Inter-relationships between objective handwriting features and executive control among children with developmental dysgraphia

OBJECTIVE: To describe handwriting and executive control features and their inter-relationships among children with developmental dysgraphia, in comparison to controls. METHOD: Participants included 64 children, aged 10–12 years, 32 with dysgraphia based on the Handwriting Proficiency Screening Questionnaire (HPSQ) and 32 matched controls. Children copied a paragraph onto paper affixed to a digitizer that supplied handwriting process objective measures (Computerized Penmanship Evaluation Tool (ComPET). Their written product was evaluated by the Hebrew Handwriting Evaluation (HHE). Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire about their child's executive control abilities. RESULTS: Significant group differences were found for handwriting performance measures (HHE and ComPET) and executive control domains (BRIEF). Based on one discriminate function, including handwriting performance and executive control measures, 98.4% of the participants were correctly classified into groups. Significant correlations were found in each group between working memory and legibility as well as for other executive domains and handwriting measures. Furthermore, twenty percent of the variability of the mean pressure applied towards the writing surface among children with was explained by their 'emotional control' (BRIEF). CONCLUSION: The results strongly suggest consideration of executive control domains to obtain better insight into handwriting impairment characteristics among children with dysgraphia to improve their identification, evaluation and the intervention process.