| Summary: | Importance: Clarifying the relationship between kindergarteners' characteristics and their future handwriting performance is beneficial for the early detection of children at risk of handwriting difficulties. Objective: To determine which visual–perceptual and motor skills and behavioral traits significantly predict kindergartners' Chinese handwriting legibility and speed in the first grade. Design: One-year longitudinal, observational design. Setting: Kindergarten and elementary schools. Participants: One hundred six kindergarten children (53 boys and 53 girls; ages 5 or 6 yr) were recruited. Outcomes and Measures: The participants completed two subtests of the Bruininks–Oseretsky Test of Motor Proficiency–Second Edition, Test of Visual Perceptual Skills–Third Edition, Beery–Buktenica Developmental Test of Visual–Motor Integration (Beery™ VMI), and the Attention-Deficit/Hyperactivity Disorder Test–Chinese Version in kindergarten. Their handwriting legibility (character accuracy and construction) and speed were assessed by investigator-developed Chinese handwriting tests in the first grade. Results: Multivariate regression analyses indicated the independent predictive power of spatial relationships (p =.042) and inattention (p =.004) for character accuracy. Visual–motor integration (VMI; p =.008) and inattention (p =.002) were the key predictors of character construction. Manual dexterity (p =.001) was the only significant predictor of writing speed. Conclusions and Relevance: Kindergarteners who perform poorly in spatial relationships, VMI, manual dexterity, and attention are likely to have less legible Chinese handwriting and slow writing speed in first grade. Plain-Language Summary: Children's visual–perceptual and motor skills and behavioral traits in kindergarten can predict their Chinese handwriting legibility and speed in first grade. This study found that kindergarteners who performed poorly in spatial relationships, VMI, manual dexterity, and attention were likely to have less legible Chinese handwriting and slow writing speed in the first grade. This study found that kindergarteners who performed poorly in spatial relationships, visual–motor Integration, manual dexterity, and attention were likely to have less legible Chinese handwriting and slow writing speed in the first grade.
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