Handwriting Proficiency Screening Questionnaire Research Articles

Psychometric Assessment of the Handwriting Proficiency Screening Questionnaire (HPSQ)-Thai Version for Primary School-Aged Children.

In this study, the original Handwriting Proficiency Screening Questionnaire (HPSQ) was translated into Thai and cross-culturally adapted for use among school-aged children in Thailand. Additionally, the initial psychometric properties of the new Thai version were assessed, including internal consistency, construct validity, and content validity. The original HPSQ was forward-translated by two independent translators from English to Thai and then back-translated. A final consolidation was conducted by an expert committee to develop the Thai HPSQ. In the psychometric evaluation, content validity was quantified using the item-objective congruence (IOC) value for each item. Intra-rater and inter-rater reliabilities were also assessed. Internal consistency was measured using Cronbach’s alpha coefficient, and confirmatory factor analysis models were used to examine its construct validity. The Thai version of the HPSQ had excellent internal consistency (α = 0.92), good construct, and content validity (IOC value > 0.6). Intra-rater reliability was good (intraclass correlation coefficient (ICC) = 0.98), and inter-rater reliability ranged from fair to good (ICC = 0.46−0.77). Factor analysis revealed that a three-factor model best fitted the data. Thus, the Thai version of the HPSQ is a reliable and valid instrument for handwriting evaluation among Thai school-aged children. It can be useful for teachers and therapists to identify students with handwriting problems.

Handwriting and Motor-Related Daily Performance among Adolescents with Dysgraphia and Their Impact on Physical Health-Related Quality of Life.

Knowledge is limited about dysgraphia in adolescence and its association with daily motor-related daily performance and health-related quality of life (HRQOL). This study aimed to (1) compare and (2) examine correlations between handwriting measures, motor-related daily performance, and HRQOL of adolescents with and without dysgraphia and (3) examine the contribution of motor-related daily performance and handwriting measures to predict their physical HRQOL. There were eighty adolescents (13–18 yr): half with dysgraphia and half matched controls without dysgraphia per the Handwriting Proficiency Screening Questionnaire and Handwriting Legibility Scale participated. They copied a paragraph script onto a paper attached to the Computerized Penmanship Evaluation Tool digitizer and completed the World Health Organization Quality of Life Questionnaire-brief version and the Adult Developmental Coordination Disorder Checklist (ADC). We found significant between-group differences in motor-related daily performance, handwriting measures, and HRQOL and significant correlations between HRQOL and handwriting process measures and motor-coordination ability. Handwriting measures predicted 25%, and the ADC A and C subscales 45.6%, of the research group’s physical QOL domain score variability. Notably, the control group’s current perceptions of their motor-coordination performance (ADC-C) predicted 36.5% of the variance in physical QOL. Dysgraphia’s negative effects during childhood and adolescence may reduce adolescents’ HRQOL now and into adulthood.

The Relationship between Parent- and Child-reported Perceptions of Children’s Handwriting Quality and Skills

ABSTRACT Handwriting is an important daily occupation for children. When assessing children’s handwriting, it is recommended that clinicians use objective handwriting performance tests as well as solicit children’s and parents’ perspectives to promote client-centered practice. However, it remains unknown to what extent objective handwriting performance test results reflect children’s and parents’ perspectives about children’s handwriting itself. This study investigates the relationship between subjective perceptions of children’s handwriting legibility with the objectively assessed quality of children’s handwriting. Twenty-seven pairs of school-aged children and parents were recruited. Both groups completed the Handwriting Proficiency Screening Questionnaire (HPSQ) and “Here’s How I Write” (HHIW) instrument. Children also completed the Evaluation Tool of Children’s Handwriting (ETCH). Data were analyzed using Spearman’s rho correlations and linear regressions with bootstrapping. Children- and parent-reported perceptions were significantly correlated (rho = .50, p = .008). Children’s perceptions of their own handwriting legibility predicted ETCH letter legibility (p < .001); parents’ perceptions of their children’s handwriting legibility predicted ETCH word legibility (p < .003). The reported perceptions of children’s handwriting quality provide significant information to the overall children’s handwriting assessment process. Therapists should solicit children’s and parents’ perspectives to optimize a holistic approach to children’s handwriting assessment.

Relationship Between Teacher’s and Therapist’s Evaluations on Handwriting Performance in First-grade Children

Objectives: Handwriting dysfunction may harm children’s wellbeing. Therapists and elementary school teachers help to identify and improve children’s handwriting performance. The present study aimed to assess the relationship between therapists’ assessment and teachers’ perception of handwriting performance in first graders. Methods: This cross-sectional study involved (n=31) first-grade students, aged 6-8 years from an international school in Riyadh City, Saudi Arabia. Teachers evaluated the handwriting proficiency using the Handwriting Proficiency Screening Questionnaire (HPSQ), and the explored students were rated as proficient and non-proficient hand writers. Furthermore, therapists assessed students’ handwriting proficiency using the Minnesota Handwriting Assessment (MHA) (manuscript &amp; D’Nealian styles) scores. The Mann–Whitney U test was used to assess the differences in MHA scores between proficient and non-proficient hand writers. Moreover, Spearman’s correlation coefficient was used to assess the relationship between the scores of MHA and HPSQ. Results: There was a significant difference in all component scores of MHA (except the rate) and both writing styles between the proficient and non-proficient writers (P&lt;0.05). There was also a significant relationship between the MHA and the HSPQ scores (P&lt;0.05). However, further analysis of these scales’ components suggested no significant association between teachers’ and therapists’ evaluation of the handwriting speed domain. Discussion: There was a significant relationship between the teacher’s and therapist’s evaluation of handwriting performance using standardized measures. Thus, therapists should work in collaboration with teachers to identify and treat handwriting difficulties in school children.

Psychometric Properties of Screening Questionnaires for Children With Handwriting Issues.

Dysgraphia (D) is a complex specific learning disorder with a prevalence of up to 30%, which is linked with handwriting issues. The factors recognized for assessing these issues are legibility and performance time. Two questionnaires, the Handwriting Proficiency Screening Questionnaire (HPSQ) for teachers and its modification for children (HPSQ-C), were established as quick and valid screening tools along with a third factor – emotional and physical well-being. Until now, in the Czechia, there has been no validated screening tool for D diagnosis. A study was conducted on a set of 294 children from 3rd and 4th year of primary school (132 girls/162 boys; Mage 8.96 ± 0.73) and 21 teachers who spent most of their time with them. Confirmatory factor analysis based on the theoretical background showed poor fit for HPSQ [χ2(32) = 115.07, p < 0.001; comparative fit index (CFI) = 0.95; Tucker–Lewis index (TLI) = 0.93; root mean square error of approximation (RMSEA) = 0.09; standard root mean square residual (SRMR) = 0.05] and excellent fit for HPSQ-C [χ2(32) = 31.12, p = 0.51; CFI = 1.0; TLI = 1.0; RMSEA = 0.0; SRMR = 0.04]. For the HPSQ-C models, there were no differences between boys and girls [Δχ2(7) = 12.55, p = 0.08]. Values of McDonalds’s ω indicate excellent (HPSQ, ω = 0.9) and acceptable (HPSQ-C, ω = 0.7) reliability. Boys were assessed as worse writers than girls based on the results of both questionnaires. The grades positively correlate with the total scores of both HPSQ (r = 0.54, p < 0.01) and HPSQ-C (r = 0.28, p < 0.01). Based on the results, for the assessment of handwriting difficulties experienced by Czech children, we recommend using the HPSQ-C questionnaire for research purposes.

Inter-relationships between objective handwriting features and executive control among children with developmental dysgraphia

ObjectiveTo describe handwriting and executive control features and their inter-relationships among children with developmental dysgraphia, in comparison to controls.MethodParticipants included 64 children, aged 10–12 years, 32 with dysgraphia based on the Handwriting Proficiency Screening Questionnaire (HPSQ) and 32 matched controls. Children copied a paragraph onto paper affixed to a digitizer that supplied handwriting process objective measures (Computerized Penmanship Evaluation Tool (ComPET). Their written product was evaluated by the Hebrew Handwriting Evaluation (HHE). Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire about their child's executive control abilities.ResultsSignificant group differences were found for handwriting performance measures (HHE and ComPET) and executive control domains (BRIEF). Based on one discriminate function, including handwriting performance and executive control measures, 98.4% of the participants were correctly classified into groups. Significant correlations were found in each group between working memory and legibility as well as for other executive domains and handwriting measures. Furthermore, twenty percent of the variability of the mean pressure applied towards the writing surface among children with was explained by their 'emotional control' (BRIEF).ConclusionThe results strongly suggest consideration of executive control domains to obtain better insight into handwriting impairment characteristics among children with dysgraphia to improve their identification, evaluation and the intervention process.

Writing Performance of Fourth Grade Primary School Students in Relation to Organizational Ability and Handwriting Proficiency: A Structural Equality Model

Organizational ability can be defined as the ability to plan ahead and organize behavior across time and space. Students need organizational ability to fulfill some of their tasks inside and outside the school. They need to represent the required sequence of cognitive and psychomotor actions at each point in time, in relation to varied spaces (e.g., bedroom, kitchen) and accessories (clothes, schoolbag, notebooks, food). This study of 114 primary school students investigates the roles of organizational ability and handwriting proficiency in writing performance. In this research study, the Questionnaire for Assessing Students’ Organizational Abilities (QASOAT), developed by Lifshitz and Josman (2006), and the Handwriting Proficiency Screening Questionnaire by Rosenblum (2008), were adapted to Turkish and subjected to validity and reliability studies. Narrative and informative texts written by students are used to assess their writing performances. Research findings suggest that there are significant relationships between organizational ability, handwriting proficiency and the students’ writing performances. The Structural Equality Model (SEM) shows that organizational ability and handwriting proficiency explain 45% of writing performance.

Identification and Rating of Developmental Dysgraphia by Handwriting Analysis

Developmental dysgraphia, being observed among 10–30% of school-aged children, is a disturbance or difficulty in the production of written language that has to do with the mechanics of writing. The objective of this study is to propose a method that can be used for automated diagnosis of this disorder, as well as for estimation of difficulty level as determined by the handwriting proficiency screening questionnaire. We used a digitizing tablet to acquire handwriting and consequently employed a complex parameterization in order to quantify its kinematic aspects and hidden complexities. We also introduced a simple intrawriter normalization that increased dysgraphia discrimination and HPSQ estimation accuracies. Using a random forest classifier, we reached 96% sensitivity and specificity, while in the case of automated rating by the HPSQ total score, we reached 10% estimation error. This study proves that digital parameterization of pressure and altitude/tilt patterns in children with dysgraphia can be used for preliminary diagnosis of this writing disorder.

Characterization of Brazilians Students with Dyslexia in Handwriting Proficiency Screening Questionnaire and Handwriting Scale

Characterization of Brazilians Students with Dyslexia in Handwriting Proficiency Screening Questionnaire and Handwriting Scale

Short-term sensorimotor-based intervention for handwriting performance in elementary school children.

Handwriting problems in childhood can have lifelong repercussions, affecting learning and career. Sensorimotor intervention therefore helps to alleviate these problems. Thirty-one students (16 boys, 15 girls) underwent Minnesota Handwriting Assessment (MHA) to assess legibility, form, alignment, size, and spacing (the primary variables in this subject) as well as rate. Finally, 10 students (seven boys, three girls) aged 6-8 years (mean age, 77.1 ± 1.45months) participated in an intervention program. Baseline MHA, Handwriting Proficiency Screening Questionnaire (HPSQ), and grip strength were measured. The same group of students acted as their own controls and were analyzed before the interventions and later after completion of the protocol. There was a significant improvement in MHA scores for legibility, form, alignment, size and spacing (P < 0.05), with the exception of rate. There were also significant changes in legibility, time performance and physical and emotional wellbeing domains in the HPSQ, and grip strength (P < 0.05, paired t-test). Short-term sensorimotor-based intervention produced significant improvements in the handwriting performance of elementary school children.

Handwriting Proficiency Screening Questionnaire for Children (HPSQ-C): Development, Reliability, and Validity.

To adapt the Handwriting Proficiency Screening Questionnaire (HPSQ), previously designated for adults, into a children's self-report version (the HPSQ for Children, or HPSQ-C) and to examine its reliability and validity. Participants included 230 children ages 7-14 yr from regular schools in Israel. The questionnaire's content validity, internal consistency, and concurrent and construct validity were assessed. The tool demonstrated good internal consistency (α=.77). We found a significant moderate correlation between final HPSQ-C scores and the HPSQ, r=.51, p<.001, establishing the HPSQ-C's concurrent validity. Construct validity was also confirmed. Results demonstrated that the HPSQ-C significantly distinguished between children with and without handwriting deficiencies on the basis of measures of handwriting product (Hebrew Handwriting Evaluation) and handwriting process (Computerized Penmanship Evaluation Tool). The HPSQ-C is suitable for identification of handwriting deficiency among school-aged children and is appropriate for varied academic and clinical uses.

Cross-cultural Adaptation, Internal Consistency and Validity of the Handwriting Proficiency Screening Questionnaire (HPSQ) for Spanish Primary School-age Children

Aim: To translate and culturally adapt the HPSQ into Spanish and to obtain a reliable and viable version. Additionally, the psychometric properties of this new version, namely, the internal consistency and validity, were evaluated using a sample of 165 Spanish school-children. Methods: The sequence of this process was as follows: forward translation, synthesis, back-translation, expert committee review and pilot study. In forward and backward translation items were easy to translate and problems with cross-cultural adaptation were not found. Content validity was evaluated by using item-objective congruence (IOC) value. Internal consistency of the Spanish version was measured with Cronbach’s alpha coefficient; whereas principal-component factor analyses were used to explore construct validity. Results: The Spanish version of the HPSQ retains the characteristics of the English original, high internal consistency (Cronbach alpha value of 0.78) and good construct and content validity (IOC values above 0.7). Conclusion: The results indicate that the Spanish version of HPSQ is a reliable and valid instrument for handwriting evaluation in Spanish school-age children.

Handwriting features of children with developmental coordination disorder – Results of triangular evaluation

Developmental coordination disorders (DCD) is one of the most common disorders affecting school-aged children. The study aimed to characterize the handwriting performance of children with DCD who write in Arabic, based on triangular evaluation. Participants included 58 children aged 11-12 years, 29 diagnosed with DCD based on the DSM-IV criteria and the M-ABC, and 29 matched typically developed controls. Children were asked to copy a paragraph on a sheet of paper affixed to a digitizer supplying objective measures of the handwriting process. The handwriting proficiency screening questionnaire (HPSQ) was completed by their teachers while observing their performance and followed by evaluation of their final written product. Results indicated that compared to controls, children with DCD required significantly more on-paper and in-air time per stroke while copying. In addition, global legibility, unrecognizable letters and spatial arrangement measures of their written product were significantly inferior. Significant group differences were also found between the HPSQ subscales scores. Furthermore, 82.8% of all participants were correctly classified into groups based on one discriminate function which included two handwriting performance measures. These study results strongly propose application of triangular standardized evaluation to receive better insight of handwriting deficit features of individual children with DCD who write in Arabic.

Handwriting measures as reflectors of executive functions among adults with Developmental Coordination Disorders (DCD).

Planning ahead and organizational abilities in time and space are ingredients of high-level cognitive functions labeled as ‘Executive Functions’ (EF) required for daily activities such as writing or home management. EF deficits are considered a possible underlying brain mechanism involved in Developmental Coordination Disorders (DCD).The aim: of the study was to compare the handwriting process measures and the planning and organizational abilities in space and time of students with DCD with those of matched controls and to find whether handwriting measures can predict daily planning and organizational abilities among students with DCD.Method: 30 students diagnosed with DCD, between the ages of 24–41, and 30 age- and gender-matched controls participated in the study. They filled out the Handwriting Proficiency Screening Questionnaire (HPSQ) and the Adult Developmental Co-ordination Disorders Checklist (ADC). Furthermore, they copied a paragraph on a digitizer that is part of a computerized system Computerised Penmanship Evaluation Toll (ComPET).Results: Significant group differences were found for the HPSQ subscales scores as well as for the temporal and spatial measures of the paragraph copy task. Significant group differences were also found for the planning and organizational abilities in space and time as reflected through the ADC subscales. Significant medium correlations were found in both groups between the mean HPSQ time subscale and the ADC-B subscale mean score (r = 0.50/0.58, p < 0.05). Series of regression analyses indicated that two handwriting performance measures (mean HPSQ time subscale and mean stroke duration) predicted 19% of planning and organizational abilities as reflected through daily functions (ADC-B) [F(3, 54) = 38.37, β = 0.40, p < 0.0001].Conclusion: The results support previous evidence about EF deficits as an underlying brain mechanism involved in motor coordination disorders, their significance as related to theoretical models of handwriting and daily function among DCD will be examined.

The effects of protracted graphomotor tasks on tripod pinch strength and handwriting performance in children with dysgraphia

Purpose. To examine the impact of prolonged graphomotor tasks on tripod-pinch strength and on handwriting process and product measures of children with dysgraphia and typical peers.Method. Participants were 51 children in third to fifth grades, divided into two groups: 23 children with dysgraphia and 28 typical peers, as determined by the Handwriting Proficiency Screening Questionnaire. The procedure included two sessions, with a 15-min break between sessions. In each session, the participants performed two tasks: the visual-motor control subtest of Bruininks-Oseretsky and a handwriting copying task, both performed on an electronic tablet as part of the Computerised Penmanship Evaluation Tool. Tripod pinch strength was evaluated before and after each session.Results. Significantly lower tripod-pinch strength was found among children with dysgrphia in comparison to typically developed peers. This deterioration in tripod-pinch strength was associated with a significant deterioration in handwriting process and product measures along the protracted task.Conclusions. Pinch force that is required for mastering the handwriting tool needs to be considered in the evaluation process of children with dysgraphia. Combining the pinch factor with an evaluation of handwriting's process and product may supply a better insight about the child's deficits and assist in focusing treatment objectives.

Relationships between handwriting performance and organizational abilities among children with and without dysgraphia: A preliminary study

Organizational ability constitutes one executive function (EF) component essential for common everyday performance. The study aim was to explore the relationship between handwriting performance and organizational ability in school-aged children. Participants were 58 males, aged 7–8 years, 30 with dysgraphia and 28 with proficient handwriting. Group allocation was based on children's scores in the Handwriting Proficiency Screening Questionnaire (HPSQ). They performed the Hebrew Handwriting Evaluation (HHE), and their parents completed the Questionnaire for Assessing Students’ Organizational Abilities-for Parents (QASOA-P). Significant differences were found between the groups for handwriting performance (HHE) and organizational abilities (QASOA-P). Significant correlations were found in the dysgraphic group between handwriting spatial arrangement and the QASOA-P mean score. Linear regression indicated that the QASOA-P mean score explained 42% of variance of handwriting proficiency (HPSQ). Based on one discriminant function, 81% of all participants were correctly classified into groups. Study results strongly recommend assessing organizational difficulties in children referred for therapy due to handwriting deficiency.

Development, Reliability, and Validity of the Handwriting Proficiency Screening Questionnaire (HPSQ)

This study was used to (1) develop an occupational therapy screening questionnaire (the Handwriting Proficiency Screening Questionnaire [HPSQ]) to identify handwriting difficulties among school-aged children and (2) examine its reliability and validity. The questionnaire's content validity was established. Internal consistency, interrater and test-retest reliability, and concurrent and construct validity were initiated. Participants included 7- to 14-year-old (N = 230) typically developing school-aged children. The tool demonstrated good internal consistency (alpha = .90). Test-retest reliability for the score revealed an intraclass correlation coefficient (ICC) of .84 and interrater reliability of ICC = .92 for the total questionnaire score. Construct and concurrent validity were also confirmed. The HPSQ is suitable for use by occupational therapists for identification of handwriting deficiency among school-aged children and is appropriate for varied academic and clinical uses. More studies with larger samples of varied age groups are required to further support the questionnaire's reliability and validity.