Structured Task-Focused Occupational Therapy in the School Environment to Support Academic Performance: Fine Motor and Visual-Motor Skills

This randomized controlled trial will evaluate the effects of a structured, task-focused occupational therapy program delivered in the school environment on handwriting performance, fine motor skills, visual-motor integration, and academic performance in primary school children. Second- and third-grade students identified as being at risk for handwriting and manual dexterity difficulties will be randomly assigned to an intervention group or a control group. The intervention group will receive a 10-week school-based occupational therapy program consisting of two 30-minute sessions per week, for a total of 20 sessions. The control group will continue routine classroom activities without therapist-led occupational therapy. Handwriting, manual dexterity, visual-motor integration, visual perception, and motor coordination will be assessed at baseline and after the intervention. Academic grades will also be recorded, and individualized goal attainment will be evaluated in the intervention group.

Study Overview

• Status: Not yet recruiting
• Conditions: Handwriting; Visual Perception; Visual-Motor Integration
• Intervention / Treatment: Behavioral: Structured Task-Focused Occupational Therapy Program

• Study Type: Interventional
• Enrollment (Estimated): 24
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul
    • Istanbul, Istanbul, Turkey (Türkiye)
      • Güngören Yahya Çavuş Primary School
      • Contact: Merve Keskin, MSc; Phone Number: +90 5375825256; Email: mervekeskiin98@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Being between 7 and 9 years of age
• Being enrolled in the second or third grade
• Demonstrating basic literacy skills
• Being identified as high risk for handwriting and/or manual dexterity difficulties based on standardized assessments and teacher observations
• Being expected to maintain regular school attendance throughout the study period
• Written informed consent provided by a parent or legal guardian

Exclusion Criteria:

• A diagnosed neurodevelopmental disorder, including autism spectrum disorder or attention-deficit/hyperactivity disorder
• Significant visual or hearing impairment
• An orthopedic or neurological condition affecting the upper extremity
• Current receipt of occupational therapy or special education services

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Structured Task-Focused Occupational Therapy; Participants will receive a 10-week structured task-focused school-based occupational therapy program delivered twice weekly in 30-minute sessions, for a total of 20 sessions. The program will target handwriting performance, fine motor skills, visual-motor integration, visual perception, and motor coordination.	Behavioral: Structured Task-Focused Occupational Therapy Program; The intervention consists of a 10-week structured task-focused occupational therapy program delivered in the school environment. Participants will receive two 30-minute sessions per week, for a total of 20 sessions. The program will include task-oriented activities targeting handwriting performance, fine motor skills, manual dexterity, visual-motor integration, visual perception, and motor coordination.
No Intervention: Routine Classroom Activities; Participants will continue their routine classroom activities and teacher-assigned homework during the 10-week study period and will not receive therapist-led occupational therapy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Handwriting Performance Assessed by the Minnesota Handwriting Test	Handwriting performance will be assessed using the Turkish version of the Minnesota Handwriting Test (MHT). The test includes 34 letters arranged in seven words and evaluates handwriting completion time, legibility, form, alignment, spacing, and size. Completion time is recorded in seconds, with shorter times indicating faster performance. Quality parameters are scored up to 34 points, with higher scores indicating better handwriting quality. Change from baseline to post-intervention will be compared between the intervention and control groups.	Baseline and within 1 week after completion of the 10-week intervention (up to Week 11)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Manual Dexterity Assessed by the Minnesota Manual Dexterity Test	Manual dexterity will be assessed using the Minnesota Manual Dexterity Test (MMDT). Completion times for the placing and turning tasks will be recorded in seconds. Shorter completion times indicate better manual dexterity.	Baseline and within 1 week after completion of the 10-week intervention (up to Week 11)
Change in Visual-Motor Performance Assessed by the Beery VMI	Visual-motor performance will be assessed using the Beery-Buktenica Developmental Test of Visual-Motor Integration. Outcomes will include the Visual-Motor Integration total score, Visual Perception subtest score, and Motor Coordination subtest score. Scores will be interpreted according to age-based normative values, with higher scores indicating better performance.	Baseline and within 1 week after completion of the 10-week intervention (up to Week 11)
Change in Academic Performance	Academic performance will be evaluated using official school grades in Turkish Language, Mathematics, and Life Sciences. Grades range from 1 to 4, with higher grades indicating better academic performance.	Baseline and within 1 week after completion of the 10-week intervention (up to Week 11)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Individualized Goal Attainment Assessed by Goal Attainment Scaling	Goal Attainment Scaling will be administered only to participants in the intervention group. Individualized SMART goals will be rated on a five-point scale ranging from -2 to +2, where -2 represents performance much lower than expected, 0 represents the expected level of achievement, and +2 represents performance much higher than expected. Higher scores indicate greater goal attainment.	Baseline and within 1 week after completion of the 10-week intervention (up to Week 11)

Collaborators and Investigators

• Sponsor: Medipol University

Study record dates

Study Major Dates

• Study Start (Estimated): July 27, 2026
• Primary Completion (Estimated): October 12, 2026
• Study Completion (Estimated): October 12, 2026

Study Registration Dates

• First Submitted: July 20, 2026
• First Submitted That Met QC Criteria: July 20, 2026
• First Posted (Actual): July 23, 2026

Study Record Updates

• Last Update Posted (Actual): July 24, 2026
• Last Update Submitted That Met QC Criteria: July 23, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Handwriting; Fine Motor Skills; Primary School Children; Visual-Motor Integration; Academic Performance; School-Based Occupational Therapy; Task-Focused Occupational Therapy
• Other Study ID Numbers: IMU-OT-STFOT-2026-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No