Children with handwriting difficulties: Impact of cognitive strategy training for acquisition of accurate alphabet-letter-writing.

Introduction: An occupational therapy handwriting programme integrating cognitive strategy training with alphabet-letter-writing instruction was found more effective than in-class instruction alone for early writers. This study investigated the impact of cognitive strategy training for children struggling to correctly write alphabet-letters. Method: Participants were ten children in the first 2 years of formal schooling identified with challenges in alphabet-letter-writing. A nonconcurrent A1BA2 single system research design was used. The A Phases represented within-class handwriting instruction only and B Phase represented additional handwriting intervention which included cognitive strategy training. The Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis (Stage 2) was the repeated outcome measure. Results: Results revealed all ten children demonstrated a similar pattern of change in cognitive strategy application which was concomitant with improvement and mastery in writing all 26-lowercase alphabet-letters from memory. Cognitive strategies which exhibited the greatest impact on acquiring and executing accurate alphabet-letter-writing skills were those related to planning, memory, attention and sensory perception. The least influential were those associated with generating and controlling motor actions. Conclusion: This study provides beginning support for including cognitive strategies training concurrently with alphabet-letter-writing instruction to assist children struggling to write alphabet-letters.