The effects of protracted graphomotor tasks on tripod pinch strength and handwriting performance in children with dysgraphia.

PURPOSE To examine the impact of prolonged graphomotor tasks on tripod-pinch strength and on handwriting process and product measures of children with dysgraphia and typical peers. METHOD Participants were 51 children in third to fifth grades, divided into two groups: 23 children with dysgraphia and 28 typical peers, as determined by the Handwriting Proficiency Screening Questionnaire. The procedure included two sessions, with a 15-min break between sessions. In each session, the participants performed two tasks: the visual-motor control subtest of Bruininks-Oseretsky and a handwriting copying task, both performed on an electronic tablet as part of the Computerised Penmanship Evaluation Tool. Tripod pinch strength was evaluated before and after each session. RESULTS Significantly lower tripod-pinch strength was found among children with dysgrphia in comparison to typically developed peers. This deterioration in tripod-pinch strength was associated with a significant deterioration in handwriting process and product measures along the protracted task. CONCLUSIONS Pinch force that is required for mastering the handwriting tool needs to be considered in the evaluation process of children with dysgraphia. Combining the pinch factor with an evaluation of handwriting's process and product may supply a better insight about the child's deficits and assist in focusing treatment objectives.