Helping Hands Therapy Pediatric Services

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Get a Grip on Fine Motor Development

Handwriting is Hard

If your child struggles with handwriting, they’ve probably thought something like…

“You mean I’m supposed to sit at a desk for a half hour just to make a bunch of squiggles? And they’re supposed to mean something–to you, my teacher, and me?”

“Uppercase and lowercase letters? Sheesh. Don’t you think that’s asking a lot?”

“I’d rather be outside or playing video games. Maybe even cleaning my room. Anything but this.”

For many children, handwriting is stressful because they have difficulty with… 

  • Attention and unmet sensory needs

  • Visual perception and visual motor senses

  • Hand-eye coordination

  • Improper posture or seating set-up

  • Decreased grip strength, core strength, shoulder strength

  • Comprehension or interpretation of letters

  • Dyslexia or other visual processing disorders

Occupational Therapists address these and several other barriers to function. We want your child to be successful at handwriting with minimal stress. 

There’s a better way.

If you aren’t sure where to start, Helping Hands Therapy Clinic hosts a Handwriting Summer Camp. This camp prepares your child for the school year ahead. We’ll be using the Handwriting Without Tears Curriculum. Our occupational therapists will guide your child through fun exercises and activities to improve their handwriting. 


Say goodbye to the writing war and huzzah to a tearless victory. We like to keep class sizes small so we can keep quality big. Register today and don’t let this opportunity slip by amidst the summer craziness. School is right around the corner. 

Click Here to claim your child’s spot. Children going into kindergarten through second grade are eligible.  Starts 07/05/2023, for six weeks.

To view a full list of available summer camps on our website click here.

Start From The Bottoms: Appropriate Seating

When occupational therapists are teaching fine motor or feeding skills, the first thing we look at is seating and positioning. This is because your child may be uncomfortable or inefficient with the task at hand if they are positioned incorrectly.

Some tips for positioning before handwriting at home…

  • The rule of 90–90–90

This rule refers to your child’s joints–elbows, knees, hips. Each of these joints should be at 90 degrees. Your child should sit with their feet flat on the floor, knees at hip height, and hips underneath their shoulders. Their elbows should be at a 90-degree angle when resting their arms on the desk in front of them. 

If your child is a smidge short, try putting a box or stool under their feet to prevent lower back strain. To make sure elbows are at 90 degrees, have your child sit on a cushion for extra height–this prevents upper back and neck strain. If your child is a smidge tall, you may need to get a desk and chair that are height adjustable.

  • Attention! Dynamic seating 

Has focus flown out the window along with a couple of paper airplanes? If your child has the wiggles or if it’s just generally difficult for them to focus, have them try handwriting while seated on a yoga ball, wobble cushion, or an active motion stool. Be sure to only use these for the purpose of getting work done. If not introduced as tools, these seats can be viewed as toys for playtime. 

  • Slanted surfaces to prevent wrist strain.

    If your child is complaining of wrist pain, have them write on a slanted surface. A four-inch binder is a simple alternative to devices like folding slant boards and slanted clipboards.

Stronger Muscles, Stronger Writing Skills

When your child writes, they aren’t just using their fingers. They’re using muscles in their core, shoulders, arms, forearms, and hands. Sometimes children are frustrated with writing because their muscles aren’t as strong as they could be and get tired quickly. 

Here are some fun activities to try at home to build upper body strength or prepare little hands to write some sentences…

  • Write on a vertical surface. Writing on a vertical surface improves shoulder and core strength. Your child can write or draw on a piece of paper taped to the wall at shoulder height. They can form the alphabet while standing at a big wipe board, smartboard, or chalkboard. They can make their name with shaving cream on a mirror or write with soap paints on the tub walls. The possibilities are limited only by your child’s imagination and your threshold for cleanup.

  • Dynamic seating. We covered this a bit in the last section, so I won’t be too long-winded. But dynamic seating is a great way to engage your child’s core. It builds up the major muscles that keep your child’s posture in ship shape. This prevents back and shoulder pain. So your child can comfortably write more at one time. 

  • Handwriting prep games. Your child can complete these games just before writing to warm up their muscles. There are several fine motor warm-ups to choose from. Some common ones include pushing palms against each other, spreading fingers out then back again, and rotating a pencil between fingers or up and down the pencil shaft.

  • Adaptive writing grips. These are helpful if your child has a difficult time knowing where to place their fingers on the pencil. Effective grips are designed to keep your child’s fingers near the base of the pencil and in a tripod grasp–the ideal grasp for handwriting.

  • Painting with Q-tips. Hear me out. First off, this was not my idea. Our pediatrics professor had us do this in the Lab one day and it’s a pretty nifty trick. This is a great activity if your child has difficulty making and maintaining a tripod grasp. Because the shaft of the Q-tip is thin, your child will naturally want to use their thumb, first and second fingers in the appropriate grasp for handwriting. 

  • Play-Doh Letters. Play-Doh involves squeezing, pressing, and molding. This is a wonderful activity to strengthen the muscles of the fingers and hand. You can even have your child form letters out of Play-Doh for a learning experience in addition to strengthening. 

Let’s See…Vision Difficulties and How to Help

There are two parts to vision–visual motor and visual perception. Impairments in either or both of these abilities can significantly affect your child’s success with handwriting. 

Visual motor refers to the actual physical movement of the eye. These are the left to right, up and down, diagonal movements–and everything between. This also involves the eyes working together to adjust to an object that is close or far away. Convergence is when the eyes move together, down towards the nose. Saccadic eye movement is the rapid movement from side to side. These are both essential skills for reading. If your child is not able to read, they will not be able to write. 


Visual perception is the brain’s interpretation of visual information gathered by the eye. Sometimes the eye talks to the brain and the brain gets a little confused. This may result in letters being flipped around and mixed up, like in dyslexia. 


There are eight types of visual perception skills(5). Your child needs these skills to read and write well. For example, understanding that a letter is the same regardless of its size is an area of visual perception called form constancy. Picking out the important stuff on a page is called visual figure-ground–this helps your child focus on reading words and sentences without getting lost in a big paragraph. To learn more or review a full list of visual perception skills, please visit the references section. 

Then there’s a good ‘ol vision check. If your child is rubbing their eyes or gets frequent headaches after reading for long periods of time, they may need glasses. If they wear glasses already, they may need their current prescription adjusted. 

An occupational therapist has skilled knowledge of assessments to determine the cause of your kiddo’s eye troubles. They’ll also work with you to solve them. A pediatric occupational therapist is skilled in guiding children through visual-motor exercises to improve eye convergence and overall motor function. They’ll also recommend resources for fun activities you can do with your child at home to improve visual perception and visual motor skills. 

Handwriting Without Tears Curriculum: FAQs

What is it?

Handwriting Without Tears is a curriculum that uses a multi-sensory, play-based approach. They use this approach to motivate children during handwriting tasks and teach them to write effectively. Created by an occupational therapist, the curriculum considers a child’s developmental skill set and makes learning fun.

Who is it for? 

Handwriting Without Tears is designed for children in Pre-K through 5th grade. A pediatric occupational therapist is skilled in adapting this curriculum to your child’s specific needs. It may be used with children who have dyslexia, autism, or other learning disabilities. 

Is it credible?

This curriculum is over 40 years old and has been used widely by teachers and occupational therapists in schools. It was originally created by Jan Olsen, an occupational therapist who compiled and refined handwriting strategies for her son who was struggling in school(2). The American Journal of Occupational Therapy has reviewed research and in an article(1) published in 2015, concluded that the curriculum successfully supports handwriting skills. 

Summer Camp: Handwriting Without Tears

Click Here to register your child for our Handwriting Summer Camp at Helping Hands Therapy Services. School starts in a month. We want your child to be comfortable and ready to write. It’s our hope your child will grow their handwriting skills and enjoy the process. 

We like to keep our classes little so we can keep quality big, so don’t delay in signing up. Group spots are limited and are going fast. 

See you soon!

References 

(1) https://research.aota.org/ajot/article/69/6/6906180050p1/6048/Handwriting-Without-TearsR-General-Education 

(2) https://www.lwtears.com/solutions/writing/handwriting-without-tears

(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329757/

(4) https://www.optometrists.org/vision-therapy/guide-vision-and-learning-difficulties/guide-to-visual-information-processing/signs-of-visual-processing-information-dysfunction/https://www.ncbi.nlm.nih.gov/books/NBK10991/ 

(5) https://www.churchillstl.org/learning-disability-resources/visual-processing-disorder/

(6 )https://onlinelibrary.wiley.com/doi/abs/10.1002/dys.1561 

Blog written and formatted by Victoria S. Eilers, COTA/L

Practicing Occupational Therapy Assistant, and Copywriter at The Copywriting COTA