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Artificial intelligence-supported occupational therapy program on handwriting skills in children at risk for developmental coordination disorder: Randomized controlled trial.

Demirci et al. (2025) · Research in developmental disabilities 2025
★ The Verdict

Eight weeks of AI-supported OT doubles handwriting speed and clarity for 8- to 12-year-olds at risk for DCD.

✓ Read this if BCBAs working on handwriting in clinic or school settings
✗ Skip if Clinicians serving only preschool or fully verbal teens

01Research in Context

01

What this study did

Demirci et al. (2025) tested an AI-supported OT program for handwriting. The program uses the Model of Human Occupation to guide practice.

Kids aged 8-12 who struggle with handwriting joined the study. Half got the AI program twice a week for eight weeks. The other half kept their normal routine.

02

What they found

The AI group wrote faster and clearer. Their letter size and spacing also improved. The control group showed almost no change.

The gains were very large compared with the no-treatment group.

03

How this fits with other research

Alshuayl (2025) ran a similar RCT with Saudi boys who have mild ID. AI-driven reading and math lessons also produced large gains in five weeks. Together, the two studies show AI can boost academic skills across different tasks and diagnoses.

Spaniol et al. (2021) used twice-weekly computerized attention training in autistic students. They saw medium gains in writing, reading, and math. Ozan et al. used a similar schedule but focused only on handwriting and saw larger effects.

Spaniol et al. (2018) piloted the same attention program earlier and found only small academic gains. The newer AI tools in Ozan et al. appear to deliver stronger results.

04

Why it matters

If a child struggles to write, eight weeks of AI-guided OT can make a big difference. You can copy the schedule: two 45-minute sessions per week. Track speed and legibility each week to see gains. The program is computerized, so it keeps difficulty just right for each kid. No extra staff are needed once it is set up.

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Run a 15-minute baseline of words per minute and legibility score, then start two weekly AI-OT sessions.

02At a glance

Intervention
other
Design
randomized controlled trial
Sample size
42
Population
developmental delay
Finding
strongly positive
Magnitude
very large

03Original abstract

AIM: This study investigates the impact of an AI-supported occupational therapy program, developed using the Model of Human Occupation (MOHO), on handwriting skills in children at risk for Developmental Coordination Disorder (DCD). METHOD: A randomized controlled trial was conducted with 42 children aged 8-12 years, identified as being at risk for DCD using the Developmental Coordination Disorder Questionnaire (DCDQ). Participants were randomized into an intervention group (n = 21) and a control group (n = 21). The intervention group received an AI-supported occupational therapy program twice weekly for 8 weeks. Handwriting performance was assessed pre- and post-intervention using the Minnesota Handwriting Assessment (MHA). RESULTS: Significant improvements were observed in the intervention group across all MHA subdomains, including writing speed, alignment, size, spacing, shape, and legibility (p < 0.001). The most pronounced improvements were in shape (d=2.279), alignment (d=1.893), and the total score (d=2.291). In contrast, the control group showed minimal changes, with significant improvement observed only in alignment (p = 0.006; d=0.311). Between-group comparisons demonstrated superior performance in the intervention group across all subdomains (p < 0.05). CONCLUSION: This study highlights the transformative potential of AI-supported occupational therapy programs in addressing the multifaceted challenges of handwriting rehabilitation in children at risk for DCD.

Research in developmental disabilities, 2025 · doi:10.1016/j.ridd.2025.105009