Occupational therapists working with children with handwriting issues lack a standard framework for selecting treatment activities. This study investigated the utility of a decision-making guide, the Tool for Optimising Written Productivity (TOW-P). In the study, 14 occupational therapists used the TOW-P to guide the selection of interventions for 60 children with handwriting issues. The therapists completed two questionnaires about the usefulness of the tool. Feedback was used to modify the structure and format of the tool. The results indicated that the TOW-P provides a clinically useful framework to assist therapists in the selection of appropriate intervention strategies for children with written productivity issues.