The SIPT in Practice – Handwriting

Blog: The SIPT in practice – Handwriting

Parents and caregivers are often full of questions about how some of the tasks and activities from the Sensory Integration and Praxis Test (SIPT; Ayres, 1989) relate to the primary area of concern of their child. In our previous blog, we described how some of the sub-tests on the SIPT relate to social skills. In the current blog, we will provide an overview of subtests of the SIPT which relate to Handwriting.

Space Visualisation

What you will see in the assessment:

The therapist places either a diamond- or egg-shaped board in front of the child, with two blocks to select the matching shape. The child is required to ‘mentally manipulate’ the shape without physically touching the block until they have selected the block they think matches the board. This subtest also looks at preferred-hand use and how often the child crosses the midline with their arms.

How it’s relevant to handwriting:

Being able to imagine how an object may look at different angles is needed for placing letters next to each other within a word. Avoidance of crossing midline can be associated with inefficient positions and actions in handwriting, which often results in high levels of fatigue and low endurance for writing activities.

Design Copying

What you will see…

Using a booklet of different shapes, the assessing therapist will ask your child to copy the figures using the dots as guidelines.

How it’s relevant…

Being able to reproduce designs is a common activity undertaken in school requiring effective handwriting skills. The dot grid in the booklet allows therapists to see if visual structure helps or hinders their performance on this type of task. The therapist will also look at how the child approaches this task, including spatial organisation and direction. These factors are often an indicator of vestibular and postural ocular difficulties, both of which interfere with efficient writing.

Motor Accuracy

What you will see…

The therapist will place a worksheet of a ‘race track’ in front of your child and ask them to trace along the black line, first with their preferred then non-dominant hand.

How it’s relevant…

Eye-hand coordination is essential for ensuring letters, words, sentences, equations etc. are placed in the correct areas. This subtest also helps to inform about ‘handedness’, which is essential when hand preference is not clear.


What you will see…

With the child’s vision shielded, the therapist ‘draws’ simple designs on the back of your child’s hand with their finger.

How it’s relevant…

This test requires the child to use their perception of touch to create a visual image in their mind. Difficulty with this task when combined with visual difficulties can often be an underlying cause of writing problems.


Ayres, A. J. (1989). The Sensory Integration and Praxis Tests manual. Los Angeles: Western Psychological Services.

Bodison, S., & Mailloux, Z. (2006). The sensory integration and praxis tests. OT Practice11(17), 20-22.

Cox, L. E., Harris, E. C., Auld, M. L., & Johnston, L. M. (2015). Impact of tactile function on upper limb motor function in children with Developmental Coordination Disorder. Research in Developmental Disabilities, 45-46, 373-383.

Koenig, K. P., & Rudney, S. G. (2010). Performance challenges for children and adolescents with difficulty processing and integrating sensory information: A systematic review. American Journal of Occupational Therapy, 64, 430– 442. doi: 10.5014/ajot.2010.09073


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