keyboarding speed and errors were measured. Relationships among these variables were analyzed using Pearson product-moment correlations and discriminant analysis. RESULTS: Keyboarding speed correlated with handwriting legibility (n = 38, r = .361, p = .026), suggesting that handwriting performance accounts for 12% to 13% of the variance in keyboarding performance. Handwriting speed and legibility together accurately categorized 71% of students as slow or fast in keyboarding. On average, students were able to keyboard faster than handwrite. Of the 20 slowest handwriters, 75% achieved more text production with keyboarding than with handwriting. CONCLUSION: Keyboarding performance demonstrated low to moderate correlation with handwriting performance, suggesting that these forms of written expression require distinctly different skills. Most students who were slow at handwriting or had poor legibility increased the quantity and overall legibility of text they produced with a keyboard. These results suggest that keyboarding has the potential to increase and improve a student's written output.

Child↗

Perceptual-motor function of school-age children with slow handwriting speed.

OBJECTIVES: This study investigated differences in perceptual-motor measures and sustained attention between children with slow and normal handwriting speed and the relationship between these factors. METHOD: Thirty-four slow handwriters and 35 normal speed handwriters (7 to 11 years of age) attending elementary schools in Taiwan were given three perceptual-motor tests and a vigilance task to assess sustained attention. Performances on these measures were analyzed using multivariate analysis of variance and regression analyses. RESULTS: A significant difference was found between slow and normal handwriters in upper-limb coordination, visual memory, spatial relation, form constancy, visual sequential memory, figure ground, visual-motor integration, and sustained attention. The three significant predictors of handwriting speed for the slow handwriters were age, visual sequential memory, and visual-motor integration. For the normal speed handwriters, age and upper-limb speed and dexterity were the only two significant predictors. CONCLUSIONS: Slow and normal speed handwriters responded to handwriting demands through different perceptual-motor systems. Whereas upper-limb speed and dexterity seems to play an important role in normal speed handwriters, slow handwriters seem to rely more on visually directed processes, including sequence memory and visual-motor integration.

Child↗

A validity study of the Evaluation Tool of Children's Handwriting-Cursive.

OBJECTIVES: This study examined concurrent validity of the Evaluation Tool of Children's Handwriting-Cursive (ETCH-C) by comparing ETCH-C total legibility percentage scores with handwriting grades from teachers. The study also identified the legibility percentage score discriminating between satisfactory and unsatisfactory handwriting. METHOD: The participants were 101 fourth graders who completed two handwriting instruments. Three teachers sorted the Cursive Practice and Review work sheets into A, B, C, and unsatisfactory groups to establish handwriting grade. The study compared ETCH-C total legibility percentage scores with teacher grading, using personal judgment of handwriting on the Cursive Practice and Review work sheet. RESULTS: Mean legibility percentage scores increased significantly as handwriting grade increased. The concurrent validity coefficients were .61 for ETCH-C total words and .65 for ETCH-C total letters and handwriting grade. ETCH-C legibility percentage scores discriminating satisfactory from unsatisfactory handwriting ranged from 73% to 82% on ROC (receiver operating characteristic) curves. CONCLUSION: Results support the concurrent validity of the ETCH-C with handwriting grades. A 75% word legibility percentage score discriminated satisfactory and unsatisfactory handwriting.

Analysis of Variance↗

Handwriting changes under the effect of alcohol.

Document examiners are often faced with difficulties in evaluating handwriting by persons under the influence of alcohol. Although numerous articles are available on the subject of alcohol influence on handwriting quality, most of them were based on empirical data such as "few" or "increased", without any statistical evaluation. The aim of this research is to determine whether previous observations on reported effects of alcohol on handwriting are valid and to establish the predictability of observing specific effects. A total of 73 participants, who completed all steps of the experiment, were surveyed. Handwriting samples were taken before and after the consumption of alcohol. The test form, including criteria of prior studies used by document examiners, was evaluated with the help of a Olympus X-Tr stereo microscope, direct and oblique angle lighting and a video spectral comparator (VSC 2000). Measurements were done by means of digital caliper, statistics using repeated measures ANOVA, Pearson correlation, Pearson Chi square test, McNemar test and Wilcoxon signed rank test. The results revealed that the handwriting parameters such as word lengths, height of upper and lower case letters, height of ascending letter, height of descending letter, spacing between words, number of angularity, number of tremor, and number of tapered ends are all significantly increased under the effect of alcohol. It was also determined that the significant correlation between the alteration of handwriting parameters such as height of upper and lower case letters, number of angularity, number of tapered ends and the amount of alcohol. Furthermore, it does not confirm the conclusions of previous studies stating that alcohol levels are not proper indicators. Our data strongly confirms that handwriting changes can be observed at any level of alcohol. None of the alterations in handwriting can be attributed to the effects of alcohol intake alone. However, the presence of some alterations together is strongly suggestive that the person was under the influence of alcohol. First of all, the duty of handwriting examiner is to identify if the questioned and known sample are coming from the same source. Consequently, as this explanatory analysis suggests that differences between sober and intoxicated persons can be identified in handwriting, but the examiner's judgement must be proportionately cautious, keeping in mind the abnormally wide range of variation.

Adult↗

Testing the effect of kinesthetic training on handwriting performance in first-grade students.

OBJECTIVE: The purpose of this study was to investigate the effect of kinesthetic training' on handwriting performance in first-grade students 6 to 7 years of age who had kinesthetic deficits and handwriting difficulties. METHOD: With a randomized-blinded three group research design, 45 children were assigned to either a kinesthetic training group, a handwriting practice group, or a no treatment group. Kinesthesis and handwriting legibility were measured before and after intervention. Teachers' judgments of handwriting legibility in the classroom setting were sought at 4 weeks after the intervention to see whether any improvement gained would be maintained in the natural setting. Two-way repeated-measures analysis of variance was used for data analyses. RESULTS: At posttest, all groups showed significant improvement of kinesthesis, with no significant difference in the magnitude of improvement among the groups. There was no significant improvement of handwriting legibility as measured by a standardized test in any of the groups, although teachers indicated improvement of handwriting legibility in the classroom setting in all groups. Teachers also reported maintenance of handwriting legibility at 4 weeks after posttest. CONCLUSION: Kinesthetic training did not improve handwriting or kinesthesis in these children. The findings of this study offer no support for use of kinesthetic training to improve handwriting legibility in first-grade students.

Analysis of Variance↗

Characteristics of handwriting of patients with Huntington's disease.

Patients with Huntington's disease exhibit poorer-quality handwriting, sometimes clinically exhibiting macrographia, an increase in the size of handwriting. To characterize deficits in handwriting of patients with Huntington's disease, we compared the writing of 12 young, 12 age-matched controls, and 12 patients with Huntington's disease. Subjects were asked to write the letter "l" four times, at a constant length, on a graphics tablet that sampled pen position at 200 Hz. Huntington's disease causes chorea (involuntary movement), akinesia (difficulty in initiating voluntary movement), and bradykinesia (slowness and difficulty in maintaining voluntary movement). To distinguish changes in handwriting quality due to involuntary movement from impairments of voluntary movement, handwriting samples with obvious choreic movements were analyzed separately from other handwriting samples. Several measures of quality of handwriting were considered, based on: the regularity and consistency of handwriting, the efficiency of movement trajectories, and the proportions of movement occurring at specific frequencies. Results suggested that Huntington's disease increases variability of movement parameters, and causes problems in producing smooth movements. Choreic movement was best characterized by the number of zero crossings in the velocity function relative to the prescribed number of writing strokes. We hypothesize that macrographia in Huntington's disease occurs when chorea predominates over bradykinesia. Comparisons were made between the handwriting of patients with Huntington's and Parkinson's diseases.

Adolescent↗

Effects of methylphenidate on kinematic aspects of handwriting in hyperactive boys.

Poor handwriting in hyperactive children often contributes to academic failure. Beneficial effects of methylphenidate on the quality of handwriting have been shown. Using a digitizing tablet, the handwriting of 21 hyperactive boys was examined both during methylphenidate treatment and following withdrawal of the drug. Half of the hyperactive boys were tested first on methylphenidate and then following withdrawal of the drug and the remaining hyperactive boys were examined in the reverse order. Twenty-one control boys underwent the same examination. Velocity and acceleration of handwriting movements were measured. Furthermore, every writing specimen was independently rated by four examiners regarding the quality of handwriting. Following withdrawal of the drug, the quality of handwriting specimens of hyperactive boys was poorer than during treatment with methylphenidate. Statistical comparison of writing movements of hyperactive boys on and off methylphenidate revealed that the medication resulted in a deterioration in handwriting fluency. The results showed that following withdrawal of medication, hyperactive children did not differ from control boys in handwriting movements. The improvement in hyperactive behavior through methylphenidate was associated with increased legibility and greater accuracy of handwriting. The intention to write neatly may interfere with the fluent writing process.

Attention Deficit Disorder with Hyperactivity↗

Individuality of handwriting.

Motivated by several rulings in United States courts concerning expert testimony in general, and handwriting testimony in particular, we undertook a study to objectively validate the hypothesis that handwriting is individual. Handwriting samples of 1,500 individuals, representative of the U.S. population with respect to gender, age, ethnic groups, etc., were obtained. Analyzing differences in handwriting was done by using computer algorithms for extracting features from scanned images of handwriting. Attributes characteristic of the handwriting were obtained, e.g., line separation, slant, character shapes, etc. These attributes, which are a subset of attributes used by forensic document examiners (FDEs), were used to quantitatively establish individuality by using machine learning approaches. Using global attributes of handwriting and very few characters in the writing, the ability to determine the writer with a high degree of confidence was established. The work is a step towards providing scientific support for admitting handwriting evidence in court. The mathematical approach and the resulting software also have the promise of aiding the FDE.

Adolescent↗

Assessing handwriting speed of children biliterate in English and Chinese.

The assessment of multiliterate handwriting performance is rarely reported despite increased globalization. The present study describes the psychometric properties of a handwriting speed test developed for children who are biliterate in English and Chinese. This included interrater reliability, test-retest reliability, interitem correlation, construct validity, and concurrent validity. The test's reliabilities between two raters and over a 1-wk. interval were high with ICCs ranging from .89 to .99. Interitem correlation between the English and Chinese items was .87. The presence of age trends but not sex differences was a positive indicator of the test's validity. Correlations of .91 and 1.00 between the Chinese and the English items of the Handwriting Assessment Tool with the Chinese Handwriting Speed Test and Handwriting Speed Test, respectively, provided evidence of concurrent validity. These preliminary results showed the Handwriting Assessment Tool is reliable and is a potentially useful handwriting test for children biliterate in English and Chinese. The feasibility of assessing biliterate handwriting speed performance with the same set of scoring criteria for different writing systems was supported.

Child↗

The effects of methylphenidate on the handwriting of children with minimal brain dysfunction.

Fifty children with minimal brain dysfunction who had handwriting deficits received methylphenidate or placebo under double-blind conditions. Twenty-six children (52%) showed improvement in hand-writing following treatment with methylphenidate for four weeks. One child receiving placebo had improvement in handwriting, but his handwriting improved further after he was switched to methylphenidate. In general, handwriting tended to deteriorate promptly when drug treatment was discontinued. Thirty-six patients (72%) receiving methylphenidate for four weeks were rated behaviorally improved by teachers; in contrast, seven children (14%) showed behavioral improvement following treatment with placebo. Improvement in attention and behavior, which was ascertained by the use of Conners' Abbreviated Teacher Rating Scale, did not always correspond with improvement in handwriting. Advances in handwriting skills following treatment with methylphenidate may have been directly related to improvement in fine motor coordination. Gains in handwriting were maintained for up to 26 months of follow-up in 21 children who received methylphenidate on a long-term basis.

Attention Deficit Disorder with Hyperactivity↗

Positive correlation between reduction of handwriting area and D2 dopamine receptor occupancy during treatment with neuroleptic drugs.

We investigated the relationship between fine extrapyramidal-motor symptoms (reduction of handwriting area) and D2 dopamine receptor occupancy under neuroleptic treatment. The handwriting of 18 schizophrenic patients before and during treatment with typical (haloperidol, haloperidol decanoate) and atypical (clozapine, risperidone) neuroleptic drugs was examined. Data analysis of the handwriting's examination was carried out with a planimetric computer programme. At the time of the second test of handwriting, D2 receptor occupancy was determined with single photon emission tomography (SPET) using [(123)I]iodobenzamide ((123)I-IBZM). In all patients, a reduction of handwriting area and a D2 receptor occupancy were found. The correlation between reduction of handwriting area and D2 receptor occupancy for typical and atypical neuroleptic drugs was linear and statistically significant (r=0.9; P > 0.001). Our findings point to the possibility that the reduction of handwriting area may be used as a clinical indicator of D2 receptor occupancy under treatment with neuroleptic drugs.

Adult↗

Attention-deficit hyperactivity disorder: a longitudinal case study of handwriting characteristics.

This longitudinal case study focuses on handwriting samples of a female diagnosed with Attention-Deficit/Hyperactivity Disorder from 12 years of age to 21 years of age. Diaries and journals produced for class assignments and later for this research yielded 293 handwriting samples. 15 characteristics of handwriting were measured and statistically analyzed to follow changes in handwriting across time. At seven years of age while in elementary school the subject was diagnosed with ADHD and placed on Ritalin (methylphenidate). At puberty the drug was discontinued. During two summers she visited grandparents, once alone and once with two sisters with whom she was in conflict. Her handwriting deviated from its pattern of general decrease in size and increase in uniformity during these visits. The changes over time of three handwriting characteristics (slant of "l," heights and areas of the lower loop of the "g," and area of the left loop of the "I") also deviated from the general pattern of her handwriting change.

Adult↗

Factors that relate to good and poor handwriting.

OBJECTIVE: This study investigated the relationships between specific performance components, eye-hand coordination, visuomotor integration, in-hand manipulation, and handwriting skill. METHOD: A sample of 48 typical first grade students were identified as good and poor handwriters by their teachers. Each child completed the Motor Accuracy Test; the Developmental Test of Visual-Motor Integration (VMI); two tests of in-hand manipulation, including a rotation and a translation task; and the Minnesota Handwriting Test (MHT). RESULTS: All test scores for the subjects with good handwriting were significantly higher than those of the subjects with poor handwriting. Each performance component test was significantly correlated to MHT scores. Translation, VMI, and rotation scores were significant predictors of MHT scores, accounting for almost 73% of variance. A discriminant analysis using the performance components correctly classified 98% of the students as good or poor handwriters. CONCLUSION: In-hand manipulation has significant association to handwriting skill.

Child↗

Handwriting of the alcoholic.

Alcohol intoxication produces abnormal handwriting with manifestations that are thoroughly described in the literature of forensic science. A less known phenomenon is the peculiar handwriting changes found in alcoholics, especially individuals in the later stages of the disease. In addition to the two handwriting states of non-alcoholic drinkers (normal/sober and intoxicated) the alcoholic writer has a third state, handwriting done in withdrawal. Withdrawal is a state of tension resulting in handwriting characterized by irregularity, ataxia and tremor. This type of abnormal handwriting creates special problems of authentication requiring detailed background history and appropriate comparison specimens, but it can also be used to judge the writer's state of sobriety.

Alcoholic Intoxication↗