This study investigated differences in perceptual-motor measures and sustained attention between children with slow and normal handwriting speed and the relationship between these factors. Thirty-four slow handwriters and 35 normal speed handwriters (7 to 11 years of age) attending elementary schools in Taiwan were given three perceptual-motor tests and a vigilance task to assess sustained attention. Performances on these measures were analyzed using multivariate analysis of variance and regression analyses. A significant difference was found between slow and normal handwriters in upper-limb coordination, visual memory, spatial relation, form constancy, visual sequential memory, figure ground, visual-motor integration, and sustained attention. The three significant predictors of handwriting speed for the slow handwriters were age, visual sequential memory, and visual-motor integration. For the normal speed handwriters, age and upper-limb speed and dexterity were the only two significant predictors. Slow and normal speed handwriters responded to handwriting demands through different perceptual-motor systems. Whereas upper-limb speed and dexterity seems to play an important role in normal speed handwriters, slow handwriters seem to rely more on visually directed processes, including sequence memory and visual-motor integration.
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