Process Versus Product Evaluation of Poor Handwriting among Children with Developmental Dysgraphia and ADHD

Handwriting is a complex activity that entails an intricate blend of cognitive, sensory and motor abilities. The act of writing presents difficulties for children with dysgraphia and ADHD. The objective of this study was to determine ways in which the analysis of both objective, digitizer-based evaluation of the handwriting process and subjective, human-based evaluation of the handwriting product may lead to greater insight about the performance of poor handwriters. Fifty third grade students with dysgraphic handwriting, and 12 children with ADHD performed functional handwriting tasks on a Wacom digitizer. Objective temporal, spatial and pressure measurements of the handwriting process were sampled and analyzed. The handwriting samples were also evaluated according to pre-established characteristics using the Hebrew Handwriting Evaluation (HHE). Both objective and subjective measures differentiated between proficient and poor (dysgraphic or ADHD) handwriting; high correlations were found between the objective measures and subjective measures and discriminant analysis showed that global legibility and In air time were the highest predictors of poor handwriting. These results demonstrated the potential advantage of combining different types of measures in order to achieve a more comprehensive understanding and evaluation of handwriting difficulties. This may facilitate cooperation between handwriting researchers and clinicians and teachers who deal with handwriting difficulties.