Objectives: To examine the specificity of handwriting impairments in children with ASD by comparing their performance to children with ADHD as well as TD children.
Methods: Nine children with ASD (mean age 10.35; 3 females), 7 children with ADHD (mean age 10.00; 3 females), and 10 TD children (mean age 10.89; 4 females) completed the Minnesota Handwriting Assessment (MHA) (Reisman et al., 1999); the groups were matched on age, gender, handedness and IQ. Subjects were instructed to use their best handwriting to copy the following words exactly on the provided test sheet: “The brown jumped lazy fox quick dogs over”. Each letter was scored individually according to the Minnesota Handwriting Assessment scoring protocol on five categories: Legibility, Form, Alignment, Size and Spacing.
Results: A 3-way MANOVA revealed a significant effect of diagnosis for form (p=0.02), alignment (p=0.05) and total (p=0.03) scores. Further 2-way analyses revealed that children with ASD demonstrated significantly worse form (F=7.36, p=0.02) and total score (F=7.98, p=0.01) than TD children. In comparison, children with ADHD demonstrated significant handwriting impairments in legibility (F=6.47, p=0.02), form (F=7.81, p=0.01) and alignment (F=10.01, p=0.01). Comparisons of ASD and ADHD children revealed no significant differences on legibility, form, alignment, size or spacing.
Conclusions: Children with ASD demonstrated an overall impairment in handwriting, specifically seen in the quality of letter formation. In contrast, children with ADHD showed a broader range of impairments, which included difficulties with legibility, form and alignment. The findings suggest that for children with ASD, difficulty with handwriting may be associated with abnormalities in the internal representation of how the letters are formed and/or how those representations are executed. In contrast, handwriting difficulty in children with ADHD appears to be associated with a broader range of difficulties, in particular problems with motor control necessary for proper alignment and legibility.
See more of: Sensory Systems, Motor Systems, and Reptetative Behavior
See more of: Autism Symptoms