Parents reported that the child avoided writing tasks and became frustrated during homework. Teachers observed illegible handwriting, inconsistent letter size, poor spacing, and slow completion of written assignments. The child frequently complained of hand pain after writing for a few minutes and showed reduced confidence in classroom activities involving writing.

At home, parents noticed difficulty with buttoning, coloring within boundaries, and using scissors properly. Academic performance was affected mainly due to poor written output despite good verbal understanding.

Occupational therapy assessment showed:

Poor pencil grasp and excessive pressure while writing

Reduced fine motor coordination

Difficulty with visual-motor integration

Poor hand strength and finger control

Inconsistent letter formation and alignment

Reduced postural stability during table-top activities

Decreased attention during lengthy writing tasks

The child demonstrated signs commonly associated with dysgraphia, including difficulty organizing written work and maintaining writing speed appropriate for age.

The occupational therapy intervention focused on improving fine motor control, handwriting skills, and functional classroom participation.

Hand strengthening exercises using therapy putty and cloth clips

Fine motor activities such as bead threading and pegboard tasks

Pencil grasp correction using adaptive grips

Multisensory handwriting training

Tracing, pattern copying, and letter formation exercises

Visual-motor integration activities

Postural control and shoulder stability exercises

Writing practice with graded difficulty

Home Program Guidance

Parents were advised to:

Encourage short daily handwriting practice

Use lined paper for spacing support

Provide movement breaks during homework

Engage the child in fine motor play activities

Avoid excessive correction to reduce frustration