2.2. Research Tools

The MABC-2 [41] is a standardized, valid test to identify children with DCD or pDCD between 3 and 16 years old. We used the appropriate battery for ages 7.00 to 10.11 years. Each battery includes eight motor tasks divided into three subdomains: manual dexterity, ball skills, and balance. Scores between 6% and 15% indicate at-risk for motor impairment; scores lower than 5% indicate the presence of a motor disorder.

The DCDQ [42] is a validated questionnaire for parents of children between 5 to 15 years who may be at risk for DCD. Parents evaluate their child’s daily motor performance on 15 items in three areas—movement control, fine motor skills and handwriting, and general coordination—on a scale from 1 (does not describe my child at all) to 5 (completely describes my child).

A Wacom Cintiq computerized tablet was used as a digital writing surface. The tablet features a 14-line background mimicking the layout of the children’s notebooks. It was covered with a screen protector to increase friction, similar to paper. The tablet was positioned about 2 cm from the edge of the table, and the children wrote with a stylus similar to a regular pen (using Pen Painter^® software, 14.24.28127.4 (MFC Version, 2020). They copied a writing section from the Hebrew Handwriting Evaluation [43]. The data (x, y, time, and pressure) were obtained at a sampling rate of 133 kHz.

The writing color changed according to the pressure the child applied on the surface while writing, providing immediate visual feedback. High pressure resulted in red text, low pressure in blue text, and moderate pressure corresponded to black text on a white background (see Table S1 and Video S1 in Supplementary Materials), similar to pencil writing in a notebook (Figure 1). The colors were calibrated based on average pressure levels among the population of typically developing children, as determined in the initial research stage. Figure S1 in the Supplementary Materials provides the conversion of pressure levels determined in the Wacom tablet version to Newtons.

Example of the writing color change according to the degree of pressure on the tablet in an intervention session. Note: Red indicates high pressure on the tablet surface, whereas black indicates appropriate pressure.