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Autism Spectrum Disorders Health Center

Kids With Autism Need Handwriting Help

As Kids Overcome Autism, Handwriting Thwarts Progress
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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.

There's no one-size-fits-all solution. But there's a lot of hope. Some of the kids in the Bastian study had more legible handwriting than some of the "normal" kids, although it took a lot of effort. Two of the kids with the best handwriting had been taught by physical therapists to steady their writing hand with their other hand.

"Physical therapists are very clever," Bastian says. "We can teach kids to change their grip on the pen, give fatter or weighted pencils -- or maybe motor practice can be effective. Many of the parents we have interacted with are happy to know this is a purely motor problem, because it is a bit more straightforward to work on such things than to work on behavioral issues."

Some kids may do better typing on a computer keyboard than writing with pencil and paper.

Bastian warns that poor handwriting can't be used to diagnose autism. There are lots of reasons why a child doesn't write well; but an autism diagnosis is based on an entirely different set of criteria.

"Parents of children with autism may want to talk to the administration about whether their child qualifies for physical or occupational therapy, or ask their doctor if they can have some occupational therapy prescribed," Bastian says. "These kids really should be looked at. Because if you are trying to listen to your teacher and trying to understand her and also having to work as hard as you can on your writing, it can be very bad for self-esteem and academic success."

Bastian and colleagues report their findings in the Nov. 10 issue of Neurology.

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