ERIC EJ1114541: A Comparison of the Handwriting Abilities of Secondary Students with Visual Impairments and Those of Sighted Students

2015·0.08 MB·English

by  ERIC

2006). Handwriting combines visual-motor
Research Reports abilities, motor skills, and coordination (Kai-
ser, Albaret, & Doudin, 2009). Factors that
increase the likelihood of experiencing hand-
AComparisonoftheHandwriting writing difficulties include decreased eye-
AbilitiesofSecondaryStudents hand coordination, visual ability, kinesthesia,
withVisualImpairmentsand sensory awareness, motor planning, and pos-
ThoseofSightedStudents ture(Cornhill&Case-Smith,1996;Karlsdot-
tir & Steffansson, 2002). Many of these fac-
TalithaHarris-Brown,JanetRichmond,
tors have the potential to be improved with
SebastianDellaMaddalena,and
the correct intervention. A permanent or
AlintaJaworski
progressive reduction in vision due to vi-
V
isualimpairmentaffectsapproximately1.8
sual impairment, however, cannot be easily
million people in Australia (Resnikoff et al.,
corrected.
2004) and is defined as a visual acuity or
Theonlyexistingliteratureontheeffectof
equivalent field loss of less than 6/18 (20/60)
visual impairment on handwriting indicates
by the International Statistical Classification
that impairment of specific ocular structures
of Diseases and Related Health Problems
or eye conditions can result in specific hand-
(WorldHealthOrganization,2010).Avariety
writing difficulties (Arter, McCall, & Bow-
of conditions can cause visual impairment,
yer, 1996). For example, for a person with a
including cataracts, glaucoma, macular de-
narrow visual field, the corresponding inabil-
generation, diabetic retinopathy, trachoma
ity to see an entire word can make copying
(Bourne et al., 2013), retinitis pigmentosa,
tasks arduous; and conditions that cause
optic atrophy, albinism, and congenital nys-
blurry vision may make it difficult to distin-
tagmus (Haymes, Johnston, & Heyes, 2002). guish letter and word forms (Arter et al.,
Despite the large number of people with vi- 1996). A person with visual impairment,
sual impairments in Australia, all Western therefore, is more likely to experience diffi-
Australian secondary students are required to cultiessuchaslowerlegibilityofhandwriting
complete their secondary exams using hand- and slower writing speed (Uysal & Aki,
writing,unlesstheyqualifyforspecialprovi- 2012); and difficulties with forming letters
sions. Students with visual impairments do andmaintainingevenspacing,size,slant,and
not necessarily qualify for special provisions alignmentofletters(Bonney,1992;Yalo,In-
onthebasisoftheirvisualimpairmentalone. doshi, & Agak, 2012).
It is hypothesized that students with visual Keyboarding as an alternative method of
impairments in Western Australia experience communication (Arter et al., 1996) does not
more difficulties with handwriting than their assist students with visual impairments who
fully sighted peers, which can potentially use handwriting for the completion of school
limit their optimal performance. assignments. Assistive technology can play
Despite advances in technology and com- an important role in helping students with
puter use within schools, a considerable por- visual impairments with their education, but
tion of the school day in Australia is com- many students feel it does not replace the
prised of handwriting tasks (Graham et al., need for a method to produce handwritten
2008; Marr, Cermak, Cohn, & Henderson, assignments. For example, secondary school
2003; Ziviani & Watson-Will, 1998). For in- students with visual impairments state that
dividuals with visual impairments, the use of althoughtechnologyisuseful,theyenjoyhav-
handwriting can be challenging (Markowitz, ing the ability to choose between technology
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JournalofVisualImpairment&Blindness,September-October2015 ©2015AFB,AllRightsReserved
and writing (D’Andrea, 2012). Furthermore, & Santos, 2001; Rodger, Brown, & Brown,
technology may stop working or be unavail- 2005). To date, there is only one study that
able during servicing and can be expensive indicates that the assessment of visual-motor
(D’Andrea, 2012). And one student with vi- integration abilities is also positively corre-
sual impairment stated that having the option lated to handwriting ability in people with
of writing enabled her to be more equal to visual impairments (Uysal & Aki, 2012).
people around her, as it enabled her to write The primary objective of the study pre-
down phone numbers and quick messages sented here is to determine if there is a sta-
without having to start up a computer tistically significant difference in the hand-
(D’Andrea,2012).Handwritinghasalsobeen writing performance of people with visual
shown to be superior in contributing to stu- impairments compared to that of sighted indi-
dents’understandingofwhattheyarewriting viduals. As a secondary objective, this study
to typing out the same content (Mueller & makes an effort to determine if there is evi-
Oppenheimer, 2014). For these reasons, dence supporting the use of The Beery-
handwriting remains an important skill for Buktenica Developmental Test of Visual-
students with visual impairments despite the MotorIntegration(Beery&Beery,2010).As
availability of assistive technology. an indicator of handwriting performance in
Handwriting is a mode of self-expression individuals with visual impairments.
and a subtle representation of a person’s in-
dividuality that is particularly important for METHODS
academic performance (Arter et al., 1996; The current study followed a matched-pair
Tseng&Chow,2000).Difficultieswithhand- design. Participants were separated into two
writing can negatively affect academic per- groups:thosewithandwithoutvisualimpair-
formance,andresearchhasshowedthatmore ments. The groups were matched for age
time is required to complete handwritten as- (within 6 months) and gender. Socioeco-
signments (Connelly, Dockrell, & Barnett, nomic status was recorded, but matching for
2005;Grahametal.,2008;Tseng&Cermak, socioeconomic status was not practical be-
1993) and that poorly handwritten exams are causeofsamplerestrictions.Theconfounding
marked lower than the same content pre- factors of motor skills, cognitive skills, self-
sented in legible handwriting (Connelly, esteem, and method of handwriting used and
Campbell, MacLean, & Barnes, 2006; Ham- taught could not be practically matched be-
merschmidt & Sudsawad, 2004; Sudsawad, tween groups, but were considered when the
Trombly, Henderson, & Tickle-Degnen, results were analyzed.
2001).Inaddition,difficultieswithhandwrit-
ing can have a detrimental effect on self- Participants
esteem, personal relationships, and students’ For the participants with visual impair-
perceptions of themselves (Goyen & Duff, ments, data on visual acuity, near vision,
2005; Graham & Weintraub, 1996). and conditions causing visual impairment
For students who are sighted, handwriting were obtained with parental permission
difficulties can be detected through the as- from records at VisAbility, the main sup-
sessment of visual-motor integration abilities portorganizationforpeoplewithvisualim-
(Klein, Guiltner, Sollereder, & Cui, 2011). pairments in Perth, Western Australia. For
Visual-motor integration ability refers to the participants who are sighted, visual acuity
degreetowhichvisualperception(processing and near vision were measured on the date
of visual information) and fine-motor move- of assessment using a standard eye chart
ments are coordinated (Gabbard, Conclaves, test and a near vision assessment provided
403
©2015AFB,AllRightsReserved JournalofVisualImpairment&Blindness,September-October2015
Table1
Demographicsanddescriptivestatisticsofparticipants.
Participantswithvision
impairment Participantswithsight
Variable Males Females Males Females
Number 12 9 12 9
Averageageinyears(mean) 14.63 15.10 14.56 15.29
Handdominancedistribution* L:3 R:7 L:0 R:9 L:1 R:11 L:1 R:8
Visualefficiencyrangescores 5–68% 8–68% 91–100% 96–100%
Averagevisualefficiencyscores(mean) 32.03% 33.15% 97.27% 98.89%
Rangenearvisionscores 4–32 3–16 4–6 4–10
Averagenearvisionscores(mean) 17.5 8.78 5 6
Socioeconomicstatus(combined
parentalincome)*
(cid:2)$60,000 1 0 2 0
$60,000–$100,000 3 4 0 2
(cid:3)$100,000 2 2 9 6
Typeofvisionimpairment
Congenitalnystagmusoralbinism 6 2
Retinaldystrophies 3 3
Opticnerveconditions 1 2
Other 2 2
*Missingdataaccountsforinconsistenciesinnumericalvalues.
byVisAbility.Visualacuityscoreswerethen writing as their primary mode of completing
convertedintovisualefficiencyscoresforanal- schoolwork.Studentswereexcludediftheyhad
ysis (Snell-Sterling Visual-Efficiency Scale, multiple disabilities, had vision greater than
n.d.). See Table 1 for information about the 6/18 (20/60) or equivalent field loss, were not
participants. involvedinmainstreameducation,orwereona
Research group (VI). Participants with vi- modified program.
sual impairments were recruited through Normative data group (control). Sighted
convenience sampling methods from a participantswererecruitedusingconvenience
previous study conducted by VisAbility and “snowball” sampling methods through
in Perth, Western Australia (VisAbility, privatecontacts.Thesamplesizeforthenor-
2014).Asamplesizeof21participantswas mativegroupwasmatchedtotheparticipants
estimated to be suitable for detecting with visual impairments in the research group.
changes in the outcome measures. Students Sighted participants were recruited in accor-
with visual impairments were invited dance with the following inclusion criteria:
to participate in the study if they met matched the age and gender of one included
the following criteria: diagnosis of visual participant with visual impairment and had
impairment determined by an optometrist corrected or uncorrected vision greater than
or ophthalmologist, aged between 12 and 6/18 (20/60) acuity or equivalent field. Stu-
18 years old, and use of handwriting dentswereexcludedfromthesightedgroupif
as the main mode of completing school they had visual impairments, diagnosed mo-
work. Students whowerelegallyblind(visual tor or intellectual disabilities, or were en-
acuity of worse than 6/60 [20/200]) were con- gagedinhome-schoolingormodified-school-
sideredforthisstudy,providedtheyusedhand- ing programs.
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JournalofVisualImpairment&Blindness,September-October2015 ©2015AFB,AllRightsReserved
Datacollectionandmeasures to17years,andnostudentswithvisualimpair-
During all assessment sessions, participants ments were included within this group.
with visual impairments were permitted the Beery VMI. Beery VMI is a standardized
assessmentusedextensivelyinpediatricprac-
use of their preexisting assistive equipment,
tice to assess the visual-motor integration
such as slant boards, modified lined paper,
abilities of children aged 2 to 18 years
and optical devices such as dome magnifiers.
in which participants to copy shapes of pro-
Assessment sessions were conducted over a
gressing difficulty (Beery & Beery, 2010).
4-weekperiodandorganizedatlocationsthat
Shapes begin with simple figures such as cir-
allowed privacy and during times that were
cles and rectangles and progress to layered
convenient for participants. The lengths of
figures in which shapes overlap. Reliability
sessions varied between 30 and 60 minutes
and validity testing of Beery VMI has been
and were conducted by the primary investi-
conducted by the authors of the assessment
gatorortherapistsfromVisAbility.Datacol-
and by external parties based on an Austra-
lection was conducted through the following
lian population (Brown & Hockey, 2013).
modes: Detailed Assessment of Speed of
Overall, the high scores for interscorer reli-
Handwriting (DASH) and Beery VMI.
ability(0.93–0.97)andtestsforcontent,con-
DASH. Participants completed all subtests
current,constructive,predicative,andcontrol
of the DASH assessment (Barnett, Hender-
forbiassupportitseffectivenessinmeasuring
son, Scheib, & Schulz, 2007) in their natural
visual-motor integration abilities. However,
handwriting,resultinginamixofmanuscript
tests for the reliability and validity of this
and cursive writing. Four subtests measured
instrumenthavenotbeenconductedwithpeo-
handwritingunderdifferentconditions:copy-
ple with visual impairments. The test’s esti-
ingasetsentencefor2minutesintheirneat-
mated completion time is 5 to 15 minutes.
estandthentheirfastesthandwriting,writing
Onthestandardassessmentform,participants
the alphabet repeatedly for 1 minute in their
copied shapes using the writing utensil they
typicalhandwritingmode,andcompleting10
used during their daily school activities.
minutes of uninterrupted handwriting on a
The size of the shapes to be copied was not
topic of their choosing in their daily hand-
changed for the participants with vision im-
writingstyle.Eachsubtestwasscoredforper-
pairments as it was deemed by professionals
formance recorded as the number of legible
in the field of visual impairment to be a suit-
wordscompletedperminute(wpm).Thecom-
able size for participants to view.
binednumberoflegiblewordscompletedper
minute was then standardized to provide an Observations
overall score for handwriting performance. During all assessment sessions, the adminis-
Inaddition,thefifthsubtesthandwritingsam- trator was required to record observations on
pleprovidedapercentagescoreforlegibility. a provided template. These observations in-
DASH has been standardized for subjects cluded descriptive data and recorded fac-
aged9to17yearsandtakesapproximately30 torssuchashandposition,specialequipment
minutes to complete (Barnett et al., 2007). Re- used, occurrence of pain, and posture, as
liabilitytestingoftheDASHrevealedhighlev- wellasgeneralobservationsregardingperfor-
els of inter-rater agreement (reliability coeffi- mance.
cients ranging from 0.853 to 0.999 across
the subtests). These coefficients were estab- Parentquestionnaire
lished based on a population of American stu- The written questionnaire for parents was
dentswithoutdisabilities,ranginginagefrom9 providedtoparentsatthestartofthestudyprior
405
©2015AFB,AllRightsReserved JournalofVisualImpairment&Blindness,September-October2015
to the children participating in handwriting ble words written per minute. A Mann-
assessment sessions and asked for information WhitneyU-testindicatedthatthehandwriting
on the percentage of homework completed us- performance of participants with visual im-
inghandwriting,whetherstudentswerereceiv- pairmentswasstatisticallysignificantlylower
ing or had received handwriting interventions, than that of the sighted participants (U (cid:4)
currentallowancespermittedbyschools,socio- 393.50,p(cid:2).00,meanVI(cid:4)29.74,meanC(cid:4)
economic status in regards to income and par- 13.26). Handwriting performance was not
ents’highesteducationlevel,andgeneralcom- significantly different between genders, both
ments regarding the children’s handwriting. among people with visual impairments (U (cid:4)
This information was used to account for con- 68.50,p(cid:4).3,meanmalesVI(cid:4)12.61,mean
founding variables and considered in the anal- females VI (cid:4) 9.79) and people who are
ysis of the results. sighted(U(cid:4)43.50,p(cid:4).46,meanmalesC(cid:4)
9.83, mean females C (cid:4) 11.88).
PROCEDUREANDDATAMANAGEMENT Handwriting legibility. The free-writing
EthicalapprovalwasobtainedfromtheEdith subtest of the DASH assessment also pro-
Cowan University Human Research Ethics vided a score for legibility as a percentage.
Committee. Consent and assent were ob- Legibility was determined by dividing the
tained from each participant prior to partici- number of legibly written words by the total
pation, and a student was free to withdraw number of words written. Analysis of all
from the study at any stage. All data were the groups revealed no significant difference
stored securely and confidentially and partic- between the legibility of the writing of high
ipants were provided with a summary of re- school students with visual impairments
sults reported at the completion of the study. and those who are sighted (U (cid:4) 253.00, p (cid:4)
.63, mean VI (cid:4) 23.05, mean C (cid:4) 19.95),
DATAANALYSIS andnodifferencebetweenmalesandfemales
Data were analyzed and coded in PASW-22 among participants with visual impairments
SPSS(IBM,2013)forstatisticalanalysis.The (U(cid:4)71.50,p(cid:4).22,meanmalesVI(cid:4)12.94,
study aims were met through descriptive sta- mean females VI (cid:4) 9.54) or participants
tistics, with measures of central tendency who are sighted (U (cid:4) 75.00, p (cid:4) .15, mean
usedtodeterminethedistributionofthedata. males C (cid:4) 13.33, mean females C (cid:4) 9.25).
Thesetestsfornormalityresultedinnonpara-
metric tests used for statistical analysis. Raw Visual-MotorIntegrationability
assessmentscoreswereconvertedtostandard (BeeryVMIscores)
scores for analysis. All tests for statistical Results from the Beery VMI indicated that
significancewereconductedusingtheMann- the participants with visual impairments had
Whitney U-test, and all correlational tests statistically significantly lower visual-motor
were conducted using Spearman’s Rho coef- integration abilities than the sighted partici-
ficient. Statistical significance was set at p (cid:4) pants (U (cid:4) 426.00, p (cid:2) .00, mean VI (cid:4)
.05. The clinical meaning of differences 31.29,meanC(cid:4)11.71).Comparingindivid-
among variables was also considered. uals from the same group indicated no statis-
tically significant difference between males
RESULTS andfemalesinregardtovisual-motorintegra-
DASH tion abilities for both participants with visual
Handwriting performance. The score from impairments (U (cid:4) 60.00, p (cid:4) .70, mean
DASH was used to record handwriting per- malesVI(cid:4)11.67,meanfemalesVI(cid:4)10.50)
formance in reference to the number of legi- and those with no visual impairments (U (cid:4)
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JournalofVisualImpairment&Blindness,September-October2015 ©2015AFB,AllRightsReserved
55.00, p (cid:4) 1.00, mean males C (cid:4) 11.11, In one case, a participant with visual im-
mean females C (cid:4) 10.92). pairment produced words that were indis-
tinguishableduetothewidespacesbetween
Correlationalanalysis letters.
Nosignificantcorrelationwasfoundbetween Patterns were recorded to determine
theBeeryVMIandtheDASHscoresineither whether the type of visual impairment pro-
participants with (p (cid:4) .14, r (cid:4) 0.34) and duced specific effects on handwriting. The
without visual impairments (p (cid:4) 0.35, r (cid:4) group of participants with congenital nystag-
0.21). A bivariate Spearman’s Rho correla- musoralbinismhadthelowestaveragescore
tion coefficient test revealed no statistically (71.5) in the DASH assessment, whereas the
significant correlation between the partici- group with retinal dystrophies had the lowest
pants with visual impairments’ near vision average Beery VMI scores (72.67). Differ-
ability and performance on the DASH (p (cid:4) ences in legibility were negligible between
(cid:5).22,r(cid:4)0.40)ortheBeeryVMI(p(cid:4)(cid:5).11, the groups of participants with visual impair-
r(cid:4)0.68).Forparticipantswithvisualimpair- ments. Participants with retinal dystrophies
ments, visual efficiency had a weak correla- had the highest occurrence of insufficient
tion to performance on the DASH (p (cid:4) .17, spacing between letters, resulting in writing
r (cid:4) 0.31) and a moderate correlation to per- being very close together. Although other
formance on the Beery VMI (p (cid:4) .10, r (cid:4) participants displayed insufficient spacing,
0.09). For the sighted participants, visual ef- 62.5% were represented in the group with
ficiency was positively correlated to hand- retinal dystrophies. For a majority of partici-
writing performance (DASH) (p (cid:4) .00, r (cid:4) pants within this group, there was also a
0.75)butnottovisual-motorintegrationabil- higher occurrence of large gaps on the right
ity (Beery VMI) (p (cid:4) 70, r (cid:4) 0.09). side of the paper, in which no writing was
present. A notable gap was considered larger
Observationsandparticipantreporting than 15 mm (0.59 inches). Only participants
Observations recorded common patterns in with retinal dystrophies produced gaps rang-
the outcome measures completed by partici- ing from 18 mm to 50 mm (0.70 to 1.97
pants with visual impairments that were not inches). This neglect on the side of the paper
present in the participants who are sighted. was also present in one of the corresponding
There was a higher number of participants Beery VMI assessments in which drawings
with visual impairments (43%) compared to were consistently positioned to the left of the
participants who are sighted (4%) whose page.
drawings in the Beery VMI were of a notice-
ably larger size. In the handwriting samples, DISCUSSION
participants with visual impairments were The results from this study support the hy-
more often unable to write within the con- pothesis that participants with visual impair-
straints of the lines provided (19% of partic- ments have lower handwriting performance
ipants with visual impairments, compared to than participants who are sighted. The hand-
4% of sighted participants). In addition, six writing assessment in this study measured
participants with visual impairments were performance using the number of legible
noted to have large writing—that is, writing wordscompletedperminute;resultstherefore
thatisgreaterthan1/3ofthespacebetween show that the representative sample of stu-
the lines—and four participants had small dents with visual impairments in Western
writing—where the body of the letter was Australia complete fewer legible words per
lessthan1/3ofthespacebetweenthelines. minute.
407
©2015AFB,AllRightsReserved JournalofVisualImpairment&Blindness,September-October2015
In addition to overall lower handwriting of the population of people with visual im-
performance, participants with visual impair- pairments.
ments had higher occurrences of large-scale The secondary objective of this study was
drawingsandwriting,alargerdiversityinthe to investigate whether the assessment of
sizeofwriting,aninabilitytowritewithinthe visual-motor integration abilities can be in-
constraintsofthelines,andirregularitymain- dicative of handwriting performance, a con-
taining spacing between letters and words. ceptsupportedinpeoplewhoaresighted(Du-
These conclusions are consistent in research iser, ven der Kamp, Ledebt & Savelsbergh,
and support the findings made in Uysal and 2014; Klein et al., 2011). This study has in-
Aki’s 2012 study that compared Turkish stu- dicated that people with visual impairments
dentswithvisualimpairmentstotheirsighted had lower visual-motor integration abilities
peers. The observations made in this study than people who are sighted, a result sup-
supportsimilarobservationsmadeinprevious portedinUysal&Aki’s2012studyonTurk-
studies(Yaloetal.,2012).However,astatis- ishstudentswithvisualimpairments.Despite
ticalstudythatsupportstheseobservationsas this result, no correlation was found between
common in people with visual impairments performance on the Beery VMI and DASH.
has yet to be conducted. Therefore, lower visual-motor integration
We found that handwriting legibility abilities do not necessarily result in a corre-
among participants with visual impairments sponding difficulty in handwriting perfor-
was not significantly different from sighted mance, which is a contrasting finding to the
participants. These results are in contrast to study in which visual-motor integration abil-
the only other study conducted comparing itieswerepositivelycorrelatedtohandwriting
handwriting between people with visual im- ability in people with visual impairments
pairmentsandthosewhoaresighted(Uysal& (Uysal&Aki,2012).Thedifferenceinhand-
Aki, 2012). Differences in the handwriting writing assessments and the population from
assessments used may account for the differ- which the participants were recruited may
ences,however,sinceonlytwostudiesinves- account for the differences.
tigatedthelegibilityofhandwritingproduced Specific visual characteristics such as near
by people with visual impairments compared vision and visual efficiency did not show any
to that of people who are sighted, conclusive correlationtohandwriting.Nearvisionwasre-
statements will not be made. corded in font size, and visual efficiency was
Studies on participants who are sighted recorded as a percentage of efficient vision.
support the theory that females have more The small sample size limits the conclu-
legible handwriting than males (Berninger, siveness of results, and therefore further
Nielson,Abbott,Wijsman,&Raskind,2008). investigation should be undertaken in order
Despite the results of this current study indi- to determine a convincing outcome regard-
catingnostatisticallysignificantdifferencein ing the effect of visual characteristics such
thelegibilityofhandwritingbetweenfemales as near vision and visual efficiency on
and males in either group of participants, there handwriting.
was still a recorded difference (males with vi- Unique occurrences in the handwriting of
sual impairments 93.29%, males who are participants with retinal dystrophies were ob-
sighted 94.16%, females with visual impair- served. These included producing letters close
ments 95.40%, females who are sighted togetherandalackofuseofspaceontheright
96.77%). Further research is required to sideofthepage.Sincethisgroupofparticipants
determine whether or not this difference includesthosewithretinitispigmentosa,which
wastheresultofchanceorisrepresentative canresultinvisualfieldloss,theseobservations
408
JournalofVisualImpairment&Blindness,September-October2015 ©2015AFB,AllRightsReserved
are consistent with expectations. However, ing, irregular spacing, and poor sentence
since these observations were not statistically alignment for all participants with visual im-
supportedandcomefromasmallrangeofpar- pairments regardless of diagnosis. A consis-
ticipants, they can be considered areas for de- tentoutcomewasthatparticipantswithvisual
velopment in future research. impairmentscompletedfewerwordspermin-
ute than their sighted peers.
Limitations
A potential limitation of this study is the gen- IMPLICATIONSFORCLINICALPRACTICE
eralizabilityofresultstothewiderpopulationof The implications of this study and its results
people with visual impairments because of the can be used to inform parents, teachers, and
small sample size and the fact that all partici- therapists of students with visual impair-
pants with visual impairments were recruited ments. For parents and teachers of students
through VisAbility. Despite these limitations, withdiagnosedvisualimpairments,theobser-
the support of other studies investigating the vationsandresultsofthisstudycanbeusedto
handwriting difficulties experienced by people determine if the student is experiencing dif-
with visual impairments lends strength to the ficultiesandmayrequireintervention,suchas
results.Outcomesinthisstudymaybeaffected anincreasedtimeallowancewhencompleting
bytheincreaseintheuseoftechnologywithin handwriting tasks.
society and schools, reflecting a decrease in Therapists are frequently the professionals
handwriting use and abilities. whomakerecommendationsandliaisewithac-
ademic staff members regarding allowances to
CONCLUSIONS facilitatethebestperformanceforstudentswith
The expectation of secondary students with vi- visual impairments. The results of this study
sualimpairmentsinAustraliatocompletetheir willstrengthenobservationsmadeduringhand-
secondary exams under the same conditions as writing assessments and help support the need
their sighted peers does not represent an equal for recommendations made by educators or
opportunity. Results indicate that Western therapists. For many therapists, a referral for
Australianstudentswithvisualimpairments handwriting includes an assessment of visual-
may complete fewer words per minute and motor integration abilities. However, results
write at slower speeds than their peers who from this study indicate that assessment of
are sighted when using handwriting. visual-motorintegrationabilitiesisnoteffective
In order to create equality for people with as handwriting assessments for people with vi-
visual impairments, an assessment of hand- sual impairments. The assessment of visual-
writing ability is required to determine the motor integration abilities can still be used,
degree to which visual impairment affects however, in conjunction with a formal hand-
their ability to produce handwriting equal to writing assessment and considered in light of
their sighted peers. Evidence shows that a the above finding. The generalizability of this
specificvisualimpairmentdiagnosisdoesnot finding is limited to the population represented
directly result in a type of handwriting diffi- in this study (secondary students with visual
culty. Despite the high occurrence of de- impairments from Western Australia), but still
creased space between letters and potential requires further investigation to determine
neglect on the right-hand side of the page whether it is a definitive conclusion. Further-
observed in participants with retinal dystro- more, the handwriting of people with visual
phies, many difficulties in handwriting were impairmentsisanareainneedoffurtherinves-
observed in participants with visual impair- tigation.Futurestudiesareneededtodetermine
ments.Thesedifficultiesincludedlargerwrit- whethertheeyestructureaffectedincreasesthe
409
©2015AFB,AllRightsReserved JournalofVisualImpairment&Blindness,September-October2015
occurrenceofspecifictypesofdifficultieswith Connelly, V., Dockrell, J. E., & Barnett, J.
handwriting. (2005). The slow handwriting of under-
Despite the availability of assistive tech- graduatestudentsconstrainsoverallperfor-
nology for students with visual impair- mance in exam essays. Educational Psy-
chology, 25(1), 99–107.
ments, the learning of handwriting enables
Cornhill,H.,&Case-Smith,J.(1996).Factors
freedom of choice and decreases reliability
that relate to good and poor handwriting.
on expensive technology that may not al-
American Journal of Occupational Ther-
ways be accessible.
apy, 50(9), 732–739.
D’Andrea,F.M.(2012).Preferencesandprac-
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