Quantitative analysis of handwriting kinematics in primary and lower secondary school children through a sensorized ink pen: A cross-sectional population-based study.

The assessment of handwriting is fundamental for identifying difficulties, which may have long-term negative consequences. However, standard evaluation typically focuses only on the final handwritten product. For this reason, Italian guidelines recommended supporting traditional evaluation with digital tools to also analyze the handwriting process. A sensorized ink pen used on paper was employed by over 700 students, ranging from first grade in Italian primary school to third grade in lower secondary school, to execute two tasks of the BVSCO-3, the gold standard for handwriting assessment. From sensorized ink pen data, handwriting indicators in the domains of Time, Force, Smoothness, Tilt, and Frequency were extracted. These indicators were then analyzed to examine their correlation with clinical scores, to model cross-sectional trends across grades, and to identify handwriting difficulties. The correlation analysis revealed significant relationships between the indicators and the clinical score, particularly for the Time domain. A cross-sectional statistical analysis showed that the indicators follow developmental trends compatible with handwriting learning curves reported in the literature: for many indicators, a performance plateau was reached in grade 3, from both motor and processing perspectives. Lastly, binary classification models successfully distinguished subjects with handwriting difficulties (based on BVSCO-3 results) from proficient writers. The sensorized ink pen allowed uncovering relevant characteristics of children's handwriting process, while guaranteeing ecological data acquisition conditions. Its use could pave the way for a prompt identification of handwriting difficulties in school settings, thus facilitating an efficient referral to clinical services.