A meta-analysis on the relation between handwriting and visual-motor integration

Abstract

Visual-motor integration is typically viewed as an important variable, subskill, or integral component of children's skilled handwriting; however, the handwriting-VMI correlation varies across studies, and its function remains elusive. In this context, this study aimed to quantify this relation and examine the moderation effects of handwriting dimensions, script types, age, and sample status. A moderate (r = 0.29, 95 % CI [0.23, 0.34]) handwriting-VMI relationship was identified based on 29 studies with 47 unique samples. Script types, age, and sample status were found to be significant moderators, whereas ‘handwriting dimensions’ was non-significant. Despite the nonsignificance of handwriting dimensions, handwriting legibility, pressure, and speed had a significant positive, negative, and non-significant correlation with VMI, respectively; handwriting had a significantly higher correlation with VMI for logographic scripts than alphabetic scripts, for children younger than six than their older counterparts, and for mixed-group students than typically-developing ones. Implications, limitations, and future directions are discussed. Educational relevance and implicationsUsing the meta-analysis method, this study identified a moderate relationship (r = 0.29, 95 % CI [0.23, 0.34]) between handwriting and VMI and clarified the significant moderation effects of script types, age, and sample status. Theoretically, both the perceptual-motor and spatial cognitive skill(s) (components) are highlighted to permeate handwriting and VMI, which may act as the theoretical basis for educators and researchers in future empirical investigations to unpack further the handwriting-VMI relationship as well as children's handwriting problems. From a practical point of view, the results of this study suggest a specific pathway that may assist in the early identification of potential handwriting problems: the relationship between handwriting and VMI. The handwriting-VMI relationship varying across different sub-groups further highlights the importance of task and population characteristics in differentiating the specific relations behind them, helping clinicians determine which task and/or population could work/benefit most from further relevant assessment and treatment.