This post offers a step by step pre-writing skills treatment plan designed to break down and master the smallest basic skills required to get students from the stage of imitating strokes all the way to actually writing letters.
Most therapists are familiar with the progression of pre-writing skills, starting with imitating vertical strokes between the age of 18-24 months (Howard, Williams, & Lepper, 2010) then progressing to imitating horizontal lines, diagonals, crosses, and circles. At around 4 yrs of age, students should then be able to copy shapes and letters.
This is the general sequence most pre-writing skills treatment plans follow. And while this does represent a global breakdown of the component skills required for pre- writing, it isn’t quite the fastest path to get students to the goal of writing letters with fluency.
Research indicates that by using a very in depth activity analysis and the principles of Precision Teaching, we can actually make more progress in teaching these pre-writing skills and save time.
Why Precision Teaching? You may ask. Well, precision teaching is a method which stresses the need for the learner to become automatic, fluent and effortless in what he/she does. It can help teachers, therapists and parents enhance the outcome for students with autism, and other disabilities, as well as help the children have fun going fast, beating their own performance standards and experiencing mastery and efficacy instead of effort or failure (Kubina, et al. 2002).
It is a method that was developed in the 1960s, at Harvard University, by Ogden Lindsey (Lindsley, 1990) and is often referred to ‘Fluency Learning’ and has been used successfully with university graduates, as well as students with diverse problems such as autism, attention deficit or severe intellectual disabilities (White, 1986).
In a nutshell it is a science that focuses on building fluency and precise data collection, which in turn can help us make data based decisions and optimize student progress faster than traditional teaching methods.
I have used it in my own practice as an OT and realized that with some minor modifications, we can make a bigger difference in a shorter amount of time. After all… what do we as OT’s never have ? …… enough time !! That is precisely why I decided to write this post.
Here are the key steps…
- Create a more in depth activity analysis: this involves breaking down the components of pre-writing skills further, into very small basic teaching steps.
- Timed Practice: Build fluency in these component pre-writing skills within very short periods of time: 10, 15, 30 seconds or 1 minute timings.
- Practice often: several times a day and/or throughout the week.
- Take data consistently and chart: a visual display of the per minute score ( fluency ) on the Standard Celeration Chart makes data collections & analysis quick and easy.
The idea is to have the student practice and become fluent in all the pre-writing skills needed to write letters, before they attempt to master the much more complex task of actually forming letters.
It boils down to is breaking down the pre-writing skills to much smaller tiny teeny components, and building fluency in those skills.
How to create an in-depth Activity Analysis for pre- writing skills?
Ask yourself: what are the basic pre-writing skills and strokes students need to master before they can write letters? The important thing here is to think small…. very small, for example….…..
For example, my student Julia is working with on pre writing skills with a goal to eventually write her name. Consider the steps she would need to get from this stage of imitating long free hand strokes to actually forming the letters of her name. She is currently able to imitate vertical strokes and horizontal strokes, but is not yet copying any letters.
This is an example of what Julia wrote when asked to write the letter ‘J’ of her name:
From a precision teaching perspective, she would benefit from practicing drawing slashes, semicircles or circles in various directions before attempting to write letters. (Vargas & Vargas, 1991). Since all alphabet letters are made up of various pre-writing strokes, we would need to make sure she can imitate all these strokes with fluency.
Before working on these pre-writing skills, I would need to make sure I address her pencil grasp. I wrote a post about how I used fluency building on a post you can find here.
What pre-writing strokes do students need to master to write letters ?
If you look at the alphabet, all letters are made up of varying combinations of some basic pre-writing strokes.
This is a list of all the pre-writing strokes that students needs to be able to draw before they can write letters:
- Vertical strokes
- Horizontal strokes
- Diagonal strokes
- Circular strokes
- Intersecting strokes +, x
- Semi-circle strokes
But it is not just about being able to imitate these strokes on a broad scale: students also need to be able to imitate these strokes in smaller proportions, especially if the expectation is to write within the lines in a notebook.
Plus, the motor control required for imitating a 6 inch vertical stroke is a lot different than motor control required for imitating a 3 inch or ¾ inch vertical stroke.
We may start by having students imitate long 6 to 8 inch strokes, but it is also important they make sure they can make shorter 3″ strokes from dot to dot which requires greater motor control and then develop further motor control with imitating 3/4″ strokes.
So this is the progression from vertical strokes to writing letters:
- Long vertical strokes (6 inches or more) free hand.
- Medium vertical strokes (3 inches or less) from dot to dot for motor control.
- Short vertical strokes (3/4 inches or less) from dot to dot for motor control.
- Fluency in drawing vertical ¾ inch strokes (60-80/min)
This progression would apply to all the aforementioned 6 pre-writing strokes students need for writing letters.
Here is an in-depth pre writing skills checklist which I often use with my students to figure out what stage of fluency they are in and what pre-writing skills I need to build fluency on. It is a resource you can download here:
It’s all about Practice, Practice and more Practice!
In this video clip, you will see a super short 10 second fluency timing of a student (Julia) working on imitating vertical strokes.
One of the biggest advantages of using fluency building is that practice is quick and easy. Since the timings are in really short bursts, it is much easier to fit in practice opportunities and super easy to incorporate into the OT session, without taking up the entire session.
For example, I may see Julia for OT for 15 mins/ week and even if we do 8 pre-writing skills practice trials (15 seconds/trial), it will only take approximately 2 minutes of the session. So there are still approximately 10 mins of the session left to do some functional activities and perhaps we can even practice again, in the last 1-2 minutes?
Since building fluency requires consistent and frequent practice; it is super helpful to recruit other team members to run timings throughout the week on the days when the student does not have OT.
I have asked parents, teachers, aides and other related services team members ( SLP, SW etc. ) to help out whenever possible. Even if they help out with running 4 timings during their session, it only requires 1- 2 minutes of their time… which really isn’t a big ask. I have found most people are super willing and helpful.
Plus there is nothing more reinforcing than the social reinforcement students get from showing off their newly learned skills.
To make fluency practice easier, I have also created a bundle of fluency building of pre writing stroke worksheets accessible here:
How to collect data on Pre writing skills in a matter of minutes ?
Data collection is actually easier than you think when working on fluency based skills. Based on researched published fluency aims that you can find here, I set my fluency goal at 80/ min as my general fluency goal. This would be my starting point, but if I felt the student had some limiting factors, and was not able to meet this goal, I may reduce my goal to 60/min. This is where you will need to use your clinical judgment.
Based on this fluency goal I know that my student needs to draw at least 80 correct strokes in a minute to be truly fluent and to have mastered this skill.
In Julia’s case we started with 10 second timings since she had significantly low tone and poor endurance. I was able to complete 10- 12 practice timings in a session. Starting with 4 at the beginning of my session and 4 at the end of the session (total of 1-2 minutes) building fluency in prewriting skills. The data collection was quite rudimentary at this initial stage. I simply wrote down the number of correct and incorrect responses on a Post-it note like this…
The next stage was to plot the data so I could visually analyze progress. Even though we typically completed 8-10 fluency timings in a session, I would pick Julia’s best score and plot it on the SCC chart.
For example, if Julia’s best score was 10 correct strokes in 10 seconds, I would simply multiply this raw score of 10 correct by 6 (because there are six 10-second increments in a minute) to convert this to a 60 correct responses per minute score.
Similarly, I would multiply her number of incorrect raw scores by 6 to convert that to a per minute score and plot that with an ‘X’ on the chart.
The beauty of this chart is that even if you are unfamiliar with the chart, you can simply visually look at the dots and figure out if progress is occurring. If the dots are going up (progress is occurring) or if the dots are in plateau (i.e. no progress). You can also look at the trajectory of the data plotted with ‘x’ s in a similar fashion. Below is an example of Julia’s data plotted on the Standard Celeration Chart:
By looking at the data (dots), you can see that Julia made good progress and you can also see that in just 3 weeks (each vertical line represents a day) she met her goal.
At this point she was only doing 10 second practice trials. So the next step would be to increase her endurance and work on 15 second timings and then 30 second timings. As soon as she can imitate vertical strokes with a score of 80/min doing a 30 second timings, then I can infer that she has met this goal. Building endurance is important because it ensures that Julia is not only fluent (and accurate) but also has the requisite endurance required for writing tasks.
If you are interested in learning more about the SCC, I have created an entire step by step presentation Intro To Charting Data in OT
How do you know if the treatment plan is working?
A treatment plan is only as good as the outcome, so naturally you will want to assess if building fluency on these pre writing component skills (horizontal, vertical strokes etc.) is actually working to address the goal of writing letters. If it isn’t then we are simply wasting our time.
So, think of the process of fluency building and taking data, as more of a formative assessment technique which “provides feedback and information during the instructional process, while learning is taking place, and while learning is occurring”. (NIU Center for Innovative Teaching and Learning. 2012).
However, we also need a summative assessment, which often takes place after the learning has been completed and tells us if the skills are generalizing. In other words we need to see if this newly learned pre-writing skill is applicable to what we actually wanted the student to be able to do or learn (write letters).
The summative assessment or what we call an ‘Application check’ in Precision teaching should occur throughout the fluency building process and can tell us if the work we are doing on building fluency in the pre writing skill is actually generalizing to address her ability to write letters.
In Julia’s case, I choose to do an application check every 2 weeks or so, by asking her to write the first letter ‘J’ of her name.
As you may recall at the beginning of the intervention, Julia could barely imitate a vertical stroke, however after 3- 4 weeks of fluency building this was one of her application checks:
This is a prime example of how building fluency in the pre-writing skills helped Julia make faster progress than expected.
I hope this post provided a different perspective of addressing pre-writing skills. With just some minor modifications to your existing treatment plan, you can elevate progress to the next level.
Next time you are working with a preschooler on pre-writing skills, I hope you will give building fluency a try and leave me a note:)
References
Bernard-Opitz, V. (2005) Autism Spectrum Disorders: A training manual for parents, teachers and therapists.
Kubina, R.M., Jr., Morrison, R. and Lee, D.L. (2002), Benefits of adding precision teaching to behavioral interventions for students with autism. Behavioral Interventions, 17: 233-246. https://doi.org/10.1002/bin.122
Northern Illinois University Center for Innovative Teaching and Learning. (2012). Formative and summative assessment. In Instructional guide for university faculty and teaching assistants. Retrieved from https://www.niu.edu/citl/resources/guides/instructional-guide
