Executive Function and Writing Performance Among Primary School Students With Writing Difficulties: The Mediating Role of Visual-Motor Integration

Executive function is critical for writing, yet its role in children with writing difficulties (WD) remains underexplored. This study examines differences in three executive-function subcomponents (working memory, inhibitory control, and cognitive flexibility) between children with and without WD, and their effects on spelling and sentence-writing abilities, mediated by visual-motor integration. The focus on Chinese children addresses a critical gap in the predominantly Western-alphabetic writing difficulties literature. A total of 244 Chinese primary school students (122 with WD, 122 without WD) were assessed. Children with WD demonstrated significantly lower accuracy and longer reaction times in executive function tasks as well as lower visual-motor integration scores, compared with their peers without WD. Structural equation modeling revealed that working memory and inhibitory control indirectly predicted writing performance through visual-motor integration, while cognitive flexibility had no significant effect. These findings suggest that executive function impairments, particularly in working memory and inhibitory control, may contribute to WD through their influence on visual-motor integration. The study highlights the importance of addressing both executive function and visual-motor integration in interventions targeting children with WD.