Grapho-motor imitation training in children with handwriting difficulties: A single-center pilot study

Imitation is a crucial process for learning and brain development. It is based on the mirror neuron mechanism and underlies our understanding of actions and the gestures of others. Some researchers hypothesized a possible correlation between a low functioning mirror neuron system (MNS) and developmental coordination disorder, including dysgraphic deficit. However, no studies have verified whether imitation of graphic gestures by exploiting the properties of the MNS could improve handwriting. This study evaluates the effects of imitation training of handwriting in five children with handwriting difficulties aged 8 to 10 years. The training lasted for five months, and was undertaken three times a week, for a total number of 60 sessions for each child. Before and after the training, we evaluated the degree of handwriting impairment using the Concise Evaluation Scale for Children's Handwriting (BHK). Our results suggest that handwriting imitation training produced a significant qualitative change in the children's writing, likely due to exercises that stimulated fine motor imitation. Furthermore, the imitation also involved ergonomic and biomechanical aspects relevant to improving imitative writing after observing the model. Each child has therefore reached an adequate level of writing, suggesting the effectiveness of the proposed intervention.