Handwriting without Tears® via Telehealth Delivery: A Case Study of Feasibility and Effectiveness for Handwriting and Spelling Outcomes

Abstract

ABSTRACT In the current environment, the effects the pandemic have had on children remains unknown. Handwriting was not addressed effectively during online education, an occupation which pediatric occupational therapists are highly qualified to support with children, families, and schools. Concurrently, the use of telehealth as a service delivery method has increased, especially during the pandemic. The ease, flexibility, and satisfaction found with telehealth, time will dictate its continued use. This case study presents a preliminary investigation into the effectiveness and feasibility of the Handwriting Without Tears® (HWT) program via telehealth delivery for handwriting and spelling outcomes for a first grader. A case study pretest/posttest design was used to assess handwriting and spelling gains for a first grade female. The Print Tool and Alphabet15 were used to assess handwriting quality and handwriting speed respectively. The Test of Written Spelling-5 and the Primary Spelling Inventory were used to evaluate spelling. The participant completed 18 synchronous HWT telehealth visits over six weeks. The participant made handwriting legibility and speed gains, but the spelling results were inconclusive. The feasibility of the telehealth service delivery was confirmed with reported participant satisfaction, high attendance, and minimal accommodations required to translate the HWT program to telehealth. The high frequency visits as recommended by a previous systematic review anecdotally was deemed taxing by the participant and family. Further research is warranted to determine the effectiveness of HWT on literacy outcomes, such as handwriting and spelling, delivered via telehealth at a lower frequency of visit.