February 1, 2024

Graphomotor Skills

There is a developmental sequence of graphomotor skills and as children develop, their scribbling and picture drawing evolves into handwriting.


Graphomotor skills are handwriting skills. The development of the handwriting process occurs in the early elementary grades and includes not only the mechanical and visual perceptual processes of graphics and handwriting, but also the acquisition of language, learned spelling and phonology. There is a developmental sequence of graphomotor skills and as children develop, their scribbling and picture drawing evolves into handwriting.


Some factors necessary to handwriting include:

  • Small muscle development in the hands
  • Hand-eye coordination
  • The ability to hold utensils or writing tools
  • The ability to form basic strokes smoothly, such as lines and circles
  • Letter perception – the ability to recognize forms, notice likenesses and differences, motor plan the movements necessary for the production of the forms
  • Orientation to printed language, requiring visual analysis of letters and words along with left-right discrimination


  • Visual-perceptual skills: these involve the ability or capacity to accurately interpret or give meaning to what is seen;
  • Orthographic coding: referring to the ability to both store in memory and retrieve from memory letters and word patterns;
  • Motor planning and execution: mainly the ability to conceive/ideate, organize/plan, and execute a novel task;
  • Kinesthetic feedback: comes from the sensorimotor system and is required for any motor action. Kinesthesia is the knowledge of where each body part is and direction in which it is moving. It is a component of motor control for legible handwriting produced at an acceptable rate; and
  • Visual-motor coordination: the ability to match motor output with visual input. It is this gross monitoring that prevents us from writing on the desk or crossing over lines, and keeps us within margins.

The development of graphomotor skills begins with scribbles on paper at 10-12 months. At 2 years, the child begins to imitate lines–vertical, horizontal and circular. At 3 years, the child copies lines clearly. When a child is 4-5 years, he copies a cross, diagonal lines, squares and some letters. He may also be able to write his name. At 5-6 years, a child copies a triangle, prints his own name and copies most lowercase and uppercase letters.


To evaluate graphomotor skills, our therapists use standardized evaluations such as the Beery-Buktenika Test of Visual Motor Integration, 5th edition, the Evaluation Tool of Children’s Handwriting (ETCH), and finger and hand strength testing, in addition to clinical observations.

To improve graphomotor skills and handwriting readiness, we incorporate activities aimed at improving fine motor control, isolated finger movements, fine motor strength, enhancing right-left discrimination and visual perception, promoting prewriting skills, and improving orientation to printed language, while also promoting a fun atmosphere. Our therapists use various models of practice to improve graphomotor skills, such as:

  • The neurodevelopmental approach: this approach focuses on the child’s ability to execute efficient postural responses, movement patterns, limb control, muscle tone, and proximal stability.
  • The acquisitional approach: this approach views handwriting as a complex motor skill that can be improved upon with instructional guidance, practice, repetition, feedback, and reinforcements.
  • The sensorimotor approach: this approach incorporates a sensory integrative view of handwriting intervention by providing various sensory opportunities so the child’s nervous system may integrate information more efficiently to produce a satisfactory motor output.
  • The biomechanical approach: this approach addresses performance in terms of range of motion, strength, endurance and posture. This approach also takes into consideration paper positioning, pencil grip, type of writing tool used, and type of paper used. Finally, the psychosocial approach for handwriting intervention focuses on improving the child’s self control, coping skills, and social behaviors.

Since children learn best when they are interested and having fun, our therapists strive to promote an exciting atmosphere which encourages learning and success.

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