Legibility Scores Research Articles

How well are we prescribing medications to our children?

Introduction: Prescription errors are common and every step in the process of writing a prescription has the potential for error. These errors can be broadly attributed to the lack of knowledge or lack of skill. Poor legibility, inaccuracy in writing, incomplete prescriptions, omissions, and use of abbreviations are the most common type of errors. Objectives: The primary objective of our study was to assess the completeness and legibility of the prescriptions. This is to estimate the rates of skill-based errors. Secondary objective of this study was to assess the appropriateness of the prescriptions using the pediatrics: Omission of Prescriptions and Inappropriate prescriptions (POPI) tool. Methods: This was a cross-sectional study, conducted in the pediatric outpatient department of a tertiary teaching hospital in New Delhi, India. Prescriptions received by outpatients attending both the general and special pediatric clinics were collected and evaluated using the World Health Organization Guide to Good Prescribing and the Medical Council of India guidelines. Results: A total of 343 prescriptions were assessed, in which 753 drugs were prescribed. A total of 1709 errors were uncovered pertaining to the completeness of the prescription. A majority of the prescriptions were written by postgraduates trainees (206), followed by senior residents (61), consultants (42), and junior residents (20). Abbreviations were used while mentioning the drug names in 53.64% prescriptions. The mean legibility score of all prescriptions was 3.35. Forty (11.66%) prescriptions were found inappropriate as per the International POPI tool. Conclusion: The legibility and completeness are largely overlooked yet crucial to the “Art of Prescription Writing.” They deserve as much awareness and education as the appropriateness of the drugs prescribed. The international POPI tool is a promising tool to analyze the appropriateness of pediatric prescriptions.

Towards Removal of Shadows Caused due to Object Interferences in Smartphone Captured Document Images using Multiple Mask Generation Technique

Shadows cause a reduction of text legibility and contrast of the overall document, leading to poor recognition rates by Optical Character Recognition (OCR). Shadows were cast during photo capturing because of object interferences due to projection angle from illumination sources and are challenging to handle by OCR. This work proposes an automated technique to detect the shadows caused by object interferences and eliminate them from document images. The proposed algorithm generates two reference masks of shadow and non-shadow regions using a global thresholding method to detect and remove shadow. Initially, the document image is pre-processed, followed by mask generation for shadow and non-shadow regions, and finally, a global thresholding strategy that removes the shadow using an image mapping technique. To evaluate the effectiveness of the proposed approach, a dataset of real-world smartphone-captured document images of about 300 is considered. The datasets encompass Mobile Dataset 3 and Mobile Dataset 4 from DIBCO datasets. Experiments are conducted to quantify the efficiency of the proposed approach using performance measures such as recognition rate by OCR, presentation score, legibility score, skew, and overall document quality score. From the results, the proposed approach collectively produces an average recognition rate of 87.15% and 81.50% towards word-level recognition of Mobile Datasets 3 and 4. The text quality of the document image post shadow removal procedure achieves a higher performance score with an average presentation score of 0.35, legibility score of 0.78, skew as 73.45 degrees from the horizontal axis, and overall document quality score above six towards datasets considered. Based on qualitative analysis, comparative analysis proves that the proposed is simple yet more proficient than existing methods.

Examining the Association Between the Computer-Aided Scoring and Manual Scoring for the Beery Buktenica Developmental Test of Visual Motor Integration (Beery VMI) and Children’s Handwriting Skills: A Convergent Validity Study

ABSTRACT Introduction Visual motor integration (VMI) is an important underlying mechanism for children’s handwriting. The Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) is commonly used to assess children’s VMI skills, using a manual scoring method which can be prone to individual subjectivity and impact its sensitivity. This study investigated the use of the Computer-Aided Scoring System for scoring the Berry VMI (CASS-Beery VMI) to assess school-aged children’s VMI and handwriting skills. Specifically, the convergent validity between the CASS-Beery VMI and three standardized handwriting assessments was investigated. Methods A quantitative cross-sectional design was used. Thirty-five neurotypical Australian students aged 6–9 years completed the Beery-VMI–6th edition, Minnesota Handwriting Assessment (MHA), Evaluation Tool of Children’s Handwriting – Manuscript (ETCH-M) and the Here’s How I Write Assessment – Child version (HHIW-C). The Berry-VMI was scored using its original scoring method and the CASS-Beery VMI. Thirty parents of the child participants completed the Here’s How I Write Assessment – Parent version (HHIW-P). Descriptive statistics, Spearman rho correlations and regression analyses using bootstrapping were completed. Results The CASS-Beery VMI error scores were significantly correlated with the Beery-VMI score, and subscales of the MHA, ETCH and HHIW-P scores (r = 0.341– −0.555; p = .045–0.001). The CASS-Beery VMI error scores and Beery VMI raw scores were found to be significant predictors of the ETCH-M number legibility scores (adjusted R2 = 0.209; p = 0.017) and MHA form scores (adjusted R2 = 0.220; p = 0.007). Individually, the CASS-Beery VMI score was a significant predictor of the ETCH-M word legibility scores (Adjusted R2 = 0.305; p = 0.001). Conclusion Findings indicate that the CASS-Beery VMI can be used to assess children’s VMI skills. The significant correlations between the CASS-Beery VMI and other standardized handwriting assessments (MHA, ETCH-M and HHIW) adds to the body of convergent validity evidence that the CASS-Beery VMI can be a sensitive scoring method for Beery VMI when assessing children’s handwriting performance.

Intensive training programme improves handwriting in a community cohort of people with Parkinson’s disease

BackgroundPeople with Parkinson’s disease (PwP) often report problems with their handwriting before they receive a formal diagnosis. Many PwP suffer from deteriorating handwriting throughout their illness, which has detrimental effects on many aspects of their quality of life.AimsTo assess a 6-week online training programme aimed at improving handwriting of PwP.MethodsHandwriting samples from a community-based cohort of PwP (n = 48) were analysed using systematic detection of writing problems (SOS-PD) by two independent raters, before and after a 6-week remotely monitored physiotherapy-led training programme. Inter-rater variability on multiple measures of handwriting quality was analysed. The handwriting data was analysed using pre-/post-design in the same individuals. Multiple aspects of the handwriting samples were assessed, including writing fluency, transitions between letters, regularity in letter size, word spacing, and straightness of lines.ResultsAnalysis of inter-rater reliability showed high agreement for total handwriting scores and letter size, as well as speed and legibility scores, whereas there were mixed levels of inter-rater reliability for other handwriting measures. Overall handwriting quality (p = 0.001) and legibility (p = 0.009) significantly improved, while letter size (p = 0.012), fluency (p = 0.001), regularity of letter size (p = 0.009), and straightness of lines (p = 0.036) were also enhanced.ConclusionsThe results of this study show that this 6-week intensive remotely-monitored physiotherapy-led handwriting programme improved handwriting in PwP. This is the first study of its kind to use this tool remotely, and it demonstrated that the SOS-PD is reliable for measuring handwriting in PwP.

Analysis of the Writings of Fourth Grade Students with Low Vision in Terms of Legibility and Spelling Mistakes

This descriptive study, which aims to analyse the writings of fourth grade students with low vision in terms of legibility and spelling mistakes, is in a general survey design. The study group consisted of 32 students with low vision who were selected by criterion sampling method, one of the purposive sampling methods. In the study, Multidimensional Legibility Scale was used to evaluate the legibility of the writings of students with low vision, and Spelling Mistakes Evaluation Form developed by the researcher to determine the spelling mistakes. In the analysis of the data, Mann-Whitney U test was used together with descriptive analysis. As a result of the research, it was determined that the writings of fourth grade students with low vision were generally not legible or were legible at a moderate level. In terms of spelling mistakes, it was observed that fourth grade students with low vision made the most mistakes in “letters”, “words”, and “spelling”. “Writing the letter smaller / bigger than the relevant range” was the most frequent, and suffix (“ki”) was the least misspelled. It was determined that the legibility and spelling mistakes scores of fourth grade students with low vision did not differ according to the variables of gender, school type, and braille writing. On the other hand, a significant and negative correlation was found between spelling mistakes and legibility scores. The findings were discussed within the framework of the relevant literature, and some suggestions for future studies and applications in the field were presented.

The relationship between muscle activation and handwriting quality with non-native grip styles

PurposeThis study aimed to explore the differences in muscle activity, handwriting legibility, and consistency when using the 4 primary handwriting grip styles: dynamic quadrupod (DQ), dynamic tripod, lateral quadrupod (LQ) and lateral tripod. Study Design and MethodsThirty-four 18-22-year-old participants completed a handwriting legibility test on paper as well as consistency and metrics tests using both surface electromyography and a digital writing tablet. Electromyography was used to measure the activity of 6 muscles associated with handwriting, and the tablet measured stroke duration, length, velocity, and pen pressure. Subjects used each grip style with all protocols and scores were normalized to their native grip. Significance was set at P < .05. ResultsFemales had a lower range in legibility scores than males by 3.5% ± 1.7% (p = .046, d = 0.713), but grip style did not impact legibility. The upper trapezius (UT) was more active in the lateral tripod and LQ grips compared to DQ by 16.8% ± 5.2% and by 13.8% ± 5.2%, (p = .007, p = .012, respectively, partial η2 = 0.188). The stroke duration was greater in the LQ grip style than dynamic tripod and DQ grip styles (p = .008, p = .023, respectively; partial η2 = 0.123). ConclusionsLateral grip styles involve more whole-arm, stabilizing movements while dynamic grip styles require fine dexterous movements. Furthermore, females are likely to be able to employ any grip with minimal effect on legibility. For a patient needing guidance in rehabilitation, understanding the differences in grips could aid selection of the optimum grip style to employ based on their muscular control deficits.

A quantitative study on the relationship between grasp and handwriting legibility: does grasp really matter?

ABSTRACTLiterature has indicated conflicting results regarding the relationship between grasp patterns and legible handwriting. Historically, the dynamic tripod grasp was viewed as the gold standard, but more recent literature indicates that grasp may not have as much of an effect on handwriting legibility as once thought. The purpose of this study is to contribute to this evidence regarding the relationship between grasp and handwriting legibility. The Print Tool, Test of Handwriting Skills-Revised, and a researcher-developed grasp checklist were administered to first- and second-grade students (N = 46). The inference between immature versus mature grasps in relation to legibility remains undetermined. However, there were no statistically significant differences between legibility scores on these two assessments for first- and second-grade students when grouped by pencil grasp. Further research is necessary regarding the relationship of mature versus immature grasps and handwriting legibility.

Reading and Writing Skills in Children With Specific Learning Disabilities With and Without Developmental Coordination Disorder.

This pilot study is to investigate the influence of a developmental coordination disorder (DCD) comorbidity in a group of children with learning disability (LD). Reading and writing were assessed to investigate if the coexistence of a motor impairment can worsen writing quality, speed, and reading accuracy. A sample of 33 LD children (aged 7-11 years) was divided in two subgroups, on the base of their scores on the Movement Assessment Battery for Children: LD-only (n = 14) and LD with a comorbidity for DCD (LD-DCD, n = 19). No differences were found in handwriting speed, but significant differences were found in handwriting quality: LD-DCD children showed a worst performance. Reading words and nonwords accuracy was more impaired in LD-only children than in LD-DCD children. Group differences suggest a poorer phonological decoding of the LD-only sample, whereas worst cursive handwriting legibility scores are typical of the motor-impaired subgroup.

Construction and validation of logMAR visual acuity charts in seven Indian languages.

Purpose:The evaluation of visual impairment requires the measurement of visual acuity with a validated and standard logMAR visual acuity chart. We aimed to construct and validate new logMAR visual acuity chart in Indian languages (Hindi, Bengali, Telugu, Urdu, Kannada, Malayalam, and Assamese).Methods:The commonly used font in each language was chosen as the reference and designed to fit the 5 × 5 grid (Adobe Photoshop). Ten letters (easiest to difficult) around median legibility score calculated for each language based on the results of legibility experiment and differing by 10% were selected. The chart was constructed based on the standard recommendations. The repeatability of charts was tested and also compared with a standard English Early Treatment Diabetic Retinopathy Study (ETDRS) logMAR chart for validation.Results:A total of 14 rows (1.0 to -0.3 logMAR) with five letters in each line were designed with the range of row legibility between 4.7 and 5.3 for all the language charts. Each chart showed good repeatability, and a maximum difference of four letters was noted. The median difference in visual acuity was 0.16 logMAR for Urdu and Assamese chart compared to ETDRS English chart. Hindi and Malayalam chart had a median difference of 0.12 logMAR. When compared to the English chart a median difference of 0.14 logMAR was noted in Telugu, Kannada, and Bengali chart.Conclusion:The newly developed Indian language visual acuity charts are designed based on the standard recommendations and will help to assess visual impairment in people of these languages across the country.

Effect of Dravidian vernacular, English and Hindi during onscreen reading text: A physiological, subjective and objective evaluation study

Multilingualism has become an integral part of our present lifestyle. India has twenty two registered official languages with English and Hindi being most widely used for all official activities across the nation. As both these languages are introduced later in life, it was hypothesised that comprehensive reading will be better and faster if the native medium was used. Therefore present study aimed to evaluate the differences in performance while using one of the four Indian Dravidian vernaculars (Tamil, Telugu Kannada and Malayalam) and two non-vernacular (English and Hindi) languages for onscreen reading task. A multi-dimensional approach including physiological (Eye movement recording), subjective (Language Experience And Proficiency Questionnaire, LEAP-Q, Legibility rating) and Objective (Reading time and Word processing rate) measurements were used to quantify the effects. Forty-four Indian infantry soldiers from each of the Dravidian language groups participated in the study. Volunteers read aloud two simple story passages onscreen in their respective vernacular and non-vernacular languages using both time bound and self-paced reading mode. Reading time was lower and word processing rate was higher respectively in case of vernacular than non-vernacular. Consideration of fixation count in both the modes of reading indicated better performance with vernaculars. Legibility score was better in Dravidian languages than others. Results indicated that reading text was faster in vernacular media followed by English and Hindi. Use of vernaculars in onscreen text display of high density workstation may therefore be recommended for easier and faster comprehension

Handwriting Legibility in Healthy Older Adults

ABSTRACTAims: Handwriting processes deteriorate with age and following neurological conditions. Improving handwriting is often a focus of rehabilitation. Yet knowledge of handwriting legibility in the elderly is limited. This study describes the distribution of handwriting legibility scores in healthy older adults, relationships between handwriting legibility, age and writing task, and reliability of rating procedures. Methods: A cross-sectional study design was used involving 120 healthy older Australians. Tasks included writing sentences, shopping lists and transcribing a telephone message. Legibility was scored using the modified Four Point Scale—version 2. Results: Legibility differed between tasks but was not related to increasing age. Conclusions: Impaired handwriting legibility in the elderly is less likely due to the effects of aging than the required task or medical conditions. Findings from this study may help therapists set intervention goals and measure legibility changes during handwriting retraining.

Examining the relationship between motor assessments and handwriting consistency in children with and without probable developmental coordination disorder.

Children with Developmental Coordination Disorder (DCD) often experience difficulties in handwriting. The current study examined the relationships between three motor assessments and the spatial and temporal consistency of handwriting. Twelve children with probable DCD and 29 children from 7 to 12 years who were typically developing wrote the lowercase letters "e" and "l" in cursive and printed forms repetitively on a digitizing tablet. Three behavioral assessments, including the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), the Minnesota Handwriting Assessment (MHA) and the Movement Assessment Battery for Children (MABC), were administered. Children with probable DCD had low scores on the VMI, MABC and MHA and showed high temporal, not spatial, variability in the letter-writing task. Their MABC scores related to temporal consistency in all handwriting conditions, and the Legibility scores in their MHA correlated with temporal consistency in cursive "e" and printed "l". It appears that children with probable DCD have prominent difficulties on the temporal aspect of handwriting. While the MHA is a good product-oriented assessment for measuring handwriting deficits, the MABC shows promise as a good assessment for capturing the temporal process of handwriting in children with DCD.

Development of Pocket Vision Screener and its effectiveness at screening visual acuity deficits.

Aim:The aim was to construct a visual acuity chart and find its effectiveness at screening visual acuity deficits.Materials and Methods:Two phases were involved in this study. Construction of the screener: Ten Sloan letters (C, D, H, K, N, O, R, S, V, and Z) were selected and the letters were constructed and reduced to 0.2 logMAR acuity size (6.92 mm) for viewing at 3 m. The screener contains three lines with seven letters in each. Few combinations of the seven letter sequences were chosen based on the row legibility scores. Three seven letter combinations close to the median of all combinations were selected, such that maximum difficulty score difference between the lines are <1%. Finding the effectiveness of the screener: 100 literate subjects with unaided visual acuity better than or equal to 6/60 were recruited for the study. Unaided visual acuity was tested using both the newly constructed Pocket Vision Screener and a logMAR visual acuity chart and the time taken to measure the visual acuity using both the charts was noted.Results:The mean age of the subjects was 43 ± 17 years. Subjects were classified as normal or deficient based on the logMAR visual acuity measurement. The screener was found to have 81% sensitivity, 94% specificity. The positive and negative predictive values were found to be 91% and 87%, respectively. A significant difference (P < 0.001) was found in the time taken to record visual acuity using both the charts.Conclusion:The Pocket Vision Screener can be used as a quick and accurate tool to screen subjects for visual acuity deficits, being highly sensitive, specific, and cost-effective.

From knife to paper: an audit of surgical communication

Purpose – The paper aims to assess the quality (content and legibility) of handwritten operation notes and the reader's interpretation of legibility by clinical seniority. Design/methodology/approach – Consecutive elective and emergency general surgical operations over a six-week period from September 2011 at one hospital were retrospectively collected. Non-retrieval of operation notes, typed notes and endoscopies were excluded. The content of each operation note was assessed against a 26-item checklist. Legibility was assessed by 4 readers (2 Foundation Doctors and 2 Registrars in General Surgery) using an original objective scoring system. Findings – A total of 404 operations were identified; 45 were excluded following review of operation notes. Operation notes were derived from 12 consultants and 11 registrars. Analysis of the content score suggested that time of procedure (1 per cent), ASA grade (1 per cent) and blood loss (5 per cent) were poorly reported. Clinical indication and post-operative instructions were documented in only 52 per cent and 66 per cent of operation notes respectively. Registrar notes had a higher content score compared with consultant notes (15.8 vs 13.5, p&lt;0.001). Legibility scores were reported to be higher for Registrar readers, compared with Foundation Doctor readers (OR 1.95, 95 per cent CI 1.75-2.18, p&lt;0.001). Registrar-written notes had higher legibility scores compared with consultants (OR 19.0, 95 per cent CI 11.6-31.2, p&lt;0.001). Research limitations/implications – The quality of handwritten notes varies. Registrar-written notes are more content-rich and legible. Practical implications – Clinical seniority and specialty training may improve the interpretation of handwritten operation notes. This study adds to growing evidence supporting the widespread adoption of a computerized immediate operation note. Originality/value – An objective scoring system to assess legibility of operation notes written as freehand was used. Also, legibility according to the reader's seniority in clinical training was evaluated.

Quality of surgical case notes at Dow University Hospital according to modified ANKLe score

To find out quality of surgical case notes according to modified Adjusted Note keeping and Legibility (ANKLe) score in Dow University Hospital. For this audit, medical records of all the patients admitted in Dow University Hospital surgery department were reviewed from February 2012 to April 2012. The modified ANKLe score (total 24) is formed by the combination of, the content (out of 20) and legibility (out of 4) to give an overall score out of 24. A score of at least 20 (content score 17/20; legibility score 3/4) is considered as acceptable. It means that a surgical record is legible and the majority of the essential content is recorded. A total of 236 records were evaluated. Overall mean ± standard deviation (SD) of ANKLe score was 18.4± 2.1 out of maximum score of 24. Content and legibility has overall mean scores of 14.4 out of 20 and 3.9 out of 4 respectively. Only two variables, patient's name and consultant on call were documented in 100% of records while the least documented variable were social history 2 (0.2%). Legibility scoring system provides that 218notes out of total set of 236 notes (that is 92.4% of overall notes) have achieved a score of 4. The benchmark of 80% was achieved in 26.1% for total ANKLe score, 6.8% for contents and 99.1% for legibility. Overall, quality of records is not good but legibility part scores exceptionally high.

Quality of Prescriptions in a Tertiary Care Hospital in South-West Nigeria

Article history: Received on: 16/07/2013 Revised on: 30/08/2013 Accepted on: 09/09/2013 Available online: 30/09/2013 The quality of prescribing influences to a large extent the health outcomes of patients as errors made could result in adverse drug reactions. The aim of this study was to assess the quality of prescription written by medical doctors in a tertiary healthcare facility in rural south-west Nigeria. A cross-sectional retrospective analysis of randomly selected prescriptions from all adult outpatient clinics of the hospital between October 1, 2010 and March 31, 2011 was carried out. The prescriptions were checked for the completeness of the patients’ bio-data (name, age, sex, and hospital number), accuracy of drug dosage and formulation, prescribing by generic name, use of abbreviation, legibility of prescriber’s writing, the name and signature of the prescriber. Six hundred and two (602) prescriptions were collected and used for analysis. A total of 2167 medications were prescribed with a mean of 3.6 ± 1.6 per encounter. All the prescriptions had patient’s name and hospital numbers written. The age, hospital number and address of the patients was recorded in 421 (69.9%), 480 (79.7%) and 323 (53.7%) respectively. The doctor’s name, signature and date of encounter was indicated 587 (97.5%), 546 (90.7%) and 556 (92.7%) respectively. The mean legibility score was 2.53 ± 0.51 out of a possible score 4. The findings of our study show that there is a need for improvement in the quality of prescription written by Nigerian doctors. The adoption of a computer –aided prescribing system would go a long way in achieving this objective.

Writing with non-dominant hand: left-handers perform better with the right hand than right handers with the left

Adult volunteers (7 females, 7 males) aged between 19 and 51 years, 7 right-handers and 7 left-handers, were asked to complete re-training writing tasks by using their non-dominant hand over 10 consecutive days. It is possible for adults to learn quickly to write legibly with their non-dominant hand. Left handers have a higher legibility score initially although right-handers improved with training more than left-handers. Individual’s performance was unrelated to age and sex in the small sample studied.

Validating the Use of the Evaluation Tool of Children’s Handwriting–Manuscript to Identify Handwriting Difficulties and Detect Change in School-Age Children

In this study we sought to validate the discriminant ability of the Evaluation Tool of Children's Handwriting-Manuscript in identifying children in Grades 2-3 with handwriting difficulties and to determine the percentage of change in handwriting scores that is consistently detected by occupational therapists. Thirty-four therapists judged and compared 35 pairs of handwriting samples. Receiver operating characteristic (ROC) analyses were performed to determine (1) the optimal cutoff values for word and letter legibility scores that identify children with handwriting difficulties who should be seen in rehabilitation and (2) the minimal clinically important difference (MCID) in handwriting scores. Cutoff scores of 75.0% for total word legibility and 76.0% for total letter legibility were found to provide excellent levels of accuracy. A difference of 10.0%-12.5% for total word legibility and 6.0%-7.0% for total letter legibility were found as the MCID. Study findings enable therapists to quantitatively support clinical judgment when evaluating handwriting.

The Effect of Form Factors and Control Types on Unsorted List Search for Full Touch Phone

Objective: The aim of this paper is to inquire into the influences form factors and control types affect a search time and comfort at list menu of full touch phone. Background: Various studies have been proceeded that are related to the optimum touch area for enhancing usability of control and legibility in mobile touch device. In the environment of list menu which is widely used to provide various information effectively, however, not only comprehensive consideration for legibility and control is to be seek but also research for control type which is to scroll a list. Method: This study executed form factor experiment to inquire into the influence that font size, height of row and fixed area affect searching time and comfort in the while information processing even if the information on the list is unsorted in alphabetical order. Among the result of form factor experiment, control type experiment was executed by selecting shortest performance time, highest legibility comfort and control comfort. Control type experiment was implemented to figure out the influence which existing flicking type, scrolling bar type, newly established button page type and button raw types affect performance time and subjective comfort depending on location of the information. Results: Font size 12pt, height of row 7mm and fixed area 15mm was shortest performance time and got highest comfort and legibility score in form factor experiment. A Button page which was newly proposed type was shortest performance time and got highest comprehensive comfort in control type experiment. Conclusion: Form factor experiment showed similar results with the study through reading a long passage of character or controlling a grid icon type. However, height of row turned out to affect not only touch area for control but also legibility by ruling space between the lines. Button page type which was newly proposed showed shortest performance time and got highest comprehensive comfort. Because Button page type needs few finger movements than other control types and implements search in the fixed form, unlikely other type which list keeps moving. Application: This study should be applied in deciding form factors and control type for scroll when designing a list menu of full touch phone.

Randomised controlled trial comparing two school furniture configurations in the printing performance of young children with cerebral palsy

This randomised controlled trial compared the same-session effects of two different school furniture configurations on printing legibility. A total of 30 school-age children with ambulatory cerebral palsy participated in this study. Each child provided one near-point printing sample of up to 34 letters while positioned on Mandal-type specialty school furniture and on standard school furniture. An assessor who was unaware of the intervention assignment scored printing errors. No significant difference in legibility score mean values between the interventions was detected and the effect size was small. Compared with standard school furniture, the use of specialty school furniture did not lead to immediate gains in printing legibility and other printing performance areas for children with cerebral palsy. Further study of the influence of functional abilities, other contextual factors and the longer-term use of school furniture on handwriting performance is recommended.