Investigating Handwriting Characteristics and Underlying Factor in Children With Autism Spectrum Disorder

Completed

• Conditions: Typical Developed Children; Children With Autism Spectrum Disorder
• Interventions: Behavioral: handwriting experiment and motor ability test

• Registration Number: NCT06228885
• Lead Sponsor: National Cheng-Kung University Hospital

Brief Summary

The mechanism of the motor problem in children with autism spectrum disorder (ASD) in handwriting has been investigated in the following three aspects, including collecting dynamic handwriting performance, exploring the related underlying factors, and investigating corresponding brain activities. This study aimed to investigate the underlying factor of handwriting issue in children with ASD. There are four study aims. The first is to examine the differences of handwriting performance between children with ASD and TD using kinetic and kinematic measurements and handwriting difficulties questionnaires. The second is to investigate the group difference of the underlying motor factors, including fine motor ability and sensorimotor ability. The third is to explore the relationship between underlying motor factors and handwriting performance. The fourth is to explore the corresponding cortical activity during writing in children.

Detailed Description

Not available

Study Timeline

• Study Start: 2022-12-27
• Primary Completion: 2023-09-01
• Status Verified: 2023-12
• Study First Submitted: 2023-12-27
• Study Completion: 2023-12-31
• Study First Submitted QC: 2024-01-24
• Last Update Submitted: 2024-01-24
• Study First Posted: 2024-01-29
• Last Update Posted: 2024-01-29

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 58

Inclusion Criteria

• Age between 5-12 years old

Exclusion Criteria

• who have a diagnosis of a seizure disorder, genetic condition, neurological condition, uncorrected significant hearing or visual impairment, and/or intellectual disability
• having non-verbal intelligent ability score lower than 70, determining by TONI-3
• unable to follow instructions during the process

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Children with Autism Spectrum Disorder	handwriting experiment and motor ability test	-
Typical developed children	handwriting experiment and motor ability test	-

Primary Outcome Measures

Name	Time	Method
Chinese Handwriting Evaluation Form (CHEF)	baseline	The CHEF is a questionnaire developed to assess and confirm the handwriting difficulties of preschooler (the third year of kindergarten) and school-aged children (grade one to two of elementary school). The school-aged version includes 25 items within five dimensions of handwriting problem: legibility, accuracy, speed, pencil grip, and directionality; while the preschooler version includes 22 items within four dimensions of handwriting problem: legibility, function (accuracy and speed), pencil grip, and attitude. The score is rated by teachers, parents, or familiar professionals with a 5-point Likert scale. A larger score indicates more difficulty in handwriting.
Force-acquisition pen (FAP) system	baseline	FAP system was used to collect the kinetic data during the process of writing. During the experiment, children will be asked to perform some tasks: tracing line, writing numbers, writing Bopomofo, and writing characters. The force of thumb, index, middle fingers and pen tip will be recorded. This is able to reflect the motor control aspect of handwriting through a variety of parameters. The following parameters will be calculated: average force, max force ration, numbers of force fluctuation per second, ... and so on.
Movement Assessment Battery for Children Second Edition (MABC-2)	baseline	The MABC test is used to measure children's motor ability, including fine motor, balance and aiming and catching ability. The score will transform into z score and rank score, to reflect child's performance. A higher score indicates a better motor ability.
Pinch-Holding-Up Activity (PHUA) test	baseline	The PHUA test is used to measure one's sensorimotor ability. Through calculating the parameters (max pinch force, max load force, force ratio ... etc) to reflect one's ability to integrate sensory and produce a new output. A higher force ratio reflects a poorer sensorimotor ability.

Secondary Outcome Measures

Name	Time	Method
Near Infrared Spectroscopy (NIRS)	baseline	The NIRS system measures changes in oxygenated hemoglobin (HbO) and deoxygenated hemoglobin (HbR) as parameters to analyze cortical activation data. During handwriting, the cortical activation will be collected to observe which brain area activates more.

Trial Locations

Locations (1)

National Cheng-Kung University Hospital; 🇨🇳 Tainan, Taiwan