Development of handwriting skill in children with unilateral cerebral palsy (CP)

Abstract

Aim. To investigate the development of handwriting, fine motor skills and school marks in children with unilateral cerebral palsy (CP) and relate the performance in handwriting skill to age and IQ at a 16-month follow-up.

Method. Data from 16 children (5 females, 11 males; mean age 11 years 4 months, SD 1 year 6 months, range 8–13 years) with left-sided hemiplegia were collected. The Minnesota Handwriting Assessment (MHA) for handwriting skill, the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) for fine motor skills, the Wechsler Intelligence Scale for Children Revised (WISC-R) for IQ, the Manual Ability Classification System (MACS) and school marks of children were used.

Results. Handwriting quality, handwriting speed and fine motor skills improved over 16 months but the children with unilateral CP still performed below their peers. School marks did not change. The regression model (Adj. R²  ==  0.76) revealed that age and IQ were negatively correlated and good predictors for the improvement in handwriting quality. No relationship was found between handwriting speed and age or IQ.

Conclusion. Children with unilateral CP continued to develop handwriting skill over a longer time period than expected. Age and IQ predicted the rate of development in handwriting quality. Children kept up school marks despite the increasing demands of the succeeding grade.

Keywords:

• Unilateral cerebral palsy
• cerebral palsy
• handwriting
• cognition
• fine motor skills

Acknowledgements

Authors wish to express their deepest gratitude to the children and families who participated in this study. Authors thank Dr. Gonca Bumin for the help to recruit children and the psychologists for performing WISC-R evaluations. Authors would also like to thank Dr. Ersen Kavak and Dr. Mesfin Kassaye Tessma for their support about statistical analysis. Financial support was granted from the Department of Habilitation Services for Children and Youth, Research Unit, Stockholm, Swedish Research Council, Stockholm County Council, FoU Committee, Stiftelsen Frimurare Barnhuset, and Sunnerdahls handikappfond.