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NCT Number: NCT07723092

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.

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Key information

Conditions

Visual Perception Handwriting Visual-Motor Integration

Age range

7 year–9 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Structured Task-Focused Occupational Therapy Program

Behavioral

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.

Primary outcomes

  1. Change in Handwriting Performance Assessed by the Minnesota Handwriting Test

    Time frame: Baseline and within 1 week after completion of the 10-week intervention (up to Week 11)

    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.

Secondary outcomes

  1. Change in Manual Dexterity Assessed by the Minnesota Manual Dexterity Test

    Time frame: Baseline and within 1 week after completion of the 10-week intervention (up to Week 11)

    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.

  2. Change in Visual-Motor Performance Assessed by the Beery VMI

    Time frame: Baseline and within 1 week after completion of the 10-week intervention (up to Week 11)

    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.

  3. Change in Academic Performance

    Time frame: Baseline and within 1 week after completion of the 10-week intervention (up to Week 11)

    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.

Other outcomes

  1. Change in Individualized Goal Attainment Assessed by Goal Attainment Scaling

    Time frame: Baseline and within 1 week after completion of the 10-week intervention (up to Week 11)

    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.

Sponsors and collaborators

Lead sponsor

Medipol University

Other

Registry information

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jul 23, 2026
Registry last updated
Jul 24, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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