Reliability and preliminary outcomes of a protocol for selection of test accommodations for higher education students with Dysgraphia: A pilot study

Importance: Students with dysgraphia often receive test accommodations to enhance their handwriting legibility or speed. However, these accommodations are seldom individualized to ensure that they actually improve the performance of a specific student. Therefore, a need exists for an evidence-based protocol (henceforth, the Protocol) for selecting individually tailored test accommodations for students with dysgraphia. Objective: To establish the Protocol's content validity, interrater reliability, and preliminary outcomes through a pilot study. Design: Descriptive and exploratory design. Setting: Research laboratory at a large university in central Israel. Participants: The sample consisted of 25 students (mean age = 24.9 yr, standard deviation = 2.1), of whom 88.0% were male. Inclusion criteria included a previous diagnosis of a specific learning disability and handwriting difficulties. Exclusion criteria were a physical condition or medication intake that may have affected students' handwriting or typing ability. Results: The Protocol was found to have face validity and high interrater reliability (k =.80). Its initial use showed that the most suitable accommodations for students with dysgraphia varied and were not always intuitive (e.g., extended time was not always the best accommodation for students with slow handwriting). Conclusions and Relevance: The Protocol appears to be a promising tool to assist occupational therapists in selecting the most appropriate accommodations for students with dysgraphia in a systematic manner. However, additional studies are required to further support these results. What This Article Adds: This study indicates that the selection of the most appropriate accommodation for students with dysgraphia is not always intuitive. It describes a Protocol that enables occupational therapists to select accommodations that are tailored to students' writing abilities, following a systematic process, while considering the students' writing performance with and without accommodations.