OCCUPATIONAL THERAPY HAND WRITING EVALUATION

         

OCCUPATIONAL THERAPY HAND WRITING  EVALUATION

 OCCUPATIONAL THERAPY HAND WRITING EVALUATION by Dr. Arunkumar.RM

1. DEMOGRAPHIC DATA:

1. Name:

2. Age:

3. Sex:

4. Date of evaluation:

5. Hospital NO(IP/OP):

6. Address:

7. D.O.A:

8. D.O.E:

9. Associated problems:

10. Reason for referral:

11. Methods of evaluation :

· History taking

· Interview

· Behaviour observation

· Standardized test

 

2. CHIEF COMPLAINTS

· Subjective (patients own words, why he/she has come here, recorded even if unable to speak or irrelevant)

· Parental concerns

· Current levels of developmental functioning

· Temperament

· Objective (patient party’s word, relationship reliability)

3. HISTORY:

1. Birth history

2. Mediacal history

3. Family history

4. social-economic history

5. Play history

6. Developmental history

7. Educational history

8. Other history:

 

4. ON OBSERVATION:

· Sitting: Bird wing, frog leg/ W sitting, Tail bone sitting/ sacral sitting, ind swept.

· Visible deformities

· Callus formation

· Attitude of the limbs B/L

· Muscle atrophy

· Posture ( alignment : kyphosis, scoliosis, lordosis )

· Skull abnormalities: microcephaly/ macrocepahaly

· Involuntary movements: Tremor/ athetoid movements/ tics etc.,

· Social emotional behaviour

 

     5. ON EXAMINATION:

              Perceptual processing

1. Stereognosis

2. Right-Left discrimination

3. Body scheme

4. Figure ground

5. Position in space

6. Spatial relation

7. Visual motor control

8. Visual Motor Integration

9. Form constancy

10. Categorization

11. Depth perception

12. Topographical orientation

13. Pain response

 

          Cognition

1. Level of arousal

2. Attention

3. Concentration

4. Orientation

5. Memory

6. Judgement

7. Problem solving

8. Generalization

9. Learning

10. Visual sequencing 

11. Visual memory

12. Visual attention

 

Fine motor control

1. in-hand manipulation

1. adjusting objects, e.g. pencil within the hand after initial grasp, in readiness for writing

2. Bilateral integration

3. Motor planning (letter forms and ordering of letters in words )

1. plan,

2. sequence

3. execute

4. Visual motor integration (Visual perception is required to accurately interpret what is seen in relation including where to start, how to track horizontally from left to right and where to finish)

1. Shape

2. Size

3. Position

4. Orientation

5. Closure, and spatial placing on the page

 

 

5. Perception of kinaesthetic/proprioceptive input

6. Auditory perception

1. discriminate sounds

2. Input ( register, transmit and interpret information)

7. Sensory awareness

8. Sustained attention

9. Postural stability

 

Development of pencil grasp

1. Palmar supinate grasp

2. Digital pronate grasp  

3. Static tripod posture

4. Dynamic tripod posture

Grasp method

1. Efficient grasp

1. Tripod grasp

2. Low developed tripod grasp

3. Adapted tripod

4. Quadrupod

 

2. In efficient grasp

1. Thump tuck grasp

2. Thumb wrap

3. Thump tuck grasp

4. Index grip

5. Left hand index grip

 

An efficient grasp,

1. Holding shaft of pencil (between pads of index finger and thumb)

2. Supporting underside of tool

3. Resting outer surface of hand

4. web space ‘C’ shape with thumb and index finger

5. Wrist in extended position

Hand development for writing

1. Development of the palmar arches

2. Development of wrist extension

3. Separation of two sides of the hand

4. Development of the web space

5. Development of intrinsic muscles

Ergonomics

 

Functional sitting position

1. Feet are supported

2. Chair seat depth

3. Lower trunk is touching the back of chair

4. Child leans slightly forward

5. Forearms placed on the table

6. Head is up  

7. Chair is pulled into the table/desk

8. Table height

9. seated as above

10. Elbows are resting on the table

11. An angled writing surface

12. A wedge cushion h elps those children who tip their chair forwards

Functional working position in standing

1. Allowing child to work in an alternative position—lying on wedge or roll, high kneeling, half kneeling on hands and knees, side lying

2. Allowing child to lean (prop) against an appropriate fixed work surface

3. Enlarging child’s workspace to allow for propping and excess

movements

4. Sitting for task or providing a raised table if table/bench is too low

5. Adapting task to enable child to sit throughout

6. Alternating standing with sitting

 

Table surface

1. More efficient position

 

2. Stability of shoulders to increase handwriting flow

 

3. Easier visual focus

 

Texture of writing paper or surface

 

1. white board

2. Chalkboard

3. Shiny and glossy paper

4. Matt and textured paper

5. Raised lined/Stop-Go paper

Paper position

1. Right-handed children

2. Left-handed children

Development of pencil skills

 

 

 

      Education:

                         

1.  Pre writing evaluation

·  Hand dominance: Right Hand

2. Grasp

·  Crayon static tripod grasp

·  Pencil LSQ grasp

·  Sketch LSQ & LDT grasp

·  Pen LSQ grasp

3. Level of grasp

·  Grip strength

·  Pinch strength

4. Strength

5. Cognitive skills

·  Shape {identification, Recoqunization}

·  Colour{identification, Recoqunization}

·  Number {identification, Recoqunization }

·  Near point coping

·  Fair point coping

6. Word Eligibility

7. Letter Eligibility

8. Space /Size/Shape

9. Writing skills

·  Use of supportive hand

·  Writing pressure on the paper

·  Colouring skills

·  Prewriting stage and Level of skills

 

10.  Ergonomic factors:

 

 

 6. PROBLEM RELEVANT TO OCCUPATIONAL THERAPY:

 

 

 

 

 

 

 

 

 

 

 

7. DIAGNOSIS:

 

 

 

8. SUMMARY AND CONCLUSION :

 

 

 

9. GOAL (PRIORITIZATION):

 

 

 

 

10. IMPLEMENTATION:

 

 

 

 

 

11. PROGRESS NOTES: