ࡱ> .0)*+,- bjbj uxXsc@ @ CCCDt{:-.-- PRRRRRRWlRC-g*;-^--R W%8%8%8-P8P%8-P%8%8p<h+6e73L<m0Ñ6ÑÑC--%8-----RR%8-------Ñ---------@ I:  Chapter 5 Assistive Technology for Writing, Including Motor Aspects of Writing and Composition Introduction 1 Decision Making Guide 3 SETT Process 4 Continuum for Motor Aspects 12 Continuum Expanded 13 Charts 23 References 25 Assistive Technology for Writing, including Motor Aspects of Writing and Composing Cindy Nankee, OTR/L, ATP, Karen Stindt MS, OTR/L, ATP, Paula Lees OTR. MS Ad Ed Writing is a complex process that involves both the motor aspects of handwriting and the cognitive component of creating or composing written material. Due to the importance of each component this chapter has been divided into two sections; The Motor Aspects of Writing and Composing Written Material. This chapter will address The Motor Aspects of Writing. Introduction Students are required to produce written material (e.g. tests, worksheets, and essays) to demonstrate what they have learned. Handwriting instruction begins prior to kindergarten and continues through first and second grade. Penmanship is practiced through the third and fourth grade with keyboarding instruction starting at or before the fourth grade in most curricula. Technological advances have made alternatives to handwriting available, including keyboarding, handwriting recognition and voice recognition. The majority of schools not only have computer labs, but also computers within the classroom. Some classrooms designate an area as a writing center that includes a computer with writing, visual-mapping, and outlining software along with a variety of pens, markers, crayons, stamps and papers. This section will be looking at assistive technology tools for the motor aspects of writing whether it be penmanship or technology based. Each section of this chapter is organized in accordance with the Decision Making Guide following the SETT format (Student, Environment, Task and Tool). The Student section will assist you in determining skills and abilities required by the student to perform the motor aspects of writing whether it is handwriting, keyboarding, or the use of various other assistive technologies. The Environment section poses questions to consider concerning the impact of the students environment, the teachers expectations, and how these impact the choice of assistive technology. The section on Tasks for motor aspects of writing poses questions to help determine what is required of the student in order to appropriately choose an assistive technology solution. Following Tasks is a section on Tools which includes the continuum of assistive technology to be considered. The continuum is organized from low- to high-technology. This is followed by a more extensive listing of tools and strategies under the continuum subtitles. The chapter concludes with a discussion of a feature match process and steps for implementation. Chapter appendices include sample IEP objectives, references, resources, and product charts. Using the SETT process and Decision Making Guide It is intended that you use this as a guide. The Decision Making Guide follows the SETT (Student, Environment, Task, and Tool) format with a subcategory of Sensory Considerations included with Student and Environment. There are three additional categories on the Decision Making Guide that further help in the selection and implementation of assistive technology. Narrowing the Focus helps the team identify a specific task for solution generation. The Implementation Plan assists the team in assigning trials, dates, responsibilities and data collection. The Follow-Up Plan directs the team to set a date for the team to reconvene and review the students progress. Again, this is intended as a guide; during the actual assessment process, each topic should be written in large print where everyone can see (e.g. on a flip chart or board). Information should then be transferred to paper for distribution, filing, and future reference. For more information about using the SETT process, please refer to Chapter 1 of this manual. The questions posed in the guide are not intended to be all inclusive but rather to prompt the team to consider as many factors as possible in order to identify and try appropriate assistive technology tools and strategies for their students. Following the SETT process and the Decision Making Guide should ultimately result in the acquisition of appropriate assistive technology tools and strategies that, with maintained use, result in success for the student WATI Assistive Technology Decision Making Guide Area of Concern: Motor Aspects of Writing Problem Identification Students Abilities/DifficultiesEnvironmental ConsiderationsTasks Review Section 4 of Student Information Guide (Chapter 1, page 30) Physically Visual Perception Social Emotional Cognitive Organization Review Chapter 1 page 42 - Environmental Observation Guide Student to teacher position/# students to adults/aid/ lecture/small group/number of classrooms/travel Teacher expectations W/C accessible/lighting/clutter Workstation/desk Student accessible computers/OS Writing assignments (worksheet/ sentence/paragraphs/pages) Note taking Projects Tests Reading Sensory ConsiderationsNarrowing the FocusVision/Hearing/Tactile (hyper/hypo-sensitive)  i.e. Specific task identified for solution generationSolution Generation Tools & StrategiesSolution Selection Tools & StrategiesImplementation Plan Brainstorming Only No Decision Review Checklist  Discuss & Select Idea from Solution Generation AT Trials/Services Needed: Date Length Person ResponsibleFollow-Up Plan Who & When Set specific date now. Important: It is intended that you use this as a guide. Each topic should be written in large print where everyone can see them, i.e. on a flip chart or board. Information should then be transferred to paper for distribution, file, and future reference. Background This section will focus on the multiple factors involved with producing written documents. Handwriting is a complex skill involving visual perceptual, neuromuscular, and motor components. There are also cognitive and social emotional factors that influence handwriting. The student who may benefit from assistive technology in the area of writing may already be receiving occupational or physical therapy for motor challenges and the therapists should be consulted. The labor-intensive motor aspect of writing includes: holding the writing utensil; stabilizing the paper; visually guiding the hand; moving the writing utensil along the paper; visual recall of the letter; kinesthetic memory of letter formation; and word formation and writing and re-writing as part of the editing process. These all make writing one of the most difficult and complex skills acquired by students. Consider then how these mechanical challenges may affect the students confidence, motivation, and self-esteem as they attempt to commit to paper what they actually know. Handwriting The following is a brief introduction to an understanding of handwriting, not meant to be all inclusive, but to give the reader a basic understanding of handwriting to better select appropriate assistive technology supports. Handwriting is a complex process requiring visual perception, neuromuscular abilities, motor skills, cognition and social emotional factors. Visual perception is the ability to understand and interpret information taken in through the eyes, which is a highly cognitive function. Visual perceptual components necessary for handwriting include: Visual Discrimination - the ability to identify like characteristics or features of visual information; and in the case of handwriting, identifying like characteristics of like letters and numbers in order to eventually replicate them. Visual Memory - the ability to demonstrate recall of visual information; and in the case of handwriting, appropriate letter formations and the sequence in which a series of letters must be placed to form words. Visual Spatial-relations - the ability to perceive the position of two or more objects in relation to each other; and in the case of handwriting, the ability to visually interpret the position of the letters/words appropriately on the lines of the paper and space appropriately between letters/words. Visual Form constancy - the ability to discriminate between similar objects; and in the case of handwriting, letters/words. Visual Figure-ground - the ability to perceive a form and find it from among an assortment of other matter found in the background; and in the case of handwriting, the proper spacing between letters and words. Visual Closure the ability to recognize a figure when it is not complete; and in the case of handwriting, the ability to determine if a letter is correctly formed or (in)complete. Neuromuscular refers to abilities that combine muscle strength and postural control. Neuromuscular components include: Muscle tone - the ability to maintain a posture. During handwriting, the student must have adequate muscle tone to maintain an upright position without support from the hands, freeing them up to grasp a writing instrument. Strength the ability to maintain a grasp of a writing instrument over time both while moving it dynamically or holding it statically. Postural control - the ability to make appropriate postural adjustments while writing. It is important to develop proximal strength or position a student for trunk stability before fine motor skills can be addressed. The students positioning must be considered for motor aspects of writing. (See Chapter 2 Assistive Technology for Positioning, Seating and Mobility.) Motor skills require the assimilation and interpretation of sensory information in order to accommodate with an appropriate motor response. Neuromuscular abilities lay the foundation for the development of motor skills. Motor skills include: Crossing the midline - the ability to cross the midline of the body without disruption of body position; and in the case of handwriting the ability to move the hand across the middle of the body while writing on a horizontal surface. Bilateral integration - the ability to use the two hands in a coordinated fashion; and in the case of handwriting, grasping a writing instrument with one hand and stabilizing the paper with the other. Laterality - the ability to demonstrate a preference of one hand over the other for a task requiring coordinated movement; and in the case of handwriting demonstrating the consistent hand preference for use of a writing tool. Praxis - the ability to plan and execute new motor movements; and in the case of handwriting, the ability to demonstrate appropriate letter formations and sequence letters by arranging letters in appropriate order to form words. Fine motor coordination - The muscle control required to make small, precise movements; and in the case of handwriting, the ability to manipulate the writing instrument to move and adjust the position of the writing instrument, turn the writing instrument over to erase, etc. Grasp is the ability to hold an item and in the case of handwriting the ability to hold a writing utensil. The tripod pencil grasp is the most frequently observed though there are other efficient grasps. The correlation between grip and handwriting success is very low and grip is generally very difficult to change. Motor accuracy is the ability to control fine motor movements and in the case of handwriting controlling the motor movements so that letters are correctly sized and on the line. In-hand manipulation skills -The ability of the small muscles of the hand to perform coordinated movements including the ability to pick up and move small items to and from the hand as well as the ability to rotate items; in the case of handwriting, the ability to move up and down the pencil when adjusting grip as well as switching from the writing end of the pencil to the erasing end. Visual motor integration The ability of the eyes to guide hand movement and in the case of handwriting the ability to trace, and imitate or copy number/letters accurately. Cognitive The level of cognition required for writing is often misinterpreted. Some professionals often think that there needs to be an average level of cognitive ability in order to write. However, most students with a desire to share information, do have the ability through assistive technology to perform a writing task. Combing strategies that build upon background information and high interest topics with assistive technology can support even the most cognitively challenged students to produce written work. Students who want to share information with others may be given opportunities to write with pictures, letters, words, or other alternative media. Hanser (2006) delineates an approach to a low-tech way to foster emergent writing with students with severe disabilities. Using partner- assisted scanning to choose letters through auditory, visual or tactile methods allows students with severe disabilities to demonstrate emergent writing skills. Students who are verbally expressive and are using AT should be able to translate their thoughts to paper, using pictures, letters, words and text. Social-Emotional Considering the level of difficulty involved in the motor aspects of writing, somestudents may experience social-emotional reactions relating to tasks requiring writing. In the case of handwriting, maladaptive behaviors ranging from minimal output to extreme avoidance behaviors may influence the production of written work. Avoidance behaviors have frequently been misinterpreted as laziness, unwillingness or generalmisbehavior when in fact the student is demonstrating difficulty with themotor aspect of the task. The easiest way to determine if it is a behavior problemversus a problem with the motor component of writingis to ask the student to tell you what they want to write on the paper. If the student has a desire to write and can tell you what they want to write, the behavior may bea reflection of their inability to get the information on the paper. Handwriting Research Complexity and multiple factors involved with handwriting For a review of the literature related to handwriting research and articles addressing a multitude of components related to handwriting, there are several research articles that delineate the various factors involved in handwriting. Cornhill and Case (1996) address factors that relate eye-hand coordination, visuomotor integration and in-hand manipulation to good and poor handwriting. They found that visual motor integration and in-hand manipulation were significant predictors of handwriting. Tseng and Murray (1994) in their research on the perceptual motor factors involved with good and poor handwriting addressed these components of handwriting: visual perception, visual motor integration, manual dexterity, hand-eye coordination, fine motor praxis, and kinesthetic perception. They found that visual motor and hand-eye coordination were the best predictors of all handwriting. With the poor handwriters, praxis (motor planning) contributed the most to legibility and visual perceptual skills contributed the most to legibility of good handwriters. More recently, research by Volman, van Schendel and Jongmans (2006) on the underlying mechanisms of handwriting difficulties looked at the various factors involved in the motor aspects of handwriting. They found that the poor handwriters had lower skills on visual perception, visual-motor integration, fine motor coordination and cognitive planning. Visual motor integration was again the significant predictor of handwriting. Tseng and Chow (2000) looked at the perceptual motor skills of children with slow handwriting and found a significant difference between slow and normal handwriters in upper-limb coordination, visual memory, spatial relation, form constancy, visual sequential memory, figure ground, visual-motor integration, and sustained attention. For an overview of handwriting research, Graham and Weintraub (1996) have undertaken a meta-analysis of the handwriting research from multiple disciplines. All of these journal articles help the reader understand the extreme complexity of a task that is often taken for grantedhandwriting. Grip Grip is often the first indication of a problem or possible problem with handwriting. In their research on grip, Schneck and Henderson (1990) provide a descriptive analysis of the developmental progression of grip. It includes pictures representative of grip that can be difficult to verbally describe. Schneck (1991) looks further at grip comparisons of students that have good and poor handwriting. Their results suggest that children with handwriting difficulties may demonstrate a lower grip score than children without handwriting problems. In addition, among children with poor handwriting, those with decreased proprioceptive-kinesthetic finger awareness may demonstrate a lower grip score than those with good proprioceptive-kinesthetic awareness. Tseng (1998) also evaluated the development of grip positions in preschool children finding that there is more than one grip that is functional. Yakimishyn and Magill-Evans (2002) looked at grip in addition to tools and surface orientation found that a short writing tool used on a vertical surface positively influenced the grasp of young children. Grip form and graphomotor control were compared in a study undertaken by Burton and Dancisak (2000). Their research supported the use of a grip assessment in documenting the grip, and at the same time finding that changing grip did not assist poor writers. Use of this research is helpful when gathering the information on how assistive technology can help students with poor or inefficient grip patterns. Despite its easily observed differences, most researchers agree that grip does not correlate with handwriting as there are many functional writers with unusual grips and many writers with good grip that have difficulty with handwriting. Visual motor integration Researchers Weil and Amundson (1994) confirmed to a significant degree what others have found in the correlation between handwriting and visual motor skills. The ability to copy shapes as a predictor for success with handwriting is evident. Cornhill and Case (1996), Tseng and Murray (1994) and Volman, van Schendel, and Jongmans (2006) in their research also agree regarding the influence of visual motor integration on handwriting. There is a significant correlation between visual motor skills and ability as a predictor of handwriting. Time spent on fine motor skills Important to handwriting and fine motor skill development is the amount of time spent on this type of activity in the elementary school years. McHale and Cermak (1992) found that 30% to 60% of the day was allocated to fine motor activities, with writing tasks predominating over other manipulative tasks. This illustrates the difficulties and frustrations that children with fine motor issues may encounter every day. Assistive technology may be a way to support students to work through writing with adaptive materials. Handwriting instruction Handwriting instruction also impacts the development of handwriting skills. See authors Marr and Cermak (2001) for a literature review of research on the affect of consistency on handwriting instruction. Using AT to support students with handwriting deficits When determining how to best meet the needs of students with handwriting difficulties through the use of assistive technology, there are several articles that can help the reader to see what others have done. Moser (2004) reviewed research on both handwriting and assistive technology and reported on the outcome measures for these interventions. This is an excellent article to use when looking for data supporting the use of assistive technology and for information on research for students with handwriting difficulties. Handley-More, Billingsley, and Coggins (2003) addressed the use of technology to facilitate written work. They found that use of word processing with word prediction improves the legibility and spelling of written assignments completed by some children. They concluded that, It is important to evaluate each child individually and provide training and ongoing support for technology use. Rogers and Case-Smith (2002) looked at the issue of keyboarding versus handwriting and its affects on written work. They found that keyboarding had only low to moderate correlation with handwriting performance, suggesting that they require distinctly different skills. Most students who were slow at handwriting or had poor legibility increased the quantity and overall legibility of text they produced with a keyboard. This supports the use of keyboarding as a way to increase and improve a students writing. Press and Banton (2007) use the SETT process to analyze technology solutions for struggling writers in the school setting and recommend using a feature match process to choose the technology, followed by an implementation plan including, trial, data collection and finally obtaining the technology for the student. Students Abilities and Difficulties - Motor Aspects of Writing As a team, discuss what the students abilities and difficulties are related to the motor aspects of writing. Please complete and review Section 4 of the WATI Student Information Guide: Motor Aspects of Writing (Chapter 1, page 30). Indications of writing difficulties are demonstrated in many ways. The student needs adequate support and skills to perform written tasks. To help the team to better understand the abilities and difficulties there are questions that may be asked to elicit the child's current level of functioning. Some examples of questions that you might ask are: Physical Does the student have a desk and chair that fit? (See Chapter 2 on Seating and positioning) Does the student demonstrate positioning issues such as laying on desk, frequent need for movement such as rocking, kicking, sitting on feet, excessive walking around? Does the student have an efficient grasp of the writing utensil? Is the student able to write in the appropriate space? Does the student fatigue when writing? Visual perceptual Does the student complete written work in a timely manner? Is the student able to maintain their place on the paper? Does the student visually attend to all answer fields on a page? Does the student fit their answers in the allotted space? Is the student able to read the work they have written? Is the student able to correctly transfer information by copying? Social emotional Does the student exhibit avoidance behaviors when asked to write? Does the student orally express more than they are able to physically write on paper? Cognitive considerations Does the student demonstrate an interest in sharing information? Does the student demonstrate attention to task? What is the student's learning style? Does the students learning style affect the writing task? Is the student able to see the need for producing written work? Organization Does the student efficiently prepare materials to initiate writing tasks? Does the student use and follow an outline or other organizing prewriting technique? Student Sensory Considerations Some students are adversely affected by environmental stimulation which others can filter out or ignore. Some common factors which can impact a students learning and focus include hypersensitivity or hyposensitivity to stimuli such as Visual clutter Fluorescent lighting versus full spectrum lighting Classroom and background noise Tactile stimulation Awareness of physical space / personal space Other individual specific sensitivities Although these factors are not directly related to the motor aspects of writing, they impact the students ability to focus on instruction and learning so should always be considered. Other Considerations Each individual student has specific skills and areas of concern. Be certain to address those as you capture the particular traits of the student in this part of the SETT process. Environmental Considerations - Motor Aspects of Writing As a team, discuss and write on chart paper any environmental considerations that might impact the students motor aspects of writing such as auditory or visual distracters, placement in the classroom, number of different writing environments or any other environmental impacts. Environmental considerations pertinent to the students success include: Ability to maneuver about the room/school as needed, need to travel from class to class; the number of class changes, and if there is sufficient time for these transitions. Lecture or small group, the ratio of adults to students, if the student has an aide. Teacher expectations. Positioning of the student in clear view of the teacher, the board, displays. Sufficient light, board free of glare. Ability to hear the teacher; is the auditory stimulation in the room conducive to the student, are students nearby talkative/distracting, is there excessive noise outside the room, does the student need background music to focus best? Visual stimulation both in and outside the room, the amount of distracting clutter. Students organization skills; desk/workstation. Physical aspects including desk height. Positioning of the student with good trunk stability, stability of materials to keep them from falling on the floor. Use of a slant board to correctly position papers for visual and dexterity purposes. Use of software, availability in all environments needed in the correct platform. Accessibility of computers in the classroom. Environmental Sensory Considerations Different environments have different levels of sensory stimulation. If the team has determined that sensory impacts are influential for the students learning, identify the acceptable sensory levels in each environment in which the student will be writing. Assistive Technology: past and present What assistive technology (AT) has been employed in the past or is currently used with the student? List all assistive technologies that have been used with the student. If some have been discontinued, make note of the reasons. Sometimes effective tools are discontinued for reasons that no longer exist such as computer conflicts, lack of training, lack of interest, or other reasons. Do not discount assistive technology that was previously tried and discarded. There may have been a mismatch between the assistive technology and the students skills at the time. Differences in skill development, maturity, a different environment or other factors may make a significant difference. If the student is currently using assistive technology, note the AT used, location, level of effectiveness, trained staff, and any other issues that are pertinent to the student/building. Be certain to list low and high tech AT supports. Tasks - Motor Aspects of Writing As a team, discuss and write on chart paper the motor aspects of writing tasks that the student needs to do. One of the most important questions when assessing a students need for assistive technology is: What are the tasks the student needs to do? Teachers require written communication in many forms including note taking, worksheets, essays, and tests. In this instance what motor aspects are required to complete the writing task? These are some questions to consider: What tasks are required of the student that would influence their choice of assistive technology? What is required in the curriculum? Is the majority of writing single words, fill in the blanks, sentences, paragraphs, or multiple page term papers? What are the daily or weekly written assignment requirements? Are test questions taken from lecture notes? If the student has difficulty taking notes are peer or teacher notes available? What is the format of the test? Essay, multiple choice, true/false? Are there pop quizzes? Before considering reducing the quantity of the required writing or increasing the time element, would the task be more efficient with the use of assistive technology? Are there aspects of the writing assignments that are busy work that is not specifically beneficial to increasing the students understanding? Is the student able to meet the reading requirements in order to perform the writing tasks? Is someone currently performing the writing tasks for the student and is the goal to make him more independent? Consider your students writing development with this typical progression of writing: Early Childhood four- and five-year-old kindergarten students are combining letters to write words and their name. Kindergarten students are combining letters to write words and their name. First graders are filling in worksheets and writing simple sentences. First through third graders practice penmanship and learn cursive handwriting. Computers are used, but not using structured keyboarding. By fourth grade, students are writing paragraphs and short stories as the writing demands at this stage become increasingly difficult. Computers are used and touch typing keyboarding is taught. Middle school and high school students are required to do various types of writing, including extensive papers and projects as well as demonstration of competency to show what they have learned. Handwriting and keyboarding are both used. Narrowing the Focus - Motor Aspects of Writing - As a team, identify by circling or highlighting those few tasks the student needs to do for writing that will have the most impact. After the team has generated a list of tasks that the student needs to do, you may want to refine the list to limit the tasks that the team (including the student) will focus on. Too many tasks can overwhelm the team. Introduction of too many factors and tools may reduce your ability to determine effectiveness. Maintain your original list of tasks and review it later. Some tasks may already be effectively addressed with the new tools/strategies that you are using. The tasks that remain can become your new focus at a later date. Solution Generation: Tools/Strategies - Motor Aspects of Writing As a team, brainstorm and write on chart paper any assistive technologies and/or strategies you think will assist the student in successfully completing those tasks you identified. The team brainstorms strategies and assistive technology tools that may be of benefit for the student to complete the identified tasks in the given environments. Do not critique or otherwise evaluate the suggestions at this time. List all suggested tools and strategies including those currently in use on chart paper for all to see. The tools and strategies discussed below follow the general continuum for motor aspects of writing. The continuum is generally organized from low to high assistive technology. It is not intended to be used as a step-by-step protocol for using AT tools with a student, but rather an organizational continuum of types of assistive technology. Subsequent to the continuum is a more in-depth description of select tools. Sometimes effective tools are discontinued for reasons that no longer exist such as computer conflicts, lack of training, lack of interest, or other reasons. Do not discount assistive technology that was previously tried and discarded. There may have been a mismatch between the assistive technology and the students skills at the time. Differences in skill development, maturity, a different environment or other factors may make all the difference. If the student is currently using assistive technology note the AT used, location, level of effectiveness, trained staff, and any other issues that are pertinent to the student/building. Be certain to list low-and high-tech AT supports. A CONTINUUM OF CONSIDERATIONS FOR ASSISTIVE TECHNOLOGY The Motor Aspects of Writing Environmental and Seating adaptations Variety of pencils/pens  Adapted pencil/pen  Adapted paper Writing templates Prewritten words/phrases  Label maker Portable talking dictionary   Portable word processor Computer with accessibility features Computer with word processing software Alternative keyboards Computer with scanner Computer with word prediction Computer with voice recognition software Low Tech Solutions to Improve Motor Aspects of Writing Environmental & Seating Adaptations (See Chapter 2 Assistive Technology for Seating, Positioning and Mobility) Slantboard Workspace environment (desk height etc.) Seating Variety of pencils/pens Office supply and even many discount stores carry a variety of different pencils/pens. They vary in diameter, shape, type of lead used, and many are constructed with a built-in gripping surface. According to research, (Carlson and Cunningham, 1990), allowing the writer to experience a variety of writing tools and allowing then to choose the one that best meets their needs is preferred to selecting the tool for the student. Variations of less conventional writing mediums offer students alternatives to the more traditional paper and pencil. For example, markers produce less resistance than writing with a pencil, allowing students who might not have the strength to apply adequate pressure to write on paper. Other students may require additional adaptations, such as a dry erase board in addition to a marker. Dry erase boards require even less pressure to produce a mark and errors can be easily erased. You can purchase Memo Board"! dry erase removable paper made by Contact and create your own low cost dry erase boards. Pencil/pen with adaptive grip Just as there are many different pencils and pens, there are also many types of pencil grips. They vary in size, shape, and composition as well as aesthetic qualities such as color. Collect a variety and allow the writer to choose which is most beneficial. Author of Living in the State of Stuck, Scherer (2004), feels that the user of the assistive technology needs to have a say in what is prescribed, chosen or used. Having a variety of grips to choose from lets the student know that their opinions and desires are important when choosing a grip or any type of AT. You can also make a quick and inexpensive pencil grip using Adhesive Mounting Putty. Sculpey oven bake clay may be formed into custom made grips and baked for a permanent adapted grip. Crayons may be melted into various shapes/molds and a Velcro cuff may be added to secure crayons in the student s hand. 3M"!Vetwrap"! Bandaging Tape is also easily shaped around a writing utensil and comes in colors that are motivating for children. Grip on the writing utensil can also be adapted by using the HandiWriter splint available from Pocketfull of Therapy. This splint holds the writing utensil in the web space between the thumb and index finger and provides a bead to be held by the ring and little finger. It simulates an efficient grip enabling the child to use this grip until their hands have developed the strength and coordination to do it independently. It can also be fabricated with easily available materials for students using their choice of colors and beads, giving the student input to splint and helping to engage them in using the splint. Adapted paper There are a variety of papers available at school supply and discount stores. Some variations include line width, color, and texture for students requiring additional sensory input. Right Line Paper; wide rule, narrow rule, stop-go red-green with raised lines. Literacy Lined Paper notebooks. You can make your own raised line paper Using Elmer s glue carefully trace the lines on paper then let it dry Using Wikki Stix"!, place stix on lines for temporary raised line You can use the software Boardmaker to make sheets with boxes for students to write in. The boxes provide a visual space to write in and help corral the students writing. They can be made different sizes and help the students learn the concept of space between words as a box is left blank between words. Using different sized boxes can also help determine what the optimal space size best meets the students needs. Adapting worksheets/Writing templates For fill in the blank worksheets, draw a box in the answer space to help the child corral their writing and see what space they have to write in. Another way to adapt the worksheet is to use a word bank and number the words. The student can then put the number of the word in the blank and if time allows they can write the words in after all the numbers are put in the blank. This way the writing does not interfere with content of the worksheet. The writing can still be practiced, but if there is not enough time to complete the writing portion, the knowledge has still been demonstrated. Enlarge the worksheet on a copy machine so that the child does not need to make as small or precise a mark as the other students may help with their ability to perform independent written work. Taping the worksheet to the desk or placing it on a clipboard may also make it easier for the student to write on by stabilizing it for them. This is especially helpful for students with use of only one arm or who have difficulty with having their hands do two different movements at the same time. Magnet letters, words or phrases may be used by students as an alternative to writing their response. Using things like masking tape, Velcro"!, Dycem, gripping stuff, or non slip rubber mats from Rubbermaid is another way to hold things in place. These simple items can go a long way to help make materials more accessible. Use of Prewritten Words/Phrases It is extremely important to provide students with the opportunity to produce written language even though they may not have the motor skills to adequately do so in the traditional method using a pencil and paper. One way to do this is to provide words already written that can be placed in sentences and paragraphs. This requires only a swiping motion to move the words into the desired arrangement. Magnetic Poetry is a commercial product offering preprinted words in various sizes. You can create your own pre-written words and phrases using magnetic paper or a label maker. Words can be printed on paper or card stock and stuck to magnetic material or be printed directly on magnetic paper. The student can then arrange them on a metal surface. Magnets can also be used by students to indicate choices on worksheets mounted on a cookie sheet beneath plastic. Preprint numbers, letters and or words with a label maker and allow the child to choose what they need and stick it on the paper. An egg carton(s) works well for storing the letters and numbers for the child to choose from. A sticker of each letter can be put on the side of each egg cup so the child can easily see what they letters are. Use rubber stamps for stamping students name on papers or for answering one-digit answers on worksheets. The students needs and environment need to be assessed when looking at stamps. In particular, pay attention to the size of the stamped image, the need for an ink pad, and the grip and pressure required to use the stamp. Some stamps are self-inking. This can reduce the need and the potential mess of a stamp pad. Software programs that help you to create your own word banks. Any word processing program can be used to make word banks. More specialized software manufacturers include Slater Software, Mayer-Johnson, IntelliTools and Crick. These word banks can be used on the computer or printed out. The IntelliShare Classroom Activity Exchange site  HYPERLINK "http://aex.intellitools.com/"http://aex.intellitools.com/ is one source that offers already created activities that allows a student to retell a story, sequence events, create their own story, etc. Writing templates A variety of plastic or metal writing guides are available from independent living aids catalogs. Writing guides are pieces of plastic with cut out areas for writing within cutout lines. They come in various sizes for writing checks, signatures, letters and envelopes. You can also make your own templates out of cardboard, manila folders or a thin plastic such as overhead transparencies. Wikki Stix"! may be used as a writing guide. Wikki Stix"! are colorful, flexible  sticks made out of a wax coated string that is tacky to touch. They stick to any surface and peel off without a trace. They can be placed on the bottom or top writing line as a guide. Children can form letters with Wikki Stix"! or use them as letter guides when writing. Teacher-made templates for note taking can reduce writing demands by providing a fill in the blank format. This works well for learning note taking skills, as the teacher can leave out important words for the child to fill in as they are listening. The student is not required to write down all the extraneous information. Students who are unable to write even single words are often given the notes from the teacher. It is important to encourage attending to the lecture by requiring the student to circle, highlight or otherwise mark the main idea as it is being discussed. This helps discourage students from thinking they dont have to pay attention because their notes are already done. It also gives the teacher a way to monitor a students attending skills and comprehension. The teacher may easily redirect the students attention to the copy of the notes to ensure that they are used correctly. Mid and High Tech Solutions to Improve Motor Aspects of Writing Label maker The new electronic label makers are another way for students with difficulties forming letters to produce written work. They can be used to type a word or phrase, print it out and attach to a worksheet or other document. You may be able to check in your local school office area to borrow one. Since these devices are readily available, using a feature match will help determine the best choice for the student. There are numerous types and sources of label makers. When choosing a label maker here are some features to consider: Keyboard- Size of keyboard, size of buttons, layout (QWERTY vs. ABC) Features -fonts, font sizes, color of text, memory, complexity of special features, Tape- size, length, color or transparent Tape cutter- automatic or manual Cost- machine and tape refills Portable talking dictionary A student with spelling challenges may need to look up words in a dictionary. The added benefit of the talking dictionary is that it provides additional auditory support to students during the writing process. Some dictionaries will spell the word one letter at a time allowing the student to write the word without having to look back and forth to the dictionary. Franklin Childrens Speller & Dictionary Franklin Homework Wiz Speller & Dictionary Portable Word Processors If you are looking for increased computer access for students with disabilities but need to keep costs down, you may want to consider purchasing a portable word processor that will interface with a computer. Portable word processors are lightweight (2.3 lbs. or less) and extremely inexpensive (under $400) when compared to a laptop computer. There are many portable word processors available, however below is information on some of the more popular ones that you might want to consider. They are very similar, but each has slight differences in features that you will want to consider when purchasing. Dana"! by AlphaSmart is an alternative, lightweight keyboard/computer that provides portable access to a full-featured word processor in addition to the organization tools of the Palm"! operating system. It is an electronic notebook that you can synchronize with a computer or send files directly to a printer. The organization tools include a Data Book with calendar and alarms, an Address Book, and a To Do List for prioritizing tasks like assignments. TextPlus, a word prediction applet, and many other inexpensive software programs that run on the Dana are also available to help a student. CalcuScribe is a portable word processor that allows the student to create text files that can be used by any application once sent to a computer. It also houses an interactive calculator for arithmetic, algebra, and trigonometry that allows the student to do math problems in a word processing environment and save the calculations to send to a computer. Using the infrared pods, files can be shared with other CalcuScribes or sent to a printer without going through a computer first. (The printer needs IR to do this.) The Fusion Keyboard by Advanced Keyboard Technologies is a portable notetaker which features a large LCD screen with a choice of font sizes, word prediction, keyboarding and optional text to speech. The Laser PC-6 by Perfect Solutions offers the additional feature of text-to-speech capabilities to the portable word processor. Text can be viewed on a changeable 4 line by 40 or 8 lines by 80 character screens. It comes with eight built-in programs including a word processor with word prediction, sticky keys, spell checker, homework calendar, typing tutor, database, spreadsheets, and a scientific calculator. It weighs 2.75 lbs with battery and has a memory of 256K which allows for 45 named files and 14 pages max of text per file with 100 pages text overall. Perfect Solutions also offers 2 add-on options. The text-to-speech cartridge provides talking word processing including talking spell checker and word prediction, and it allows text to be spoken in letters, words, sentences or paragraphs. NEO by AlphaSmart is a light-weight, portable, stand-alone notebook for word processing and math. Ready to send text to any computer or printer using USB cable or infrared. Features include file management, word-processing with spell check, thesaurus, calculator, features for special needs including sticky keys, slow keys. The Writer by Advanced Keyboard Technologies is a portable word processor that allows students to organize and store their assignments, by name, in 1 of 16 password-protected work folders. Features include wireless infrared file transfer capability or via a USB connection to a Mac or PC computer, spell check, and word prediction. UBI DUO is a device that resembles two small portable keyboards. It was designed for the deaf or hearing impaired to communicate with anyone at anytime, without a third party, personal interpreter. The communication mimics text messaging and instant messaging. It is not intended as a word processor but has features that would make it appropriate for note taking, real time modeling, or asking questions. A chart that compares some of the features of the portable word processors is on the following page. ProductOrdering InfoFeaturesAdvantagesDisadvantagesNEO AlphaSmart, a division of Renaissance Learning, Inc. P.O. Box 8036 Wisconsin Rapids, WI 54495-8036Full size keyboard Large LCD screen USB & Infrared Special Needs features (sticky keys etc.) Small to Extra large fonts Portable & rugged 2 MB software storage for multiple applets 512KB storage for 100s of text pages Alternative keyboard layouts Under $250.00 CalcuScribeCalcuScribe 98 Cervantes Blvd. Suite #1 San Francisco, CA 94123-1672Word Processing Calculator 300 hours on 3 AA 50 page memory Full sized keyboard Infrared capabilities 2.75 lbs Sticky Keys Auto-repeat option Zoom feature 8 pt to 16 pt Unlimited files Under $275.00Unable to download files from PC DanaAlphaSmart, a division of Renaissance Learning, Inc. P.O. Box 8036 Wisconsin Rapids, WI 54495-8036Runs Palm applications Date book Address book, Memo Pad, To Do List Infrared capableLightweight Onscreen keyboard/graffiti Easy touch keyboard Larger LCD runs over 10,000 applications Under $430.00 Graffiti and onscreen input available only in vertical setupThe FusionThe Writer Learning Systems PO Box 186 Paso Robles, CA 93447-186 portable notetaker word prediction Dictionary & Thesaurus keyboarding tuition optional text to speech.Large LCD up to 10 lines of print Large font for vision issues lightweight Under $415.00 Laser PC-6Perfect Solutions Software, Inc 15950 Schweizer Court West Palm Beach, FL 33414-7128 Word Processing Spell Checking SpreadsheetsAdjustable size of text Typing tutor Text-to-speech Under $150.00 8 built in programs add to complexity The WriterAdvanced Keyboard Technologies, Inc. P.O. Box 2418 Paso Robles, CA 93447-2418Infrared capabilities Auto-Thesaurus Spell Check Password protected foldersKeyAcademy "! keyboarding program  116 lessons WriterExpress"! -customized formatted files Word prediction in Education Package Power skin overlays available Good writing checklist Under $200.00 UBI DuoSComm 6238 Hadley Street Raytown, MO 641332 keyboards in one device Wireless Allows 2-4 people to text each other Adjustable Font size 12 to 24pt Change contrast between text and background 2-4 people can communicate Could provide just-in-time note-taker Download text to computer Save text $1995Portable Word Processors Operating system Accessibility Features Both Windows and Mac platforms offer accessibility settings helpful to people with visual, hearing, and mobility needs. Some examples of these are sticky keys (the ability of one key to stay depressed so that another key can be pressed at the same time-- i. e., when you press the shift key), key repeat rate (changing the key repeat rate so that students with difficulties releasing the keys do not get multiple letters printed), magnification (the ability to change the size of the information on the screen), visual or auditory alarms (to compensate for the typical alarms that may not work for the students disability). To learn about Microsoft accessibility features go to:  HYPERLINK "http://www.microsoft.com/ENABLE/"http://www.microsoft.com/ENABLE/ Go to Apple Accessibility website for information about accessibility settings and pdf. files that describe in detail the settings and how to use them.  HYPERLINK "http://www.apple.com/accessibility/"http://www.apple.com/accessibility/ Computer with Word Processing Software The computer can be an exceptionally effective tool to support students who are struggling with writing. Word processing on the computer offers the opportunity to change letters, words, sentences, and paragraphs easily and quickly while allowing a clean, attractive, and readable end product. Formatting options such as font styles, color and size are beneficial for the visually impaired and motivating for students who have struggled to produce legible materials. Alternative Keyboards / Alternative Access Another means to provide access for a student who is experiencing difficulties with the motor aspects of writing is to use an alternative keyboard (See Chapter 4 Assistive technology for Computer Access) IntelliKeys USB from IntelliTools, Inc is an alternative keyboard that enables students with physical, visual, or cognitive disabilities who can press and release a part of the keyboard to type, enter numbers, navigate onscreen displays, and execute menu commands. The IntelliKeys keyboard comes with six standard overlays (plus a setup overlay) that are ready to use with any word processing program or software that requires keyboard input. These overlays include an alphabetical overlay which is very useful for early writers. The IntelliKeys is a programmable alternative keyboard which can be configured to almost any layout based on student need. Mac/Win compatible. Big Keys is an alternative keyboard with large keys and features which may include color coded keys or high-contrast lettering and an optional detachable Plexiglas keyguard. Features: optional ASSIST Mode (for those who cannot press 2 or more keys simultaneously or need 1-handed typing; works with and enhances the Windows "Sticky Key" Accessibility Option), and optional ability to switch between ABC and QWERTY layouts. No special software required; it is a plug 'n play device. This keyboard comes with a USB adapter making it compatible with both Win and Mac computers. Logitech diNovo Mini is a palm sized cordless mini keyboard that connects to the computer or is used for running entertainment options. This keyboard has the thumb layout of many phones which proves to be more accessible to some users. Another popular alternative keyboard is the TASH USB Mini keyboard, a small size alternative keyboard that plugs directly into a computer with no special interface needed. The membrane keys are less than one half inch square and are closely spaced for easy access. This is especially useful to someone with limited range of motion. Dana/Neo: see portable word processors above. Onscreen keyboards provide the various keyboard layouts on the computer screen. Depending on the software, selections on the keyboards may be made by mouse click, mouse dwell, or scanning. Use of the onscreen keyboard decreases the physical space between the keyboard and the monitor, thus eliminating some distracters. Onscreen keyboards are now available through the latest versions of both Windows and Mac. Handwriting recognition is a feature available through Microsoft Word. Your natural handwriting is converted to typed characters and inserted into the word document. You can write directly on a Tablet PC or on non-touchscreen computers by using a handwriting input device, such as a Graphire pen tablet device used with 3-D drawing programs or Computer Aided Drafting (CAD) software, or you can write using your mouse. Handheld computers offer a small, portable tool for written language. Handhelds allow input of text into various applications including memo pad, to do list, and word processing programs. Text can be inputted via a small onscreen keyboard and stylus or by writing on the handhelds LCD screen. The latest in handheld operating system software allow the student to write anywhere on the screen and the written words are translated into text. A variety of keyboards are available for use with the handhelds including portable wireless keyboards and snap on thumb keyboards. Some handhelds such as the Blackberry, iTouch or iPhone come with a thumb keyboard and also touch screen and onscreen keyboards. Tablet PCs also offer word processing applications with all the capabilities of a laptop or desktop. The Tablet PC incorporates a touch screen with handwriting recognition capabilities. iTouch offers an MP3 device with Internet connectivity and hundreds of downloadable applications. Using an MP3 format, this device is not only beneficial for listening to audible books, but can be used as a writing tool through applications for word prediction, instant messaging, and email. The technology for this device is evolving and becoming very usable and much less expensive. Scanning A scanner connected to the computer may be used to assist writing by scanning worksheets or chapter questions that the student may then access digitally on the computer. Worksheets may be designed with text boxes for short answer, fill in the blank, multiple choice or true/false. A student using other software to assist writing, such as word prediction or voice recognition, would then be able to complete worksheets using these types of programs. (See Chapter 7 Assistive Technology for Reading.) Many of todays light portable scanners come with a scanning program and many are compatible with various scan and read software frequently used (e.g. Kurzweil, WYNN, Read and Write Gold, Premier) OCR (optical character recognition) scanning software is required if you intend to have the scanned documents used with text-to-speech software. Classic scanning software simply takes a picture of a document versus recognizing characters or letters as with the OCR scanning software. A classic scanning program may be used for worksheets that a student can read independently. Text boxes may be inserted to this type of document and the student may answer the questions digitally. Consider a high speed scanner for scanning entire textbooks or workbooks. Keep in mind copyright laws. The student must have a purchased workbook and be identified as a student with a print disability.(See Chapter 7 Assistiive Technology for Reading-NIMAS Standards) Portable Scanners Portable handheld scanners work like a digital highlighter to scan and read text from books, magazines, newspapers, and other printed documents. They capture the text to memory and allow the user to download the text to their PC via a cable. This tool allows a student to capture important information from textbooks, glossaries, research materials, etc. and download it directly into a word processor. The QuickLink Pen from Wizcom Technologies, Inc., LTD is a handheld scanner that scans full lines of text from 6-22 point size, store it, and then transfer it to a computer, Palm Pilot, or text enabled cellular phone. The SuperPen Voice from Wizcom Technologies, Inc., LTD is a handheld scanner and translator. The pen combines the functionalities of the Quicktionary II and the QuickLink Pen. This pen allows the user to scan full sentences of text and receive instantaneous auditory word-by-word translation. The pen weighs 3 ounces and is capable of storing up to 3000 pages of data. Computer with Word Prediction Software Word prediction is most frequently considered for the student with spelling difficulties but should not be overlooked for the student with mechanical difficulties. The use of word prediction software may decrease keystrokes and increase quantity and efficiency; for the student with physical limitations, using fewer keystrokes to complete words and phrases will increase the quantity and quality of writing, while reducing fatigue. Word prediction software is fairly easy to use, and requires minimal instruction. Many programs include phonetic spelling prediction, auditory text to speech feedback and customized topic dictionaries to assist students in many curriculum areas. Most scan and read programs now include word prediction (e.g. Kurzweil, WYNN, Read and Write Gold, SOLO) Other word prediction programs: WordQ by Quillsoft, Premier Accessibility Suite including Predictor Pro by Premier Literacy, Clicker 5, Pen Friend and Wordbar by Crick, Co:Writer by Don Johnston, IntelliTalk by IntelliTools, ClaroRead by Claro Software. Voice Recognition Software Voice recognition is a computer application that lets people control a computer by using speech. Students can write using voice recognition in conjunction with a standard word processing program. When users speak into the microphone their words appear on a computer screen in a word processing format, ready for revision and editing. Not only can voice recognition software benefit students with learning disabilities but also the student with physical access challenges. While many such students benefit from standard word processing, the visual-motor demands of keyboarding can be a major stumbling block that compounds the writing process. Similarly, students who are the poorest spellers are frequently unable to effectively use standard spell checkers. For whatever reason, if a student's oral language skills far exceed their ability to generate text with pencil and paper or standard word processing, voice recognition may enable them to become successful writers. There are two kinds of voice recognition software: discrete speech and continuous speech. Discrete speech recognition requires the user to speak one - word - at - a - time. Continuous speech recognition allows the user to dictate by speaking at a more or less normal rate; both have their advantages and disadvantages. Dragon NaturallySpeaking is one of the most comprehensive voice recognition programs for the Windows OS, enabling hands-free navigation and dictation in Microsoft Word, Excel, Corel WordPerfect, and virtually all Windows-based applications. Dragon NaturallySpeaking may be used to create documents, reports, send e-mails, instant messages, surf the web, and even operate many of the computer functions. Microsoft Office has incorporated voice recognition within Microsoft Word 2003 and XP. The voice recognition engine within Word is not designed specifically for individuals with disabilities; however, it provides an excellent diagnostic tool to use to determine if voice recognition may indeed be a useful tool for the student. The voice recognition component requires custom installation. Microsoft Windows Vista operating system now has voice recognition built into the operating system. SpeakQ by Quillsoft plugs into WordQ and adds simple speech recognition. Users can benefit from a combination of word prediction, speech output and speech input to generate text when stuck with spelling and word forms, identifying errors, proofreading and editing. Designed with special students needs in mind, it works in both discrete and continuous modes. IBM ViaVoice for Mac OS X is a continuous speech voice dictation for Apple's Mac OS X. Users can dictate, correct, edit, and format text with their natural voice. Mac OS X Edition also provides voice command and control of the Internet, so users can move back and forth between Web sites. An enhanced Speech Recognition Engine takes advantage of Mac OS X audio features and provides for a fast enrollment. Writing AT into the IEP There are many correct ways to write AT into the IEP. It must be considered on the special factors form of the IEP and a listing of AT may be included there. It may be included as a related service and maybe also be included as a supplemental aid or service. If in an exploritory phase, do not write AT as a goal, put it in the special factors until the technology has been determined to work for the student.. (Purcell, Grant, 2002, 2004, 2007) and (Bateman, Herr 2003) state many examples of writing present level of performance, objectives and goals. The following is a four step formula for writing an IEP goal. (e.g. #1) Time Frame: In 36 weeks Conditions: Given a computer with adapted keyboarding Behavior: Eric will use an onscreen keyboard to complete writing assignments Criterion: in 10th grade English and civics class (e.g. #2) Given access to a computer with voice recognition (condition), the student will dictate sentences (behavior) averaging 15 words per minute in a 10 min. practice session (criterion) one of two opportunities (time frame). Solution Selection: Tools & Strategies - Motor Aspects of Writing Use a Feature Match process to discuss and select those ideas, tools, and strategies that were generated during the solution brainstorming. Select those that best match the student, the environment and the motor aspects of writing tasks that need to be accomplished. Limit your selections to a reasonable number and prioritize them according to those that can be accomplished immediately, in a reasonable time period and those that will be considered at a later time or require additional or significant staff training. Implementation Plan - Motor Aspects of Writing After tools have been selected and prioritized, identify any trials or services that are needed including procurement of trial materials, team member(s) responsibilities, start date and length of trial, training needed and any other student/staff specific issues. Be certain to identify motor aspects of writing objectives and criteria of performance to determine the effectiveness of the trials. Feature Match The following charts are examples of ways to involve the student in the feature match process. The student can choose the template that appeals to them visually. Then the student can highlight or otherwise mark their thought process when choosing the tool for the specific task they need to accomplish. It can also be used to remind the student of the choices they may have. Additionally, the student can have copies of it available to them to use independently to further increase their ability to perform written tasks.    References Bateman, B., & Herr, C. (2003) Writing Measurable IEP Goals and Objectives,, Verona, WI, Attainment Company Burton, A. W., & Dancisak, M. J. (2000). Grip form and graphomotor control in preschool children, American Journal of Occupational Therapy, 54, 9 17 . Carlson, K., & Cunningham, J. L. (1990). Effect of pencil diameter on the graphomotor skill of preschoolers. Early Childhood Research Quarterly, 5, 2 7 9 2 9 3 . Cornhill, H., & Case-Smith, J. (1996). Factors that relate to good and poor handwriting. American Journal of Occupational Therapy, 50, 732739. Graham, S., & Weintraub, N. (1996). A review of handwriting research: Progress and prospects from 1980 to 1994. Educational Psychology Review, 8, 787. Handley-More, D., Deitz, J., Billingsley, F. F., & Coggins, T. E. (2003). Facilitating written work using computer word processing and word prediction. American Journal of Occupational Therapy, 57, 139151. Marr, D., & Cermak, C. (2001). Consistency of handwriting development in the early elementary years: A literature review. Israeli Journal of Occupational Therapy, 10, 109130. McHale, K., & Cermak, S. (1992). Fine motor activities in elementary school: Preliminary findings and provisional implications for children with fine motor problems. American Journal of Occupational Therapy, 46, 898903. Moser, C. I. (2004, September). Using outcome measures to enhance occupational therapy in school-based practice. School System Special Interest Section Quarterly, 11, 13. Preminger, F., Weiss, P. L., & Weintraub, N. (2004). Predicting occupational performance: Handwriting versus keyboarding. American Journal of Occupational Therapy, 58, 193201. Press, M. & Banton, M. (2007 September). Technology solutions for struggling writers. Technology Special Interest Quarterly, 17(3), 1-4. Purcell, S., & Grant, D., (2002)Using Assistive Technology to Meet Literacy Standards K-3, Verona, WI, Attainment Company Purcell, S., & Grant, D., (2004)Using Assistive Technology to Meet Literacy Standards 4-6, Verona, WI, Attainment Company Purcell, S., & Grant, D., (2007) Using Assistive Technology to Meet Literacy Standards7-12, Verona, WI, Attainment Company Rogers, J., & Case-Smith, J. (2002). Relationships between handwriting and keyboarding performance of sixth-grade students, American Journal of Occupational Therapy, 56, 3439. Scherer, M. (2004). Living in the state of stuck: How technology impacts the lives of people with disabilities. Brookline, Massachusetts: Brookline Books. Schneck, C. M., & Henderson, A. (1990). Descriptive analysis of developmental progression of grip position for pencil and crayon control in nondysfunctional children. American Journal of Occupational Therapy, 44, 893900. Schneck, C. M. (1991). Comparison of pencil-grip patterns in first graders with good and poor writing skills. American Journal of Occupational Therapy, 45, 701706. Tseng, M. H., & Murray, E. (1994). Differences in perceptualmotor measures in children with good and poor handwriting. Occupational Therapy Journal of Research, 14, 1936. Tseng, M. H. (1998). Development of pencil grip position in preschool children. Occupational Therapy Journal of Research,18, 207224. Tseng, M. H., & Chow, S. M. K. (2000). Perceptualmotor function of school-age children with slow handwriting speed. American Journal of Occupational Therapy, 54, 8388. Volman, M. J. M., van Schendel, B. M., & Jongmans, M. J. (2006). Handwriting difficulties in primary school children: A search for underlying mechanisms. American Journal of Occupational Therapy, 60, 451460. Weil, M. J., & Cunningham Amundson, S. J. (1994). Relationship between visuomotor and handwriting skills of children in kindergarten. American Journal of Occupational Therapy,48, 982988. Yakimishyn, J. E., & Magill, E. J. (2002). Comparisons among tools, surface orientation, and pencil grasp for children 23 months of age. American Journal of Occupational Therapy,56(5), 564572. Product/Vendor Guide for this Chapter ProductVendor3M"!Vetwrap"! Bandaging TapeAvailable locallyAdhesive Mounting PuttyAvailable locallyBigKeysGraystone Digital, Inc.CalcuScribeCalcuScribeDana"!AlphaSmart, Inc.Dragon Naturally Speaking NuanceDycemDycem TechnologiesFranklin Children s Speller & DictionaryFranklin Electronic PublishersFranklin Homework Wiz Speller & DictionaryFranklin Electronic PublishersHandheld computersPalm, Compaq, Handspring etc.IBM ViavoiceNuanceIntelliKeysIntelliTools, Inc.Laser PC-6Perfect SolutionsMagnetic PoetryMagnetic PoetryMemo BoardabcdprB ̺~o~~~~~~[Mhgh^;5OJPJQJ&h9{Qh^;5CJ OJPJQJ\^JhY5OJPJQJ\aJhck5OJPJQJ\aJhe5OJPJQJ\aJh^;5OJPJQJ\aJh|5OJPJQJ\aJ"h9h^;5OJPJQJ\aJ h^;5CJ OJPJQJ\^J&h9h^;5CJ OJPJQJ\^Jh^;5CJ OJPJQJ\bcdstB C gd^;$a$gd^;$gd^; $ !gde $$a$gd^; Y`=I x&F])pmmmmm#hgh^;6B*OJQJ]ph#hgh^;5B*OJQJ\phhgh^;OJQJ]h|OJQJhgh^;6OJQJ]hgh^;B*OJQJph#h|h^;5CJOJQJ^JaJh^;OJQJhgh^;5OJQJhgh^;OJQJhgh^;OJPJQJ) wxH5; $$G$Ifa$gd31   ^ gd^;  %dhgd^;$  %dha$gd^; $$a$gd^;gd^;7$gd^;gd^;;=DPƲp]QA1$hCJOJQJ\aJhgh^;CJOJQJ\aJhgh^;CJOJPJQJ\hgh^;5OJQJ%hgh^;5:CJOJPJQJ\%hgh^;5:OJPJQJ\aJhgh^;>*OJPJQJ!hgh^;5>*OJPJQJ\hgh^;5OJPJQJ\&hgh^;5CJOJPJQJ\aJ hgh^;CJOJPJQJaJ(hgh^;5B*CJ OJPJQJph&hgh^;5>*B*OJQJ\ph ;<={m``````O$If]^gd31 & F,$Ifgd^; 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DQOkdk$$IfT0, 44 layt31T !$G$Ifgd31Okd$$IfT0, 44 layt31T"! Contact PaperAvailable locallyMicrosoft Office MicrosoftMicrosoft WindowsMicrosoftNEOAlphaSmart, Inc.QuickLink PenWizcom Technologies, Inc.Quicktionary IIWizcom Technologies, Inc.Research Assistant for Students (and Teachers) with Bibliography GeneratorESSDACKSculpey modeling clayAvailable locallySmartAppletsAlphaSmart, Inc.SpeakQQuillsoftProductVendorSuperPen VoiceWizcom Technologies, Inc.TASH USB Mini keyboardTASH Inc.The WriterVelcro"!Available locallyViaVoice IBM North AmericaWikki Stix"!Wikki Stix      Assessing Students Needs for Assistive Technology (2009)  PAGE 23 Important: It is intended that you use this as a guide. Each topic should be written in large print where everyone can see them, i.e. on a flip chart or board. Information should then be transferred to paper for distribution, file, and future reference. Low tech Utensils- Variety of sizes and types Utensils -Modified with pencil grip or splint Paper-different sized lines, boxes heavier paper (24 pound) is easier to write on and erase Templates- eliminate excess writing Prewritten words phrases Cut and paste preprinted words Magnetic letters or numbers Words printed on magnetic paper Handwriting Writing tools pencils, mechanical pencils, markers, pens Increasing handwriting legibility Space between words, between lines Margins -keep uncrowded Note taking- make copies, use carbon paper or get from teacher Mid Tech Labeler Portable word processor No Tech Dictation to another person Although not assistive technology, dictation can solve some of the issues with written language assignments High tech Computer with accessibility features Computer with word processing Alternative keyboard Computer with word prediction Computer with Voice recognition software K J Stindt MS OTR 2007 Factors to Consider 1. Amount of writing Very little& & & & & & & & & & & & & & & & & & & & & & & to& & & & & & & & & & & & & & & & & & & & & & & & & & & & ..Lots of writing Single words& & & & & & & & & ..Sentences& & & & & & & & & & .Paragraphs& & & & & & & & & & & & & ..Essays& & & & & & & & & & & & .Papers 2. Due date right away& & & & & & & & & & & & & & & & & & & & & & & & .to& & & & & & & & & & & & & & & & & & & & & & & & & & & much later date Immediately& & & & & & & & & & & & & Next day & & & & & & & & & & & & & & & & & & & ..Next week& & & & & & & & & & & & & & & & & Next month 3. Purpose of task Are there other ways to do the work besides writing? Copying information& & & & & & & & & & & & Review information& & & & & & & & & & & & & & & Demonstrate knowledge& & & & & & & & & & & & & .Create new information 4. 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