Collaborative Parent Coaching: An Alternative Handwriting Intervention Model for Kindergarten Students

Due to school-based OT service limitations, handwriting remediation for unserved students falls to parents without sufficient support or evidence-based instruction knowledge. There is no current research on the effectiveness of home programs as a viable intervention for poor handwriting. Occupational therapists serve to ameliorate occupational access disparity and advocate for collaborative, effective interventions to reduce poor occupational outcomes for these unserved, but failing children (AOTA, 2006, 2017). The purpose of the research study was to explore the effectiveness of an alternative service delivery advocacy intervention model as a means to facilitate family-centered, evidence-based handwriting interventions through parent coaching.

This two-group quasi-experimental research measured pretest-posttest handwriting outcomes of alphabet letter formation for those students who had not met kindergarten writing standards, or who had scored below 70% with year-end handwriting screening. For inclusion, intervention group parents served as the supplemental educator, reported survey data, and attended in a 3-hour training class with their child. Control group parents only completed one survey. All children completed The Test of Handwriting Skills- Revised (THS-R) for baseline and outcome standard and scaled scores. Children with impaired motor skills or those who received direct OT services were excluded.

At year-end parent conferences, selected teachers referred students for remediation based on inclusion-exclusion criteria. Parents consented for two student handwriting evaluations, demographic and outcomes survey completion, and optional coached handwriting instruction. Parent participation level preference determined group assignment. Intervention group parents were coached on developmental program elements and delivery of individual lessons. Both student groups were post tested after the seven-week summer program. The intervention group parent post program survey provided perceived effectiveness and actual program participation data. Comparative THS-R quantitative data analysis answered the primary research question of program effectiveness with alphabet letter formation. Survey data addressed parent perceptions of student response effectiveness and were converted to numerical values for mean and standard deviation calculations. Independent-samples t- tests, paired samples t-tests, and mean change with standard deviation of scaled and standard scores provided correlation and statistical significance.

From 18 potential subjects, 16 children and parents consented for participation. Fourteen (N = 14) met inclusion criteria for the intervention (n = 7) and control groups (n = 7). Intervention group parents reported moderate gains with alphabet letter formation, readability of written text, ease of program use for an effective alternative service delivery model. Parent survey results correlated to child THS-R mean change standard scores. The hypothesis that intervention group mean change standard scores would exceed the control group was supported and statistically significant (p<.05). Intervention group students demonstrated a statistically significant increase in full scale THS-R scores from pre-test (M = 89.57, SD = 12.12) to posttest (M =101.4, SD = 10.39), t(6) = 6.175, p = .001 (two-tailed). Intervention group percentile ranking improved from the 25^th to 53^rd percentile in mean scaled scores.

Student handwriting improved as a direct result of parent coached, evidence-based home remediation. Advocacy efforts improved the validity of occupational therapy referrals, explored a viable alternative service delivery model, facilitated parent-school collaboration, and met our professional vision for advancing family-centered care.

References

American Occupational Therapy Association. (2006). Children and Youth Ad Hoc Committee-Recommendations for education and practice. Bethesda, MD.

American Occupational Therapy Association. (2017) . Vision 2025. American Journal of Occupational Therapy, 71,7103420010. https://doi.org/10.5014/ajot.2017.713002