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Phys Occup Ther Pediatr. 2007;27(2):43-62.

Handwriting performance on the ETCH-M of students in a grade one regular education program.

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  • 1School of Optometry University of Montreal, Montreal, Quebec, Canada.


This nonexperimental correlational study describes handwriting performance in 69 typically developing first graders (mean age = 82.0 months +/-3.6) using the Evaluation Tool of Children's Handwriting- Manuscript. The relationship between handwriting and specific sensorimotor components was also examined and revealed modest associations (r = 0.32-0.40; p < 0.05). Mean legibility scores ranged from 68% to 87% with wide variability in speed. Boys demonstrated significantly lower mean legibility scores compared with girls. Teacher rating of handwriting and the ETCH-M scores were modestly correlated (r =-0.37 to -43; p < 0.01). Handwriting predictors included in-hand manipulation, visual motor control, upper limb speed, dexterity, and steadiness. The factors contributing to legible handwriting are multifactorial and complex. The results have implications for identification of students in first grade whose handwriting is below age expectations.

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