Handwriting is one of the most complex skills that is learnt and taught. It requires motor, sensory, perceptual, praxis and cognitive functions, and the integration of these functions. When the complex nature of this skill is considered, it comes as little surprise that many children experience difficulty in mastering this area. When an occupational therapist observes that a child referred to the service is having difficulty with handwriting, it becomes necessary for the therapist to administer procedures to identify the strengths and weaknesses that will then become the basis for a remedial programme. This article presents a conceptual framework for evaluating and treating handwriting difficulties presented by children in mainstream education with specific developmental disorder, such as dyspraxia or dyslexia. The performance components and functional performance of handwriting are briefly reviewed. Both evaluation and intervention procedures are discussed in order to guide the therapist in developing remedial and instructional programmes. The article highlights the unique role of the occupational therapist in evaluating and treating a child's functional performance of handwriting skills.

An occupational therapy delineation model of practice is presented, which guides a multidimensional understanding of the psychopathology of attention deficit hyperactivity disorder (ADHD) and its management. Previous research has established that occupational therapists lack detailed training or theory in this field. The delineation model of practice is based on a literature review, clinical experience and a consensus study carried out with occupational therapists to determine their priorities for the evaluation of, and intervention with, children with ADHD. Part 1 of this article presents the model and examines its implications for evaluation and intervention at the levels of child, task and environment. A family-centred assessment and treatment package, based on the delineation model, is described. Part 2 of this article will report the results of a multicentre study, which was designed to evaluate the effectiveness of this package.

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There has been a substantial increase in clinical activity related to the identification and treatment of children with attention deficit hyperactivity disorder (ADHD) in the United Kingdom. The accurate diagnosis and successful management of children with ADHD requires a multifaceted evaluation and treatment package provided by a team of medical, psychological, educational and therapy professionals. Occupational therapists can make distinctive contributions in the processes of evaluation, diagnosis and multifaceted intervention. A national survey was carried out to investigate the level and nature of involvement of paediatric occupational therapists in services for children with ADHD in the United Kingdom. The learning needs of the therapists were also explored in this survey. A questionnaire was sent to all 941 members of the National Association of Paediatric Occupational Therapists. The response rate of this survey was 30%, that is, 282 completed questionnaires were returned. The results showed that only 8.5% of the therapists who responded had involvement in a designated service for children with ADHD. Twenty-seven per cent of the therapists indicated that they did not see children with ADHD. The 63.8% of therapists who did see children with ADHD as part of their overall caseload in a community service did so mainly because of the children's associated problems in different sensory, perceptual, motor and functional performance areas. The reasons for non-involvement are explored and discussed and the learning needs of the therapists and their preferred modes of training are identified.