Handwriting instruction occurs the first 15 minutes of session one. The occupational therapist serves as the lead teacher for letter formation instruction. The co-teaching format for this 15 minutes is team teaching.

Prior to letter formation instruction, the students are divided into three small groups. Groups of 7 to 8 are ideal, but will vary by class size. Each group should comprise children with a range of handwriting competency by consisting of high-proficiency students who have mastered most letters and low-proficiency students who need additional support. Children with delayed handwriting skills benefit from peer modeling and peer support during the instruction.

During letter formation instruction and practice, each group is supported by one of the adult instructors. It is very difficult for one classroom teacher to monitor an entire class during practice and effectively identify and intervene in letter formation errors. Each adult instructor monitors student writing, providing guidance and feedback on letter formation. The goal is for students to develop a correct motor plan for the formation of each letter, rather than practicing and learning incorrect motor plans.

The letter formation instruction should contain key elements supported by handwriting research and remain consistent regardless of the handwriting curriculum used by the school. Stroke sequence, instructional order, and the verbal description of letter formation are determined by the handwriting curriculum.