A study examining the impact of an occupational therapy intervention on the support for children who are delayed in their readiness to write.

Background Writing is a crucial lifelong skill which supports communications and aids cognitive development, memory, fine motor skills, and reading ability. However, learning to write is challenging, with handwriting difficulties affecting between 10 and 30% of all children. In our recent survey of early career primary school teachers (ECTs) in the UK, we found significant gaps in their knowledge on handwriting readiness, handwriting difficulties and delay, and handwriting interventions. Working with occupational therapists (OTs) and ECTs, we co-produced a workshop to address gaps in knowledge, and teachers reported that they would value a screening tool to use alongside the workshop and assist intervention selection. The focus for the current proposal is to further develop the workshop, create the screening tool through co-production, and explore the intervention's feasibility in the classroom. Research question How can an occupational therapy workshop and screening tool improve tier-1 (whole-school) and tier-2 (targeted) support for primary school children with handwriting delay? Aim(s) of the research To establish what is known about the barriers or enablers to introducing health interventions in mainstream schools To establish the key components of current school-based prewriting interventions and supporting evidence To develop an applied intervention in the form of a screening tool for handwriting prerequisites To refine a prototype of an OT workshop and integrate it with the screening tool to form an applied intervention To evaluate the feasibility of the co-produced intervention (workshop and screening tool) to support children with handwriting delay by primary school teachers To understand teachers views on the workshop and screening tool To understand the views and feelings of children on how handwriting interventions can be supportive for them Methods The study design has been informed by the Medical Research Council (MRC) guidelines for development of complex interventions and the Framework for the Co-production and Prototyping of Public Health Interventions. It has been developed in collaboration with key stakeholders including public advisors who will also be involved throughout the project. It has 3 phases: Phase 1: scoping review A scoping review of health interventions (workshops or training, delivered by healthcare professionals) introduced to schools. The findings of the scoping review will be used to shape phases two and three of the study. Phase 2: refining the workshop and co-designing the screening tool Through two meetings with OTs, primary school teachers, and teaching assistants, the workshop will be refined and a screening tool co-produced. Phase 3: feasibility testing Focus groups and semi-structured interviews will be conducted with teachers who attended the workshop. Data will also be gathered from children affected by handwriting difficulties. Data will be integrated and analysed using thematic analysis. Anticipated impact and dissemination Results will be shared locally with education and health stakeholders. The study will measure the impact of a feasibility-tested workshop and applied intervention (screening tool) which will inform practice and can be used to meet the needs of children at a tier-1 and -2 level in the classroom, allowing for OT services to focus on delivering tier-3 (one to one) intervention.