A serious game to anticipate handwriting difficulties screening through visual perception assessment

Dysgraphia is a learning disability that causes handwritten production below the expectancies. Its diagnosis is delayed until handwriting development should be completed, with the possible worsening of children's weaknesses. To allow a preventive empowerment program, abilities not directly related to handwriting should be evaluated, and one of them is visual perception. To investigate the role of visual perception in handwriting skills, we gamified standard clinical tests of form constancy, figure-ground discrimination and visual closure exercises, to be played with an eye tracker at three difficulty levels. Then, we related game performances to a handwriting speed test. The aims of this work are: to test game usability and design effectiveness, and to preliminarily explore the relationship between visual performance and writing skills. Game performances were computed with principal component analysis, combining time-to-completion and errors in each game. A linear regression related game performance (predictors) with writing speed (target). Perceived increase in difficulty among levels was tested by means of an ANOVA. As for usability, participants answered the System Usability Scale. In total, 28 subjects - 3 children, 19 young adults and 6 older adults - participated in the study. Game scores provided a good quality of fitting (R2= 0.67, p<0.001) of handwriting speed in the regression model. ANOVA suggested that masked form constancy and visual closure games were perceived as more challenging as difficulty raised (game score significantly decreased, p<0.001), while in form constancy and figure-ground perception a learning effect was observed (game score significantly increased, p<0.001). Interesting qualitative observations emerged from eye-tracking data, drawing suggestions for exploiting ocular strategy to better investigate its role in game performance. The game reached excellent usability (92.86±5.08), which allows to confidently extend the study to a younger, more adequate sample. These results are promising to suggest a new tool for dysgraphia early screening, based on visual perception skills