Children begin to integrate visual and proprioceptive information by copying shapes and letters in pre-school; when they start school, they typically learn to associate movements with the visual image of letters. They learn to write from dictation and to control the movements required for writing, practicing their newly learned writing abilities allows the process of handwriting to become automatic. Acquiring good handwriting sets the foundation for more advanced literacy skills such as the production of written texts, children who have difficulty with automatic handwriting will likely have fewer resources for planning the content of the text.7 If young writers have to devote large amounts of working memory to controlling lower-level processes such as handwriting, there may be little working memory available for higher-level processes. The writer needs adequate working memory for generating ideas, selecting vocabulary, mental planning, and text revision, to avoid crowding out the composing processes. This makes another case for the need for automaticity of writing to eliminate the need for conscious attention to letter formation, freeing more mental space for working memory. Some research suggests that automatic letter writing is the single best predictor of length and quality of written composition in the primary years.8
De Vries reported that two of the characteristics needed for effective handwriting include a stable pencil grip and controlled dynamic finger movements. Difficulty with fine motor coordination may impair a writer’s ability to control the writing utensil. In-hand manipulation was studied in relation to handwriting, and the results indicated that there is a strong relationship between handwriting performance and in-hand manipulation skills. In-hand manipulation skills differed significantly between good and poor performers in tasks involving translation with stabilization and with rotation. Translation was the most important predictor of handwriting speed tasks.9 In-hand manipulation is the movement of objects within the hand post-grasp. Rotation, translation, and stabilization are the three types of in-hand manipulation. Rotation is the movement of an object around one or more of its axes, translation involves the manipulation of an object between fingertips and palm for storage, and stabilization entails the use of these skills while objects are stored in the palm.10
Schwellnus stated that functional handwriting depends on the complex interplay of a variety of abilities, including skillful fine motor coordination, force regulation, cognitive, perceptual, and language skills. Given the need for the complex integration of skills, learning to write can be challenging for children. The number of typically developing children who struggle with handwriting varies, with reported prevalence worldwide ranging from 6% to 34%.11
Steele reports that handwriting is a difficult skill to learn. Environmental factors, which appear to be inhibiting an individual’s capacity to acquire the ability to write, involves an intricate exchange of cognitive, visual motor, hand strength, and fine motor skills. Stating that the most important skill required for writing individual letters is muscle memory and that hands, arms, and eye muscles, may work effectively, but the writing muscles need to be exercised correctly and adequately in order to acquire the proper habit of making a letter.5 In OT language it appears that the authors are saying that the proper letter formation needs to be taught so the student is not learning poor formation habits or motor engrams that later will be difficult if not impossible to correct. Acquiring the habit of making a letter, could be translated to automaticity of letter formation.
Handwriting does not only involve hand movements; it involves training the memory and hand to work together to generate the correct mental codes for the production of letters and to translate these codes into motor patterns. With this in mind, the authors go on to state that handwriting is a language act, not just a motor act performed to record words. They state that focusing exclusively on formation, neatness, and speed, may only be a small part of the handwriting process.6