Heavy pressure through the writing instrument can slow writing without output significantly. We know that many children struggle to monitor pressure through their limbs due to what is termed poor proprioception, therefore we need to help the child to develop an awareness of the amount of pressure placed through the limbs, the upper limbs in particular. The following will help:
- Regularly undertake a series of exercises whereby pressure is placed through the upper limbs, i.e. crawling games, wheelbarrows, press-ups, elephant/ animal walks etc. these should be incorporated into a daily schedule.
- Provide a light-up pen which can be bought cheaply from stationary shops. Challenge the child to write so that the light does not come on.
- Play a game of M15- provide a pad created by placing a layer of paper alternately with carbon paper. Ask the child to write a secret message so that only one agent can read it. Initially the pressure may make the child write so that the message can be seen on 3 or 4 copies, but by encouraging the child to self-monitor, pressure will reduce.
- Use a hard leaded pencil such as HB so that writing is not easily smudged.
Many children struggle to plan and organize their movements; they will also find writing across the page in a left to right horizontal direction very difficult. Guidance is therefore needed to help them with writing alignment.
- Always use lined paper rather than a line guide which easily moves.
- Mark a margin at the left hand side in a clear colour or place starting points at the left margin to reiterate where each line of writing should start.
- Create coloured lines on plain or pastel coloured paper encouraging the child to write on a different colour each line (this can be done easily using a computer with colour printer).
- If a child has significant difficulties in this area, create coloured bands across the paper (rather than lines) encouraging the child to write within each band before proceeding to the next.
- Provide 'Right line' or 'hint-print' paper which incorporates lines which are slightly raised giving a tactile reference when writing each letter or use glue.
- Have short breaks between long periods of writing will help relieve the tension in hand muscles. Exercises can be done to help relax the hand.
- Hand relaxation techniques.
- Investigate nib type and flow of pen on paper.
- Larger barrelled pencils will reduce strain on finger joints.
- Propelling pencils with lead length long.
- Use carbon paper underneath work to write without making a carbon copy.
- Use mouse mat underneath paper as excessive pressure will make a hole.
- Use different paper textures to encourage pressure awareness.
- The optimum position is when a child's forearm is supported. The child should be encouraged therefore to move the paper up rather than her arm down.
- Tape paper at an appropriate angle on desk.
- Encourage frequent checking of paper position and body alignment.
- Stick electrical tape on the table at 30° angle.
Reference: Calderdale and Huddersfield NHS Foundation Trust