Vision, Hearing and Health Checks to Rule Out First

By Laura Lurns · Reviewed by Philip Weaver · Last reviewed 2026-10-04

What the writing lists leave out

Two lists of writing trouble leave out trouble that a vision or hearing problem better explains. One is from the American Psychiatric Association. The other is the World Health Organization's list, ICD-11. Neither list names a handwriting skill.

Have your child's eyes checked.

Ask your child's doctor whether hearing has been checked recently.

The eyes and handwriting

One UK study looked at over 7,000 children aged 7 and 8 (Creavin and colleagues, 2014). Some had severe trouble with coordination. For some of them, that included failing a school handwriting test. Children with severe coordination trouble more often had eye problems than other children. These included focusing and how the two eyes work together. The authors advise an eye check for children like these. The study found a link, not a cause. It was about coordination trouble, not handwriting alone. We could read only its summary.

We hold no study that tests whether eye problems cause handwriting trouble.

When to book an eye exam

Have your child's eyes checked. A child who cannot see the page clearly needs that found.

Some children avoid close work, rub their eyes or lose their place. In our view, that is a reason for a full eye exam. Ask for one that includes near vision.

If an exam finds an eye problem, that problem needs its own care.

We cover reading and the eyes on a page of its own.

Checking hearing

A 2025 schedule from the American Academy of Pediatrics has hearing checked at routine visits. Ask your child's doctor whether hearing has been checked recently.

We hold no study of hearing problems and handwriting. A child who cannot hear well needs that found. In our view, take a hearing concern to your child's doctor or an audiologist.

The hand and coordination

Does your child's hand often hurt when writing? In our view, tell the teacher, and your child's doctor if it keeps up.

In our view, if coordination worries you, raise it with your child's doctor.

Some programs promise better handwriting from an activity that is not writing. Check that claim before you pay for it. Handwriting improves most consistently with handwriting practice; motor work alone has not been shown to improve it.

If a skill has gone

Some children could do something and now cannot. That is different from a child who has not built the skill yet. Our position is that a lost skill goes to a doctor first, not a tutor.

Checks and teaching side by side

In our view, a child may need both a check and help with handwriting. One does not replace the other. In our view, neither has to wait for the other. Our position is that a lost skill goes to a doctor first, not a tutor.

In our view, handwriting is built, not waited for.

Santangelo and Graham (2016) pooled studies of teaching handwriting. Handwriting lessons made handwriting clearer and faster than other lessons or none.

Handwriting improves most consistently with handwriting practice; motor work alone has not been shown to improve it.

When to ask for help

Each of these is a reason to ask for help on its own.

• Little change, even with steady practice and good teaching.
• Writing well below your child's other schoolwork.
• A teacher who raises a concern about writing.
• Extreme upset about writing.
• Complete avoidance of writing.
• Hopelessness about learning.
• Sadness or worry that lasts.
• Significant delays in speech, language or motor development.
• A skill that was there and has gone. Our position is that a lost skill goes to a doctor first, not a tutor.

If no skill has gone, start with the teacher. Say what you are seeing at home, and what you have tried. Beyond the teacher, the right person depends on what it turns out to be about. If the work is too hard, someone who works on that school skill. If worry or mood is the thing, someone who works with children's mental health. In our view, delays in speech, language or movement are worth raising with your child's doctor. In our view, if you are worried enough to ask, a professional evaluation is worth asking about.

Any talk of hurting themselves is a same-day call to your doctor or a crisis line.