Hey Reader,

As a school-based OT practitioner, it doesn't take long to realize how vague and unhelpful a referral for "poor handwriting" can be.

Poor handwriting during what task?

Copying? Note-taking? Writing an original paragraph?

That distinction is exactly why I think you’ll want to hear my conversation with Kelli Fetter in Episode 205 of the OT Schoolhouse Podcast.​

Kelli is an OT, a Certified Handwriting Specialist, and the founder of Handwriting Solutions. And in this episode, we talked about dysgraphia, written expression, assessment, intervention, and the role school-based OT practitioners can play when students are struggling to get their thoughts onto paper.

One point from our conversation that stood out to me was this:

Just because a student can copy and maybe even legibly produce “the quick brown fox jumps over the lazy dog” during an OT assessment doesn’t mean they'll be able to fully participate in writing activities in the classroom.

As Kelli explained, copying from a model is one level of cognitive load. It can tell us something about letter formation, spacing, sizing, alignment, visual-motor integration, and motor control.

But it does not tell us the whole story.

In the classroom, students are rarely asked to just copy one sentence in a quiet setting.

They are being asked to:

• Listen to directions
• Think about what they want to say
• Organize their ideas
• Spell correctly
• Use correct punctuation
• Manage the motor task of writing
• And keep up with their peers.

All while not showing a whiff of "refusal"

And if we only assess the copying piece, or even writing from dictation, we may walk away thinking, “Their handwriting looks fine,” while the teacher is still seeing a student who cannot get thoughts onto paper during real classroom writing tasks.

This is why I appreciated Kelli’s framework around cognitive load. She encourages us to look at handwriting across different demands:

• Tracing or imitation
• Near-point copying
• Far-point copying
• Writing from dictation
• And self-generated writing

That progression matters. And it is why I appreciate using the ETCH when assessing handwriting. The Decoste is also a popular tool for this.

We must not forget that the physical aspect of handwriting is just one part of written expression. It is connected to literacy, executive functioning, classroom participation, and a student’s ability to show what they know.

That does not mean OT practitioners need to address every piece alone. In fact, Kelli emphasized that this work is collaborative. Teachers, special educators, SLPs, families, and OT practitioners all have a role to play.

It means that we have to ask better questions before we decide what support a student needs.

• Can they copy accurately but fall apart during dictation
• Can they write neatly when the words are provided but struggle when they have to generate their own sentence
• Are we supporting handwriting practice while also giving accommodations that help the student participate right now?

Those questions can change the way we assess, write goals, and even collaborate with teachers.

And most importantly, they can change the way we support students who are often told they are lazy, rushing, or not trying hard enough when the task is actually asking far more of them than we realize.

Handwriting referrals aren’t going away, so I know this episode will be well worth your time.

​Listen to the full episode with Kelli here during your next walk, drive, or workout!​

CONTINUING EDUCATION 🎓

More handwriting support starts with stronger school-based OT practice.

At the Back to School Conference, we are focusing on evidence, practical tools, and the evolving role of school-based OT.

That includes topics like MTSS, educationally relevant goals, assistive technology, sensory supports, and evaluations that better reflect student participation.

If you want the conference plus year-round support, the School-Based OT Collaborative includes conference access, extended replays, monthly mentorship, additional courses, templates, tools, and the Goal & Treatment Bank.

​See the Conference + Collab option​

RESEARCH 🧪

You heard the podcast, now review this scoping review by Andrew Cole: “Occupational therapy intervention to address handwriting deficit in elementary-aged school children: How to, how much, and how often?”

The review found that curriculum-based handwriting programs using task-specific motor learning approaches showed statistically significant improvements in handwriting, including programs with direct and indirect OT involvement.

​Read the article abstract​

LAST WORD 👋​
​I think we all agree that OT is more than fine motor.

Now, we just have to remember that:

1. Handwriting is also more than fine motor
   ​
2. We can support many of those non-fine motor aspects of handwriting (eg., working memory, processing speed, organization, fatigue, confidence, etc)

When the VMI and the BOT tell you that fine motor and visual motor skills are within an average range, but a student’s handwriting is still not functional, don’t just stop and say this isn’t an OT issue. Continue questioning and find out what the real barriers are.

Handwriting is a form of written expression, and we have a responsibility to understand it deep enough to support students, teachers, and teams in meaningful ways.

Thank you for the work you do for the students whose writing struggles are not always easy to see or explain.

​Listen to the full conversation with Kelli Fetter here​

Catch you next time,

👋 Jayson

Jayson Davies, MA, OTR/L
​
​Say hi 👋 on Instagram, LinkedIn,
and inside the School-Based OT Collaborative​