Chinese handwriting performance in preterm children in grade 2

Hui-Ning Shih; Wen-Hui Tsai; Shao-Hsia Chang; Chung-Ying Lin; Rong-Bin Hong; Yea-Shwu Hwang

doi:10.1371/journal.pone.0199355

Chinese handwriting performance in preterm children in grade 2

PLoS One. 2018 Jun 19;13(6):e0199355. doi: 10.1371/journal.pone.0199355. eCollection 2018.

Authors

Hui-Ning Shih¹, Wen-Hui Tsai^{2

3}, Shao-Hsia Chang⁴, Chung-Ying Lin⁵, Rong-Bin Hong⁶, Yea-Shwu Hwang^{1

7}

Affiliations

¹ Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan.
³ Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan.
⁴ Department of Occupational Therapy, I-Shou University, Kaohsiung, Taiwan.
⁵ Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
⁶ Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan.
⁷ Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Abstract

Background: First graders born prematurely perform poorly on handwriting speed and legibility. However, whether there are specific legibility factors in which preterm children demonstrate difficulty remains unknown. In addition, handwriting performance beyond the first grade and the influence of sex on handwriting performance in preterm children are still unclear. We aimed to investigate the influence of prematurity and sex on multiple dimensions of handwriting in grade two and to identify the contributors to performance.

Methods: Sixty-three preterm (34 boys and 29 girls) and 67 full-term (27 boys and 40 girls) peers in grade two were included. Class teachers were asked to complete the Chinese Handwriting Evaluation Form. A subgroup of 39 preterm children received assessments on intelligence, visual perception, tactile and kinesthetic sensation, and fine motor skills. Their inattention behavior was rated using a maternal self-report with a behavioral scale.

Results: Boys born prematurely exhibited poorer performance in the speed dimension than full-term boys (p = 0.008), whereas there was comparable performance in the two groups of girls (p = 0.221). In the dimensions related to legibility, preterm boys (32.4%) had a higher percentage of children with difficulty in the construction dimension than the other groups (preterm girls: 6.9%, full-term boys: 7.4%, full-term girls: 5.0%). However, no group difference was found in the dimensions of accuracy and directionality. Of the sensory-perceptual-motor factors, attention was the most significant predictor of accuracy in performance (p = 0.046) and speed dimensions (p = 0.001) in preterm children.

Conclusions: Boys appear to be vulnerable to the adverse impacts of preterm birth in terms of performance in the dimensions of speed and construction in grade two. Based on the significant contribution of attention to handwriting performance in preterm children, assessment and intervention in the area of attention is strongly suggested for preterm children with handwriting problems.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Attention / physiology*
Child
China / epidemiology
Female
Handwriting*
Humans
Male
Premature Birth / epidemiology*
Premature Birth / physiopathology
Schools
Vision, Ocular / physiology*

Grants and funding

This study was supported by the Ministry of Science and Technology, Taiwan (grant number: MOST 104-2410-H-006-068) and Chi Mei Medical Center (grant number: CMFHR 10604).