Pencil Grasp Pattern: How Critical is it to Functional Handwriting?

Pencil Grasp Pattern: How Critical is it to Functional Handwriting? Heidi D. Schwellnus Doctor of Philosophy Graduate Department of Rehabilitation Science University of Toronto 2012 This thesis reports the results of a large study to evaluate the kinetics of pencil grasp patterns in terms of speed and legibility of handwriting of children in Grade 4. Current clinical practice as recent as 2008 suggests that teachers identify the dynamic tripod pencil grasp as an optimal pencil grasp for handwriting. Research findings had suggested that three other pencil grasps may be functional for handwriting, though there was still inconclusive evidence upon which to base clinical practice. The purpose of the present study was to: assess the impact of pencil grasp on the speed and legibility of handwriting; to determine the effect of grasp on speed and legibility following a 10-minute copy task intended to induce fatigue; and to describe the axial and grip forces of the four pencil grasps. 120 children were assessed, completing a standardized handwriting assessment before and after a 10-minute copy task. The participants utilized an instrumented pen and wrote on a digitizing tablet, which measured, respectively, the axial and grip forces associated with their grasp patterns. Pencil grasp was not found to impact the speed or legibility of the written product in either short or long duration copy tasks. Fatigue decreased the legibility of the product across all pencil grasps but increased the speed across all pencil grasps equally. Grip and axial forces were only different in grasps with an adducted thumb and mainly during the initial assessment. Collectively, these results suggest that four mature grasps are equally functional for handwriting in children of this age. These findings contradict common clinical impressions that the dynamic tripod pencil grasp is optimal.