Functional Assessment of Handwriting Among Children: A Systematic Review of the Psychometric Properties.

IMPORTANCE: Handwriting legibility and speed assessments have a critical role in identifying and evaluating handwriting problems, which are common among children. OBJECTIVE: The objective was to evaluate the psychometric properties and clinical utility of handwriting assessments for children ages 3 to 16 yr. DATA SOURCES: A systematic review was conducted in CINAHL, PubMed (MEDLINE), Scopus, and education databases, with no time limits. The search strategy included a combination of the following keywords: handwriting, write, children, assessment, and validity. The exclusion criteria were assessment tools that were electronic, that focused on cognitive components of handwriting, or that only evaluated alphabets other than Latin. STUDY SELECTION AND DATA COLLECTION: The systematic review was carried out on the basis of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The protocol was registered in the Prospective Register of Systematic Reviews (PROSPERO). FINDINGS: The 14 included instruments had a total sample of 4,987 children. Internal consistency ranged from moderate (.73; Writing Readiness Inventory Tool in Context) to high (.98; Letter Writing). The interexaminer reliability values of the 11 direct assessment instruments ranged from .77 (Systematic Screening for Handwriting Difficulties) to 1.00 (Handwriting Speed Test). CONCLUSIONS AND RELEVANCE: In this systematic review, existing tools were evaluated by clinical utility and the quality of psychometric properties. Direct assessments showed good psychometric properties. Indirect and self-assessment tools demonstrated poor psychometric properties. Further research on screening tools and tools in other languages is needed. What This Article Adds: Specific learning disorders (e.g., dysgraphia) negatively affect academic learning and, when prolonged in time, self-concept. However, handwriting legibility and speed assessments could be used to identify and evaluate these learning disorders if an early referral to occupational therapy is carried out.

Motor Assessment With the STEGA iPad App to Measure Handwriting in Children.

IMPORTANCE: Handwriting and the fine motor control (hand and fingers) underlying it are key indicators of numerous motor disorders, especially among children. However, current assessment methods are expensive, slow, and subjective, leading to a lack of knowledge about the relationship between handwriting and motor control. OBJECTIVE: To develop and validate the iPad precision drawing app Standardized Tracing Evaluation and Grapheme Assessment (STEGA) to enable rapid quantitative assessment of fine motor control and handwriting. DESIGN: Cross-sectional, single-arm observational study. SETTING: Academic research institution. PARTICIPANTS: Fifty-seven typically developing right-handed children ages 9 to 12 yr with knowledge of cursive. OUTCOMES AND MEASURES: Predicted quality, measured as the correlation between handwriting letter legibility (Evaluation Tool of Children's Handwriting-Cursive [ETCH-C]) and predicted legibility (calculated from STEGA's 120 Hz, nine-variable data). RESULTS: STEGA successfully predicted handwriting (r2 = .437, p < .001) using a support vector regression method. Angular error was the most important aspect of STEGA performance. STEGA was much faster to administer than the ETCH-C (M = 6.7 min, SD = 1.3, versus M = 19.7 min, SD = 5.2). CONCLUSIONS AND RELEVANCE: Assessment of motor control (and especially pen direction control) may provide a meaningful, objective way to assess handwriting. Future studies are needed to validate STEGA with a wider age range, but the initial results indicate that STEGA can provide the first rapid, quantitative, high-resolution, telehealth-capable assessment of the motor control that underpins handwriting. What This Article Adds: The ability to control pen direction may be the most important motor skill for successful handwriting. STEGA may provide the first criterion standard for the fine motor control skills that underpin handwriting, suitable for rehabilitation research and practice.

Ready for handwriting? A reference data study on handwriting readiness assessments.

INTRODUCTION: Early evaluation of writing readiness is essential to predict and prevent handwriting difficulties and its negative influences on school occupations. An occupation-based measurement for kindergarten children has been previously developed: Writing Readiness Inventory Tool In Context (WRITIC). In addition, to assess fine motor coordination two tests are frequently used in children with handwriting difficulties: the modified Timed Test of In-Hand Manipulation (Timed TIHM) and the Nine-Hole Peg Test (9-HPT). However, no Dutch reference data are available. AIM: To provide reference data for (1) WRITIC, (2) Timed-TIHM and (3) 9-HPT for handwriting readiness assessment in kindergarten children. METHODS: Three hundred and seventy-four children from Dutch kindergartens in the age of 5 to 6.5 years (5.6±0.4 years, 190 boys/184 girls) participated in the study. Children were recruited at Dutch kindergartens. Full classes of the last year were tested, children were excluded if there was a medical diagnosis such as a visual, auditory, motor or intellectual impairment that hinder handwriting performance. Descriptive statistics and percentiles scores were calculated. The score of the WRITIC (possible score 0-48 points) and the performance time on the Timed-TIHM and 9-HPT are classified as percentile scores lower than the 15th percentile to distinguish low performance from adequate performance. The percentile scores can be used to identify children that are possibly at risk developing handwriting difficulties in first grade. RESULTS: WRITIC scores ranged from 23 to 48 (41±4.4), Timed-TIHM ranged from 17.9 to 64.5 seconds (31.4± 7.4 seconds) and 9-HPT ranged from 18.2 to 48.3 seconds (28.4± 5.4). A WRITIC score between 0-36, a performance time of more than 39.6 seconds on the Timed-TIHM and more than 33.8 seconds on the 9-HPT were classified as low performance. CONCLUSION: The reference data of the WRITIC allow to assess which children are possibly at risk developing handwriting difficulties.

Preliminary Rasch Construct and Reliability Validation of TeleWrite: A Telehealth-Based Handwriting Assessment.

BACKGROUND: Telehealth is rapidly expanding, and telehealth-based occupational therapy assessments must be developed and validated to keep pace with this transition. TeleWrite aims to bridge this gap. OBJECTIVES: To analyze the tool's initial psychometric properties using Rasch methods. METHOD: Internal construct validity and test reliability were analyzed using data from 148 children from first to third grade. RESULTS: Rasch analysis helped to identify that TeleWrite is composed of three separate constructs for rate, accuracy, and fluency. All Infit/Outfit mean square (MNSQ) values fell within acceptable ranges of 0.5 to 1.7 logits. Separation analysis indicated lower but acceptable person separation values for rate (0.68-0.76) and fluency (0.61-0.73), but accuracy scales were in the poor-fair range (0.20-0.60), given sample limitations. CONCLUSION: TeleWrite is comprised of three separate constructs, showed a good fit with the Rasch model, indicated strong construct and internal validity, and moderate ability to reliably separate abilities of students in terms of handwriting skills.

The Development and Preliminary Psychometric Properties of the TeleWrite: A Telehealth-Based Handwriting Assessment for School-Aged Children.

This article describes the development and preliminary psychometric properties of the TeleWrite, a handwriting assessment tool designed to measure the rate, accuracy, and fluency of children's handwriting for children in first through third grade administered via telehealth. A series of three pilot studies were completed to determine initial interrater reliability, content validity, and clinical utility of the TeleWrite. A study with eight children was used to determine preliminary interrater reliability testing using a beta version of the TeleWrite with (n = 9) raters. The reliability coefficient was obtained using intraclass correlation (ICC) and yielded α = 0.92 for total scores, CI [0.815, 0.983] and the Cronbach's α measure for internal consistency was α = 0.95 (excellent). A clinical utility survey of (n = 55) pediatric occupational therapists was used to obtain their clinical impression regarding the usefulness and accuracy. Representing twelve different countries and twenty-two U.S. states, the respondents indicated that 61% (n = 33) are quite or extremely likely to use the TeleWrite in their practice and most participants (64%; n = 35) indicated that TeleWrite was quite/extremely accurate in measuring handwriting performance. Third, a content validity study with nine handwriting experts reviewed and concluded that all ten subtests of the TeleWrite tool are considered essential. All preliminary studies strengthen the development of the TeleWrite assessment to advance to construct validation of the tool.

Assessment of children's writing features: A pilot method study of pen-grip kinetics and writing surface pressure.

The writing process is a complex task involving dexterous manipulation of the writing instrument by the hand digits and biomechanical ergonomic factors that contribute to handwriting efficiency and productivity. We describe a pilot study using an instrumented writing apparatus - a sensor (pen) and a digitized writing surface (tablet) - to measure the pen-grip kinetics (digit forces) and the pen pressure applied to the tablet during a writing task. Eight elementary school students with no handwriting difficulties copied a short story. The mean digit forces on the pen were compared with the mean pen pressure on the tablet at five interval points. Results revealed that the digit forces on the pen were significantly stronger than the pen pressure on the tablet. Results also showed significantly less digit-force variability throughout the writing task than the pen-pressure variability on the writing surface, which significantly lessened toward the end of the writing task. Information on these properties can broaden understanding of the elements that influence nonproficient handwriting in children with dysgraphia. Results also indicate the possible efficacy of a therapeutic tool for handwriting assessment and intervention using objective measurements during writing, warranting future studies with children with and without dysgraphia.

Por uma pesquisa e escrita parafusos: pulos, rodopios e invenções de si / For research and writing screws: jumps, twirls and inventions of self / Para tornillos de investigación y escritura: saltos, giros e autoinvenciones

O artigo parte da aposta na pesquisa como uma prática em movimento, na composição de territórios do ato de pesquisar como uma experiência. Inspiradas(os) na força disruptiva do torcer-retorcer dos Parafusos (folguedo sergipano, derivado de práticas de resistência à escravidão dos povos pretos), propomos um método-pensamento de inventar modos de ver, dizer e narrar a partir daquilo que está ao nosso redor, uma posição em relação ao mundo e a si mesmo, engendrando a ideia de que este mundo não é um dado, mas um efeito de nossas práticas. A partir dessa perspectiva, intentamos interpelar as próprias práticas discursivas e não discursivas da Psicologia, em favor de abrir trilhas nas quais esse saber possa refundar sua própria história, acentuando suas descontinuidades e heterogeneidades e, com isso, uma atitude de fazer frente às tendências colonialistas, agora em suas versões neoliberais. Esse modo de pesquisar se faz por: operar uma ideia-método genealógico-cartográfica e uma escrita polifônica; produzir máquinas de guerras nômades, minoritárias, pós-identitárias, decoloniais; e inventar com aquilo que está ao nosso redor em favor de saberes e fazeres das redes locais, que, tais como a planta mangabeira, não se deixam domesticar.(AU)

The article starts from the research as a moving practice; in the composition of territories of the act of researching as an experience. Inspired by the disruptive force of the twisting-twining of the Screws (revelry from Sergipe, derived from practices of resistance to the slavery of black people), we propose a thought-method of inventing ways of seeing, saying, and narrating from what is around us, a position in relation to the world and itself, engendering the idea that this world is not a given, but an effect of our practices. From this perspective, we try to question the very discursive and non-discursive practices of Psychology, in favor of opening trails, in which this knowledge can refund its own history, accentuating its discontinuities and heterogeneities and, thus, an attitude of facing the colonialist tendencies, now in their neoliberal versions. This way of searching is done by: operating a genealogical-cartographic idea-method and polyphonic writing; producing nomadic, minority, post-identity, decolonial war machines; and inventing with what is around us, in favor of knowledge and practices of local networks, which, like the mangabeira plant, do not allow domestication.(AU)

Este artículo parte de la investigación como práctica en movimiento, en la composición de territorios del acto de investigar como experiencia. Inspirándonos en la fuerza disruptiva de torsión-retorsión de los Tornillos (juerga de Sergipe, derivada de prácticas de resistencia a la esclavitud de los negros), proponemos un método de pensamiento para inventar formas de ver, decir y narrar a partir de lo que nos rodea, una posición en relación con el mundo y con él mismo, el cual constituye la idea de que este mundo no es un hecho, sino un efecto de nuestras prácticas. Desde esta perspectiva, pretendemos cuestionar las prácticas discursivas y no discursivas de la Psicología en favor de abrir caminos, en las cuales este conocimiento pueda refundar su propia historia, acentuando sus discontinuidades y heterogeneidades y, así, una actitud de hacer ante las prácticas colonialistas, ahora desde una perspectiva neoliberal. Este modo de investigación se realiza mediante: el funcionamiento de un método-idea de escritura genealógica, cartográfica y polifónica; la producción de máquinas de guerra nómadas, minoritarias y posidentitarias; y la composición con el tema que nos rodea a favor del conocimiento y las redes locales que no puede ser domesticada, como el árbol mangabeira.(AU)

Documentos psicológicos: um estudo comparativo das resoluções CFP n. º 006/2019 e CFP n. º 007/2003 / Psychological documents: a comparative study of resolutions CFP n. º 06/2019 and CFP n. º 07/2003 / Documentos psicológicos: un estudio comparativo entre las resoluciones CFP n. º 006/2019 y CFP n. º 007/2003

As resoluções emitidas pelo Sistema Conselhos são instrumentos essenciais de orientação e promoção de práticas éticas que denotem qualidade técnica no exercício profissional da Psicologia. Dada a complexidade que envolve a elaboração de documentos psicológicos, esta pesquisa teve como objetivo identificar as principais mudanças observadas no texto da recém-publicada Resolução CFP n.º 006/2019 quando comparada à Resolução CFP n.º 007/2003, ambas referidas à elaboração de documentos psicológicos. Trata-se de uma pesquisa descritiva-comparativa de abordagem qualitativa, que utilizou da análise de conteúdo no tratamento e interpretação dos dados oriundos de fonte exclusivamente documental. Os resultados indicaram poucas diferenças qualitativas entre os marcos resolutivos, embora se vislumbre altamente relevante o ganho adquirido com a proibição de escritos descritivos, a exigência de referencial teórico para fundamentar o raciocínio profissional e a obrigatoriedade da devolutiva documental. Entre os achados que ganham notoriedade consta a preocupação com os princípios que regem a elaboração de documentos, cuja apresentação tautológica responde a um cenário político de retrocessos que tem favorecido o desrespeito aos direitos humanos e às minorias.(AU)

Resolutions issued by Sistema Conselhos are essential tools to guide and promote ethical and quality psychology practices. Given the complexity involved in elaborating such documents, this descriptive, qualitative research outlines the main changes in the text of the recently published CFP Resolution no. 006/2019 when compared with CFP Resolution no. 007/2003, both addressing the elaboration of psychological documents. Documentary data was investigated by content analysis. Results indicated few qualitative differences between the analyzed Resolutions, among them the prohibition of descriptive writing, the requirement for a theoretical framework to support professional reasoning, and the obligation to return documents. Concern with the principles that guide document elaboration stands out, responding to a political scenario of major setbacks regarding respect for human rights and minorities.(AU)

Las resoluciones que expide el Sistema Conselhos consisten en instrumentos fundamentales que guían y promueven prácticas éticas respecto a la calidad técnica en el ejercicio profesional de la Psicología. Dada la complejidad que implica la elaboración de documentos psicológicos, esta investigación tuvo como objetivo identificar los principales cambios observados en la Resolución CFP n.º 006/2019, de reciente publicación, en comparación con la Resolución CFP n.º 007/2003, ambas abordan la elaboración de documentos psicológicos. Se trata de una investigación descriptiva-comparativa con enfoque cualitativo, que utilizó el análisis de contenido en el tratamiento e interpretación de datos de fuente exclusivamente documental. Los resultados indicaron pocas diferencias cualitativas entre los marcos resolutivos (aunque el logro de prohibir los escritos descriptivos es muy relevante), la exigencia de un marco teórico para sostener el razonamiento profesional y la devolución obligatoria de los documentos. Entre los hallazgos que cobran notoriedad está la preocupación por los principios que rigen la elaboración de documentos, cuya presentación tautológica responde a un escenario político de retrocesos que ha favorecido la falta de respeto a los derechos humanos y las minorías.(AU)

Apropriação dos espaços urbanos na infância e na velhice em Brasília (DF) / Occupation of urban spaces in childhood and old age in Brasilia, Brazil / Apropiación de espacios urbanos en la infancia y en la vejez en Brasília, Brasil

Os estudos sobre as relações mútuas entre as pessoas e o ambiente buscam subsidiar melhorias no contexto urbano a partir de métodos e técnicas pautados na compreensão do uso de espaços públicos e privados. A crescente demanda pela promoção de ambientes amigáveis para idosos e crianças nos cenários urbanos direcionou esta pesquisa e elencou dois componentes: o panorama relativo à população local e o arcabouço teórico da psicologia ambiental. Para tanto, buscou-se identificar as principais atividades realizadas por crianças e idosos em seus respectivos locais de moradia. Foram avaliados os principais usos e atividades desses dois grupos, em duas vizinhanças, diferenciando-os de acordo com suas especificidades em termos de demandas individuais e ambientais. As observações sistemáticas a partir da técnica de mapeamento comportamental centrado no lugar (MCCL) ocorreram na cidade de Brasília, Distrito Federal (DF) e permitiram compreender o processo de apropriação dos espaços na infância e na velhice e suas repercussões em termos da congruência pessoa-ambiente. Cada um destes setores organizados a partir de elementos específicos direciona as ações dos participantes para determinados tipos de comportamentos, observados de maneira a compor um roteiro em que a brincadeira (lazer ativo) surge como central na infância e a caminhada (circulação) como mais potente para a população idosa. Os resultados demonstram que o diálogo entre a psicologia ambiental e a ciência do desenvolvimento humano tem sido bastante profícuo e tem contribuído para a compreensão de aspectos da relação pessoa-ambiente em diferentes momentos do ciclo de vida.(AU)

Studies on the mutual relations between people and the environment seek to support improvements in the urban context from methods and techniques based on understanding the use of public and private spaces. The growing demand for the promotion of friendly urban environments for older people and children guided this research, with two notable components: the panorama related to the local population and the theoretical framework of Environmental Psychology. Therefore, we sought to identify the main activities carried out by children and older people in their respective dwellings. The main uses and activities of these two groups were evaluated in two neighborhoods, differentiating them according to their specificities in terms of individual and environmental demands. Systematic observations using the place-centered behavioral mapping technique took place in the city of Brasília, Federal District, and allowed us to understand the process of appropriation of spaces in childhood and old age and its repercussions in terms of person-environment congruence. Each of these sectors, organized from specific elements, directs the participants' actions towards certain types of behavior, observed in order to compose a script in which playing (active leisure) emerges as central in childhood and walking (circulation) as more potent for the older people. The results demonstrated that the dialogue between environmental psychology and the science of human development has been very fruitful and has contributed to the understanding of aspects of the person-environment relationship at different times in the life cycle.(AU)

Los estudios sobre las relaciones mutuas entre las personas y el medio ambiente buscan aportar mejoras en el contexto urbano mediante métodos y técnicas basados en la comprensión del uso de los espacios públicos y privados. La creciente demanda de la promoción de ambientes amigables para las personas mayores y los niños en entornos urbanos guio esta investigación y enumeró dos componentes: el panorama relacionado con la población local y el marco teórico de la Psicología Ambiental. En este contexto, buscamos identificar las principales actividades que realizan los niños y las personas mayores en sus respectivas viviendas. Se evaluaron los principales usos y actividades de estos dos grupos en dos barrios, diferenciándolos según sus especificidades en cuanto a las demandas individuales y ambientales. Las observaciones sistemáticas utilizando la técnica de mapeo conductual centrado en el lugar (MCCL) ocurrieron en la ciudad de Brasília, Distrito Federal (Brasil) y nos permitieron comprender el proceso de apropiación de espacios en la infancia y la vejez y sus repercusiones en la congruencia persona-ambiente. Cada uno de estos sectores, organizados a partir de elementos específicos, orienta las acciones de los participantes hacia determinados comportamientos, observados para componer un guion en el que el juego (ocio activo) emerge como central en la infancia y el caminar (circulación) como el más potente para las personas mayores. Los resultados demuestran que el diálogo entre la Psicología Ambiental y la ciencia del desarrollo humano ha sido muy fructífero y ha contribuido a la comprensión de aspectos de la relación persona-entorno en diferentes momentos del ciclo de vida.(AU)

O papel da consciência fonológica para a leitura, escrita e matemática em estudos brasileiros e principais instrumentos de avaliação: uma revisão narrativa / The role of phonological awareness for reading, writing and mathematics in Brazilian studies and main assessment instruments: a narrative review / El papel de la conciencia fonológica para la lectura, la escritura y las matemáticas en los estudios brasileños y los principales instrumentos de evaluación: una revisión narrativa

Introdução: A consciência fonológica é uma habilidade muito importante para leitura, escrita e matemática em muitos anos escolares. A sua investigação e avaliação tem sido realizada em diversos contextos com populações típicas ou atípicas para entender como ela se desenvolve e, consequentemente, contribuir para pesquisas sobre desempenho acadêmico. Objetivo: O objetivo deste trabalho éestudar a influência da consciência fonológica no desempenho acadêmico em estudos brasileiros e apresentar os principais instrumentos padronizados utilizados na avaliação desta habilidade. Métodos: Realizou-se busca de artigos dos últimos cinco anos, nas bases de dados LILACS e SciELO usando descritores em português: "consciência fonológica" e "leitura" ou "escrita" ou "matemática" ou "desempenho acadêmico" ou "habilidade acadêmica", assim como descritores em inglês usando mesmas expressões. Foram selecionados estudos de acesso livre, realizados no Brasil, publicados em português, inglês ou espanhol, que utilizaram um instrumento padronizado e apresentaram os descritores mencionados no título ou resumo. Resultados: Dos 18 artigos analisados, 17 concluíram que a consciência fonológica foi importante para a leitura, escrita e matemática, sendo que a leitura e escrita foram as habilidades mais investigadas. Os instrumentos usados avaliam principais componentes da consciência fonológica e foram desenvolvidos por autores brasileiros. Conclusão: Os achados evidenciam que a consciência fonológica é uma habilidade muito importante para o desempenho acadêmico em diversas séries escolares. Reforça-se a necessidade de monitoramento, avaliação e estimulação precoce com a habilidade em crianças típicas e atípicas.

Introduction: Phonological awareness is a very important skill for reading, writing and math in many school years. Its investigation and evaluation has been carried out in different contexts with typical or atypical populations to understand how it develops and consequently contribute to research on academic performance. Objective: The aim of this paper is to study the influence of phonological awareness on academic performance in Brazilian studies and to present the main standardized instruments used in the assessment to this skill. Methods: Articles from the last five years were searched in LILACS and SciELO databases using descriptors in English: "phonological awareness" and "reading" or "writing" or "mathematics" or "academic performance" or "academic ability", as well as descriptors in Portuguese using the same expressions. Open access studies carried out in Brazil, published in Portuguese, English or Spanish, which used a standardized instrument and presented the descriptors mentioned in the title or abstract, were selected. Results: Of the 18 articles analyzed, 17 concluded that phonological awareness was important for reading, writing and mathematics, with reading and writing being the most investigated skills. The instruments used assess the main components of phonological awareness and were developed by Brazilian authors. Conclusion: The findings show that phonological awareness is a very important skill for academic performance in different grades. It reinforces the need for monitoring, assessment, and early intervention with skill in typical and atypical children.

Introducción: La conciencia fonológica es una habilidad muy importante para la lectura, la escritura y las matemáticas en muchos años escolares. Su investigación y evaluación se ha realizado en diferentes contextos con poblaciones típicas o atípicas para comprender cómo se desarrolla y consecuentemente contribuir a la investigación sobre el rendimiento académico. Objetivo: El objetivo de este trabajo es estudiar la influencia de la conciencia fonológica en el rendimiento académico en los estudios brasileños y presentar los principales instrumentos estandarizados utilizados en la evaluación de esta competencia. Métodos: Se buscaron artículos de los últimos cinco años en las bases de datos LILACS y SciELO utilizando descriptores en portugués: "consciência fonológica" e "leitura" ou "escrita" ou "matemática" ou "desempenho acadêmico" ou "habilidade acadêmica", así como descriptores en Inglés usando las mismas expresiones. Se seleccionaron estudios de acceso abierto realizados en Brasil, publicados en portugués, inglés o español, que utilizaron un instrumento estandarizado y presentaron los descriptores mencionados en el título o resumen. Resultados: De los 18 artículos analizados, 17 concluyeron que la conciencia fonológica es importante para la lectura, la escritura y las matemáticas, siendo la lectura y la escritura las habilidades más investigadas. Los instrumentos utilizados evalúan los principales componentes de la conciencia fonológica y fueron desarrollados por autores brasileños. Conclusión: Los hallazgos muestran que la conciencia fonológica es una habilidad muy importante para el desempeño académico en los diferentes grados. Refuerza la necesidad de seguimiento, evaluación e intervención temprana con habilidad en niños típicos y atípicos.

Self-determined Occupational Performance Model for Children From Economically Disadvantaged Backgrounds.

Background. Children from low-income backgrounds have a higher incidence of handwriting challenges due to the unique social and environmental stressors associated with poverty. Additionally, children from economically disadvantaged households are at risk for motor, cognitive, and social deficits, which further impact their handwriting performance. Purpose. The purpose of this paper is to propose a theoretical model that provides a holistic perspective for addressing the handwriting needs of children from low-socioeconomic backgrounds. Key Issues. The presented conceptual model is derived from the person-environment-occupation model for occupational performance and self-determination theory. These theories reciprocally complement and enhance each other, providing a foundation from which clinicians can guide evaluation and intervention. Implications. Through the use of the proposed model, evaluation and intervention focus on intrinsic motivation while considering the physical, social, and cultural impacts on a child's occupational performance. The provider connects with the child's basic psychological needs, thus improving handwriting outcomes and facilitating improved academic performance.

Development of the Ultralight Hybrid Pneumatic Artificial Muscle: Modelling and optimization.

Pneumatic artificial muscles (PAMs) are one of the key technologies in soft robotics, and they enable actuation in mobile robots, in wearable devices and exoskeletons for assistive and rehabilitative purposes. While they recently showed relevant improvements, they still present quite low payload, limited bandwidth, and lack of repeatability, controllability and robustness. Vacuum-based actuation has been recently demonstrated as a very promising solution, and many challenges are still open, like generating at the same time a large contraction ratio, and a high blocking force with enhanced axial stiffness. In this paper, a novel Ultralight Hybrid PAM (UH-PAM), based on bellow-type elastomeric skin and vacuum actuation, is presented. In particular, open-cell foam is exploited as a structural backbone, together with plastic rings, all embedded in a thin skin. The design and optimization combine numerical, analytical, and experimental data. Both static and dynamic analysis are performed. The weight of the optimized actuator is only 20 g. Nevertheless, a contraction ratio up to 50% and a maximum payload of 3 kg can be achieved. From a dynamic point of view, a rise time of 0.5 s for the contraction phase is observed. Although hysteresis is significant when using the whole contraction span, it can be reduced (down to 11.5%) by tuning both the vacuum range and the operating frequency for cyclic movements. Finally, to demonstrate the potentiality of this soft actuation approach, a 3 DoFs Stewart platform is built. The feasibility of performing smooth movements by exploiting open-loop control is shown through simple and more complex handwriting figures projected on the XY plane.

Mode effect: An issue of perspective? Writing mode differences in a spelling assessment in German children with and without developmental dyslexia.

Digital technology has an increasing influence on writing processes. In this context, the question arises whether changes in writing mode (i.e., handwriting vs. computer-keyboard typing) also require changes in writing assessments. However, data directly comparing writing mode influences in children with and without developmental writing deficits are scarce. This study investigated the influence of writing mode in German-speaking, typically developing children and children with developmental dyslexia (DD) from two different levels. Results showed on a general level that writing mode influenced overall spelling accuracy, writing time, and self-corrections comparably in children with and without DD. On a rule-specific level, outcomes for writing time and self-corrections substantiated these findings. However, as regards spelling accuracy, a mode effect was only apparent for capitalization, whereas other spelling rules were resistant to writing mode influences. Present findings suggest that a mode effect is present only for typing specific aspects (e.g., capitalization) rather than reflecting a general influence on orthographic principles (e.g., grapheme-phoneme assignment, morphologic principles). These mode-specific aspects seem to comparably affect the writing performance of typically developing children and children with DD. We recommend writing assessments to consider that different writing modes may influence individual spelling rules differently.

Initial psychometric evaluation of the Hartley Knows Writing Shapes Assessment Version 2 with typically developing children between the ages of 4 and 8.

INTRODUCTION: Despite advances in technology, handwriting still remains an important part of the school curriculum. Especially during the early years of schooling, handwriting difficulties have been shown to negatively affect academic success. Consequently, occupational therapists rely on sound psychometric tools to assess a child's visual motor abilities and implement appropriate strategies to facilitate their handwriting outcomes. The Hartley Knows Writing Shapes Assessment Version 2 (HKWSA-V2) evaluates knowledge of writing shapes, ability to replicate writing shapes and knowledge of handwriting concepts used in the Hartley Knows Writing Program (HKWP). The current study describes the initial development and psychometric evaluation of the HKWSA-V2. METHOD: Typically developing children (N = 50) between 4 and 8 years old, completed two visual motor assessments: the HKWSA-V2 and the Beery Buktenica Developmental Test of Visual Motor Integration 6th Ed. (Beery VMI). Guided by the COnsensus-based standards for the Selection of health Measurement INstruments, statistical analysis was conducted using various non-parametric tests to assess the internal consistency, construct, and criterion validity of the HKWSA-V2. RESULTS: The internal consistency of the HKWSA-V2 ranged between adequate and excellent (Cronbach's α = 0.61-0.88). Construct validity as hypothesised, was supported with strong correlations found between groups of children who had and had not been involved in the HKWP. Statistically significant differences were also found in HKWSA-V2 scores based on the child's chronological age (r = .51, p < .01; r = .34, p < .05) and year level (p = .00). Criterion validity was substantiated with moderate to strong correlations found between all HKWSA-V2 scales and subscales and the Beery VMI subscales (ρ = 0.06-0.53). CONCLUSION: Evaluation of the tool provides promising initial psychometric findings. The tool allows professionals and clinicians to evaluate a child's visual motor abilities according to concepts learnt within the HKWP. Further development of the HKWSA-V2 is warranted.

Longitudinal Assessment and Functional Neuroimaging of Movement Variability Reveal Novel Insights Into Motor Dysfunction in Clinical High Risk for Psychosis.

Motor dysfunction in youth at clinical high risk (CHR) for psychosis is thought to reflect abnormal neurodevelopment within cortical-subcortical motor circuits and may be important for understanding clinical trajectories of CHR individuals. However, to date, our perspective of brain-behavior relationships has been informed solely by cross-sectional correlational studies linking behavior in the lab to brain structure or respective resting-state network connectivity. Here, we assess movement dysfunction from 2 perspectives: study 1 investigates the longitudinal progression of handwriting variability and positive symptoms in a sample of 91 CHR and healthy controls during a 12-month follow-up and study 2 involves a multiband functional magnetic resonance imaging task exploring the relationship between power grip force stability and motor network brain activation in a subset of participants. In study 1, we found that greater handwriting variability was a stable feature of CHR participants who experienced worse symptom progression. Study 2 results showed that CHR individuals had greater variability in their grip force and greater variability was related to decreased activation in the associative cortico-striatal network compared to controls. Motor variability may be a stable marker of vulnerability for psychosis risk and possible indicator of a vulnerable cortico-striatal brain network functioning in CHR participants, although the effects of antipsychotic medication should be considered.

Assessment of completeness and legibility of handwritten prescriptions in six community chain pharmacies of Asmara, Eritrea: a cross-sectional study.

BACKGROUND: Incompleteness and illegibility of prescriptions are prescription errors that account for a high proportion of medication errors that could potentially result in serious adverse effects. Thus, the objective of this study was to assess the completeness and legibility of prescriptions filled in the community chain pharmacies. METHODS: An analytical and cross-sectional study was conducted in the six government owned community chain pharmacies of Asmara, Eritrea from June 3rd to 10th, 2019 using a stratified random sampling technique. A total of 385 prescriptions were analyzed for completeness and legibility by three pharmacists (two experienced and one intern pharmacist). Descriptive statistics and multinomial logistic regression were employed using IBM SPSS® (Version 22). RESULTS: A total of 710 drugs were prescribed from the 385 prescriptions assessed. On average, a prescription was found to have 78.63% overall completeness. In the majority of the prescriptions, patient's information such as name, age, sex, and prescriber's identity were present. Prescribed drugs' information such as dose, frequency and quantity and/or duration were present in 83.7, 87.7, and 95.1% respectively. Moreover, generic names were used in 83.3% of the drugs prescribed. About half (54.3%) of the prescriptions' legibility were classified in grade four (clearly legible) and 30.6% in grade three (moderately legible). It was observed that legibility significantly increased with an increase in percentage completeness (rs = 0.14, p = 0.006). However, as the number of drugs written in brand name increased, legibility decreased (rs = - 0.193, p < 0.001). Similarly, as the number of drugs prescribed increased, legibility decreased (rs = - 0.226, p < 0.006). CONCLUSION: Majority of the handwritten prescriptions received in the community pharmacies of Asmara are complete and clearly legible.

Biometric handwriting analysis to support Parkinson's Disease assessment and grading.

BACKGROUND: Handwriting represents one of the major symptom in Parkinson's Disease (PD) patients. The computer-aided analysis of the handwriting allows for the identification of promising patterns that might be useful in PD detection and rating. In this study, we propose an innovative set of features extracted by geometrical, dynamical and muscle activation signals acquired during handwriting tasks, and evaluate the contribution of such features in detecting and rating PD by means of artificial neural networks. METHODS: Eleven healthy subjects and twenty-one PD patients were enrolled in this study. Each involved subject was asked to write three different patterns on a graphic tablet while wearing the Myo Armband used to collect the muscle activation signals of the main forearm muscles. We have then extracted several features related to the written pattern, the movement of the pen and the pressure exerted with the pen and the muscle activations. The computed features have been used to classify healthy subjects versus PD patients and to discriminate mild PD patients from moderate PD patients by using an artificial neural network (ANN). RESULTS: After the training and evaluation of different ANN topologies, the obtained results showed that the proposed features have high relevance in PD detection and rating. In particular, we found that our approach both detect and rate (mild and moderate PD) with a classification accuracy higher than 90%. CONCLUSIONS: In this paper we have investigated the representativeness of a set of proposed features related to handwriting tasks in PD detection and rating. In particular, we used an ANN to classify healthy subjects and PD patients (PD detection), and to classify mild and moderate PD patients (PD rating). The implemented and tested methods showed promising results proven by the high level of accuracy, sensitivity and specificity. Such results suggest the usability of the proposed setup in clinical settings to support the medical decision about Parkinson's Disease.

Lecturas de Piaget en América Latina: Emilia Ferreiro, la lectoescritura y el fracaso escolar / Leituras de Piaget na América Latina: Emilia Ferreiro, alfabetização e fracasso escolar / Piaget readings in Latin America: Emilia Ferreiro, literacy and school failure

Se presentan las transformaciones en la lectura y utilización de la teoría de Piaget que desarrollaron en la Argentina en la década de 1970, y cómo estas recogieron importantes problemáticas sociales de su tiempo. En primer lugar se presenta la labor de Emilia Ferreiro, sus antecedentes formativos y la investigación que dio lugar a la publicación del libro Los sistemas de escritura en el desarrollo del niño (Ferreiro & Teberosky, 1979). Luego se destacan las innovaciones que ese texto produjo en la época: la introducción de una lectura novedosa de la teoría de Piaget; la utilización de conceptos de psicología genética en un campo nuevo; la realización de una investigación empírica desde el método piagetiano; la localización del problema del acceso a la lectoescritura y su relación con el fracaso escolar involucrando aspectos hasta ese momento invisibilizados, como la pobreza y la desigualdad social en América Latina. Finalmente se analiza la recepción del texto en la Argentina, donde aparecen las marcas de la dictadura militar, como el exilio, la censura y la clandestinidad; el encuentro con el texto de Ferreiro muestra una cara de la persecución ejercida sobre los intelectuales y las formas clandestinas de circulación de saberes que una generación profesional enfrentó.(AU)

O texto apresenta as transformações na leitura e utilização da teoria de Piaget na Argentina na década de 1970, e como foram estes trabalhos levantaram importantes questões sociais da época . Primeiro, introduz-se o trabalho de Ferreiro, sua formação educacional e as pesquisas que levaram à publicação do livro Psicogênese da língua escrita (Ferreiro & Teberosky, 1979). Em seguida, apresentam-se as inovações que esse texto produziu na época: uma nova leitura da teoria de Piaget na mídia acadêmica da Argentina; a utilização da psicologia genética em um novo campo; a realização de uma pesquisa empírica a partir do método piagetiano; a localização do problema do acesso à alfabetização e sua relação com o fracasso escolar, envolvendo aspectos até então invisíveis, como a pobreza e a desigualdade social na América Latina. Finalmente, expomos os avatares da recepção do texto na Argentina, aí aparecendo as marcas da ditadura militar, como o exílio, a censura e a clandestinidade; o encontro com o texto de Ferreiro mostra o rosto da perseguição exercida sobre os intelectuais e as formas clandestinas de circulação de conhecimento que uma geração profissional teve que enfrentar.(AU)

Transformations in readings and use of the theory of Piaget in Argentina in the 1970s are presented, and how they collected social important problems of their time. First, we present the work of Emilia Ferreiro, his educational background and the research that led to the publication of the book Literacy before schooling (Ferreiro & Teberosky, 1979). Then we highlight the innovations that that text introduced: a novel reading of Piaget's theory in the academic media of Argentina; the qualification of genetic psychology concepts in a new field; an empirical research process from the Piagetian method; To place the problem of access to literacy and its relation to school failure, involving aspects that until then have been invisible, such as poverty and social inequality in Latin America. Finally we expose the vicissitudes of the reception in Argentina, were they appeared the marks of the military dictatorship, such as exile, censorship and clandestinity; the encounter with Ferreiro's text shows one side of the persecution exerted on the intellectuals and clandestine forms of circulation of knowledge that a professional generation had to face.(AU)

Evaluation of the Reliability and Validity of the Brazilian Version of the Here's How I Write: A Child's Self-Assessment and Goal Setting Tool.

OBJECTIVE: Our objective was to translate the Here's How I Write: A Child's Self-Assessment and Goal Setting Tool (HHIW) to Portuguese; adapt it to the Brazilian culture; and analyze its reliability, validity, and clinical feasibility. METHOD: The study was developed in two steps: adaptation of the HHIW to Brazilian Portuguese, followed by experimental application to examine its validity and reliability. The participants were 60 children and their teachers, divided into two groups: Group 1, whose members had handwriting difficulties, and Group 2, whose members did not. RESULTS: Children with poor handwriting scored lower on the HHIW for both self- and teacher report. Test-retest reliability of the children's (.96) and teachers' (.93) questionnaires as well as internal consistency (.91 and .95, respectively) were excellent. There was good agreement (.74) between the children's and teachers' total scores. CONCLUSIONS: This study adds further evidence of validity and reliability and supports the international use of the HHIW. The HHIW is a useful resource to engage children and teachers in a collaborative relationship to improve handwriting.

Handwriting movements for assessment of motor symptoms in schizophrenia spectrum disorders and bipolar disorder.

The main aim of the present study was to explore the value of several measures of handwriting in the study of motor abnormalities in patients with bipolar or psychotic disorders. 54 adult participants with a schizophrenia spectrum disorder or bipolar disorder and 44 matched healthy controls, participated in the study. Participants were asked to copy a handwriting pattern consisting of four loops, with an inking pen on a digitizing tablet. We collected a number of classical, non-linear and geometrical measures of handwriting. The handwriting of patients was characterized by a significant decrease in velocity and acceleration and an increase in the length, disfluency and pressure with respect to controls. Concerning non-linear measures, we found significant differences between patients and controls in the Sample Entropy of velocity and pressure, Lempel-Ziv of velocity and pressure, and Higuchi Fractal Dimension of pressure. Finally, Lacunarity, a measure of geometrical heterogeneity, was significantly greater in handwriting patterns from patients than from controls. We did not find differences in any handwriting measure on function of the specific diagnosis or the antipsychotic dose. Results indicate that participants with a schizophrenia spectrum disorder or bipolar disorder exhibit significant motor impairments and that these impairments can be readily quantified using measures of handwriting movements. Besides, they suggest that motor abnormalities are a core feature of several mental disorders and they seem to be unrelated to the pharmacological treatment.