Dysgraphia is a learning disability that makes it difficult to write. The word comes from the Greek dys (difficulty) and graphia (making letter forms). A person with dysgraphia knows what to write and how to write, but copying and turning thoughts into words is a challenge.
Dysgraphia, like other learning difficulties, has nothing to do with intelligence or motivation but with how the brain processes the information it receives. It’s a condition that never goes away, though there are methods and tools to improve writing. A child may have other learning difficulties along with dysgraphia, for instance, dyslexia, dyspraxia, language disorders, or ADHD.
Children with dysgraphia may find it difficult to hold a pen or pencil. They may find it hard to line up letters as they should, even with the help of lined paper. They may also have trouble spelling words or taking the thoughts in their heads and putting them down in writing.
For some children it’s an organization, storage, and memory problem. A child may have learned everything he needs to know about writing. Finding, sorting it all out, and using that information is another thing.
Writing is complicated. Think about your hand picking up a pencil and placing it in the writing position. Watch your hand move this way and that as you write the different letters and punctuation. There is a lot going on there with your fine motor skills as your brain tells your hand how to make all those many, small graceful movements.
At the same time as you’re using all those many fine motor skills, you’re also using language processing skills. Your brain must think how to take all the thoughts and words in your head and turn them into written words and thoughts on paper. You need good hand-to-eye coordination to get pencil to paper, get letters and words to be approximately the same size, and to line them up, nice and straight on the page. You have to know where it makes sense to put a space between letters, words, and paragraphs, (and where it does not).
All of these many brain-based activities must be working just so for writing to come out right, for letters and words to be neat and readable. But in dysgraphia, something, somewhere along the line, goes wrong. It could be any number of things. The result is that the child finds it difficult to write, and we find her writing difficult to read.
The brain is a lot like a circuit board. The connections from one part of the brain to another are called synapses. Synapses are like thin threads or wires and there are lots of them in the brain. Just like the wires in a circuit board, synapses can get kinked up or twisted. They can get crossed or connect to the wrong place.
Now think how many brain processes are used for writing. That means lots of opportunity for things going wrong. You may never know why your child has dysgraphia, since the exact cause could be so many different things and even many different things at once. It’s actually miraculous that any of us can write smoothly and well, since writing is such a complicated process. For the child with dysgraphia, writing is a long, slow, sometimes even painful process, and the results may still be quite difficult to read.
The word “dysgraphia” doesn’t appear in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). Instead, the DSM-5 calls dysgraphia “an impairment in written expression.” Because of this, most experts refer to dysgraphia this way. For most people however, “dysgraphia” is easier to say and use.
A child with dysgraphia should qualify for special education services under the Individuals with Disabilities Education Act (IDEA). To qualify for help, a child must have a condition that is named or described under IDEA. Like the DSM-5, IDEA doesn’t actually use the word “dysgraphia.” But IDEA does specify that children with specific learning disabilities are entitled to help. The DSM-5 classifies “an impairment in written expression” (dysgraphia) under the category: “specific learning disability.” IDEA defines a specific learning disability as something that makes it hard to understand or use language, either spoken or written, so it’s difficult to “listen, think, speak, read, write, spell, or to do mathematical calculations.”
Lots of children have messy handwriting when they are first learning to write. For some children, however, poor handwriting continues over a period of years, even with lots of practice and help. That’s when it’s time to look into whether the child might have dysgraphia.
Experts think that memory plays an important role in dysgraphia. The brain pulls in information through our five senses and stores it for later use. Think about the way you automatically raise your cup of coffee when going over a bump when riding in a car or airplane. You don’t think about it, it’s information you absorbed. You don’t know why you do it. You just know that if you don’t, your coffee will spill.
There are all kinds of information like this that you have absorbed through your senses and stored in your brain. These bits of information help you do your daily tasks, including writing. The information could be something as small as how to grasp a pencil, or how to turn that pencil with your fingers and hand to make a circle, a curve, or a loop. It could be about how to cross a t or dot an i. When a person gets ready to write, he has to find and use all these bits of information that are stored in his short-term or long-term memory. Then he must think how he wants to use all this information and in what order to use it so that his writing makes sense on the page.
In someone with dysgraphia, something goes wrong with this process. It may be about how the bits of writing information are organized and stored in the memory. Or it may be about getting the words out and onto paper or a computer screen. The result is writing that is full of mistakes and difficult to read. What we see may not even be what the child meant to write.
Sometimes dysgraphia is about the working memory. The child may not be able to remember how a new word is supposed to look and be written. He can’t write the word or type it, because he can’t remember how it goes. When a child can’t remember how words look in written form, he is said to have a problem with orthographic coding.
Dysgraphia may be genetic, which means that dysgraphia may run in families. If a child is behind the class into his writing and has some symptoms of dysgraphia, he should be evaluated for the condition.
Dysgraphia symptoms fit into six groups:
Visual-spatial: Has trouble telling shapes apart, and leaving the right amount of space between letters and words. Finds it difficult to write words in one direction, for instance left to right. Has difficulty writing on the line or inside a margin. Finds it hard to read maps, and to draw or copy a shape. Is slow to copy text. Letters may be written in all different directions, with letters and words running together.
Fine motor: Finds it difficult to hold a pencil the right way. Other things that are hard to do: tracing, tying shoelaces, cutting up food, doing puzzles, typing, coloring inside the lines, using a scissors. Holds arm, wrist, body, or paper in an awkward manner when writing.
Language processing: Needs more time than others to get his thoughts typed out or written on paper. Finds it difficult to follow directions or understand game rules. Forgets what he was going to write in the middle of writing or loses his train of thought.
Spelling and Handwriting: Spelling rules are difficult to understand, for instance: i before e, except after c. Finds it hard to tell if a word is spelled wrong. May have perfect spelling when spelling aloud, but makes spelling mistakes when writing. May misspell the same words a number of different ways. Spell check is more confusing than helpful—he looks at the spelling suggestions and can’t figure out which is the right word to choose. Doesn’t know when to use upper or lowercase letters—his writing is a jumble of both. May mix printing and cursive in the same word or sentence. May not be able to read back to you what he’s written in his own handwriting. Tries to get out of writing. His hand gets tired and cramps up and aches as he writes. Goes through many erasers.
Grammar: Can’t figure out punctuation—may use the wrong punctuation, not enough punctuation, or too much punctuation (for example, too many commas, or run-on sentences that lack period or full stop punctuation marks, so that they never seem to end). May use different verb tenses in the same sentence or paragraph, for example, “When running, Sally ran to the beach.” Forgets to begin sentences with capital letters. Sentences may look unfinished, or be written in list format.
Language organization: Finds it difficult to tell stories, and may begin in the middle. May leave out important ideas, thinking you already know what he’s talking about. He might add many extra unimportant details, because he doesn’t know which facts are or aren’t important to a story. Uses vague language to describe things, so you don’t know what he’s talking about. A story he tells may seem to have no point, or the point is repeated many times over. Two or more sentences may get mixed up, so they’re impossible to understand. He’s better at telling you something than writing it out for you.
Dysgraphia Symptoms by Age
Symptoms of dysgraphia are different at different ages. You might not know a child has dysgraphia until the child begins learning how to write.
In preschool children, you might suspect dysgraphia in the child who hates to color and tries to get out of writing and drawing.
Children already in elementary school may mix up print and cursive in the same word or sentence. They can’t seem to stay on the lines and their letters aren’t even in size or height. School children with dysgraphia may need to sound out words as they write them. They may find it hard to get their thoughts out in written form.
High school students with dysgraphia may keep their sentences very simple. They make many grammar mistakes compared to their classmates.
Impact of Dysgraphia
In some children, dysgraphia is mild, in others, the symptoms are severe. That means that the impact of dysgraphia is different for each person. Here are some of the more common areas of difficulty for children (and adults) with dysgraphia:
Life: Children with dysgraphia may have trouble with their fine motor skills. It can be hard for them to tie their shoes or button a shirt. Scrambling an egg may be hard to do. Since writing and typing is difficult, it’s hard for them to make grocery or to-do lists.
School: Students with dysgraphia may push off or avoid writing assignments. It takes longer for them to write and their writing may be full of mistakes. It’s hard for them to take notes and it’s hard for them to read them. They may not complete their assignments on time. These issues can cause children to fall behind their classmates.
Social and Emotional: The challenges of dysgraphia can affect a child’s self-esteem and make it hard to develop friendships. Children with dysgraphia feel different than the other children they know. They have trouble expressing their thoughts. They feel frustrated at how hard it is for them to do their schoolwork. The thought of going to school or doing schoolwork, is a source of stress. When a child has not been identified as having dysgraphia, her teachers may not understand that the student has a real condition. A teacher may tell a child that she’s not working hard enough or that her writing is “messy” or “careless.” These labels can be hurtful, especially when the child is trying hard, and still failing. When children with dysgraphia fall behind in school, they may feel discouraged. They may even decide to drop out of school.
Signs of dysgraphia can be seen in preschool and elementary school children. Often, however, the condition is not diagnosed until middle school or high school. As with all learning difficulties, the earlier a child is diagnosed, the sooner the child can get help.
Dysgraphia is diagnosed by psychologists who specialize in learning disorders. Your child will need to be evaluated. During the evaluation, the tester will assess the child’s fine motor skills and writing ability. The evaluator will also want to see how your child expresses himself in writing.
Your child will also be asked to copy text and write sentences. The evaluator will watch your child as he writes to see how he writes, his posture, the way he holds the pencil, and whether it looks like the child’s hand is cramping as he writes. He will look at the child’s handwriting and measure the child’s fine motor speed as he taps his fingers, or flexes his wrists.
Other professionals, for instance school psychologists or special education teachers, may look at how the child’s difficulties affect his social life, his school work, or his emotions and self-esteem.
Once a child is diagnosed with dysgraphia, he should qualify for special education services. A team of teachers and experts will work with you to create an Individualized Education Program (IEP). Your child may receive tutoring in handwriting, and receive accommodations and modifications to address his specific issues. If your child isn’t found to be eligible for an IEP, request a written 504 plan that lays out how the school will work with your child to accommodate his needs.
Some schools use the response to intervention (RTI) approach. This helps identify any learning difficulties and offers extra group help to students who are behind in class. If group instruction doesn’t seem to help your child, the school may move to private, one-on-one tutoring.
Types of Dysgraphia Help
There are three kinds of help your child can receive for dysgraphia: accommodations, modifications, and remediation:
Accommodations change the way your child learns. Examples of accommodations include letting a child type on a keyboard instead of writing by hand; using voice-to-text software for note-taking and written assignments; or taking tests orally, instead of in writing.
Modifications change the content of what your child learns. Your child may be able to write shorter written reports, or receive fewer or different test questions than the other students in the class.
Remediation is extra work in the skills your child needs. Your child may spend more time doing tasks like copying letters and drawing inside raised lines. A child with dysgraphia may receive occupational therapy such as hand exercises to improve strength, agility, and hand-to-eye coordination.
Some children also find that medication for ADHD can ease the symptoms of dysgraphia.
Dysgraphia Home Help
At home, here are some of the many things parents can do to help children with dysgraphia:
Keep a notebook: Watch your child and write down what you observe about your child’s writing issues. How is your child sitting? What time of day is writing more difficult? Does stress make things worse? What makes things better or easier? Your notebook will be a big help when you discuss your child’s progress with teachers and other experts and educators.
Do hand exercises before and during homework: Have your child stretch the fingers of his hands several times, shake his hands out, or rub his hands together before doing written work. You may want to have your child take several breaks in his homework to repeat these exercises. The purpose of these exercises is to warm up the muscles and relieve built-up muscle tension, too.
Find fun ways to improve motor skills and increase strength: Have your child crumple a piece of paper, squeeze a wet sponge, squirt a water gun, or work with modeling clay.
Always watch your child to see how she’s handling these activities. Try not to overwhelm the child. Offer lots of praise for real accomplishments. It may not be easy—it never is—but with your help and support, your child will learn to cope with dysgraphia and succeed in school and in life.
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