What is Dysgraphia?

According to the Diagnostic and Statistical Manual of Mental Health Disorders, fifth edition (DSM-5), dysgraphia is a “difficulty with spelling (e.g., may add, omit, or substitute vowels or consonants) and written expression (e.g., makes multiple grammatical or punctuation errors within sentences; employs poor paragraph organization; written expression of ideas lacks clarity).” That definition is difficult to comprehend. My interpretation is that dysgraphia is difficulty writing by hand that does have another neurological origin or diagnosis. It can be co-morbidly linked to ADHD but is its own diagnosis.

Is dysgraphia a form of dyslexia?

No. Dyslexia organizations have purged dysgraphia with dyslexia and included it with dyslexia as a diagnosis. However, they should be separate diagnoses as they are separate neurological processes. Dyslexia by neurological definition is difficulty reading which is sensory. Whereas, dysgraphia is a motor process. Hence, writing. Dyscalculia is difficulty with math concepts. Because math involves writing. It is crucial that a comprehensive diagnosis is differentiated.

How is it diagnosed?

A diagnosis of dysgraphia is completed using a multidisciplinary approach. A neuropsychologist will synchronize the data and provide the final diagnosis. The disciplines that should be included are the occupational and speech therapist. Disabilities relating to visual perception, visual-motor integration, oral expression, and executive function could coexist.

What are the types of dysgraphia?

Dyslexia organizations identify three types of dysgraphia. Through my research, I was able to identify 6 types. They include visual-spatial; motor; memory; and word formation, sentence, and paragraph formation dysgraphia. Children with visual-spatial dysgraphia exhibit difficulty writing letters, numbers, and shapes. Children with Motor control, accuracy, precision, and speed delays are categorized under motor dysgraphia. The inability to recall how a letter, word, or sentence is structured is memory dysgraphia. These aspects of dysgraphia are biomechanical. Transitioning to language aspects, you have word and sentence formation difficulties. Word formation dysgraphia includes problems with spelling. Problems with sentence structure is sentence formation dysgraphia. Paragraph formation dysgraphia involves the lack of understanding of putting sentences together. It involves the cognitive aspects of writing.

What are the symptoms of dysgraphia?

Avoiding writing tasks
Awkward pencil grasp
Cramping fingers or hands
Difficult managing margins
Difficulty with written expression
Inconsistency in forming letters
Inefficient pencil pressure
Intentionally watching their handwrite letters
Irregular letter formation, size, sequencing, or line placement
Letter and number reversals
Mixing upper and lowercase letterforms
Need extended time to complete tasks
Odd positions of the wrist or paper
Poor fine motor skills
Poor letter organization
Poor spelling
Unorganized thought processes when writing paragraphs
Writing slower than typical students of the same age

How can I find out if my child has dysgraphia? To whom should I consult if I suspect dysgraphia?

Any delay in the ability to write from the preschool days on can yield a diagnosis. Schools are not obligated to test students until they have at least six months’ worth of data. If your child exhibits any of the symptoms, contact a professional that is part of the diagnosis team and ask them to evaluate.

If you look on my website, there are six occupational therapists that have taken the training to become K-5 Dysgraphia Specialists.

Can dysgraphia be cured?

This answer is going to cause controversy. My answer is Yes. There is no long-term neurological condition associated with dysgraphia. Therefore, it should resolve itself with the development of neurological pathways. However, many times there is a co-morbid neurological condition that is preventing the growth of these pathways such as ADHD. In these situations, the handwriting delay with continue for a lifetime.

What therapies and treatments do you recommend?

The remediation of handwriting delays are completed by an occupational therapist. Adding a speech therapist to support language delays will also help generate the neural pathways. Any movement programs can support students. They include formal programs such as Brain Gym, but also any sport will improve the neural development of the brain-body connection. Sports like gymnastics and karate have helped many of my students. Anything that adds weight-bearing to the upper extremities will improve the tolerance for writing.

What about school and home supports?

There are many areas that help students improve their neurological development. I am an advocate of practice, practice, practice. That be said, keyboarding is often a resource for students who have continued problems. I prefer paralleling this support. That means DO BOTH! Most accommodations that you have heard on websites like Understood.org are wonderful. Accommodations should be based on the child’s tolerance for writing. If they can so part of the work, encourage it! If it is that much of a challenge, have someone scribe it.

At home, do not exceed the time guidelines set up by your child’s teacher. If they are supposed to get schoolwork completed in 30-minutes, that is all they do. After that time, help. Use timers and rewards (no food) to encourage completion. Don’t make it fight night! Give yourself and your child grace.

Any specific tools or products you can recommend for helping children?

Encourage multi-step crafts and games that promote imagination. One item that I keep with me every week for treatment is clothes pins of different resistance. Creating new ways to have students clip with them while holding a small object like a dice in their hand.

Encouraging your child to cup his/her hand is a very basic posture for legible handwriting.

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