The objective of this survey was to describe assessment and treatment approaches commonly used by occupational therapists for children exhibiting handwriting and related fine motor difficulties. Secondarily, the application of weights as a treatment modality was also explored. Fifty experienced paediatric occupational therapists from Ontario (46%), Quebec (22%) and six other Canadian provinces, were surveyed by telephone. The majority of therapists indicated that they evaluated gross/fine motor and perceptual skills, motor planning, quality of movement and sensory functioning for this population, while psychosocial and environmental factors were often not formally evaluated. Evaluations most commonly utilized included the Beery, Bruininks-Oseretsky and Gardner Tests. Standardized handwriting assessments were rarely employed. All used an eclectic treatment approach with sensorimotor most frequently selected (90%). Work setting and years of experience did not influence the treatment approach favoured.