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Kids With Autism Need Handwriting Help

As Kids Overcome Autism, Handwriting Thwarts Progress
WebMD Health News
Reviewed by Louise Chang, MD

Nov. 9, 2009 -- Kids battling autism face an extra hurdle: handwriting.

The problem seems to be something parents have long suspected, but that researchers are only beginning to define.

It's long been obvious to Jennifer Toney. Her son, Alex, has autism. Alex, age 9, is at least as intelligent as his fourth-grade classmates who don't have autism. But in addition to overcoming the relational and developmental challenges of autism, Alex also battles subtle motor-control issues.

"He's always had a bit of minor gross motor delay," Toney tells WebMD. "For example, he doesn't know how to ride his bike without training wheels. And he's always had balance issues, like walking up stairs one foot at a time."

None of this has kept Alex from being placed in a regular classroom with other kids his age. But his difficulty writing numbers and letters means he has to work harder than others do -- and, frustratingly, he sometimes gets lower grades than he deserves.

"His writing is very hard to read. The letters are really big and spaced funny and malformed and misshaped and the circles are not really circles," Toney says. "Because of that, he has trouble completing work. And in math, he often gets questions marked incorrectly even though the numbers really are there. ... His problem isn't getting the knowledge -- it's getting it on paper to demonstrate he's getting the knowledge."

Things may soon change for kids like Alex. A new study -- in which Alex participated -- shows that high-achieving kids with autism very often have trouble with handwriting.

It should come as no surprise. Hans Asperger, the first to describe relatively high functioning people with autism, noted that "the pen did not obey" one of his original patients. But research failed to show exactly what was wrong.

Now Amy J. Bastian, PhD, PT, and colleagues at Baltimore's Kennedy Krieger Institute, have identified a central clue. Using a test that dissects five separate aspects of handwriting, they showed that normal-intelligence kids with autism can align, size, and space their letters as well as normal kids.

The problem is that they have great difficulty forming their letters -- suggesting that the problem relates to motor control. That's new, because motor signs are not classically associated with autism.

"Where they broke down was in the fine motor control when they had to form actual letters," Bastian tells WebMD. "Their letter 'D' might have a gap at the top, or they are unable to make the curve match up with the line on a lower-case 'd.' A letter might have a piece falling out, or have sharp protrusions rather than clearly curving features. Clearly they have this problem with fine motor control."

It's not just writing that's a problem, as Toney and other parents already know. These high-achieving kids also have other problems, such as holding and using eating utensils in a normal way.

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