Children with high-functioning autism spectrum disorder show unique handwriting patterns

Children with high-functioning autism experience difficulties in the social, sensory, and movement fields, but differ from other children on the autism spectrum in terms of their linguistic and cognitive development. Among other differences, these children are usually integrated in regular schools where they are required to perform routine activities such as reading and writing. Writing tasks play an important part in academic progress: writing-related activities account for 30-60 percent of daily activity time in schools. Despite this, the education system places a strong emphasis on reading, whereas skills development, monitoring, and assistance in handwriting performance are much less frequent. There is also a lack of teacher training in this important area.

The present study is unique and the first of its kind in the world. The study was undertaken as part of the thesis prepared by Hemda Amit Ben Simhon of the Neuro-developmental Center at Maccabi HMO, supervised by Prof. Rosenblum, and in consultation with Dr. Eynat Gal, an autism specialist, both from the Department of Occupational Therapy at the University of Haifa. The study included 60 children aged 9-12 from the 3rd through 6th grades at various schools. Half the subjects were children with high-functioning autism spectrum disorder with IQs above 80, while the other half were children with normal development. The children were asked to complete three writing tasks: writing the first name and family name; copying a paragraph; and writing a story describing a picture that was shown to them.

The writing tasks were completed using a special system developed by Prof. Rosenblum that provides objective, computerized data relating not only to the rhythm and speed of handwriting, but also to the degree of pressure applied on the page by the writer, the length of time the pen is in the air, the degree of slant of the pen during handwriting, and so forth.

The study findings show that in 91.5 percent of the instances, the objective indicators provided by the computerized system enabled the identification of children with high-functioning autism as distinct from children with normal development. In other words, the handwriting performances of the two groups showed statistically significant differences. The children with high-functioning autism produced taller and broader letters; waiting times on paper and in the air were longer; and the degree of slant of the pen was smaller.

It also emerged that the differences between the children with high-functioning autism and those with normal development were particularly prominent in the copying task, and less so in the free writing task. The text copying task required significantly more time. The researchers suggest that the need to invest a long period of time in the handwriting task may exacerbate fatigue, impair concentration, and even hamper the ability to produce handwritten content. This investment in the handwriting task may come at the expense of availability for other academic tasks the children receive, as well as their availability for social challenges in the classroom. "When a child has difficulty writing, they effectively have to cope with this difficulty over many hours a day, making it harder for them to cope with the additional challenges they face (social, cognitive, and functional). For example, if a child has to stay behind in recess to copy text from the board, they will have less time to practice social skills," the researchers explained.

The researchers added that the study findings are particularly important in light of the trend to integrate children with different disabilities in the regular education system, in accordance with the Special Education Law. "Since children with high-functioning autism are integrated in classes together with children with normal development, it is important to be careful not to pressure them during the performance of handwriting tasks. They should be given sufficient time, because time pressure creates cognitive stress and may impair the content of their handwriting. Given the central role of writing throughout the academic process, including in academic studies, improving handwriting skills with the assistance of an occupational therapist may improve academic abilities and contribute to an improvement in achievements and in self-confidence," concluded the study authors Ben Simhon and Prof.