Background

First graders born prematurely perform poorly on handwriting speed and legibility. However, whether there are specific legibility factors in which preterm children demonstrate difficulty remains unknown. In addition, handwriting performance beyond the first grade and the influence of sex on handwriting performance in preterm children are still unclear. We aimed to investigate the influence of prematurity and sex on multiple dimensions of handwriting in grade two and to identify the contributors to performance.

Methods

Sixty-three preterm (34 boys and 29 girls) and 67 full-term (27 boys and 40 girls) peers in grade two were included. Class teachers were asked to complete the Chinese Handwriting Evaluation Form. A subgroup of 39 preterm children received assessments on intelligence, visual perception, tactile and kinesthetic sensation, and fine motor skills. Their inattention behavior was rated using a maternal self-report with a behavioral scale.

Results

Boys born prematurely exhibited poorer performance in the speed dimension than full-term boys (p = 0.008), whereas there was comparable performance in the two groups of girls (p = 0.221). In the dimensions related to legibility, preterm boys (32.4%) had a higher percentage of children with difficulty in the construction dimension than the other groups (preterm girls: 6.9%, full-term boys: 7.4%, full-term girls: 5.0%). However, no group difference was found in the dimensions of accuracy and directionality. Of the sensory-perceptual-motor factors, attention was the most significant predictor of accuracy in performance (p = 0.046) and speed dimensions (p = 0.001) in preterm children.

Conclusions

Boys appear to be vulnerable to the adverse impacts of preterm birth in terms of performance in the dimensions of speed and construction in grade two. Based on the significant contribution of attention to handwriting performance in preterm children, assessment and intervention in the area of attention is strongly suggested for preterm children with handwriting problems.

中文翻译：

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2年级早产儿的中文笔迹表现

背景

早产的一年级学生的笔迹速度和可读性较差。但是，是否有具体的易读性因素使早产儿表现出困难尚不清楚。此外，尚不清楚一年级以后的笔迹表现以及性别对早产儿笔迹表现的影响。我们旨在调查早产和性别对二年级笔迹多维维度的影响，并确定影响表现的因素。

方法

包括二年级的63个早产儿（34个男孩和29个女孩）和67个足月儿（27个男孩和40个女孩）同龄人。要求班主任填写中文笔迹评估表。39个早产儿童小组接受了智力，视觉感知，触觉和运动感觉以及精细运动技能方面的评估。他们的注意力不集中行为是通过母亲自我报告和行为量表进行评估的。

结果

过早出生的男孩在速度维度上的表现比足月男孩差（p = 0.008），而两组女孩的表现相当（p = 0.221）。在与易读性相关的维度中，早产男孩（32.4％）的儿童在建筑方面遇到困难的比例高于其他群体（早产女孩：6.9％，足月男孩：7.4％，足月女孩：5.0 ％）。但是，在准确性和方向性的维度上没有发现组差异。在感觉-感知-运动因素中，注意力是早产儿表现准确性（p = 0.046）和速度大小（p = 0.001）的最重要预测指标。

结论

从速度和结构方面的表现来看，男孩似乎很容易受到早产不利影响的影响。基于注意力对早产儿童手写表现的重大贡献，强烈建议对有手写问题的早产儿童进行注意力领域的评估和干预。