Effect of Slant Boards in Combination with Handwriting Practice

Handwriting difficulties affect 10% to 30% of children in elementary school often hindering their successful participation in a number of occupations, including academic participation. Occupational therapists provide treatments for handwriting difficulties; however, many of these interventions have limited to no evidence to support their effectiveness. One of these interventions is the use of a slant board, a treatment strategy often combined with handwriting practice. Clinicians commonly combine the use of slant boards and handwriting practice to facilitate the development of handwriting skills in young children. However, the effectiveness of this combination of interventions in improving the quality of handwriting remains unclear. The aim of this study was to investigate the difference in the change of letter formation scores in children who have practiced handwriting on slant boards compared with those who have practiced on a horizontal surface. A randomized block design was employed. Children entering the second through third grades who participated in a 19-day summer enrichment program were recruited via mailed recruitment letters and/or email. Twenty-one children were enrolled. Children were blocked by classroom and randomly assigned to a group that practiced handwriting on a slant board or a group that practiced on a horizontal surface. Children completed a total of 15 group sessions lasting 15 minutes each. These sessions occurred 3 to 5 days a week over the course of 4 weeks. During these sessions, they practiced writing letters and words utilizing the Handwriting Without Tears curriculum. There was no significant difference in average group change in letter formation performance as determined by independent samples t test. Children with below average handwriting at baseline made statistically significant changes in their handwriting, regardless of writing surface, when compared with their peers that was identified by secondary analyses. Acknowledgements This process has been one of the most challenging journeys in my life, and there is no remote possibility I could have completed alone. First, I very much thank God for moving boulders I never thought could be moved and for maintaining my hope in the midst of valleys. Next, I am incredibly thankful that my husband Brett has walked this road with me. He experienced each high and each low sitting beside me. He has sacrificed for this degree in numerous ways, and I will be forever grateful. I would like to express my gratitude to Dr. Sonia Kay. As the chairperson of my committee, Dr. Kay provided a perfect mix of guidance and support. She somehow knew when to push me, when to help, and when to give me room to come to the conclusion on my own. I also have a great amount of appreciation for the other members of my committee: Dr. Karen Harpster and Dr. Elise Bloch. Their constructive feedback was instrumental to my success, and I am deeply grateful for their time and effort. I am certain I would not be where I am today without the steadfast love and unwavering support of my grandparents, Jacob and Alice Sasser. They never stopped believing in me and always encouraged me. Words truly cannot express my gratefulness for all that they have contributed to help me get to this place. I also have to thank my parents, Bob and Brenda Gartner and Cindi and Stuart Nicholson. In their own ways, they have taught me the value of hard work, perseverance, and humility. Without these values, I am certain I would not have completed this degree. I would specifically like to acknowledge Dr. Jennifer Angeli and Korie Frost for their support, encouragement, and guidance. So many friends and family members have supported me through the highs and lows of this journey. I am so very thankful for each word of encouragement, each hug, each moment sitting beside me. They will likely never fully understand the importance of the role they played in this story. Table of