Theses Doctoral

Telewrite: A New Telehealth-Based Assessment to Evaluate the Handwriting Skills of Children in First Through Third Grade

Guzman, Julia M.

Telehealth is needed urgently nationwide, given the COVID-19 pandemic. It isespecially urgent in rural and less populated areas where healthcare access is limited. Currently, because there are no pediatric handwriting assessments validated for telehealth use, the TeleWrite assessment would fill an unmet service need and expand the use of telehealth-based occupational therapy (OT) assessment in pediatric practice. This dissertation explored the preliminary psychometric properties of TeleWrite, a handwriting assessment tool designed to measure the legibility and fluency of handwriting for children in first through third grade administered via telehealth. A series of studies were completed to determine initial interrater reliability, content validity, and clinical utility using classical test theory.

The Rasch model of measurement was used to determine the preliminary psychometric properties of TeleWrite using Winsteps® (v. 4.7.0). The quantitative Rasch analysis of TeleWrite included administration of the tool to 148 children from first to third grade. This study tested the initial construct validity (internal validity) and test reliability of TeleWrite using the Rasch model of measurement. The Partial Credit Model (PCM) was used for rating scale analysis because TeleWrite is composed of three distinct scales (handwriting rate, accuracy, and fluency) that differs per task (near point or far point) and per grade level. The Rasch analysis showed a generally good fit with the Rasch unidimensional model, indicating strong construct and internal validity and moderate ability to separate abilities of students reliably in terms of handwriting skills. However, following the Rasch model, a larger sample is necessary to obtain improved calibration, reliability, and validity measures.

This study and supported by the literature described the need for a new handwriting evaluation tool validated for telehealth use. The findings of the current research contribute to the literature and OT practice as the first handwriting assessment specifically designed and validated for telehealth use that assesses all pertinent variables of handwriting associated with handwriting difficulties.


  • thumnail for Guzman_tc.columbia_0055E_11180.pdf Guzman_tc.columbia_0055E_11180.pdf application/pdf 1.24 MB Download File

More About This Work

Academic Units
Biobehavioral Sciences
Thesis Advisors
Grajo, Lenin
Ed.D., Teachers College, Columbia University
Published Here
July 15, 2021