Viewing development through an occupational lens: learning to handwrite.

Handwriting is a valued childhood occupation (Amundson, 1992), and considered a prerequisite for later academic achievement (Feder & Majnemer, 2007; Graham Berninger, Abott, Abott & Whitaker, 1997; Graham & Harris, 2000). A child's developing sense of self occurs through opportunities for engagement in challenging occupations (Farnworth, 2000; Passmore, 2003) which society deems meaningful and important. Success in learning to handwrite can build a child's self-esteem (Sassoon, 1990; Stewart, 1992), and foster feelings of emotional well-being and social functioning (Cornhill & Case Smith, 1996). Therefore engagement in the task of handwriting is of concern to occupational therapists as difficulties engaging in this occupation can have negative effects on a student's occupational development.

There is a growing expectation for occupational therapists to complete handwriting interventions in the context in which they occur. To do this well, occupational therapists need to understand the relationship between the teachers' task of teaching handwriting and the students' role in learning to handwrite both of which are influenced by the person, occupation and environment fit. This research article considers the human environment of the teacher in the co-occupation of learning to handwriting. Acknowledging the classroom context and the teacher's role in the task of learning to handwrite reflects the professions move to complete interventions within the naturally occurring environments. To facilitate understanding of the context and process this qualitative research study asked six new entrant teachers: How do new entrant teachers teach handwriting to year one students, while acknowledging the physical and sociocultural environments which shape their practice?

Literature search

The traditional handwriting approaches used by occupational therapists to address handwriting difficulties focus on areas such as pencil grip, seating posture, co-ordination of the muscles of the hand as well as visual perception. This way of approaching an occupational concern is often referred to as 'bottom-up' approach (Ideshi, 2003; Weinstock-Zlotnick & Hinojosa, 2004). This approach fitted well with the medical model emphasis on 'fixing the problem'; the problem being an outcome of delayed or altered developmental processes. The three main approaches guiding reasoning behind this way of thinking are the biomechanical, neuromuscular, and multisensory approaches (Admundson, 1992).

Multisensory or the sensorimotor approach is still very popular as a way of addressing handwriting difficulties (Feder, Majnemer & Synnes, 2000; Woodward & Swinth, 2002). In this approach to handwriting the therapist provides various sensory experiences such as writing in shaving cream or writing with chalk. The assumption being that if the task of handwriting is learnt through a variety of sensory mediums it will assist in the child's learning (Admundson, 1992). The biomechanical approach and the neuromuscular approach place a larger emphasis on the sitting posture of the child and the development of the hand muscles and pencil grasp.

These bottom-up perspectives provide useful information from a body structures perspective (World Health Organisation, 2001) enabling therapists to consider the component skills that influence a task. However, to adequately express our unique role in supporting children with handwriting difficulties, inquiry methods that reflect our professional paradigm of occupational based intervention are required (Humphry & Wakefield, 2006). This perspective provides occupational therapists with a way to view child development and childhood tasks through an 'occupational lens' (Davis & Polatajko, 2004). The benefits of such a view have been validated through research (Chapparo & Hooper, 2002; 2005; Wiseman, Davis, & Polatajko (2005).

An occupational lens

Inquiry using an occupational lens broadens the knowledge already gathered on hand development and handwriting to also include expectations, experiences, and meaning surrounding the task (Lawlor, 2003). Opportunities for increased awareness of the interactions that occur between the child and the environment, both human and non human can also be facilitated (Nelson, & Jepsen-Thomas, 2003). Utilising an occupational lens therefore supports the premise that learning to handwrite is the result of a person, task and environment interaction. In acknowledging the interactions between these three factors (person, task and environment) therapists' interventions can move closer to the modern consultative service delivery models endorsed by the Ministry of Education (Hasselbusch, 2007). This also reflects contemporary professional beliefs about the importance of participation, belonging, and connectedness (Wilcock, 2006). These contemporary professional beliefs are often initiated by using a top down approach and enabled by engaging in services that occur in the tasks natural context. This type of service is often described as ecologically based services.

Ideshi (2003) defines 'top down' approach as looking at the life role or occupations which are meaningful to the person as the first point of inquiry. For children, top-down inquiry starts with participation (Primeau & Ferguson, 1999). Participation for children is often dependent on the adults in their lives being able to afford (to give) them opportunities which are growth-enhancing and assist the child to develop skills which will allow a positive future (Primeau & Ferguson, 1999). Teachers, especially teachers of new entrant children, offer the opportunity to learn handwriting in a structured way. Therefore when studying children's participation in handwriting, inquiry needs to start with this group. The teacher is central to the experience of learning to handwrite as they influence what is done, and how it is done. To frame this research a basic understanding of the educational context which influences teaching practices needs to be considered.

Aotearoa / New Zealand education context

Educational context is greatly influenced by the policy and resources available to support teacher training and in classroom practices. Educational resources include the Formation Guide (Department of Education, 1985) and the English Curriculum Guidelines (Ministry of Education, 1994). These documents among others (Ministry of Education, 1992, 2003) reveal the beliefs and long-held traditions which form the fundamental nature of how literacy is taught in Aotearoa/New Zealand. The term "wholeness of letters" (Robinson, 2008, p. 42) captures the belief that letters have a voice, shape, form, and name.

The wholeness of letters

Educationalists see handwriting as more than a visual motor task. Handwriting is viewed by the Ministry of Education (2003) as an encoding task, holistic in that it requires the skills of doing, listening, and seeing to be taught simultaneously. The specific teaching of these three skills, mirrors Clay's (1991) concept of a flexible networking system. Clay, an Aotearoa/New Zealand expert on literacy felt that some sort of memory system pulls all the components of literacy together. In particular she felt the act of 'doing', that is the act of 'learning to read' by reading and 'learning to write' by writing provided children with the opportunity to network vast amounts of knowledge together in varied ways. For a flexible networking system to develop Clay advocated that teaching across all sensory areas of doing, listening, and seeing is required. In short handwriting, spelling, reading and creation of written messages should be taught together and in this way the child gains a holistic understanding of literacy.

Documents reflecting the educational context of Aotearoa/New Zealand assist in understanding some of the reasons teachers teach handwriting in the ways they do. Education documents provide guidance, but these are not prescriptive. Therefore the only way to obtain first hand information about how handwriting is taught in Aotearoa/New Zealand is to ask teachers currently teaching within this context, specifically teachers who teach new-entrant children, how to handwrite. This identified need guided the development of the research question. Ethics approval was obtained from Otago Polytechnic Ethics Committee on 13/09/2006.

Method

The research methodology for this study was designed to capture the teachers' voice and the context influencing this voice. Yin (1994) and Stake (1995) identified a qualitative instrumental collective case study using a semi-structured interview format as the most effective design. Stake (1995) also described this type of study as a collective, meaning more than one case study was explored. The collective case study was chosen over a single case study design because the ability to draw themes across cases from the data collected is a way of determining a shared cultural view (Nelson & Jepsen-Thomas, 2003).

Recruitment process

Initially eighteen potential schools were selected using the Directory of New Zealand Schools. This website was used to access contact addresses and to obtain information about the decile rankings of schools. An opportunity sampling method was used (Burns, 1994). All of the schools contacted fitted within the inclusion criteria of being a government-owned primary school, using English as their main language for teaching.

A decile rating of between 5 and 8 was determined to define the socio-economic status of the school as well as probable literacy achievement standards. McNaughton, Phillips and MacDonald (2003) demonstrated that although decile ratings did not make a difference in pupils' ability to acquire letter and phonological knowledge, markedly lower progress was noted for word recognition, writing words and text reading in children from lower decile schools. Since difference in literacy achievements have been correlated with the decile rating of the school, an attempt to limit this influence was made by accessing only schools in the mid range. This ensured neither a very high, nor a very low socio-economic makeup was represented within this study. Doing this eliminated other factors such as, language enrichment groups, and greater and lesser exposure to printed materials likely to affect the ways in which teacher's teach handwriting.

Invitations to take part in the study were initially sent to the school principal. Once approval was granted at the principal and board of trustee level, the invitation was forwarded to new entrant teachers with over two years of teaching experience within Aotearoa/New Zealand.

An exclusion criterion was developed to facilitate maintenance of participant safety. Any teacher or schools in which the researcher had worked within a professional or personal capacity in the past 12 months were excluded to ensure that participation was voluntary, and not a case of perceived obligation (Creswell, 1998).

Data collection

Interview was the main tool used to gather data on how teachers taught handwriting. An interview protocol which included semi-structured open-ended questions as well as a prompt sheet (Appendix 1) to assist the teachers reflections was provided to create "a framework for exploring experiences" (Maycutt & Morehouse, 1998 p. 89) and perceptions. Semi-structured interviews provided sufficient flexibility to gather similar data from each teacher's story while allowing room for each teacher to describe teaching handwriting in their own way. Enabling flexibility in how the teachers described how they taught handwriting provided further information into each teacher's individual style and the emphasis of their programme.

Interview process

The interviews were conducted in the teacher's classroom after the school day. Each participant was interviewed once. Interview times varied between one to one and a half hours in duration. Once the interviews were transcribed into written text they were sent to the participants for member checking (Creswell, 1998). Member checking is advocated as both a verification step and an analysis step; in that it provides the researcher an opportunity to get feedback from the participants ensuring that the researcher correctly captured their voice (Creswell, 1998). Minor changes were made to five out of six transcripts, mostly additional information or changes in terminology from informal language to formal e.g. kids to children.

Data analysis

On completion of member checking all the transcripts were read several times by the researcher, using open coding procedures. Common experiences, key words and explanations described by the teachers were identified and grouped into categories of similar meaning. The theme behind each of these categories was then given a heading for example, pencil grip. These categories were then compared to literature within the Aotearoa / New Zealand education context (Department of Education, 1985; Ministry of Education, 1992, 1994, 2003) and occupational therapy, specifically Larson (2006) and Humphry (2002), from this process the categories developed into themes.

The six teachers all taught multi-leveled handwriting programmes and their descriptions of how they taught handwriting reflected a belief that handwriting passed through three distinct stages. Each stage orchestrated by the teacher affected how the task of learning to handwrite was taught, the expectations they communicated to the students and what the teachers stated they observed the students doing. The teachers' expressed values, expectations and the tasks of handwriting were then compared to previous handwriting, motor learning and occupational science literature. In reflecting against this range of literature the following terms emerged, occupation, cyclic process and tool. The three stages are briefly defined and discussed.

Results

As illustrated in Figure 1, Stage One of learning to handwrite is labelled 'occupation'. The terminology occupation reflects an occupational science view that a defining criteria of children's occupations relates to the value others place on it (Humphry, 2002). Therefore the first stage of the handwriting process is highly valued by the teachers, and is consequently given an occupational status. The occupation stage is initially seen by the teachers as a process which assists the child to develop networks of understanding around knowledge of letters and literacy. Due to the process of forming internal networks (Clay, 1991) within the brain, the child's initial acquisition of learning to handwrite is slow. The child needs to create, then organise the information they gain from learning the wholeness of letters including the letter shape, name, formation and voice, (the sound it makes when spoken) (Clay, 1991; Robinson, 2008). Teachers value the building of foundational literacy networks, and consider the physical act of learning to handwrite an important task that facilitates this process. Consequently, it is the value teachers place on the task of handwriting and its connection to the child's development of learning to be literate, which supports the claim of this research that handwriting is initially viewed by teachers as an occupation.

[FIGURE 1 OMITTED]

The third stage is handwriting as a tool. Handwriting starts off as an occupation but is demoted to a tool once it can be completed with comfort and speed. At this stage the teachers believe that the child is not consciously thinking about the task of forming the letters, but is focused only on communicating a written message. Feder and Majnemer (2007) and Rosenblum, Weiss and Parish (2003) considered handwriting a tool which assists in enabling children to fulfill their occupational role of being a student. The terminology of tool to describe the last stage of the handwriting process was chosen to reflect this definition used by these authors.

Moreover, drawing from the teachers' stories, it appears that this process of handwriting as an occupation and handwriting as a tool also includes a stage in which the child continually shifts between learning to write--the occupation of handwriting and writing to convey a message--handwriting as a tool. This stage is described as a 'cyclic process'.

The stages of occupation, cyclic process and tool are physically seen through the child's speed of writing. In the occupation stage the child writes slowly, the teacher is able to verbally direct the child's pencil as they create the movements required for the formation of the letter. During the cyclic process stage the child is observed forming some letters effortlessly (quicker than the teacher can verbally guide the child) while other letters are still laborious in their formation. In the tool stage the teachers described handwriting being completed with comfort and pace (speed), all of the networks are formed and accessed in an automatic and effortless manner. Therefore speed is a key indicator as to whether the child is engaged in the occupation stage of handwriting, cyclic process or the tool stage. Alongside the child's ability to write with speed the teachers' interviews provided concrete examples of how the three stages of handwriting could be observed within a classroom setting. These concrete examples are outlined in the following table, they include the teachers' expectations, how the teacher orchestrated the task and the observable actions the teachers expected to see as the child participates in the task of learning to handwrite.

As outlined in Table 2, Stages of handwriting, teachers' expectations affect their observable practices, and these in turn affect the children's observable actions and experiences of learning to handwrite.

Discussion

This research frames handwriting as described by teachers through an occupation lens. As demonstrated in Table 2, an occupational lens enabled a new way of understanding the task of handwriting. Considering occupation, cyclic process, and tool stage of handwriting expands on the normal observations by occupational therapists of posture, pencil grip, legibility and speed (Chu, 1997; Cornhill & Case-Smith, 1996; Erhardt & Meads, 2005). This alternative view may assist therapists to view students participating in the dynamic teacher student co-construction surrounding the task of hand writing. Co-construction acknowledges shared influences that both the teacher and child bring to the task of learning to handwrite. The teacher brings expectations and strategies while the child brings current understanding around the 'wholeness of letters' and participation in the task.

Observing teacher child co-construction during the engagement of the task reflects Fisher's (1994) advice for therapists to focus on the doing of a task. Fisher urges occupational therapists to observe and evaluate a person's skills as they engage in the process of performing a task, in real time, in real context. Table 2 provides a starting point to guide a therapist's observation in noticing the complex co-construction of learning to handwrite.

Table 2 can also be used to guide intervention. In collaboration with the teacher, the therapist could use the stages of handwriting to untangle the meaning embedded within the task of participating in handwriting. The column titled: Teachers expectations, offers a guide to assessment and goal making process. By clarifying the teacher's expectations, awareness of a possible mis-match between a child's observable actions and a teacher's expectations may be highlighted. This mis-match would assist in identifying the focus for intervention.

The column titled: Teachers observable practices, will help the therapist and teacher to clarify current strategies used, as well as potential intervention strategies to support the child's handwriting development. Once again, a mis-match between the teachers teaching strategies and the child's observable actions would identify a need for intervention. The final column: Childs observable actions, provides a list of possible activities and experiences through which the stated goals could be achieved.

Intervention for handwriting as an occupation, cyclic process or tool.

Expectations and tasks change depending on the specific stage of learning to handwrite that the child is experiencing. Therefore interventions need to accommodate the child's stage of handwriting development, together with the teacher's expectation and focus of their teaching. During the occupation stage the teaching focus is on the child learning the letters name, form, voice and its connection to decoding and encoding written language. Intervention at this stage needs to acknowledge the letters name, form, voice and use in words. All letters are focused on and taught at this stage just as pencil grasp and correct letter formation are stressed. The wholeness of letters is reinforced by using the developing letter knowledge in the tasks of spelling, reading and writing, even though the students skills is only just emerging.

In the cyclic process stage only those letters that cannot be retrieved from a child's memory quickly are focused on during intervention. Poor letter formation as long as it is legible, and formed with speed, is accepted. Unusual pencil grasp unless directly affecting output is accepted as effective. Decoding spoken words from sounds into letter shapes is still a focus. Size and letter placement begins to be worked on.

In the tool stage handwriting becomes a tool to communicate understanding about other things broader than letter knowledge. In this stage there may be a trade off between speed and legibility. In addition, there may be difficulties with legibility and poor spelling but understanding of the wholeness of letters should be in place. Poor spelling highlights an incomplete development of the foundations of literacy and needs to be addressed alongside handwriting interventions. Adaptive technology may become a necessary option for the student to be able to meet the expectations of the teacher. Technology may also need to compensate for lack of literacy learning (spelling) as well as decreased output of written communication.

Limitations and further research

These findings are not intended to be generalised as this study only consulted six teachers in one geographical region. Another limitation is that Table 2; Stages of Handwriting is in its early stages of development. Ongoing research to investigate whether other teachers also see the task of learning to handwriting as having three distinct stages with the same observable features would validate this study. The suggestions in Table 1 also need to be re-tested by a variety of therapists across a range of age groups to determine the applicability of the tool for school based practice. Most importantly research exploring whether or not this model makes a positive difference to the handwriting outcomes of children is also required.

Conclusion

Teachers view handwriting as more than a visual motor task, therefore occupational therapists also need to view handwriting as more than a visual motor task. The teachers in this study used handwriting to teach literacy; therefore handwriting had a role in encoding and decoding written language. It was during the learning process of how to encode and decode that teachers placed more value on the task of handwriting and gave it what occupational scientists would describe as occupational status. In contrast when automatic mastery of handwriting occurred it was demoted to tool status. These differing stages of handwriting, as identified by the teachers, directly affect how the task of learning to handwrite is experienced by the student.

The differing expectations and experiences are summarized in Table 2. This knowledge provides a structure for ecologically based inquiry and intervention. Fisher (1994) notes that our assessment methods must emphasize the client's ability to actively do while placing the doing in the context that is relevant and meaningful. The findings from this research provide therapists a tool to enable this to occur. The initial stages of the occupational therapy process are guided by identifying a mis-match between a child's handwriting skill, the teacher's expectations and the classroom programme. This knowledge can then support the development of ecologically appropriate goals and interventions strategies. Intervention outcomes could be documented on Table 2, thus providing functional evidence of an improved match between the teacher's expectations, classroom programme and the child's ability. This evidence would reflect practice that is occupational based, showcasing occupational therapists unique role in assisting children with handwriting difficulties.

Key points

* Learning to handwrite goes through three distinct stages, occupation, cyclic process and tool.

* Teachers' expectations and the children's experiences change depending on the stage of handwriting.

* Handwriting is a co-constructed activity blending the teacher's expectations and the child participation.

* Documenting the co-constructed handwriting task of teachers' expectations, classroom programme, and the children's experiences provides an occupation based structure to guide the occupational therapy process.

* Handwriting is more than a visual motor task.

Acknowledgement

This article focuses on one theme from the first author's unpublished Masters thesis undertaken at Otago Polytechnic (Robinson, 2008).

Appendix One

Priming questions and interview guide

Question Guide

Participants will be given the following instructions when initially asked to participate in the research. This will assist them to gain a better understanding of their contribution to my inquiry, as well as prime their thinking for the up-coming interview.

Examples of questions that will be asked on the interview Show and tell me how you teach handwriting to the children in your classroom?

(This question will hopefully provide an opportunity for you the teacher to show me your resources, as well as communicate your definition or description of the handwriting process.)

At what point during the day do you usually concentrate on the specific task of teaching handwriting?

What other classroom activities cross over into teaching this skill?

(This question will hopefully assist me to understand how handwriting fits within the context of the whole school day.)

If a child struggles to learn to write--what other things might you do?

(This question will help me gain an understanding of the differing techniques and teaching strategies you as a teacher may call on.)

Can you tell me about which things/events or policies which have influenced how you teach handwriting in the classroom?

(For example, are there school or syndicate policies, ideas from other staff members, attendance at workshops or courses.)

References

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Reference

Robinson, R. & Penman, M. (2011). Viewing development through an occupational lens: Learning to handwrite. New Zealand Journal of Occupational Therapy, 58(2), 23 - 29.

Rita Robinson and Merrolee Penman

Corresponding author:

Rita Robinson M OccTher., NZROT

School Of Occupational Therapy

Otago Polytechnic Wintec

Private Bag 3035

Waikato Mail Centre

Hamilton 3240

Email: [e-mail]

Merrolee Penman MA(Educ.), DipOT, NZROT

School of Occupational Therapy

Otago Polytechnic

Private Bag 1910

Dunedin 9054

Table 1. Demographics of participants

Participant       School size       School setting

Participant A     200-300           Urban
Participant B     100-150           Rural
Participant C     400-600           Urban
Participant D     400-600           Urban
Participant E     200-300           Urban
Participant F     200-300           Urban

(Robinson, 2008, p.27)

Table 2: Stages of handwriting

Stages of handwriting

Stage of                                     Teachers' orchestration
handwriting      Teachers' expectations      of handwriting tasks

Occupation       To participate in the       Teaching the sound,
                 experience of learning      shape and name of the
                 to handwrite and writing.   letter to whole class.

                 To begin to develop some    Silencing the need for
                 letter knowledge as         tidiness (the teachers
                 demonstrated by producing   do not voice any
                 marks which begin to        concerns about the
                 resemble letters.           tidiness of work).

                 Formation may be more at    Encouraging risk taking
                 drawing stage rather        behaviours by having
                 than at a formation         children try and write
                 stage.                      their name on papers/
                                             sign in sheets, etc.

                 To hold their pencil in     Direct teaching to the
                 an 'effective and           whole class on how to
                 acceptable way'. To         hold a pencil correctly.
                 develop control over a      Use of pencil grips and
                 pencil                      visual aides to support
                                             the development of this
                                             skill.

Stage of
handwriting      Child's observable actions

Occupation       Engaging in writing their name,
                 handwriting and writing tasks even if
                 they cannot form letters.

                 Verbalising and demonstrating
                 recognition of letters, either by sight,
                 sound, shape or name.

                 Holding the pencils and drawing tools
                 in a number of ways, altering between
                 immature and more mature patterns.

                 Engaging in a wide variety of pencil and
                 paper tasks demonstrating increasing
                 control over a pencil.

                 Formation of letters may be at a drawing
                 stage (drawing would be demonstrated
                 by many short strokes added in a non
                 logical inconsistent manner to create
                 an end product which resembles a
                 letter. At this stage the child possibly
                 emphasises the letter matching a copy
                 or a perceived image).

                 Vision guides hands to form or draw the
                 letters. Visual guidance initiates and
                 supports the task of letter formation.

Stage of                                     Teachers observable
handwriting      Teachers expectations       practices

Cyclic process   To increase participation   Greater amounts of
between          in handwriting and          handwriting is required.
occupation and   writing tasks.
tool                                         Encouraging children to
                 Expect more volume of       source and copy high
                 work to be completed or     usage words from
                 tasks to be completed in    environmental props
                 a quicker time frame.       within the classroom.

                 To form most letters        Instruction to form
                 with correct letter         letters from their
                 formation.                  memory during
                                             handwriting tasks.
                 To develop basic letter
                 knowledge for letters       Making attempts at
                 which are not secure.       sounding out and
                                             spelling words from
                 To use an effective         memory.
                 pencil grasp.
                                             Individual instruction
                 Letters which are secure    to facilitate acceptable
                 and are formed correctly    pencil grasp.
                 begin to have tidiness
                 criteria placed on them.    The value of tidiness
                                             encouraged during some
                                             specific tasks.

Tool             Handwriting is completed    Teacher provides numerous
                 with comfort and speed.     tasks which use writing
                                             as a tool to demonstrate
                 All letters are formed      understanding about
                 legibly.                    concepts broader than
                                             knowledge of letters.
                 Writing is readable.        For example the life
                                             cycle of a butterfly.

                                             Writing and handwriting
                                             tasks are varied in the
                                             expectation of the time
                                             and tidiness. For
                                             example, essay plans,
                                             draft copies and good
                                             copies.

                                             Teacher provides class
                                             wide and or individual
                                             instruction on how to
                                             improve tidiness of
                                             handwriting.

Stage of
handwriting      Child's observable actions

Cyclic process   Name writing mastered.
between
occupation and   Child writing more during handwriting time
tool             and story writing time.

                 Producing more letters which are
                 recognizable. Moving from drawing letters to
                 forming letters

                 (drawing would be demonstrated by
                 many short strokes added in a non logical
                 inconsistent manner to create an end
                 product which resembles a letter. At this
                 stage the child possibly emphasises the
                 letter matching a copy or a perceived image.
                 However, in the forming a letter stage, the
                 child emphasises the flow of movement).

Tool             Children use writing to demonstrate ideas
                 and understanding about a range of topics.

                 Children modify handwriting tidiness
                 and speed to fit the expectations of each
                 individual task.

                 Children use visual surveillance to write
                 rather than visual guiding formation of letters
                 (surveillance occurs after the fact, while
                 visual guidance initiates and supports the
                 task of letter formation).

(Robinson, 2008, p. 69-70)