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Handwriting and Fine Motor Skills: New Insights into Autism

New research probes the link between handwriting problems and autism.

Handwriting and Fine Motor Skills: New Insights into Autism

Over the last couple of years, I've been privileged to interview several researchers who work at the Kennedy Krieger Institute in Baltimore. I've written about their work on the brain's motor (movement control) regions and functions as they relate to autism. Just this week, I received word of another Kennedy Krieger study--this one on handwriting and autism--that made me think about my teenage friend--we'll call her Lara--who was diagnosed with dyslexia in kindergarten. With a lot of hard work, determination, and tutoring, Lara has managed to excel in her schoolwork, but the dragon she has never slain is handwriting. Now a senior in high school, Lara still struggles with forming letters on a page. The keyboard is her best friend, and she uses it whenever she can.

Now--before I get a lot of correction comments about autism and dyslexia being different things--let me assure you, I understand the difference. But I also understand that the more we learn about how the brain works--whether the normal brain or the impaired brain--the more we know about how to protect and preserve the healthy brain and, perhaps, how to restore health to the brain when something goes wrong. I can only speculate that Lara's handwriting difficulties may share a common origin with those now documented for autism, but the research is intriguing enough, I think, that I wanted to share it here.

This new study, published in the November 10 issue of Neurology, the medical journal of the American Academy of Neurology, identifies fine motor control as a root source of some of the problems categorized as autism spectrum disorders (ASD). The study reveals that children with ASD may have difficulty forming letters without expressing problems in other cognitive, social, or sensorimotor domains.

Amy Bastian, who is corresponding author of the study, worked with a team of researchers to compare handwriting samples, motor skills, and visuospatial abilities of children with ASD to those of typically developing children. The researchers found that overall, the handwriting of children with ASD was worse than typically developing children. Specifically, children with ASD had trouble forming letters; however, in other categories, such as size, alignment, and spacing, their handwriting was comparable to that of the typically developing children. The researchers also found that motor ability, specifically for timed movements, was a strong predictor of handwriting performance in children with ASD.

"Identifying this fine motor deficiency in handwriting provides important insight about ASD," said Bastian. "It provides another example of motor skill problems that may give us cues for other deficits with socialization and communication. Furthermore, occupational therapists and teachers can now take the information from this study and apply it to the students they see on a daily basis."

I suspect those innovations in education and therapy will come too late to help Lara, but they may help Lara's cousin, age nine, who has been diagnosed with Asperger syndrome, which is indeed one of the autism spectrum disorders. Little Gary's handwriting is illegible, even when he labors over his printing. Lara is understanding and supportive, but unable to help him. If she can't, maybe this new research will.

For related articles on autism and motor skills:

Autism and Motor Skills: A Matter of White Matter?, November 19, 2007

In Autism, Movements May Not Quickly Become Habit, June 26, 2009

Click here to read the abstact of the Neurology paper.

Brain Sense contains several chapters on how the brain's motor control centers operate. The book explains why, for example, when you are buttering your bread, your left hand doesn't know what your right hand is doing.