The purpose of this study was to evaluate the effectiveness of an occupational therapy skill development programme in improving handwriting, scissor use, visual motor co-ordination and classroom behaviour, in a group of grade-one Australian urban Indigenous students. The sample (N = 13) was randomly assigned to an experimental group or comparison group. Both groups were exposed to the intervention. The experimental group received a six week school skills programme in addition to regular schooling, while the comparison group received regular schooling only. Following this, the comparison group received the same six week programme. Participants underwent pre- and post-testing using Beery-Buktenica's Developmental Test of Visual Motor Integration, Conner's Abbreviated Symptom Questionnaire, and two non-standardized handwriting and scissor skill measures. Results indicated that participants significantly improved in aspects of handwriting, scissor skills, and behaviour, but not visual motor co-ordination, following participation in the programme. The experimental group demonstrated greater improvements only in handwriting ability scores (p = 0.037), compared to a comparison group. It was concluded that a school-based occupational therapy programme was effective in improving handwriting, in a group of grade-one Australian Indigenous children.