Dysgraphia

Dysgraphia is a learning disability that affects the ability to write. In the school environment, writing is the primary form of expression of knowledge and understanding. Having difficulty with handwriting may diminish the child’s capabilities in the classroom and may lead to frustration, decreased self-confidence and a dislike or avoidance of writing related tasks or school itself.

A person with dysgraphia may have one or a combination of: fine motor difficulty, inability to revisualize letters, and/or difficulty with learning the patterns of letter formation. When looking at dysgraphia, it is important to distinguish which type of dysgraphia the student has and how to address these special challenges with accommodations, modifications and/or remediation.

Types of Dysgraphia

Poor handwriting alone does not mean a student has dysgraphia. Writing is a complex set of processing and motor capabilities; for students with dysgraphia, the breakdown may occur in the processing portion, motor portion, or both. The following are the three types of dysgraphia and the features and symptoms associated with each:

  Dyslexic Dysgraphia Spatial Dysgraphia Motor Dysgraphia
Features
  • Difficulty with spelling and reading that result in poor handwriting.
  • Good motor control, but lack of language skills (spelling, grammar, formulating thoughts), affect legibility of writing.
  • Usually normal or high fluency and motor skills but have difficulty with visual perception leading to poor letter formation, decreased alignment and sizing of letters for written work.
  • Usually normal or high fluency, but demonstrate fine motor skills that are uncoordinated or slow.
  • May have difficulty keeping pace with copying work or extended writing tasks.
  • Symptoms
  • Oral spelling - Poor
  • Drawing/copying - Normal
  • Finger tapping - Normal
  • Oral spelling - Normal
  • Drawing/copying - Poor
  • Finger tapping - Normal
  • Oral spelling - Normal
  • Drawing/copying - May be poor
  • Finger tapping - Poor
  • Tests (For practitioners)
  • Developmental Spelling Assessment
  • Wechsler Individual Achievement Tests (Spelling Subtest, Test of Written Spelling)
  • Informal observations of spelling
  • The Developmental Test of Visual Motor Integration (VMI)
  • Developmental Test of Visual Perception (DTVP)
  • Draw a Person
  • Clinical Observations
  • Fine Motor Olympics
  • Bruininks-Oseretsky Test of Motor Proficiency
  • Halstead-Reitan Neuropsychological Test Battery: Finger Tapping Test
  • Classroom observations of fine motor skills: Writing, cutting with scissors, manipulation small classroom objects (sheets of paper, pencil box, zippers, etc.)
  • Accommodations
  • Extra time
  • Word processing device (Neo, Alphasmart, iPad, laptop)
  • Scribe
  • Copy of instruction
  • Peer support
  • Adapted paper (graph paper, bolded/highlighted lines)
  • Word processing device
  • Scribe
  • Copy of instruction
  • Peer support
  • Slant board (to help with wrist position)
  • Adapted writing tools (grips, ergonomic pencils, weighted pencil)
  • Word processing device
  • Scribe
  • Copy of instruction
  • Peer support
  • Modifications
  • Shortened written tasks/assignments
  • Alternate format test
  • Alternate format assignments
  • Shortened written tasks/assignments
  • Alternate format test
  • Alternate format assignments
  • Shortened written tasks/assignments
  • Alternate format test
  • Alternate format assignments
  • Remediation
  • Memory aids
  • Spacing strategies
  • Improve body posture
  • Dysgraphia and OT

    In the school environment: A school-based occupational therapist can help trial and recommend accommodations to increase legibility and expression of knowledge in the classroom. They can assist in teaching different techniques individual to the student and trial accommodations such as adapted papers and spacing strategies. An OT can also look at body mechanics such as posture, desk ergonomics, and pencil grip for efficient use of body for writing tasks. School-based OTs also assist with recommending and monitoring the use of word processing devices. They can also work with the school team to recommend modifications in the student workload.

    In a private setting: Occupational therapists also work on all the school-based skills; however, they may have more of a hand in remediation strategies, such as strengthening upper body and fine motor skills, increasing dexterity, refining visual motor and visual perception skills, finding individual memory aids for children with dyslexic dysgraphia, social skills, and looking at how home life is affected.

    Links

    Playing Milestones
    Dyslexia
    Visual Motor Skills

    References

    Zobel-Lachiusa, J., & Pierce, M. (2011, May 9). Write Ways No-Tech Low-Tech High-Tech Tools for Teaching Students with Handwriting Difficulty. OT Practice, 11-15.
    Just the Facts - Dysgraphia. (2000). Retrieved May 23, 2015, from http://dyslexiasd.org/factsheets/dysgraphia.pdf
    What Is Dysgraphia? | LD Topics | LD OnLine. 2015. What Is Dysgraphia? | LD Topics | LD OnLine.http://www.ldonline.org/article/12770/. May 23, 2015
    Deuel, Ruthmary K., M.D. Developmental Dysgraphia and Motor Skills Disorders. Journal of Child Neurology, Vol. 10, Supp.1. January 1995, pp. S6-S8.