Sensory challenges faced by individuals with ASD may be in the form of sensitivities or decreased responsiveness to sensory input (Myles et al. 2014). Both can create challenges in holding writing implements and executing strokes for handwriting. Tool features that may be useful for individuals who are sensory sensitive may include trying various sizes, shapes, textures, and types of writing utensils to see which are most sensory acceptable to the student. In addition to the actual writing implement, writing paper and surfaces can also impact students with sensory sensitivities (Fuentes et al. 2009). Consideration for the type, color, and texture of the paper used may be necessary. Some students may also have a sensory preference for the drag of the pencil or pen on the writing surface. Dry erase boards or gel pens offer a harder and smoother writing experience with less drag, whereas fine point pens and thicker papers may offer more resistance when writing. Finally, individuals with autism may also not only have tactile and kinesthetic sensitivities, but some also have visual sensitivities to the paper and text color (Ludlow et al. 2008). Color screens tests may be useful in determining which colors are more effective in supporting the writing needs for a specific student (Wizla 2012).

If a student is an emergent writer who has difficulty holding a writing implement due to sensory sensitivities, sometimes touch screen technologies offer an alternative to support the student’s future use of writing tools (Pennington 2010). Often, a finger can be used to create letters/words/sentences that are displayed on the screen without the need to hold a writing implement, allowing the student to develop the kinesthetic feel of the letter formation without also dealing with the challenge of holding the utensil simultaneously. This may be done through built-in handwriting recognition within the touch screen device or through separate apps, particularly drawing apps. Because of the smaller size of most touch screens and the size of the strokes made by a finger, this is typically not a good solution for those who plan to generate a large amount of text. However, there are now styli that can be worn on the finger rather than held like a writing implement. These styli can be used to create a more localized touch by the finger resulting in a smaller stroke that may allow for more text entry than previously provided by finger strokes. Some apps, particularly those developed specifically for drawing, also allow the option to adjust the size of the mark created by the finger despite the actual size of the finger. However, generally speaking, the use of a finger to provide handwritten input on a touch screen is best used for students who are emergent drawers/writers to help facilitate the understanding that movements captured on paper have meaning and to further develop kinesthetic awareness of the formation of letters.

Students with decreased sensory responsiveness may benefit from a trial of weighted writing utensils, as well as those that provide more drag on the writing surface such as fine tip pens, soft pencil leads, and chalk. Writing surfaces and papers with texture and increased thickness may also provide additional resistance and input. Increasing the weight and resistance is sometime helpful in providing the additional sensory input the student needs (Myles et al. 2014). There is often a fairly wide variation in what each individual student finds as an acceptable writing utensil and paper based on sensory preferences and needs. Experimenting with a variety of utensils and papers with consideration for the above features could help to narrow down the choices.

Individual with ASD may demonstrate motor challenges that include poor body awareness, proximal stability, and generalized weakness. These challenges can directly impact handwriting output in terms of speed, quality, and endurance (Fournier et al. 2010). However, before the actual motor impact of writing is addressed, the student’s general seating and positioning should be considered, as this also will impact handwriting success (Tomchek and Case-Smith 2009).

While seating and positioning assistive technology options will not be discussed in detail in this chapter, the reader should be aware of general guidelines for appropriate seating of all students. Desk and chair heights should be adjusted such that students are able to sit comfortably at the desk with the full surface of their feet firmly on the floor. They should also be able to rest elbows on the desk at a natural height for appropriate support and have adequate reach to engage in the activity of handwriting. Students with more significant weakness and low tone issues will likely need additional postural and seating supports beyond that which is provided with an appropriately sized standard classroom desk and chair. An occupational and/or physical therapist should assess these additional accommodations. It is important to address these issues before making other handwriting accommodations, and appropriate seating support often positively impacts handwriting performance without additional or with fewer accommodations.

Some individuals with ASD may demonstrate alternate grasp patterns of writing implements that may in part be related to sensory sensitivities, low muscle tone, and/or weakness. Pencil grips that offer visual cues for specific finger placement locations may be useful to encourage students who need help finding and developing a functional grasp pattern.

For students who have decreased strength and weakness as an underlying issue to handwriting challenges, large barrel writing utensils are sometimes helpful. Wearable writing implements that support the appropriate positioning and reduce the grasp needed to hold the writing implement may also be helpful. They may also benefit from writing surfaces that are smooth and offer little resistance of the writing implement on the writing surface such as dry erase boards (Tomchek and Case-Smith 2009).

Some individuals with autism may have underlying deficits in visual motor integration impacting their ability to execute letter and word formations including the appropriate sizing and spacing of letters. Specifically, macrographia, which is characterized by excessively large handwriting, is a common issue found in the handwriting of individuals with ASD (Johnson et al. 2013). These types of challenges may be supported by using specialized papers that have tactile and/or visual cues.

Papers that offer tactile cues often have one or more of the writing lines raised so students can feel the line with their writing implement when they bump up against it. These types of papers can be commercially purchased or they can also be made with puffy paints or liquid white glue by tracing over the lines on the paper and then allowing the paint/glue to dry before use. These papers can be helpful for guiding the student in appropriate letter and word sizing.

Specialty papers with visual cues can include many variations that provide visual cues for lines and spaces. Many times these papers can be used to support instruction in handwriting development, as well as provide ongoing visual supports for maintenance of developed skills. There are papers with different line/boundary types such as dashed lines, dotted lines, bold lines, and letter boxes. There are also papers with color-coding such that both lines and writing spaces may be color-coded. In addition, papers with pictures of supports on the lines delineate the top, middle, and lower lines for writing.

Despite efforts to accommodate sensory motor and visual motor needs with standard and alternative writing implements and papers, some students with autism may not be able to use those accommodations successfully for effective writing speed and legibility (Trewin and Arnott 2009). For those students keyboarding, touch screen technologies, scanning, and speech-to-text technologies may offer handwriting alternatives that still allow the students to generate written text independently but in a digital text format. Oftentimes, these solutions can also help to increase the overall legibility of the written product, as well as the speed at which the student is able to generate text.

The use of keyboarding as a successful alternative to handwriting for students with ASD has been noted in the research (Tomchek and Case-Smith 2009). Keyboarding can offer support for students who may have sensory motor or visual perceptual challenges that impact the production of handwritten output (Hellinckz et al. 2013). Keyboarding has been found to offer improved legibility and speed of written output for some students with ASD. There are many different types of keyboard options available. Oftentimes, students do very well with a standard keyboard attached to a desktop or laptop computer. There are also dedicated portable word processing devices such as the Forte and Fusion by Writer Learning. These types of devices offer an easy-to-use interface that includes features that support only the writing process. There are typically no additional features in the portable word processors that can create distractions for students, such as Internet access, games, programs, or apps. These devices are simple writing support systems only. Features that may be found on these types of devices include text-to-speech, word prediction, spelling check, and electronic writing rubrics. The screens typically display four-to-six lines of text at a time which can be a disadvantage for some students who need to see all content while composing. However, the text generated on these devices can be sent to a computer via Bluetooth and/or cable connection for final editing in a word processing document.