Objectives: Handwriting is one of the first things children are taught at school and need to perform in an efficient manner throughout life. Various studies have indicated that handwriting skills are related to many different variables including ergonomic factors. The purpose of this study was to investigate the differences between children with good and poor handwriting on ergonomic factors that underlie handwriting (e.g. body and paper positioning, pencil-grip and pressure) and to examine the relationship between the handwriting legibility and speed and these ergonomic factors. Study Design: The study included 209 students in Grades 2 and 3 in Israel. The students were identified as good (N = 116) and as poor handwriters (N = 103) by their teachers. The Hebrew Handwriting Evaluation (HHE) was used to collect data on handwriting quality and speed as well as on ergonomic factors. A Chi square procedure was used to compare the differences between the handwriting groups. Discriminant analysis determined the percent of correct discrimination of subjects with poor or good handwriting based on the ergonomic factors. Finally, Spearman correlation coefficients were employed between the ergonomic variables and speed and quality of handwriting. Results: The results indicated that children with poor handwriting had inferior pencil, paper and body positioning, stabilization of paper and consistency of pressure, compared to children with good handwriting. Conclusions: The implications of the results in general, and specifically for clinical practice are discussed. Finally, further research related to this topic is suggested.

Introduction: Adolescents with attention deficit hyperactivity disorder face neurocognitive impairments that impede their occupational functioning. The Cognitive-Functional model is a metacognitive occupational therapy intervention for individuals with attention deficit hyperactivity disorder that harnesses self-awareness and strategy behavior to support participation in an individualized occupational context. This study explored preliminary feasibility and efficacy of the Cognitive Functional model adapted for adolescents with attention deficit hyperactivity disorder, the Teen Cognitive-Functional intervention. Method: A mixed method feasibility study including 22 adolescents with attention deficit hyperactivity disorder and their parents was conducted. Pre-post assessments included: occupational performance (Canadian Occupational Performance Measure); executive functioning (Behavior Rating Inventory of Executive Function); self-awareness and strategy behavior (Self-Regulation Skills Interview). Results: Modest attrition and high satisfaction from Teen Cognitive-Functional intervention were found. Significant improvements were reported in adolescents' occupational performance, executive functioning and strategy behavior. No significant gains were found in adolescents' self-awareness. Adolescents' strategy behavior was correlated with parent-rated occupational performance. Qualitative analysis of the strategies reported by the adolescents after intervention revealed three categories: "self-determined choices"; "plan and organize" and "adaptations." Conclusion: This study provides initial support for feasibility of the Teen Cognitive-Functional intervention and its potential efficacy in promoting occupational performance, executive functioning and strategy behavior. Controlled studies are needed to further validate these findings.

Findings demonstrate the presence of OI challenges among adolescents with ADHD. Occupational therapy intervention may be needed in order to promote occupational adaptation.