Importance: Approximately 7% to 30% of children contend with handwriting issues (HIs) in their school years. However, research studies to define and quantify HIs, as well as practical assessment tools, are lacking.
Objective: To confirm the validity and reliability of two screening scales for HIs: the Handwriting Legibility Scale (HLS) and the Concise Assessment Scale of Children's Handwriting (BHK).
Design: Structural equation modeling (SEM) and confirmatory factor analysis (CFA) of five different models were used to examine the construct and discriminant validity of both scales. Furthermore, internal consistency and interrater agreement were evaluated. The association among scales, grades, and children's self-evaluation was also explored.
Setting: Elementary schools and state counseling centers in the Czech Republic.
Participants: On a voluntary basis, 161 children from elementary schools and state counseling centers in the Czech Republic were enrolled. The variable of children with typical handwriting development versus HIs was missing for 11 children. Thus, for discriminant validity analysis, 150 data records from children were used.
Outcomes And Measures: The HLS and BHK were used to evaluate the handwriting quality of the transcription task. The Handwriting Proficiency Screening Questionnaires for Children was used for children's self-evaluation.
Results: The study confirmed the validity and reliability of the shortened BHK and HLS. A strong relationship was found between the BHK and HLS, grades, and children's self-evaluation.
Conclusions And Relevance: Both scales are recommended for occupational therapy practice worldwide. Further research should focus on developing standards and providing sensitivity studies. What This Article Adds: Both the HLS and the BHK are recommended for occupational therapy practice. Practitioners should also take the child's well-being into consideration in handwriting quality assessment.
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