Handwriting is an essential skill for developing sensorimotor and intellectual skills in children. Handwriting constitutes a complex activity relying on cognitive, visual-motor, memory and linguistic abilities, and is therefore challenging to master, especially for children with learning difficulties such as those with cognitive, sensorimotor or memory deficits. Recently-emerged haptic guidance systems have a potential to facilitate the acquisition of handwriting skills in both adults and children. In this paper we present a longitudinal experimental study that examined the effects of haptic guidance to improve handwriting skills in children with cognitive and fine motor delays as a function of the handwriting complexity in terms of visual familiarity and haptic difficulty. A haptic-based handwriting training platform that provides haptic guidance along the trajectory of a handwriting task was utilized. 12 children with cognitive and fine motor delays defined in terms of intellectual difficulty (IQ score) and mild motor difficulty in pincer grasp control, participated in the study. Children were divided into two groups, a target group and a control group. The target group completed haptic-guided training and pencil-and-paper test whereas the control group took only the pencil-and-paper test without any training. A total of 32 handwriting tasks was used in the study where 16 tasks were used for training while the entire 32 tasks were completed for evaluation. Results demonstrated that the target group performed significantly better than the control group for handwriting tasks that are visually familiar but haptically difficult (Wilcoxon signed-rank test, p $< $ 0.01). An improvement was also seen in the performance of untrained tasks as well as trained tasks (Spearman’s linear correlation coefficient, 0.667; p $=$ 0.05). In addition to confirming that haptic guidance can significantly improve motor functions, this study revealed a significant effect of task difficulty (visual familiarity and haptic complexity) on the effectiveness of haptic guidance for handwriting skill acquisition for children with cognitive and fine motor delays.

中文翻译：

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支持认知和精细运动延迟儿童手写的触觉指南

手写是培养儿童感觉运动和智力技能的基本技能。手写是一项复杂的活动，依赖于认知、视觉运动、记忆和语言能力，因此掌握起来具有挑战性，特别是对于有学习困难的儿童，如认知、感觉运动或记忆缺陷的儿童。最近出现的触觉指导系统有可能促进成人和儿童获得手写技能。在本文中，我们提出了一项纵向实验研究，该研究检查了触觉指导对提高认知和精细运动延迟儿童手写技能的影响，作为视觉熟悉度和触觉难度方面的手写复杂性的函数。使用了基于触觉的手写训练平台，该平台可沿着手写任务的轨迹提供触觉指导。12 名患有认知和精细运动延迟的儿童参与了这项研究，这些儿童被定义为智力困难（IQ 分数）和轻度运动困难。孩子们被分为两组，目标组和控制组。目标组完成了触觉引导训练和纸笔测试，而对照组只进行了纸笔测试，没有任何培训。研究中总共使用了 32 个手写任务，其中 16 个任务用于训练，而 32 个任务全部完成用于评估。磷 $< $0.01）。未训练任务和训练任务的性能也有所提高（Spearman 的线性相关系数，0.667；磷 $=$0.05）。除了证实触觉指导可以显着改善运动功能外，这项研究还揭示了任务难度（视觉熟悉度和触觉复杂性）对触觉指导对认知和精细运动延迟儿童手写技能习得的有效性的显着影响。