EFFECTIVENESS OF A STRUCTURED OCCUPATIONAL THERAPY-BASED HANDWRITING INTERVENTION ON WRITING PERFORMANCE IN CHILDREN WITH ASD

Abstract

Background: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder marked by the presence of social communication deficits, repetitive behaviors, and associated motor coordination and sensory impairments. ASD children often suffer from severe handwriting problems due to poor fine motor control, deficient visual-motor integration (VMI), and impaired motor planning and praxis abilities. Such problems affect their academic performance, class room involvement, and functional independence.

Objective: To investigate the effectiveness of a Structured Occupational Therapy (OT) handwriting intervention strategy in children with Autism Spectrum Disorder (ASD).

Methodology: Single-blind randomized controlled trial was conducted in Lahore, Pakistan involving 60 children with ASD (ages 7–12 years old). The participants were divided equally into 2 groups, Group A (conventional therapy, n=30) and Group B (structured 6–8 weeks OT Structured intervention strategy for 30–45 min, 3 days per week, n=30). The outcomes were measured through a standardized handwriting assessment and Canadian Occupational Performance Measure (COPM).

Results: Though both the groups were equal at baseline levels, the experimental group (Group B) demonstrated highly significant, clinically better outcomes after 8 weeks (p < 0.001). Handwriting scores increased significantly from 41.85 to 56.20 for the experimental group, while there was a small increment of 42.10 to 45.80 in the case of the control group. There was an excellent Time by Group interaction effect observed through mixed ANOVA (η² = 0.46). Performance on everyday functional activities (COPM) and parent satisfaction scores also achieved clinically significant improvements in the experimental group.

Conclusion: Task-oriented occupational therapy programs are far more effective than traditional therapy for enhancing both writing skills and functional capabilities of children with ASD.