Empowering Everyday Living: OT Tips for Handwriting
- Engage PT, OT, SLP Therapy and Wellness
- Apr 14, 2022
- 3 min read
Updated: Apr 15, 2022
For people with Parkinson’s disease (PD), writing can be a challenge because of micrographia and tremor.
Micrographia — small handwriting and handwriting that becomes progressively more cramped and smaller — is a common and early sign of PD.
Tremor — a common motor symptom of PD — may start in the hand and arm on one side of the body and eventually affect the other side. Tremor can obviously have a big impact on handwriting legibility.
Occupations — the meaningful and purposeful everyday activities that you need and want to do — may be impacted by these handwriting challenges. Occupational therapists often work with people with PD to improve handwriting for everyday activities.
For example, think about how handwriting is needed for:
taking care of yourself (self care or activities of daily living “ADLs”) - signing a check, taking down a phone number
work or productive activities - filling out a form, taking notes at a meeting or class
leisure and recreation (including social interaction) - writing cards or keeping a journal
Here are helpful OT tips to make writing easier and more legible:
Prep for Success — plan to do your writing during medication ”on” times
Lay the Groundwork - sit in a chair that supports good posture (and feet on the floor!), use a table with height that provides full elbow and arm support, make sure you have adequate task lighting
Get in the Zone — write in quiet place free of distractions; try motor imagery to mentally practice writing before starting your work
Get a Grip — use pens with an ergonomic design or built up grip; try a weighted pen if you experience tremor in your writing hand; use an erasable ink pen to make corrections
Let it Flow — experiment with gel ink pens, which write more smoothly with less pressure needed than ball point pens (note: lefties should watch out for smudging since gel ink takes slightly longer to dry)
Be on Cue — use lined paper instead of plain paper — visual cues (like lines) are a big help in reducing micrographia and increasing legibility; wider spacing between lines will cue you to write larger. Don’t have lined paper? Click here for a website to print your own.
Warm Up — practice flicks to get your fingers moving
GO BIG — Try BIG AIR WRITING. Hold a pen and write in the air. Make the writing as BIG as possible, then try to make it even BIGGER. You can sign your name, write numbers or draw a picture. Just make it BIG. Use a window or mirror frame cue you to help keep the letters BIG! Do this for 2-3 minutes before writing and as needed while you work.
Be a Copy Cat — Use this website to make handwriting practice sheets for practice; trace and copy words you need to write often — practice makes progress!
Take breaks — Focus on writing one word at a time — not the whole name or sentence. Take breaks between words to “reset” (try finger flicks or motor imagery) if writing starts to become smaller or more cramped.
Stay Straight — use a straight edge or ruler and a pencil to draw guide lines for your letters; erase them after you are done; use block letters instead of cursive because straight lines are easier to write out
Loop the loops — for a more legible signature or cursive handwriting, warm up by practicing letters that loop and curve such as a, c, u, l and f
Focus on the Big Picture — handwriting is necessary for all kinds of everyday activities (signing a form, writing a grocery list, keeping a daily journal, sending a birthday card) — your handwriting needs only to be legible NOT perfect!

My wife was diagnosed of Parkinson’s Disease at age 61. She had severe calf pain, muscle pain, tremors, slurred speech, frequent falls, loss of balance, difficulty in getting up from sitting position. She was put on Senemet for 6 months and then Siferol was introduced and replaced the Senemet. During this time span she was also diagnosed with dementia. She started having hallucinations and lost touch with reality. Last year, our family doctor started her on Uine Health Centre PD-5 formula, 2 months into treatment she improved dramatically. At the end of the full treatment course, the disease is totally under control. No case of dementia, hallucination, weakness, muscle pain or tremors. My wife is strong again and has gone…