This randomized controlled trial will evaluate the effects of a structured, task-focused occupational therapy program delivered in the school environment on handwriting performance, fine motor skills, visual-motor integration, and academic performance in primary school children. Second- and third-grade students identified as being at risk for handwriting and manual dexterity difficulties will be randomly assigned to an intervention group or a control group. The intervention group will receive a 10-week school-based occupational therapy program consisting of two 30-minute sessions per week, for a total of 20 sessions. The control group will continue routine classroom activities without therapist-led occupational therapy. Handwriting, manual dexterity, visual-motor integration, visual perception, and motor coordination will be assessed at baseline and after the intervention. Academic grades will also be recorded, and individualized goal attainment will be evaluated in the intervention group.
Being between 7 and 9 years of age
Being enrolled in the second or third grade
Demonstrating basic literacy skills
Being identified as high risk for handwriting and/or manual dexterity difficulties based on standardized assessments and teacher observations
A diagnosed neurodevelopmental disorder, including autism spectrum disorder or attention-deficit/hyperactivity disorder
Significant visual or hearing impairment
An orthopedic or neurological condition affecting the upper extremity
Current receipt of occupational therapy or special education services