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Background: Specialized resisted strengthening activities to improve handwriting legibility are the process of training prewriting skills. Children can do activities of hand function. When a child develops finger strength, their hand strength also improves. These easy hand exercises can help a child develop fine motor skills and strengthen their hands. Objectives: The objective of this study was to identify the level of handwriting legibility in the control group and experimental group using the Evaluation Tool of Children's Handwriting (ETCH) Scale and to compare the effect of specialized resisted strengthening activities in the experimental group than with the control group. Study Design: This was a quasi-experimental study design. Methods: A total of 30 autism children were selected according to inclusion and exclusion criteria. The samples were split into two groups, each with 15 samples: the experimental group and the control group. The experimental group received 3 months of 12 sessions, each session of 45 min of specialized resisted strengthening activities individually whereas the control group did not receive specialized resisted strengthening activities but occupational therapy that excludes these specialized resisted strengthening activities. The pretest and posttest were assessed by the ETCH scale in both groups; the outcome of the posttest was investigated. Results: The results showed that the comparison of pretest and posttest mean scores of handwriting legibility in the experimental group was significantly effective after implementing resisted strengthening activities (P = 0.000 [significant]; 95% confidence interval CI: 71.13, 76.91). Conclusion: This study proves that specialized resisted strengthening activities can be used as an effective intervention to improve handwriting legibility in autism spectrum disorder. [ABSTRACT FROM AUTHOR]