Is there a difference in the handwriting of children with Autism Spectrum Disorders (ASD)?

Table 8 Author: Sarah Kersey

Author, Year / Study Objectives / Study Design/ Participants / Level of Evidence / Sample Size / Interventions and Outcome Measures / Summary of Results (Conclusions and Implications) / Study Limitations
Cartmill, L., Rodger, S. & Ziviani, J. (2009) / Examine whether the handwriting of children with ASD was different from that of children without ASD in regards to speed and legibility. / Cross-sectional experimental design
56 eight year old children from Australia, 28 with ASD and 28 without ASD that were matched as a comparison group / IV / 56 / The Sequential Handwriting Process, the Speed Subtest of the Handwriting Performance Test, Test of Legibility of Handwriting, Letter Recognition Test, Alphabet to Dictation Test, the Minnesota Handwriting Assessment, The Test of Innervatory Programme-Percentage Similarity, and The Test for Innervatory Programme-Ratio of Size were used. / Handwriting of children with ASD was both slower and less legible that that of the comparison group, however the differences found were not significant. In regards to process variables, accuracy of letter formation was the only variable found to be significantly different, with children with ASD having less accurate letter formation. All other aspects of handwriting measured were not significantly different. / Smaller sample size, limited ages and ranges of children with ASD, variables were insufficient to explain handwriting speed, complexity of handwriting and differing factors that can impact children with ASD was not explored
Mayes, S. D. & Calhoun, S. L. (2007). / To determine differences between typical children and children with ADHD, autism, anxiety, depression, and oppositional defiant disorder in learning, attention, graphomotor, and processing speed / 886 children with clinical disorder and 149 typical children ages 6 to 16 with an IQ of 80 or above were assessed using a variety of instruments to determine differences in learning, attention, graphomotor abilities, and processing speed. / IV / 1035 (886 with clinical disorders, 149 typical) / The outcome measures used were WISC-III to measure intelligence, the WIAT and WRAT-III for academic achievement, the GDS and Digit Scan to measure attention, the VMI and Coding Subtest of the WISC-III to measure graphomotor ability, and the Symbol Search subtest from the WISC-III to measure processing speed. / No significant differences were found between the control group and children with anxiety, depression, or oppositional defiant disorder in any of the areas explored. Control children performed better than children with autism and ADHD in all areas, with particular weaknesses in attention, graphomotor and speed. Children with autism and children with ADHD performed similarly in all areas / Number of children in each group were very disproportionate (724 ADHD, 118 autism, 25 depression and/or anxiety, 19 ODD, and 149 typical)

Summary: As evidenced by the research, children with Autism (ASD) do demonstrate less skill in accuracy of letter formation as compared to their typical developing peers. Children with ASD also demonstrate weakness in attention, graphomotor, and speed of handwriting. Their handwriting quality was poorer and speed was much slower than their typically developing peers, however the differences in handwriting were not significant. More research needs to be done to examine the differences in handwriting of children with ASD as compared to their typically developing peers.