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Exploratory study of handwriting disorders in school-aged children for a better nosography

Published online by Cambridge University Press:  19 July 2023

C. Lopez
Affiliation:
1INSERM Unit 1018-CESP, Faculty of Medicine, University of Paris-Saclay, UVSQ, Villejuif
L. Vaivre-Douret*
Affiliation:
1INSERM Unit 1018-CESP, Faculty of Medicine, University of Paris-Saclay, UVSQ, Villejuif 2Faculty of Health, Department of Medicine Paris Descartes, University of Paris Cité 3Chair in Clinical Neurodeveloppmental Phenotyping, Institut Universitaire de France (IUF) 4Department of Endocrinology, IMAGINE Institute of Necker-Enfants Malades hospital 5Department of Child Psychiatry, Necker-Enfants Malades Hospital, AP-HP.Centre, Paris, France
*
*Corresponding author.

Abstract

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Introduction

Handwriting disorders (HDs) are prevalent in elementary school children, but their nature is poorly understood. Moreover, the diagnosis of dysgraphia is often too quickly concluded on a single assessment.

Objectives

In the present study, we aimed to use a transdisciplinary assessment approach. We looked for to provide objective data to better understand the nature and aetiology of HDs.

Methods

27 school aged children with HDs aged 6-11 years were included in the study and were compared to typically developing children. They performed a normed prescriptural task of copying cycloid loops. Postural and gestural inter-segmental coordination of arm movements were recorded with two video cameras allowing 2D reconstruction of the gesture. Spatial/temporal kinetic and kinematic measures were recorded with a digital pen. All children underwent normed and standardized clinical assessments of neuropsychomotor, neuropsychological and oculomotor functions. The handwriting test (BKK) were used.

Results

Handwriting disorders seem very heterogeneous. However, there is a significantly poorer gestural of inter-segmental coordination and of kinetic/kinematic performances of the tracings in HDs. Furthermore, it was possible to highlight three levels of HDs: mild HD not detected by the BHK test (26% of children), moderate HD with the BHK (33%), dysgraphia identified by the BHK (41% of children). The mild nature of HDs not dectected by the BHK seems to occur to a relatively low frequency with associated disorders identified during clinical assessments. On the contrary, dysgraphia appears linked to a high frequency of the associated disorders with a majority of oculomotor disorders (55% of children) leading to visual-perceptual difficulties (44%).

Conclusions

HDs appear to be multifactorial but have a common characteristics of immaturity of gestural synergy of the arm, associated with poorer spatio-temporal kinetic and kinematic parameters. Dysgraphia occurs with more severe disorders as oculomotor and visual perception impairments. Our findings highlight the importance to identified a nosography of HDs with a transdisciplinary evaluation to better understand the nature and aetiology of the disorders in order to better clinical decision-making processes for handwriting remediations.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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