Visual-perceptual-kinesthetic inputs on influencing writing performances in children with handwriting difficulties

• CHD showed slower speeds of writing and produced less legible characters than the normally developed control.
• Both CHD and control groups deteriorated from copying to dictation without visual feedback condition.
• Poor legibility may due to less intact spatial representation of Chinese characters in working memory.
• Viewing characters during writing can improve legibility of the characters produced.
• Visual feedback regarding one's own actions in writing can also improve legibility of CHD.

This study investigated the role of visual-perceptual input in writing Chinese characters among senior school-aged children who had handwriting difficulties (CHD). The participants were 27 CHD (9–11 years old) and 61 normally developed control. There were three writing conditions: copying, and dictations with or without visual feedback. The motor-free subtests of the Developmental Test of Visual Perception (DTVP-2) were conducted. The CHD group showed significantly slower mean speeds of character production and less legibility of produced characters than the control group in all writing conditions (ps < 0.001). There were significant deteriorations in legibility from copying to dictation without visual feedback. Nevertheless, the Group by Condition interaction effect was not statistically significant. Only position in space of DTVP-2 was significantly correlated with the legibility among CHD (r = −0.62, p = 0.001). Poor legibility seems to be related to the less-intact spatial representation of the characters in working memory, which can be rectified by viewing the characters during writing. Visual feedback regarding one's own actions in writing can also improve legibility of characters among these children.