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Written communication with an ABI fact sheet

Written communication in students with an acquired brain injury

Following a brain injury, many children will experience handwriting difficulties due to a range of fine motor and cognitive problems.

How do I know if my student is having difficulties with their written communication?

Signs include:

  • messy, illegible writing
  • messy, illegible writing
  • reduced speed, difficulty keeping up with peers
  • letters wrong direction
  • words poorly spaced on the paper
  • writing deteriorates after a short period of time
  • student complains of sore hands.

Reasons for this include:

  • changes to the muscle strength in the hand and arm muscles (either weakness, or uncontrolled tightness in some muscles)
  • changes to the muscle strength in the hand and arm muscles (either weakness, or uncontrolled tightness in some muscles)
  • changes to their ability to sit with good postural control, which cause increased effort to remain seated
  • changes to their ability to coordinate their hands
  • fatigue and reduced stamina
  • possibly a tremor or uncontrolled shakiness of the hands.

What can I do to help my student overcome difficulties with written communication?

  • Ensure that the student has a good posture: you may need to provide seating that supports this. Good posture is where the student’s feet are flat on the floor, the hips and knees are at 90 degrees and the desk height is about 2 cm above the elbow.
  • Ensure that the student has a good posture: you may need to provide seating that supports this. Good posture is where the student’s feet are flat on the floor, the hips and knees are at 90 degrees and the desk height is about 2 cm above the elbow.
  • Trial of variety of different pens and pencil grips, including fine felt tip pens, pens with built up barrels.
  • Provide frequent rest periods.
  • Provide back up notes or photocopy of lessons / board work.
  • Use audio-taping of lessons.
  • Use a scribe.
  • Allow extra time to complete written work, especially timed work like exams.
  • Allow extra time to complete written work, especially timed work like exams.
  • Allow some work in point form.
  • Be aware that homework will take longer to complete. High school teachers need to communicate with each other so that a realistic amount of homework is set.
  • Use of technology: use ipads, tablets and laptops allowing them to complete work on these devises. Typing is often easier then handwriting.

Using Computers for Writing

  • The following considerations should be discussed with the rehabilitation team when thinking about technology use for written communication.
  • Input devices – Consider type of keyboard and mouse, use of keyguards and alternative keyboards to ensure that selection enhances the child’s capabilities, speech to text programs.
  • Input devices – Consider type of keyboard and mouse, use of keyguards and alternative keyboards to ensure that selection enhances the child’s capabilities, speech to text programs.
  • Type of typing program  – Decide how the child types best e.g. one handed, two handed, modified fingering.
  • Software to assist with typing skills – Choose software appropriate to the age and skill of the child.
  • Software to assist with speed – e.g. word prediction programs, spelling and grammar checks.
  • Training – Provision of a keyboard / computer must include adequate time for training the child in its use, including correct typing techniques, and training needs to be incorporated into the child’s timetable.

Contact us

Queensland Paediatric Rehabilitation Service
Lady Cilento Children’s Hospital
Level 6, 501 Stanley Street, South Brisbane 4101
t: 07 3068 2950
t: 07 3068 1111 (general enquiries)
f: 07 3068 3909
e: qprs@health.qld.gov.au

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Developed by the Queensland Paediatric Rehabilitation Service, Children’s Health Queensland. Updated: October 2017. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.

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