FINE MOTOR SKILLS

Problem Checklist

Name of student ______________________________________ Date ___________________________

Observed Behavior Underlying Problem Assessment Technique Notes

 Slouching Poor postural control, i.e.  Observe sitting posture throughout the
 Lying on desk while poor control of the muscles day.
writing and shifting body that maintain an upright  Check desk and chair height for proper
position frequently while posture fit (see Appendix B for an example).
writing (Appendix B)  Check with the school - based contact
person for assistance.

 Poor Pencil grasp Weakness in or lack of  Check to determine whether the

(Appendix B) coordination of arm or student has difficulty with other
 Poor endurance for hand muscles activities requiring the management of
writing small materials, e.g. opening
Poor fine motor containers, using snaps, cutting.
Difficulties with: and/or  Be certain that the student has been
 Controlling writing poor eye-hand instructed carefully in letter formation,
implements coordination rather than reliance on “copying” from
 Forming letters a wall chart.
 Writing on the line No hand dominance  Check to determine that the student
 Performing a task such established has mastered letter formation skills in
as circling or contrast to reliance on “copying.”
underlining specified  Observe the student using mouse-
words driven software after providing
 Using a mouse to instruction and practice in proper
operate a computer mouse manipulation.
 For students who use a keyboard,
ascertain whether the student has
received formal training in
keyboarding/typing.
 Maintain a portfolio of the student’s
handwritten work, including samples
from different writing tasks.

 Poor keyboarding ability For a student who relies on  Observe the student’s typing speed
keyboarding for written and accuracy as he/she types a work
communication, the sample; then compare this result
inability, physically, to informally with that of typical peers.
access all of the keyboard
and function keys with
accuracy and speed

 Low productivity Writing speed that is too  Instruct the student to write and type a
slow to keep pace with familiar phrase and compare the speed
language formation and accuracy achieved in each
situation.

11
FINE MOTOR SKILLS
Change Strategies Checklist

Use the following to select, implement, and follow up change strategies that address the underlying problem(s) identified.
The superscript numbers refer to information contained in the Resources list (p.28).

Name of Student ___________________________________________________ Date __________________________

Follow Up

Underlying Increased Improved Curriculum Student

Problem Change Strategies Quantity Quality Fit Acceptance

Poor postural control Environmental Modifications

 Experiment with desk and chair size (see
Appendix B).
 Use specialized furniture to hold position. (Consult
the school-based contact person for assistance or
a referral to a physical or occupational therapist.)
 Provide a slanted writing surface: easel, 4-inch
1
binder, slant board.

No hand dominance Instructional Modifications

established  Provide increased opportunities for activities that
require one-handed manipulation (e.g. painting,
erasing board, spraying plants with water) to help
promote hand dominance.

Weakness in, or lack Instructional Modifications

of coordination of,  Increase the number of opportunities to practice letter
arm or hand muscles formation with a variety of media.

Poor fine motor Task Modifications

coordination  Adapt tests to reduce the amount of writing: use fill-in
blanks, multiple choice, true/false.
and/or  Allow the student to highlight words or phrases in text
rather than to copy.
Poor eye-hand  Allow students to highlight or mark answers rather
coordination than underline or circle them.
 Modify worksheets, e.g. use an enlarged copy of a
paper or one with triple-space lines, and/or wider
margins.
 Consider using handwriting guides or templates that
provide tactile feedback to facilitate staying within a
defined writing space.
 Color code where to start and stop on paper or use
color-coded paper.
 Use writing implements that are easier to grasp.
 Substitute Specialized Materials (see list below)-
grippers, papers, writing tools, or alternate methods
such as stamping.
 Use graph paper for writing math problems, allowing
one block for each number.
 Provide chalkboard practice in writing.
 Provide additional instruction in letter formation.
 Consider another handwriting curriculum (e.g., books
12
such as Handwriting Without Tears or Loops and
3
Other Groups ) to teach mechanics.

12
 Follow UP

Underlying Problem Change Strategies Increased Improved Curriculum Student

Quantity Quality Fit Acceptance

Weakness in. or lack  Use multimodality instruction for teaching letter

of coordination of, formation; also tracing, “talk through,” “walk through,”
arm or hand muscles writing in air, dot to dot techniques.
 Teach finger-spacing techniques to aid in letter and word
Poor fine motor formation.
coordination
and/or
Poor fine motor
eye-hand
coordination

Writing speed that too Task Modifications

slow to keep pace  Modify assignments by providing additional time, or by
with language shortening the length of the assignment.
formation  Allow the student to use either the manuscript or cursive,
depending on which is most productive.
 Allow dictation and/or oral reporting to demonstrate
mastery of content.
 Provide copies of the teacher’s notes and/or a note-
taking partner.

Specialized Materials Paper stabilizers that prevent the writing surface from moving
and that position the paper at the appropriate writing angle:
4
The determination of which types of specialized materials are  Tape
4
appropriate is dependent on the degree of muscle control and  Clipboard
the compensatory skills developed by the student. For example,  Nonslip rug matting (available from hardware stores)
4
if a student uses a static pencil grip with little wrist movement, a  Post-It glue stick
TM5
 Dycem
specialized pencil gripper may be helpful and a narrow width
paper may be best. If the student has difficulty holding the paper Alternatives to erasing by hand:
4
down with one hand while writing with the other, the paper may  Correction tape
4
need to be taped to the desk to provide stability. It is  Correction fluid in pen form
4
recommended that the classroom teacher consult an  Electric eraser
occupational therapist to assist with the determination of which
Stamping as an alternative to handwriting:
specialized materials would be most beneficial for a student. 4
 Rubber stamp with student’s name
4
 Number and/or letter stamps
Writing Implements that may be easier to handle or grip:  Handwriting guides or templates to promote staying within the
4 4.7
 Pencils or crayons of different diameters . designated writing space
4
 Markers, pens, or grease pencils
4 Assistive technology/high-technology solutions:
 Pencils with softer lead 9
 A word processor
Grippers that enlarge or change the shape of standard
writing tools or implements: Consult the school-based contact person for assistance with the
4-6 following items:
 Stetro, triangular, or pear-shaped gripper  A chair with arm rests to support the forearms and increase
5,6
 Rubber tubing used as a wrap for the writing implement . the student’s control for writing
5,6
 Foam tubing used as a wrap for the writing implement  Use of Control Panel features in the system software to adjust
. keyboard and mouse functions
Papers that provide prompts or visual cues to guide  A word processor with an adapted keyboard or with an
10
handwriting . alternate method of control
11
 Different colors of paper
4  Specialized software, such as word prediction program
4  Use of short-cut techniques to reduce the amount of typing
 Colored lined paper or dark lined paper
8 . required, such as macro commands to abbreviate frequently
 Raised lined paper . used words and file template for each writing task.
 Acetate sheets used with transparent markers (instead of
4
. paper)

13
VISUAL SKILLS
Problem Checklist

Visual acuity and perception are at the root of many poor handwriting and keyboarding problems as evidenced by:
• Handwriting that is illegible (Appendix A)
• Difficulty with copy work or with retaining letter locations (on a keyboard)
• Errors in letter formation and spacing (Appendix A)
• Slow production of written work, whether produced by hand or typed

Use the following checklist to analyze vision problems that relate writing performance:

Name of Student ___________________________________________________

__________________________________________________________
_______ Date ________________________________

Observed
Observed Behavior Underlying
Underlying Problem Assessment Technique Notes

Difficulties with self-  Check to be certain that the student

monitoring of: Visual acuity . has had an eye examination for
 Spelling and/or . visual acuity.
 Word and line spacing Visual perception  Check for documentation of visual or .
 Punctuation . perceptual difficulties
 Capitalization  Consult the school-based contact
 Near-or far-point . person for assistance in discriminating
. copying . between problems with visual acuity
 Efficiently locating keys . and visual perception
. on a keyboard  Note the length of time it takes the
. student to understand, respond to, or
Difficulties with: . cognitively process visual materials.
 Orientation to place on  Note whether the student scans
. a computer screen . materials in a sequential or random
 Effective use of a . pattern.
. mouse or arrow keys .  Observe how the student copies
. for cursor . information.
 Consistency in the size  Maintain a portfolio of the student’s
. and form of letters . handwritten work, including samples of
   . near-and far-point copying.
 Check that the student can locate keys
. on the keyboard
 Check the speed of typing to determine
. whether slowness relates to searching
. for the location of keys.

14
VISUAL SKILLS
Change Strategies Checklist
Use the following to select, implement, and follow up change strategies that address the underlying problem(s) identified. The
superscript numbers refer to information contained in the Resources list (p. 28).

Name of Student ______________________________________________________ Date _____________________________________

Follow Up
Underlying Problem Change Strategies Increased Improved Curriculum Student
Quantity Quality Fit Acceptance

Visual acuity Environmental Modifications

 Use direct lighting (seat student away from
windows to avoid glare; seat with back to window
to allow for natural lighting; reduce amount of
fluorescent lighting and increase natural lighting)

Task Modifications
 Reduce glare by using black print on cream-
colored paper, rather than black on white; also
provide visual cues that have high contrast without
glare by using the black on cream combination.

Instructional Modifications
12
 Place a piece of window screen under the paper
to provide tactile feedback while writing, thus
enabling the student to “feel” the letters produced.
 Provide handwriting and/or signature guides to
promote staying within a defined writing space.

Visual perception Environmental Modifications

 Minimize visual distractions (such as bright
pictures or objects) around material to be copied
or directions that are posted.

Both visual acuity Environmental Modifications

And  Seat the student close to the blackboard
Visual perception or teacher.
 Keep the chalkboard clean to provide higher
contrast.
 To increase readability of the chalkboard, use
different colors of chalk, put boxes around
information to call attention to it, and draw lines
and arrows to emphasize specific information.

Task Modifications
 Enlarge worksheets to reduce problems with near-
or far-point copying; use larger, bolder type and
exaggerated spacing between letters, words, and
graphics.

 Permit dictation and/or oral reporting to

demonstrate mastery of content.

 Eliminate copy work as much as possible.

15  Provide a clear copy of the teacher’s notes or

have a note-taking partner.
 Follow Up
Underlying Problem Change Strategies Increased Improved Curriculum Student
Quantity Quality Fit Acceptance
 Reduce the amount of written work, stressing
quality rather than quantity.
 Use every other line or provide a writing space of
13
a different color or shade to help the student
stay within the lines.

 Provide high-contrast tools such as markers, felt-

tipped pens, soft lead pencils, or fine felt-tipped
13
pens for ease in reading own writing.

 Use Groovy Letters8, raised line paper14,

sandpaper letters, or stencils as guides for letter
formation.

Assistive technology/high-technology solutions:

 Use of a keyboard with enlarged key labels, different
Consult the school-based contact person for assistance with
the following items. textures for different rows or function keys, or an angled
keyboard.

 Use of a tape recorder or video cassette recorder for  15

Use of a word processor providing auditory feedback,
oral reporting, as appropriate. i.e., that can speak what is written as the student types it.
 Use of Control Panel features in the system software or  Use of specialized software and hardware for screen
font commands in word processors to increase the size enlargement, reading the screen, and converting the
and readability of the type. screen to a Braille display for students with visual
impairments.

16
ORGANIZATION AND ATTENTION SKILLS
Problem Checklist

Organization and attention issues are at the root of many poor writing and thinking problems as evidenced by:
• Inability to keep papers and assignments organized and neat, including difficulty locating materials.
• Difficulty staying on task and completing tasks within the timelines that peers can manage.
• Difficulty making transitions from one task or activity to another.

Use the following checklist to analyze organization and attention problems that relate to written task performance.

Name of Student _____________________________________________ Date _________________________________

Observed
Observed Behavior Underlying Problem Assessment Technique Notes

Difficulties organizing: Poor organization skills  Check the top and inside of the
 Personal space student’s desk and the student’s ability
 Personal activities to locate papers and materials; to keep
 Books and papers materials together (rather than
 Ideas for writing dropping them on the floor); and to do
 Work on paper tasks in the proper sequence.
and/or  Check the ability to use classroom
 Hands in incomplete organization strategies.
work  Check the ability to work on paper in a
top-to-bottom sequence and a left-to-
right sequence; to leave appropriate
margins; to align math problems
properly and space them so they can
be understood; and to use unlined
paper.
 Monitor whether homework goes back
and forth between home and school.
 Check for completeness and neatness
of the student’s work.
 Maintain a portfolio of the student’s
handwritten work, including samples
that reflect a variety of organizational
strategies.

 Difficulty staying with a Short attention span  Check the student’s ability to stay in
. task to completion one place for a specified period.
 Completes assignments  Check for distraction by sounds and
quickly but does them sights.
incorrectly  Check the accuracy of the student’s
 Easily distracted work.

17
ORGANIZATION AND ATTENTION SKILLS
Change Strategies Checklist

Use the following to select, implement, and follow up change strategies that address the underlying problem(s) identified.
The superscript numbers refer to information contained in the Resources list (p. 28.).

Name of Student ________________________________________________ Date ________________________________

Follow Up
Underlying Problem Change Strategies Increased Improved Curriculum Student
Quantity Quality Fit Acceptan.

Poor organization skills Environmental Modifications

 Provide or allow a limited number of materials
to be with the student at a time (such as texts
are kept in classrooms so that the student does
not have to store or carry additional texts,
student has one pencil and one notebook at a
time).
 Give student extra space for materials (such as
an extra desk, storage bin, or shelf.
Task Modifications
Modifications for Organizing Information
 Use graphic organizers or outlining techniques to
help the student organize thoughts and
information.
 Provide both written and oral directions for the
same activity.
 Provide a written or pictorial representation of
directions and/or assignments.
 Provide a tape recording of directions and/or
assignments.
 Provide an assignment calendar book that is
organized by subject.
 Develop a personal assignment contract or
checklist.
 Provide a homework hotline that students can call
for a review of the day’s assignment.
 Use a reward system to reinforce the use of
organization strategies.

Modifications for Organizing Work Space

 Allow the student to write on every other line.
 Use visual cues such as highlighting the left
margin, drawing light lines on the left and right
side of the paper as guides to prevent running off
the page, and for marking the top, bottom and
middle lines of the page.
 Provide lines for answers on worksheets and
allow plenty of space for answers.
 Provide labels to designate specific areas for
13
various items.
 Color code and label specific folders and
notebooks for various subjects and activities.
 Have the student repeat directions orally.
Dedicate time throughout the day for organizing
the student’s desk and materials, and for checking
book bag/folders for homework and assignments.

18
 Follow Up
Underlying Problem Change Strategies Increased Improved Curriculum Student
Quantity Quality Fit Acceptan.

Instructional Modifications
Poor organization skills
(continued)  Hold desk inspections frequently and reward
students with organized desks.
 Have students examine all of the items in
notebooks and folders frequently to remove
unneeded items.
 Teach the student to question any directions
that are unclear.
 Give each student a list of materials needed for
each activity and have them check items on
the list before starting a new activity.
 Teach the student organizational strategies
and provide periodic reminders; have the
student make a daily “to do” list and teach how
to prioritize assignments.
 Encourage parents to follow through with
organization strategies at home.
 Develop short, clear objectives.
 Record progress and provide tangible
feedback or reinforcement.
 Make sure that tasks assigned are geared to
the student’s level of readiness.

Allow the student to draw a line through errors
instead of erasing them.
 Assign a peer to check that the student has the
proper materials for the activity.

Assistive Technology Modifications

 Create and use computer-based templates for

files as a structure for different writing tasks.

Short attention span Environmental Modifications

 Redesign instructional areas to minimize

distraction (e.g., use study carrels or furniture
dividers.)

Task Modifications

 Minimize number of assignments provided at one

time, provide long assignments broken into chunks
 Break long assignments into checks.
 Provide frequent breaks.
 Seat the student close to the teacher to minimize
distractions.
 To decrease distraction, use headphones for listening
independently to assignments recorded on tape.
 Use heavyweight paper that does not tear easily when
13
erased.

Instructional Modifications

 Establish routines and post them.

 Provide small-group instruction.
 Provide specific time limitations for assignments.
 Provide information and instruction that fit the
19
 Follow Up
Underlying Problem Change Strategies Increased Improved Curriculum Student
Quantity Quality Fit Acceptan.

student’s strengths in using visual, auditory, or

tactile skills.
 Modify tests to decrease the amount of information
printed on one page.
 Provide continual praises and encouragement for
effort as well as for success.
 Provide real-life experiences and hands-on projects
that hold the student’s attention and are highly
motivating.
 Provide short, dynamic periods of work.
 Alternate short periods of listening with short
periods of activity.
 Maintain eye contact with the student.

Assistive Technology Modifications

 Create and use computer-based templates for

files as a structure for different writing tasks.

20
WRITTEN EXPRESSION AND/OR MECHANICS SKILLS
Problem Checklist

Poor Development of written expression and mechanics skills is at the root of many poor writing and thinking problems as
evidenced by:

• Good ideas presented orally that cannot be converted into written language.
• Difficulties caused by a limited vocabulary, redundant word use, and/or use of overly simplistic sentence structure.
• Difficulties with syntax and/or paragraph construction.
• Demonstration of inconsistent use of capitalization and punctuation.

Use the following checklist to analyze organization and attention problems that relate writing performance.

Name of Student ________________________________________________ Date ________________________________

Observed
Observed Behavior Underlying Problem Assessment Technique Notes

Difficulty with missing Poor written expression  Obtain unedited writing samples and
and/or inappropriate use skills analyze mechanical errors.
of:
 Punctuation
 Capitalization and/or
 Grammar
and/or Poor mechanics skills
 Syntax
 Ask the student to relate ideas
 Difficulty with verbally and compare them to the
student’s written responses.
expressing ideas in  Consult the school-based contact
writing person for assistance.

21
WRITTEN EXPRESSION AND/OR MECHANICS SKILLS
Change Strategies Checklist

Use the following to select, implement, and follow up change strategies that address the underlying problem(s) identified.
The superscript numbers refer to information contained in the Resources list (p. 28).

Name of Student ________________________________________________ Date ________________________________

Follow Up

Underlying Increased Improved Curriculum Student

Problem Change Strategies Quantity Quality Fit Acceptance

Poor written expression Task Modifications

skills  Provide extra time for writing copying, and
completing tasks.
 Allow the student to begin assignments early.
 Allow the student to complete homework during
school tutorial period or “down” times.
 Provide a thesaurus to facilitate choosing words.

Instructional Modifications

 Use content outlining, graphic organizers or

representations, or semantic webbing strategies
to help the student organize ideas.
 Brainstorm descriptive words or details about a
subject before beginning a writing assignment.
 Provide daily opportunities for writing to increase
the time spent practicing.
 Use a specific routine or sequence of tasks to
structure the writing process.

Assistive Technology Modifications

Consult the school-based contact for assistance with
the following
 Word processor with grammar-checking feature.
 Outline/graphic organizer software to help the
student organize thoughts for a writing assignment.
 Software that provides voice feedback to enable
the student to hear what has been written on the
computer.
 Word prediction software to help the student
develop an expressive language vocabulary.

Poor mechanics skills Task Modifications

 Allow the style of handwriting that is most effective
for the student (either manuscript or cursive) to
facilitate writing.
 Allow the student to use a word processor with
grammar-checking capability. (Consult the school
based contact for assistance.)

Instructional Modifications
 Review and post the rules of punctuation and
capitalization and reinforce them through practice.
 Provide a checklist to guide the editing process.
22
 Follow Up

Underlying Increased Improved Curriculum Student

Problem Change Strategies Quantity Quality Fit Acceptance

Poor mechanics skills  Teach the student a specific strategy for proofing
and editing papers (such as the COPS Error
Monitoring or Visual Spelling Mnemonic Clue
(Appendix D).
 Use personalized notebooks as a model for
written language rules, e.g. “Period Rules,”
“Comma Rules.”
 Provide leisure (nonstressful) opportunities for
writing, e.g., creating a shopping list (see also
Role of Motivation and Behavior, p. 8).

Poor written expression Instructional Modifications

and  Use many verbal, pictorial, and written cues to

help enrich the student’s knowledge of word use
Poor mechanics skills and word order.
 Use a specific routine or sequence of tasks to
structure the writing process.
 Use a visual model of expected projects or models
for written language rules.
 Use color-coding strategies (colored highlighters,
colored pencils, or colored papers) to indicate, for
instance, parts of speech, syntax, beginning and
ending of phrases and/or sentences.
 Use peer or cross-age tutors and/or editors.
 Hold a one-on-one writing conference with the
student to focus (a) on specific aspects of the
student’s written expression/mechanics skills and
(b) on preparing the student for revising his/her
own work.

23
APPENDIX A

Common Problems of Legibility

Height: The height of the letters is irregular relative to the guidelines.

Size: The size of the letters spills over or does not meet boundary lines.

Alignment: Letters do not sit evenly on the bottom line.

Direction: Formation of the letters shows changes in direction that are not standard.

Slant: The slant changes direction.

Spacing: The use of spaces between words or within words is inconsistent.

Closures: Letters that are formed by closures typically are left open. 24
Tremors: Letters wavy squiggles in line formation.

APPENDIX B

Factors Affecting Fine Motor Control for Handwriting1

Correct Posture for Handwriting

The student should face the chalkboard and the

following other conditions should be met (see
diagram):

• Knees and hips bent at a 90-degree angle.

• Hips resting against the back of the chair.
• The chair positioned 1” to 2” from the edge of
the desktop.
• The desktop positioned 1” to 2” higher than
the student’s elbow.
• Surface slanted to encourage upright posture.

Using the nondominant hand, the student holds the

paper down on the desk and sits still.

From Loops and Other Groups3

Functional Pencil Grips

The following are considered

functional methods of holding a
pencil, listed in order of observed
frequency:
(a) Dynamic tripod
(b) Lateral tripod
(c) Transpalmar interdigital
(d) Cross-thumb
(e) Dynamic bipod (index
finger omitted)
(f) Dynamic bipod (third digit
omitted)
(g) Static tripod

By Kerstin P. Bergman, “Incidence of Atypical Grasps Among Dysfunctional

Adults, AJOT August 1990

25
APPENDIX B (continued)

Factors Affecting Fine Motor Control for Handwriting

Proper Positioning of the Paper for Handwriting

(a) Proper positioning of the paper

for a right-handed student

(b) Proper positioning of the paper

for a left-handed student

(c) Correct positioning for a right-

handed student

(d) Correct positioning for a left-

handed student

(e) Incorrect positioning

From Writing Skills for the Adolescent by Diana Henbury King

26