Handwriting is a complex perceptual-motor task that requires years of training and practice before complete mastering. Its acquisition is crucial since handwriting is the basis, together with reading, for the acquisition of higher-level skills such as spelling, grammar, syntax, and text composition. Despite correct learning and practice of handwriting, some children never master this skill to a sufficient level. These handwriting deficits, referred to as developmental dysgraphia, can seriously impact the acquisition of other skills and thus the academic success of the child if they are not diagnosed and handled early. In this review, we present a non-exhaustive listing of the tools which are the most reported in the literature for the analysis of handwriting and the diagnosis of dysgraphia. Tools focusing on both the final handwriting product and the handwriting process will be considered. We will then discuss the pros and cons of the existing tools, and the perspectives for the development of future tools.

Handwriting abnormalities in children with attention deficit hyperactivity disorder (ADHD) have sometimes been reported both (i) at product level (i.e., quality/legibility of the written trace and speed of writing) and (ii) at process level (i.e., dynamic and kinematic features such as on-paper and in-air durations, pen pressure and velocity peaks, etc.). Conversely, other works have failed to reveal any differences between ADHD and typically developing children. The question of the presence and nature of handwriting disorders in ADHD remains open and merits an in-depth examination. The aim of this systematic review was therefore to identify studies investigating the product and/or process of handwriting in children with ADHD compared with typically developing individuals. This review was conducted and reported in accordance with the PRISMA statement. A literature search was carried out using three electronic databases. The methodological quality of the studies was systematically assessed using Critical Appraisal Skills Program (CASP) criteria. Twenty-one articles were identified. Of these, 17 described handwriting quality/legibility, 12 focused on speed and 14 analyzed the handwriting process. All studies (100%) with satisfactory methodology procedures reported impaired product and process in children with ADHD while 25% evidenced difference in speed of production. Most importantly, the studies differed widely in their methodological approach. Substantial gaps remain, particularly with regard to ascertaining comorbidities, ADHD subtypes and the medical status of included children. The lack of overall homogeneity in samples calls for higher quality studies. We conclude with recommendations for further studies.

In Switzerland, psychomotor therapy (PMT) is a standard treatment for children with graphomotor impairments, but scientific evidence of its effectiveness is rare. To investigate the effectiveness of PMT, we conducted a randomized field trial (RFT). The sample consisted of 121 first and second graders with graphomotor impairments, some of whom met the criteria of developmental coordination disorder, while the remaining suffered from developmental dysgraphia. The treatments lasted over 5 months. Handwriting fluency and consistency were measured five times on a digitizing tablet. All participating children completed a self-concept interview, and a standardized fine motor performance test twice. Psychomotor therapy significantly improved the fine motor skills of the therapy group compared to those of the waiting group. However, there was no evidence that the treated children improved more than the waiting children in terms of their graphomotor skills such as frequency, automaticity, and consistency of forming letters. Finally, the children of the therapy group showed partial improvements in their handwriting self-concept, while those of the waiting group children remained stable. This short-term RFT demonstrated the effectiveness of PMT in terms of fine motor skills and some aspects of the handwriting self-concept but showed no effects on handwriting fluency and consistency.