Abstract
BackgroundDifficulties in handwriting, such as dysgraphia, impact several aspects of a child’s everyday life. Current methodologies for the detection of such difficulties in children have the following three main weaknesses: (1) they are prone to subjective evaluation; (2) they can be administered only when handwriting is mastered, thus delaying the diagnosis and the possible adoption of countermeasures; and (3) they are not always easily accessible to the entire community.ObjectiveThis work aims at developing a solution able to: (1) quantitatively measure handwriting features whose alteration is typically seen in children with dysgraphia; (2) enable their study in a preliteracy population; and (3) leverage a standard consumer technology to increase the accessibility of both early screening and longitudinal monitoring of handwriting difficulties.MethodsWe designed and developed a novel tablet-based app Play Draw Write to assess potential markers of dysgraphia through the quantification of the following three key handwriting laws: isochrony, homothety, and speed-accuracy tradeoff. To extend such an approach to a preliteracy age, the app includes the study of the laws in terms of both word writing and symbol drawing. The app was tested among healthy children with mastered handwriting (third graders) and those at a preliterate age (kindergartners).ResultsApp testing in 15 primary school children confirmed that the three laws hold on the tablet surface when both writing words and drawing symbols. We found significant speed modulation according to size (P<.001), no relevant changes to fraction time for 67 out of 70 comparisons, and significant regression between movement time and index of difficulty for 44 out of 45 comparisons (P<.05, R2>0.28, 12 degrees of freedom). Importantly, the three laws were verified on symbols among 19 kindergartners. Results from the speed-accuracy exercise showed a significant evolution with age of the global movement time (circle: P=.003, square: P<.001, word: P=.001), the goodness of fit of the regression between movement time and accuracy constraints (square: P<.001, circle: P=.02), and the index of performance (square: P<.001). Our findings show that homothety, isochrony, and speed-accuracy tradeoff principles are present in children even before handwriting acquisition; however, some handwriting-related skills are partially refined with age.ConclusionsThe designed app represents a promising solution for the screening of handwriting difficulties, since it allows (1) anticipation of the detection of alteration of handwriting principles at a preliteracy age and (2) provision of broader access to the monitoring of handwriting principles. Such a solution potentially enables the selective strengthening of lacking abilities before they exacerbate and affect the child’s whole life.
Highlights
BackgroundDysgraphia is a learning disability that involves unsatisfactory handwriting production, given age, normal intelligence, and absence of neurological, perceptual, or motor problems [1]
The designed app represents a promising solution for the screening of handwriting difficulties, since it allows (1) anticipation of the detection of alteration of handwriting principles at a preliteracy age and (2) provision of broader access to the monitoring of handwriting principles
We proposed the following three goals: (1) to investigate if these writing principles hold when writing on a tablet surface; (2) to verify that symbol drawing can anticipate the detection of potential difficulties at the preliteracy stage; and (3) to investigate how writing-related skills and principles change with gesture acquisition
Summary
BackgroundDysgraphia is a learning disability that involves unsatisfactory handwriting production, given age, normal intelligence, and absence of neurological, perceptual, or motor problems [1]. Dysgraphia can occur in isolation or in association with a specific learning disorder (eg, developmental dyslexia with a moderate comorbidity correlation) [1] or fall within a more generalized developmental coordination disorder [5]. In the latter case, motor coordination difficulties are not limited to writing, but emerge in other daily activities (eg, playing an instrument, performing sports activities, and lacing up shoes). Motor coordination difficulties are not limited to writing, but emerge in other daily activities (eg, playing an instrument, performing sports activities, and lacing up shoes) Difficulties in handwriting, such as dysgraphia, impact several aspects of a child’s everyday life. Current methodologies for the detection of such difficulties in children have the following three main weaknesses: (1) they are prone to subjective evaluation; (2) they can be administered only when handwriting is mastered, delaying the diagnosis and the possible adoption of countermeasures; and (3) they are not always accessible to the entire community
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