Balancing Text Generative and Text Transcriptive Demands: Written Content and Handwriting Legibility and Speed of Children and Youth with Autism Spectrum Disorder

Abstract

The aim of this study was to assess text generation and text transcription of children and youth with Autism Spectrum Disorder (ASD, n = 67) and Typically Developing (TD) peers (n = 67). Participants (80.6% male, ages 9-14) produced a free-style handwriting task analysed for written content and handwriting legibility and speed. Findings showed children and youth with ASD perform significantly poorer than TD peers for written content and handwriting legibility and speed. For children and youth with ASD, poor handwriting legibility predicted poor written content. For TD peers, fast handwriting predicted good written content. Collapsing both groups, ASD group membership negatively predicted written content, after controlling for handwriting legibility and speed. Practical implementations for the educational context are provided. Keywords ASD • Written content • Handwriting legibility • Handwriting speedAutism Spectrum Disorder (ASD) is a pervasive neurological disorder characterized by unique communicative and social interactive behaviours, as well as repetitive and rigid patterns of behaviour, interests, or activities (APA, 2010; APA, 2013; ICD-10). Although there is high comorbidity of ASD with intellectual disability (ID), 30-50% of the individuals diagnosed with ASD have intelligence in the normative range (IQ > 70) (Matson and Shoemaker, 2009). Nevertheless, children and youth with ASD with intelligence in the normative range are challenged in different academic areas, including writing (e.g., Keen et al., 2016;Whitby & Mancil, 2009). Writing comprehends text generation and text transcription (Berninger et al., 1999;Zajic & Wilson, 2020). Text generation is the production of linguistic content and is analysed for its written content. Text transcription is the transcription of the written content to symbols that can be read (Berninger, 1999;Zajic & Wilson, 2020), for instance through handwriting. Handwriting is the act of recording words with the hand by means of a writing tool such as a pen or pencil (Rosenblum et al., 2003a) and is generally analysed for handwriting legibility and handwriting speed (Feder & Majnemer, 2007). For children and youth with ASD who are in the developmental phase of establishing functional handwriting that continuous to evolve in a more personalized style (grade 4 to 9), balancing higher-order text generation demands for producing written content as well as lowerorder text transcription demands for producing handwriting of proper legibility and speed is challenging and may affect their academic performance (Palmis et al., 2017;Whitby & Mancil, 2009).

Using Structural Equation Modeling to analyze handwriting of children and youth with Autism Spectrum Disorder

“…Handwriting is a complex activity that requires higher-level cognitive functions such as working memory, planning, and organization to compose and retain text, while retrieving and activating motor programs and adjusting performance according to visual feedback (e.g., Cartmill et al, 2009;Feder & Majnemer, 2007). Since children and youth with ASD performed significantly more poorly on handwriting legibility as TD peers as shown in this study and other studies (e.g., Fuentes et al, 2009;Hellinckx et al, 2013;van den Bos et al, 2021), these results may suggest that for children with poor handwriting, longer stroke duration in air helps them to achieve better legibility by allowing them time to deal with the cognitive demands (e.g., composition, storage and retrieval of text while allocating and monitoring motor programs) of the handwriting process (Luria & Rosenblum, 2012;Werner et al, 2006). This suggestion aligns with the results of Rosenblum and colleagues (2006), who found that among TD students in the third grade, longer stroke in air duration negatively predicted handwriting product legibility of TD students without handwriting difficulties, while stroke in air duration positively predicted handwriting product legibility of TD students with handwriting difficulties.…”

“…Given the sample size of the current study, the authors had to limit themselves on the number of potential predictors that could be included in the handwriting models for both handwriting tasks. Several studies have suggested that in addition to the different predictors of handwriting analyzed in this study, linguistic functions such as verbal memory or reading are associated with different handwriting product characteristics (e.g., Cartmill et al, 2009;Dockrell et al, 2014) and predict handwriting legibility and speed (Van den Bos et al, 2021). Future studies with sufficiently large sample sizes should include linguistic variables to determine the relative effect of linguistic functions as a predictor of the handwriting difficulties of children and youth with ASD.…”

“…3 among students from ethnically diverse and low-income backgrounds (Manfra et al, 2016), written content of essays of TD students in the second, fourth and eighth grade (Salas & Silvente, 2019) and written content of a freestyle handwriting task of children and youth with Autism Spectrum Disorder (ASD), ages 9 to 14 (Van den Bos et al, 2022). Thus, although typing increasingly replaces handwriting as medium for writing, studies of the last decade show that handwriting is still relevant for diverse populations, especially in the educational context.…”

“…Regarding literate achievements, well-developed handwriting was found to positively relate to word writing and word reading among Typically Developing (TD) preschoolers (Kiefer et al, 2015), paragraph reading in grade 2013) functions. Since producing legible handwriting requires interactive performance of cognitive, sensory, and motor functions (Feder & Majnemer, 2007;Kushki et al, 2011), these functions have been studied in relationship to handwriting of children and youth with ASD (for an overview, see Van den Bos and Rosenblum [2022]). Building on these studies, the current study aims to test a comprehensive model of cognitive, sensory, and motor functions as predictors of handwriting of children and youth with ASD.…”