Background: The Developmental Test of Visual-Motor Integration (VMI) is commonly used to assess handwriting dysfunction in children. The relationship between handwriting and underlying abilities as measured by the VMI, beyond the writing readiness stage, is unclear. The present study examined the ability of the VMI to discriminate between children with and without handwriting dysfunction. Methods: As part of a larger research study, 35 children with handwriting dysfunction from grades 4-6 (as identified by their teachers) and 35 children without handwriting dysfunction were assessed with the VMI. Results: The VMI correctly identified only a small number of the children with handwriting dysfunction (sensitivity, 34%). Conclusion: The authors caution against the routine use of the VMI to assess older school-aged children with handwriting dysfunction. Use of a model of practice and clinical reasoning is recommended to guide the assessment of children with handwriting dysfunction.

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The ETCH-C, using the general scoring criteria, is a reliable and valid test of handwriting for children using alternative scripts.

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