Persistent handwriting problems are hard to predict: A longitudinal study of the development of handwriting in primary school

Background: After one year of tuition, up to a third of primary school children show insufficient handwriting. It is unclear whether this early insufficient handwriting predicts persistent handwriting problems, because there is a dearth of studies that followed developmental trajectories longitudinally. Aims: To describe handwriting development in primary school children longitudinally and to determine predictive positive value and sensitivity of early handwriting assessment. To analyse whether underlying abilities helps early identification of persistent handwriting problems. Methods: 173 primary school children were yearly assessed for four years using the Concise Assessment Scale for Children's Handwriting and the Beery Buktenica developmental test of visual-motor integration. Results: Both quality and speed of handwriting increased with years of tuition, with a pronounced increase in quality between two and three years of writing tuition. Sensitivity and positive predictive value were low. The only significant predictor of handwriting quality was handwriting quality in the previous year. For handwriting speed, no significant developmental model was revealed. Conclusions: Quality and speed of handwriting after one year of tuition is not sufficiently predictive for distinguishing between transient insufficient handwriting and persistent handwriting problems three years later. Practitioners should hold back when referring children for remedial teaching.