OBJECTIVE. The purpose of this study was to describe the factors that led elementary school teachers to refer students with handwriting difficulties to occupational therapy, the criteria they used to determine acceptable handwriting, and the handwriting outcomes they looked for after occupational therapy services.

METHOD. A paper questionnaire composed of 31 close-ended questions was mailed to 400 first- through fourth-grade regular education teachers from 32 states to collect data from the 2000–2001 school year. The data were analyzed descriptively using frequency counts and converted to percentages.

RESULTS. Information was obtained from 314 teachers. The main factor for handwriting referral to occupational therapy was that the student was not improving with classroom assistance alone. Teachers chose not being able to read student's writing as the main criterion they used to determine if the student's handwriting was acceptable, and increased legibility was the most important outcome they desired following occupational therapy services for handwriting remediation.

CONCLUSION. The perceptions of regular education teachers on problems with handwriting can provide valuable information to occupational therapy practitioners when providing consultation and direct services related to handwriting in schools.