The ETCH-M and ETCH-C in School OT: Tasks, Legibility Scoring, Research, and Reporting Tips

Handwriting remains one of the most common reasons teachers refer students to school OT. When the question is "Can others read this child's writing, and how fast can they produce it during classroom tasks?", the Evaluation Tool of Children's Handwriting (ETCH) is a common choice. Here is what it is, how it is scored, what the research supports, and how to report it.

Why School and Clinic Therapists Use the ETCH

The ETCH looks at handwriting during tasks that resemble what students do in class: writing the alphabet and numerals from memory, copying from a page and from a board, writing to dictation, and composing a sentence (Shirley Ryan AbilityLab, n.d.). Instead of rating letter form in isolation, it asks whether the letters, words, and numerals a child produces in those tasks are legible, and it times the child's writing.

That makes it useful for documenting a baseline, writing measurable IEP goals tied to legibility percentages, tracking change over time, and describing handwriting in classroom terms teachers and families understand.

What the ETCH Is

The ETCH was developed by Susan J. Amundson and published in 1995 by O.T. KIDS (Amundson, 1995; Shirley Ryan AbilityLab, n.d.). The kit is currently sold through Therapro, which describes it as a criterion-referenced assessment of handwriting legibility and speed for grades 1 to 6, typically ages 6 to 12 (Therapro, n.d.-a). As far as we could find, the 1995 version is still the current one; no newer edition has been published.

There are two versions:

• ETCH-M (manuscript): intended for grades 1 and 2
• ETCH-C (cursive): intended for grades 3 to 6

Therapro lists testing time at 15 to 25 minutes and scoring time at 15 to 25 minutes (Therapro, n.d.-a). The kit includes reproducible response booklets and score sheets, task sheets, wall charts, a scoring card, and a 163-page examiner's manual (Therapro, n.d.-a). The Rehabilitation Measures Database notes that educators or allied health professionals can administer it if they follow the manual's legibility procedures, and that it is generally not appropriate for children for whom handwriting is not a realistic means of communication (Shirley Ryan AbilityLab, n.d.).

What the ETCH Measures

According to the Rehabilitation Measures Database summary, the ETCH-M includes six tasks and the ETCH-C includes seven (Shirley Ryan AbilityLab, n.d.):

1. Alphabet writing: lowercase and uppercase letters from memory
2. Numeral writing: numerals from memory
3. Near-point copying: copying from a sheet on the desk
4. Far-point copying: copying from a chart at a distance, similar to board copying
5. Manuscript-to-cursive transition: ETCH-C only; the child converts printed text into cursive
6. Dictation: writing words, letters, and numerals as they are spoken
7. Sentence composition: writing a sentence the child generates

The ETCH yields three kinds of information (Shirley Ryan AbilityLab, n.d.):

• Legibility: the percentage of legible letters, words, and numerals, by task and as totals
• Speed: time in seconds for alphabet and numeral writing, and letters per minute for copying, dictation, and composition tasks
• Qualitative observations: pencil grasp and other handwriting behaviors that the examiner records but does not convert into a score

How the ETCH Is Scored and Reported

The ETCH is criterion-referenced. It does not produce standard scores, scaled scores, percentile ranks, or age equivalents. A legibility score is simply the proportion of letters, words, or numerals judged legible, expressed as a percentage from 0 to 100 (Shirley Ryan AbilityLab, n.d.). Speed is reported as raw time or as letters per minute.

A few reporting principles follow from that:

• Lead with total legibility. Total letter and word legibility have been more stable than individual task scores (Diekema et al., 1998; Duff & Goyen, 2010), so use totals for decisions and goals.
• Treat task scores descriptively. They can show patterns, such as a drop on far-point copying, but are less reliable alone.
• Do not invent a classification. The ETCH has no publisher descriptive ranges like "below average." If you compare a percentage to a cutoff, name the study it came from.
• Follow the manual's legibility criteria exactly. Confirm task details and calculation steps in your manual rather than from secondary summaries.

A Realistic School Example

Maya (fictional) is a second grader referred because her journal entries are hard to read and she rarely finishes copying the morning message from the board. Her OT gives the ETCH-M, observes grasp and posture, and collects a class writing sample.

Sample Score Summary (FICTIONAL)

These numbers are invented for illustration. Legibility values are percentages judged legible using the manual's criteria. There are no standard scores or percentiles because the ETCH does not produce them.

• Total word legibility: 64%
• Total letter legibility: 71%
• Total numeral legibility: 85%
• Near-point copying legibility (letters): 80%
• Far-point copying legibility (letters): 62%
• Near-point copying speed: 18 letters per minute
• Far-point copying speed: 11 letters per minute
• Observations: heavy pencil pressure; frequent head turns between chart and paper; inconsistent word spacing

For context only, Brossard-Racine et al. (2012) identified cutoffs of 75.0% for total word legibility and 76.0% for total letter legibility in grades 2 and 3, and Long and Conklin (2019) tentatively suggested cutoffs of below 82% for words and below 77% for letters in typical second graders. Maya's fictional totals fall below both sets of cutoffs, which supports, but does not by itself establish, a handwriting concern.

How to Write It Up

Report percentages in plain language and connect them to classroom function:

Maya completed the Evaluation Tool of Children's Handwriting, Manuscript (ETCH-M), a criterion-referenced measure of handwriting legibility and speed during classroom-type writing tasks. The ETCH-M does not yield standard scores. Maya's total word legibility was 64% and her total letter legibility was 71%, meaning roughly one in three words she wrote was judged illegible. Both totals fall below research cutoffs used to identify second and third graders with handwriting difficulties (Brossard-Racine et al., 2012). Legibility was lowest on far-point copying (62% of letters), and she copied at 11 letters per minute from a distance compared with 18 letters per minute from a sheet on her desk, which is consistent with her teacher's report that she rarely finishes copying from the board. Numeral legibility was a relative strength at 85%. Together with work samples and observation, these results indicate that legibility is affecting Maya's written work.

When retesting, Brossard-Racine et al. (2012) reported minimal clinically important differences of 6.0% to 7.0% for total letter legibility and 10.0% to 12.5% for total word legibility, a useful yardstick for judging whether change is meaningful.

What the Research Says

The ETCH has a modest research base built on small samples. The main takeaways:

• Test-retest reliability (ETCH-M). In 31 first and second graders with handwriting dysfunction retested after one week, coefficients were .77 for total letter, .71 for total word, and .63 for total numeral legibility; individual tasks ranged from .20 (near-point copy) to .76 (uppercase alphabet) (Diekema et al., 1998).
• Concurrent validity (ETCH-C). With 101 fourth graders, ETCH-C total word and total letter legibility correlated .61 and .65 with teacher handwriting grades, and a 75% word legibility score best separated satisfactory from unsatisfactory handwriting (Koziatek & Powell, 2002).
• Older students and other scripts (ETCH-C). Duff and Goyen (2010), using the general scoring criteria with children in Years 5 and 6 who wrote in alternative cursive scripts, found total letter scores most reliable, total word scores more variable, and total numeral scores not reliable enough to recommend. They proposed cutoffs of below 90% for letters and below 85% for words.
• Teacher perception. Results are mixed. Sudsawad et al. (2001) found no significant relationship between ETCH scores and teacher questionnaire ratings in 45 first graders, while Long and Conklin (2019) found that ETCH-M letter legibility predicted teacher ratings of legibility in 74 typical second graders.

Practical Cautions

• No normative sample. Means from individual studies are not norms; use them as context only.
• Cutoffs differ by study, grade, and script. Cite the source and population whenever you mention one.
• Rater judgment matters. Practice scoring before using results for decisions, and use identical procedures at retest.
• Numeral totals are the least stable. Lean on letter and word totals (Diekema et al., 1998; Duff & Goyen, 2010).
• Grade fit. The tasks were designed for grades 1 to 6. With older students, results are descriptive at best (Shirley Ryan AbilityLab, n.d.).
• Pair it with function. Combine results with work samples, teacher input, and observation.

How the ETCH Compares With Related Tools

• Minnesota Handwriting Assessment (MHA). By Judith Reisman (1999), published by Pearson for grades 1 and 2, the MHA scores a short near-point copying sample for rate and five quality categories: legibility, form, alignment, size, and spacing (Pearson, n.d.). It covers manuscript and D'Nealian print but not cursive. Pearson's product page states that it will go out of print on December 21, 2026.
• Test of Handwriting Skills, Revised (THS-R). By Michael Milone (2007), published by Academic Therapy Publications and sold through Therapro, the THS-R is norm-referenced for ages 6-0 through 18-11 and reports scaled scores, percentile ranks, stanines, and a composite standard score (Therapro, n.d.-b). Choose it when you need a norm-referenced comparison.
• ETCH. Criterion-referenced, but it covers both manuscript and cursive and samples several classroom-type tasks, including far-point copying, dictation, and composition.

Bottom Line

The ETCH gives you classroom-relevant legibility percentages and speed data for manuscript and cursive writers in grades 1 to 6. It does not produce standard scores and its research base is small, so lead with total letter and word legibility, cite the study behind any cutoff, and pair results with work samples and teacher input.

References

Amundson, S. J. (1995). Evaluation Tool of Children's Handwriting. O.T. KIDS.

Brossard-Racine, M., Mazer, B., Julien, M., & Majnemer, A. (2012). Validating the use of the Evaluation Tool of Children's Handwriting-Manuscript to identify handwriting difficulties and detect change in school-age children. American Journal of Occupational Therapy, 66(4), 414-421. https://doi.org/10.5014/ajot.2012.003558

Diekema, S. M., Deitz, J., & Amundson, S. J. (1998). Test-retest reliability of the Evaluation Tool of Children's Handwriting-Manuscript. American Journal of Occupational Therapy, 52(4), 248-255. https://doi.org/10.5014/ajot.52.4.248

Duff, S., & Goyen, T.-A. (2010). Reliability and validity of the Evaluation Tool of Children's Handwriting-Cursive (ETCH-C) using the general scoring criteria. American Journal of Occupational Therapy, 64(1), 37-46. https://doi.org/10.5014/ajot.64.1.37

Koziatek, S. M., & Powell, N. J. (2002). A validity study of the Evaluation Tool of Children's Handwriting-Cursive. American Journal of Occupational Therapy, 56(4), 446-453. https://doi.org/10.5014/ajot.56.4.446

Long, D. M., & Conklin, J. (2019). Handwriting performance of typical second-grade students as measured by the Evaluation Tool of Children's Handwriting-Manuscript and teacher perceptions of legibility. The Open Journal of Occupational Therapy, 7(4), 1-14. https://doi.org/10.15453/2168-6408.1492

Pearson. (n.d.). Minnesota Handwriting Assessment. Retrieved October 26, 2026, from https://www.pearsonassessments.com/en-us/Store/Professional-Assessments/Motor-Sensory/Minnesota-Handwriting-Assessment/p/100000275

Shirley Ryan AbilityLab. (n.d.). Evaluation Tool of Children's Handwriting. Rehabilitation Measures Database. Retrieved October 26, 2026, from https://www.sralab.org/rehabilitation-measures/evaluation-tool-childrens-handwriting

Sudsawad, P., Trombly, C. A., Henderson, A., & Tickle-Degnen, L. (2001). The relationship between the Evaluation Tool of Children's Handwriting and teachers' perceptions of handwriting legibility. American Journal of Occupational Therapy, 55(5), 518-523. https://doi.org/10.5014/ajot.55.5.518

Therapro. (n.d.-a). Evaluation Tool of Children's Handwriting (ETCH). Retrieved October 26, 2026, from https://www.therapro.com/Browse-Category/Handwriting-Evaluations/Evaluation-Tool-of-Childrens-Handwriting-ETCH.html

Therapro. (n.d.-b). Test of Handwriting Skills, Revised (THS-R). Retrieved October 26, 2026, from https://www.therapro.com/Browse-Category/Handwriting-Evaluations/Test-of-Handwriting-Skills-Revised-THS-R.html

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