Frame of Reference for Development of Handwriting Skills

Conceptual Model for Performance in Handwriting

The Conceptual Model for Performance in Handwriting views that handwriting is important for one’s work and/or education domains of occupations. It considers the performance components, performance areas (functional performance), performance contexts, and the interactive relationship among them. Prerequisites to handwriting include performance components in sensory, perceptual, motor cognitive, and language functions, as well as integrations of these components.

The Sensory Integration (SI) frame of reference focuses on how the interaction between the sensory systems including auditory, vestibular, proprioceptive, tactile, and visual systems, provides integrated information that contributes to a child’s learning and adaptive behaviors. The key consideration is that children have the abilities to make adaptive responses to constantly changing sensory environments. The sensory integrative abilities include sensory modulation, sensory discrimination, postural-ocular control, praxis, bilateral integration, and sequencing.

The Biomechanical frame of reference for positioning children for function is applied to individuals who are unable to maintain posture from appropriate automatic muscle activity caused by neuromuscular or musculoskeletal dysfunction. The goals of this frame of reference are (1) to enhance development of postural reactions, which can be done by reducing the demands of gravity and aligning the body, and (2) to improve functional performance by providing external support for proximal stability to improve distal function.

This frame of reference adapts a top-down approach to identify visual perceptual factors that limit an individual’s daily participation, and adaptive and compensation approaches are used to facilitate engagement in meaningful occupation. It uses theories from cognition, developmental psychology, education, and Warren’s developmental hierarchy of visual perceptual skills. Visual Perceptual skill development is viewed to be developed from a hierarchy, starting from oculomotor control, visual fields, visual acuity.

The Neuro-Developmental Treatment (NDT) frame of reference is used to analyze and treat posture and movement impairments based on kinesiology and biomechanics. To identify difficulties and plan for intervention, the following concepts are to be considered in NDT, including planes of movement, alignment, range of motion, base of support, muscle strength, postural control, weight shifts, and mobility. NDT assumes that posture and movement impairments are changeable. Thus, it utilizes movement analysis to identify missing or atypical elements.