How to Support Handwriting Acquisition for Students with ADHD

Supporting Neurodivergent Learners: Evidence-Based Handwriting Strategies

90-95% of student with ADHD have difficulty with handwriting.

Writing is a significant school occupation. “The ability to write legibly and with fluency supports productive engagement in the student role.” (Grajo et al., 2020)

While occupational therapists are not handwriting teachers, it is entirely within our scope to support learners in acquiring writing skills. That may look or feel similar, but it is very different from teaching a student (who has never been instructed) to write. Our job is to support the student’s performance and participation in the occupation of writing by hand.

Many students with ADHD lack automated or fluent writing skills. Working memory, executive function, or motor skill delays compromise their ability to access the writing curriculum at the same rate as peers. (given there is a writing curriculum).

Lack of automated handwriting becomes a significant barrier to written expression by early third grade when students are no longer learning to read and write; they are expected to read and write to learn. This shift is massive! 

Students with ADHD learn best from structured and explicit instruction. This post will provide the reader with evidence-based interventions that ate used to support, differentiate and make explicit some of the more implicit expectations found in the common handwriting curriculum used in many classrooms today. The strategies align with educational best practices, best practices for students with ADHD, and best practices for school-based occupational therapy. 

Top Ten Handwriting Practice Supports for Students with ADHD 

Implicit expectations are rampant in early education. Students are expected to write on a line without any explanation or instruction on how to write on the line. 

One popular program, Fundations addresses this missing link by teaching the students how to use a their “writing grid”. While this is a step in the right direction, I often find that when the child writes on anything but the grid, they are again expected to generalize this skill incidentally.

Picture of different types of handwriting papers that impair automation for students with ADHD

Students with ADHD and executive function challenges do not “incidentally” or generalize well. Within any given day, students will be expected to write on many different sizes and styles of lines, whether on tests, in a notebook, in other workbooks, projects, or even just paper with no lines. The child quickly loses their way. Baseline orientation and sizing go down the toilet. They do not have a chance to develop fluent motor plans when the rules of the game are constantly changing.

Strategy 1: Teach the Parts of the Line Explicitly

To support the foundation of handwriting in students with ADHD, we need to teach the parts of the writing line explicitly. I also use color to teach the parts of the writing line found on most primary broken middle line paper. 

The line is divided into two parts. The top is the sky, and the bottom half is the grass. Below the line is the dirt. I use a simple slide show or print the slide like a mini book and read it before we play ” Pin the Tail on the Writing Line” . Place stickers , lego mini figures, counting bears ect… on the line (or space) I call out. 

Handwriting Practice The Writing Line broken explicitly down for students with ADHD

If using Fundations grid , the program names the lines instead of the space. Same concept. They identify the sky line, the plane line, the grass line and the worm line. Student may need explicit practice until the space or line names are fluent.

Handwriting Practice The Writing Line

Strategy 2: Practice Line Generalization

For student with ADHD, struggling with handwriting , this one is a game changer. Many love nothing more than avoiding being tricked!

Once your student understands and can label the parts of the writing line, support the students with what to do when those parts of the line disappear. Because they do, all the time, those tricky teachers. 😉Very dramatic!

Using a simple story, we talk about it and practice fitting our letters onto different types of lines to see if those lines trick us. Classroom teachers are encouraged to point this out explicitly often when using a different type of paper. Engagement increases when a school aged child thinks someone is trying to trick them. They won’t allow it!

Handwriting Practice Line Generalization

Strategy 3 : Master the Name First

Students write their names (and are expected to) way before they are ever instructed on how to form that letter. They write their name, often incorrectly, over and over again. Little kids are very excited about writing their name. However, the letters in their name become automated engrams prior to instruction causing problems later on.

Teach each student how to form the letters of their name immediately.🙏

Differentiated name lesson for students with ADHD making name explicit and correct

My daughters name is Morgan, she has three c derivative letters in her name.  When she was four years old , her lovely preschool teacher agreed to place a green arrow pointing around to the left on the lowercase “o, g and a” because she was writing her o, g and a around to the right. I know this may seem trivial and like a totally insane parent request, but without this intervention she would have had continuous difficulty forming c, o, a d, q,g, capital G, O, Q . Extremely common and 100% preventable.

Strategy 4 : Prevent Incorrect Practice 

Incorrect practice is a prevalent and common cause of handwriting challenges for a child with ADHD. These students have difficulty with working memory and sustained attention that may impair their performance on multiple step sequences of instruction.

Often most teachers provide a whole class demonstration of the letter. Then they walk around as the students go on practicing the letter across a long stretch of a line, like the one pictured below, often incorrectly.  Practicing something incorrectly is counterproductive to developing fluency in letter formation. We need to prevent incorrect practice.

Examples of problems

We can prevent incorrect practice with selection and differentiation of the instructional materials by outsourcing the demonstration and providing carefully timed reinforcement.

Selection and differentiation of the instructional materials is critical to mitigate incorrect practice. The paper below has strategically faded sequence and placement cues, practices only one letter form at a time and provides an opportunity for the child to trace between attempts to prevent incorrect practice.

Use Specifically Timed Reinforcement- Love Letters 

“Loving” letters encourages children to identify their best work, correct errors and front loads positive reinforcement and engagement. I place a heart around my favorite letter the line. I ask my students to show me their favorite and why?

Students with ADHD has a very hard time with even gentle correction. Most have endured a substantially increased amount of negative messages “No, Stop, Don’t”and the smallest hint of an error will turn on defense mode and shut off learning mode.

We can point out what they are doing right! Love the letters as they are practicing , love the first one they do, not at the end of the worksheet. This takes one second and I have seen the “love” switch on engagement like a flood light.

Strategy 5 Video Modeling

Teachers, I see it. It’s a rigged game teaching handwriting in a 1:25 ratio.

One teacher trying to teach a group of at least 20 young children to learn and perform a multi step, muti-process skill. Some students will need repeated visual and verbal modeling to write that letter, and you can not do that and observe.

One way to be in two places at once, is to use video models of a hand writing the letter. The video can play up on the smartboard, IPad , Chromebook. or even phone. With or without words, on a loop, so you can walk around and watch the 20 plus kids try the letter.

Send the video home via a QR code so parents, tutors and babysitters can use them to help practice. The COVID pandemic essentially created a free You tube library of video models of every letter formation for every writing program out there. Create a playlist.

I made mine during that 2020 panic and continue to use them to this day.

Strategy 6: Scaffolding Boundaries

The broken middle line paper is designed to help students with sizing and placement consistency. But unfortunately for some it is just not enough.

For some brains, it just isn’t loud enough. They may need increased boundaries to be successful . We can systematically fade boundaries as the students practice.

This allows them to process that motor plan explicitly in an error free manner.  I find using color highlighting and the box dot method to be the most effective.

Extend Visual Cues

Using color extends the cue for the entire writing line. A tiny cloud at the left hand of the paper indicating sky is gone from your working memory while you are writing. Truly gone if you’re left handed. I use colored pencils, because it accepts pencil on top of it .

Teach Baseline Orientation

Almost all the letters sit on the baseline. But for many students this is an extreme challenge.  To explicitly practice stopping at that baseline, we play bump the line. The Bump the Line concept, originated by Jan Olsen, of Handwriting Without Tears, and I have used consistently. 

Using two different color pencils, slows children down, and also gives a teacher a chance to walk the room to observe grasp. That green grass line is usually the last visual cue to fade.

Strategy 7: Teach Letter Size Consistency

This is the most common handwriting referral that I see in students with ADHD grade two and above. The perfectly formed letters pictured above are just in the wrong space. Inaccurate and inconsistent size and placement of letters decreases legibility. 

We need to make letter size consistency explicit.  For 22 years, I have been using one simple and effective strategy to improve letter size consistency.

There are three types of letters, tall, short and dirty. I typically suggest that teachers review the lowercase letters in a sequence grouped by size, which makes a notice difference in legibility immediately.

However, I pay extra explicit attention to five of them. Which five?

Strategy 8: “The Dirty Five”

Handwriting Practice Support for Students with ADHD

All letters bump the grass line, except the dirty five!

The Dirty Five concept makes descendent letters explicit and memorable. Parents even pause and give it the just right attention because it’s borderline risqué when the child tells them that” dog” is a dirty word.

A neurodivergent mind needs novelty and interest to engage and this seems to light up those centers like no other silly strategy I have used.  I have made worksheets, videos, stories, posters and games with it through the years. But finally organized it digitally for this post. 

For younger students , I have created a story and video that has a happy ending about the “Dirty Five” . They are a considerate bunch.

For “older students”, third graders, I simply describe them as a group of misfit rule breakers .

“The Dirty Five letters are a gang or rule breakers. They are the only letters that break the rule, they do not stay on the writing line.They kick you out of the dirt with their tails.” I tell them they must beware of the “Dirty Five” and put up a sign. Some of the more mature students get the pun, works just as well.

We are always on the look out for a dirty letter. Do you have one in your name? Can you find any dirty words on your paper? The word “play” has two, double dirty. “Puppy” has four!

Strategy 9: Reduce Extraneous Working Memory Load

Students with ADHD and executive function delays need working memory supports in the classroom to remain available for learning. They will shut down when they see handwriting paper that looks like this. 

 I shut down.  It is never ending looking. 

To prevent working memory overload and produce quality not quantity, I would differentiate this worksheet. By highlighting the grass, providing every other one models, starting dots and separating the upper and lowercase practice, the neurodivergent student is given an actual chance to succeed. All it took was a colored pencil and marker. 

Reduce Perceived Workload

I use 1/2 sized horizontal worksheets for my small group RTI students. Students with ADHD often shutdown when they see handwriting work that looks too long for their sustained attention. This simple change decreases anticipated workload and extraneous cognitive load. Once done we flip and try it with our eyes shut. 

For K students, we make rings of letters we learned (like they do for site words) and laminate them for quick practice. Great way to practice the name! The wipe off marker is just so satisfying to the K-1 age group. And one and done decreases perceived effort and increases engagement .  

Strategy 10: Intervene at the Point of Performance

While many of these interventions appear simple, they will make a tremendous difference in the student with ADHD’s ability to acquire handwriting skills. We can mitigate the most common handwriting barriers seen for learners with ADHD and executive function challenges by:

  • Decreasing the extraneous working memory load
  • Providing explicit instruction for legibility and line awareness.
  • Decreasing the frequency of shutdown due to perceived workload. 
  • Increasing boundaries and models to prevent incorrect practice. 
  • Providing video models for slow processors and increased teacher availability. 
  • Increasing engagement with color and memorable stories
  • Increasing engagement and self efficacy with positive feedback at the point of performance

Students with ADHD learn best from interventions placed at the exact point of performance. Many general education teachers do not receive support with differentiation. We must collaborate with the teachers and differentiate the work our students are doing in the classroom.

Share this website, give them handouts, offer to differentiate notebooks. Provide your intervention at the point of performance, where it works!  

Tools and Downloadable Resources

Lowercase Letters Practice Printable Cards with fading box dot visual support

Link to Educational Fontware. For 15 or more years, I have used Educational Fontware’s font collection to differentiate my students work. Almost every teacher I work with asks. The fonts will upload as a font in my Word and Powerpoint Programs but not on Google Doc/Slides. I am not an affiliate for the company, just a huge grateful fan!


Kadar, M,  Wan Yunus, F,  Tan, E,  Chai, SC,  Razaob, NA,  Mohamat Kasim, DH.  A systematic review of occupational therapy intervention for handwriting skills in 4–6 year old children. Aust Occup Ther J.  2020; 67: 3– 12.

Grajo, L. C., Candler, C., & Sarafian, A. (2020). Interventions within the scope of occupational therapy to improve children’s academic participation: A systematic review. The American Journal of Occupational Therapy, 74(2), 7402180030p1-7402180030p32.