Graduation Year


Document Type


Degree Type

Open Access Capstone

Degree Name

Doctor of Occupational Therapy (OTD)


Occupational Therapy


Background: Handwriting is one of the most utilized forms of written communication and there is a lack of research comparing the effectiveness of two different handwriting programs in elementary aged students.

Purpose: The purpose of this Doctor of Occupational Therapy (OTD) Capstone project was to compare the efficacy of two handwriting programs implemented in first grade classes at one elementary school in Kentucky. The research question that guided this Capstone Project was: Which of the following handwriting programs were more effective in achieving handwriting legibility in first grade students: Handwriting Without Tears or Write Start?

Theoretical Framework: The theoretical frameworks and scientific underpinnings that guided this capstone project were the Conceptual Model for Performance in Handwriting, the Developmental Theory and Ayres Sensory Integration.

Methods: A pre-experimental design comparing pretest and posttest data was utilized to analyze results using descriptive statistics and jamovi in first grade students. Students in each classroom received six sessions of handwriting interventions that lasted twenty minutes each. One classroom received Handwriting Without Tears instruction. The other classroom received Write Start instruction.

Results: Statistical significance was found for improvement in handwriting legibility in students who received the Handwriting Without Tears intervention. Both programs demonstrated clinical significance and improvement in student handwriting legibility.

Conclusions: The use of handwriting programs can provide a positive impact on handwriting legibility in first grade students. A hybrid model combining methods from Handwriting Without Tears and Write Start could be implemented to provide instruction to students on handwriting skills.

Faculty Mentor

Julie Duckart, PhD, OTR/L

Department Affiliation

Occupational Therapy

Committee Member

Jennifer Hight, OTD, OTR/L

Department Affiliation

Occupational Therapy

Department Affiliation

Occupational Therapy

IRB Approval Number (if applicable)