Occupational therapists often address pre-printing skills in young children, but the evidence supporting such practice has not been thoroughly investigated. The purpose of this scoping review was to summarize and evaluate pre-printing literature and outline a theoretical framework to inform best practice. Utilizing PRISMA guidelines and scoping review methodology, two independent reviewers selected articles for abstract and full-text review and rated the level of evidence of each article. Most of the 98 articles that were included were low levels of evidence, often based on "expert" opinion. Two theoretical approaches emerged based on printing skill prerequisites and development. Occupational therapy research appears to follow a neurodevelopmental approach, which describes a prescriptive developmental sequence with direct instruction, leading to mastery of pre-printing shapes, strokes and skills. An emergent literacy approach is prominent in education literature. This approach also incorporates developmental considerations, but is less prescriptive and more focused on a literacy-rich, curricular approach to pre-printing instruction. An emergent literacy approach encourages children to experiment with printing, matching task demands with the child's natural printing development, without prescriptive mastery of certain skills. We propose an integrated theoretical framework, to capture both educator and therapist expertise, to facilitate a more collaborative approach when guiding pre-printing development both for typically developing children and children with developmental challenges. Evidence from this scoping review will be used to develop a pre-printing program based on an integrated theoretical framework. This combined approach may prevent confusion and conflicting information about printing readiness, and thus allow occupational therapists, early childhood educators, kindergarten teachers, and parents to provide consistent guidance and learning opportunities for young children to learn pre-printing skills.