JMIR Publications

ABSTRACT

Background:

Difficulties in handwriting, such as Dysgraphia, impact several aspects of a child’s everyday life. Current methodologies for the detection of such difficulties in children suffer three main weaknesses: (1) they are prone to subjective evaluation; (2) they can be administered only when handwriting is mastered, thus delaying the diagnosis and the possible adoption of countermeasures; and (3) they are not always easily accessible to the entire community.

Objective:

This work aims at developing a solution able to: (1) quantitatively measure handwriting features whose alteration is typically seen in children with Dysgraphia; (2) enable their study also in a preliteracy population; and (3) leverage a standard consumer technology to increase the accessibility of both an early screening and a longitudinal monitoring of handwriting difficulties.

Methods:

We designed and developed a novel tablet-based app─Play-Draw-Write─to assess potential markers of Dysgraphia through the quantification of three key handwriting laws: isochrony, homothety, and speed-accuracy tradeoff. To extend such study also to a preliteracy age, the app includes the study of the laws on both word writing and symbol drawing.

Results:

App testing on a group of 15 primary school children confirmed that the three laws hold on the tablet surface, both when writing words and drawing symbols, in at least 93% of cases. Importantly, the three laws were always verified on symbols on a group of 19 kindergartners. Results from the speed-accuracy exercise showed a significant evolution with age of the global movement time, the goodness of fit of the regression between movement time and accuracy constraints, and the index of performance. Our findings show that homothety, isochrony and speed-accuracy tradeoff principles are present in children even before handwriting acquisition; however, some handwriting-related skills are partially refined with age.

Conclusions:

The designed app represents a promising solution for the screening of handwriting difficulties, since it allows (1) anticipating the detection of alteration of handwriting principles to a preliteracy age; and (2) providing a broader access to the monitoring of handwriting principles. Such a solution potentially enables the selective strengthening of lacking abilities before they exacerbate till affecting the whole child’s life.