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When the handwriting on the wall spells autism

A new and very small study shows that kids with autism spectrum disorder (ASD) tend to have worse handwriting than their non-ASD peers.

Of 14 kids with ASD and 14 without who were asked to complete a standardized handwriting test, those with ASD specifically had trouble forming letter shapes correctly. Otherwise their handwriting was fine. They spaced and aligned letters correctly and -- perhaps because the test dictated the size of the letters -- made them the right size.

The researchers (from the Johns Hopkins School of Medicine and the
Kennedy Krieger Institute, both in Baltimore) speculate that the handwriting deficit likely stems from the poor fine-motor skills associated with ASD. They observed that among the kids with ASD who performed best on the handwriting test, two clenched the forearm of their writing hand with their non-writing hand as if to steady themselves as they wrote, a technique they'd learned at school.

The authors, whose work appears in the journal Neurology, note that earlier research showed that adults with ASD tend to write their letters very large, perhaps to compensate for their difficulty forming the shapes correctly. It's possible, the authors say, that the kids with ASD in this study, whose average age was just over 10 years, hadn't yet developed that strategy.

This is not the first time it's been noted that kids with ASD tend to have poor handwriting skills. The study quotes Dr. Hans Asperger, for whom one of the syndromes on the autism spectrum is named, as writing of a young patient, "this motorically clumsy child had atrocious handwriting...The pen did not obey him."

But why is this observation important? The study points out that poor handwriting can make academic learning and communication difficult and contribute to lack of self-esteem. Therapies targeting fine motor skills might improve kids' handwriting and thus ward off those difficulties.

I have to say that the study makes me reconsider my attitude toward handwriting, though, especially the notion that bad handwriting contributes to the problems noted in the study. Some of the smartest, best-adjusted people I know have terrible handwriting. And not that I myself am a paragon of knowledge or self-esteem, but people have been bemoaning the chicken-scratches that are my handwriting since I was in grade school, and I've never felt my scrawling hand has held me back.

Of course, the impact of poor handwriting might be more substantial among people with ASD or other developmental issues.

How about you? What's your handwriting like? Has its quality -- or lack thereof -- had any impact on your life in general?

By Jennifer LaRue Huget  |  November 12, 2009; 7:00 AM ET
Categories:  General Health , Neurological disorders  
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Being the father of a child with ASD, this is matter of some interest to me. I would say that it emphasizes the importance of occupational therapy for children with ASD. Secondo is still behind in his fine motor skills, but has made remarkable progress in the last year.

Speaking as a fairly intelligent, non-austistic (as far as I know) adult with horrible handwriting, I can't say as it has affected my life that much. Then again, I'm a very good typist.


Posted by: FairlingtonBlade | November 12, 2009 9:09 AM | Report abuse

I work with a man I suspect has Asperger's and his handwriting looks like a 6-year-old's writing. Big, blocky letters, some written backwards. My handwriting, after working at a keyboard for 45 years, is thin and spidery-looking. I sometimes break into shorthand if I'm writing fast and nobody can read it but me. I tend to type just about everything instead of writing with a pen.

Posted by: Baltimore11 | November 12, 2009 10:10 AM | Report abuse

My 18 YOS's handwriting is very bad and he has PDDNOS. My writing is fairly good but my father's is so bad he sometimes can't read it.

Posted by: Arggg | November 12, 2009 11:23 AM | Report abuse

So, kids with poor fine-motor skills have poor handwriting? Shocker! Who would've thought? The autism angle is a total red herring.

I love the fact that the researchers had to "speculate" that the poor handwriting might (just might) be related to the fine-motor skills deficit.

Maybe for their next study, the researcher will compare visually impaired people to normal people on a test of visual acuity. Conclusion: "People with visual impairments perform worse on tests of visual acuity compared to their normal counterparts."

Posted by: rlalumiere | November 12, 2009 11:25 AM | Report abuse

The writer, rialumiere, who posted his flippant remark just shows you how the public view children who suffer from this debilitating disability. As a parent, I find his or her attitude mean and cruel. It's difficult enough for a young child with normal fine motor skills to master the art of penmanship. Imagine being a child who suffers everyday with impaired social skills as will as poor motor skills. A school age autistic child does not understand why they aren't doing what their peers are, or as well as they. My daughter is 15 years old and she still questions me why she isn't like the other kids? How about a little compassion and understanding? Any research that answers one of the many questions concerning this disability show be applauded not dismissed!

Posted by: jeiken | November 12, 2009 12:36 PM | Report abuse

If fine motor skills are required for good handwriting, how do you explain doctors' and surgeons' handwriting? Nearly impossible to read -- many have gone to typing their prescriptions because pharmacists can't read them.

Posted by: Baltimore11 | November 12, 2009 1:14 PM | Report abuse

Uh, jeiken, you completely misunderstood my comments. My comments were making fun of the research. As I noted, the autism aspect of the research was a red herring. If you have a population of people with impaired fine motor skills, doing a study in which you demonstrate that they are impaired at a task that requires fine motor skills is silly and definitely does not deserve a mention in the WaPo.

Therefore, your point that any research that answers one of the many questions about autism is important does not apply to this research. Why? Because, as I've pointed out twice now, the research doesn't actually answer any questions.

In fact, if you care so much about autism research, you should be agreeing with me and wondering why autism researchers are demonstrating something that is frankly obvious.

To Baltimore11, your logic is flawed. If P, then Q does not imply: If Q, then P. That is, while having poor fine motor skills leads to poor handwriting, poor handwriting does not mean that the person has poor fine motor skills.

Posted by: rlalumiere | November 12, 2009 2:18 PM | Report abuse

Low muscle tone runs in my family. My brother's handwriting is *really* bad. Mine isn't great either, ugly, but usually legible.

My older son has autism, and his handwriting is at least as bad as my brother's. The solution for him is typing.

Younger son is neurotypical, but his handwriting isn't very good either. Like mine, ugly but legible.

When older son's low muscle tone was identified, about a year after his autism diagnosis, we were told that its frequency is about 10 times higher in the autism spectrum population than in the general population. I think the numbers were about 1% overall, and about 10% of autistics.

Posted by: SueMc | November 12, 2009 3:09 PM | Report abuse

rlalumiere, the autism issue is not a red herring at all.

I went and read the actual paper. The researchers were asking two questions:
1. do autistic children in fact have poorer handwriting than typical children? (especially, is it worse in some specific way?)
2. if so, WHY is their handwriting worse?

This is where the autism issue becomes important. Autistic children are known to have various motor skills issues, AND visuospatial processing differences. Either one of these could cause handwriting problems. So the researchers administered some tests.

They found that (within the limitations of the tests they administered, which I think are substantial) visuospatial processing biases were not associated with handwriting scores.

However, they did find that motor skills abilities correlated with handwriting ability in the ASD children. Additionally, they found specifically that the best correlation was with the section of the test requiring timed movements, which also placed the highest demands on fine motor control.

Motor skills ability was NOT correlated with handwriting performance in the typical children, possibly due to a lack of variability in the typical children's scores.

Posted by: cypherpunks3 | November 12, 2009 3:32 PM | Report abuse

To offer some further perspective: autism runs in my family so I have a lot of familiarity with ASD children's various problems, both ours and other families'.

Handwriting is an academic issue for a lot of ASD and ADHD people. The problem is not just legibility and form of a finished sample. It's the ease or fluency with which that sample was produced.

Many ASD and ADHD children have not only "bad" handwriting but also very slow handwriting, produced clumsily or with excessive effort. If you watch them, they appear to be trying to draw the letters each time. It's very much like watching someone who just can't get the hang of riding a bike, no matter how much they practice. Some kind of neurological connection is not being made. The problem is usually called "dysgraphia."

The solution for some kids has been to allow them to type their written assignments, or in cases where that's not practical (an in-class math worksheet), allow them to demonstrate their mastery of the work orally or by producing whatever written/drawn work they can.

Interestingly, many kids with dysgraphia can draw pretty well. If given enough time, some of them can produce beautiful handwriting. Most often, it's the fluency that's missing: that ability for letters and numbers to flow from the pencil without having to think about drawing a 2 or a G from scratch every time.

Posted by: cypherpunks3 | November 12, 2009 3:56 PM | Report abuse

Can they tell authoritatively that a person has some sort of disorder simply by analyzing handwriting samples? Some people just have really blanky writing. And, the digital age has only made it worse, because most people are now typing, texting, or talking, instead of taking pen to paper.

I think there comes a point when the 'diagnosis' is simply OVER-diagnosis.

You meet people walking around, and they're saying, 'oh, I have Exotic-Disorder-Syndrome-Complex', when by observation, there doesn't seem to be much, if anything really wrong with em, other than they have a freshly-minted excuse, and it's either self-assessment(which is ALWAYS accurate) or underemployed-psychoanalyst-disorder-syndrome, some variant in there, and it's not that, you hear people at WORK piping off with this or that, and I just question it. I think that frankly, they still don't know that much, authoritatively, about what goes on between people's ears, there's some educated guesses, but there's a lot of speculation and whistling in the dark, too.

Chances are, you go back, and give some of these people a penmanship class, and their handwriting will improve, I guess you could call that cursive-scripting-educational-deficit, but I think trying to express everything in quadranomic nomenclature amounts to using 30-dollar words on 30-cent problems, and I wouldn't give 2 cents for some of the B.S. that I hear people pawning off as their latest spurious and probably inaccurate diagnosis of medical problems that could probably be chalked up to something else. That's my view. People that want to learn how to be graceful, flowing calligraphers will spend the time to do just that. People that don't place much value in handwriting in the digital age will learn to use the more modern tools, and you could do a lot worse than a computer keyboard, because most people's handwriting SUCKS! Plus, the biggie is the time factor. If you're going to knock out a 1-page letter, what's faster? The keyboard. Even a typewriter is faster than someone scrivening away in painstaking perfect script on a sheet of foolscap. We sort of live in the 'now' world, and unless you're an expert stenographer, you just can't keep up with a practiced typist, period.

Through practice, you can improve your skills in the area of scripting and writing. But, the pencil(er) has to WANT to change. LOL.

Posted by: walkerbert | November 12, 2009 4:07 PM | Report abuse

Why not identify the authors of this junk science study?

were they too embarrassed to be indentified?

this is a complete joke

Posted by: JohnAdams1 | November 12, 2009 4:37 PM | Report abuse

“There are indications of a rapidly growing population of infants who show developmental abnormalities as a result of prolonged exposure to the supine position.”
Dr. Ralph Pelligra regarding the impact of the Back to Sleep Campaign

“Since the implementation of the “Back to Sleep” campaign, therapists are seeing increasing numbers of kindergarten-aged children who are unable to hold a pencil.”
Susan Syron, Pediatric Physical Therapist

“In its fundamental purpose it has been largely successful. The incidence of SIDS has been reduced dramatically. However, as many orthotists can attest, this important gain has not been without its lesser comorbidities. The one we tend to think of has been the rapid increase in the incidence of positional plagiocephaly and positional brachycephaly. However, there have been whispers and rumors of other effects.”
Phil Stevens, MEd, CPO regarding side effects of the Back to Sleep Campaign.

“The potential implications of a SIDS risk-reduction strategy
that is based on a combination of maintaining a low
arousal threshold and reducing quiet (equivalent to
slow-wave sleep) in infants must be considered. Because
SWS is considered the most restorative form
of sleep and is believed to have a significant role in
neurocognitive processes and learning, as well as in
growth, what might be the neurodevelopmental consequences
of chronically reducing deep sleep in the first
critical 12 months of life?”

Dr. Raphael Pelayo, Stanford University

Posted by: xyz_tsc | November 12, 2009 8:39 PM | Report abuse

To optimize gut health and improve brain function or for suggestions of what to eat and not to eat for autism go to:

Posted by: rlatkany | November 13, 2009 8:58 AM | Report abuse

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