2025 Volume 21 Issue 1 Pages 77-93
Objective: This scoping review identifies and synthesises the factors—child, task, environment, and intervention-related—that are associated with improved handwriting performance in children with handwriting difficulties.
Materials and Methods: Using Arksey and O'Malley's five-step framework and reported in line with PRISMA-ScR, we searched PubMed, CINAHL, MEDLINE, Web of Science and ERIC in May 2023. Articles were evaluated by three reviewers based on the inclusion criteria: (1) children under 18 years of age with handwriting difficulties, (2) studies involving interventions, assessments, and/or observations, and (3) studies conducted in diverse geographical contexts.
Results: The review included 29 studies, of which six were conducted in the United States. Occupational therapists served as the principal investigators in 21 studies, while the remaining studies were led by speech-language pathologists, physical therapists, psychologists, special educators, or system designers. A qualitative thematic analysis of the selected studies identified two key themes: (1) the rationale for designing handwriting programs and (2) additional programs to support handwriting programs.
Conclusion: This study highlights that integrating multiple interventions, including alphabetic tasks, cognitive strategies, and ergonomic exercises, can significantly enhance handwriting performance. Additionally, incorporating home and classroom exercises as supplementary programs can enrich handwriting curricula by leveraging the involvement of parents and instructors, which plays a critical role in motivating and improving children's handwriting abilities. Future research should test these combined approaches in large, controlled trials and explore under-represented regions to strengthen the evidence base.
