This article from Erica Patino and Understood.org will help you understand what dysgraphia is, which skills are affected by dysgraphia, how dysgraphia is diagnosed, conditions related to dysgraphia, and how you can help your child.
You probably hear a lot about learning and attention issues like dyslexia and ADHD. But chances are you don’t hear much about dysgraphia. If your child has trouble expressing himself in writing, you may want to learn more about this condition.
Writing difficulties are common among children and can stem from a variety of learning and attention issues. By learning what to watch for, you can be proactive about getting help for your child.
There’s no cure or easy fix for dysgraphia. But there are strategies and therapies that can help a child improve his writing. This will help him thrive in school and anywhere else expressing himself in writing is important.
What is dysgraphia?
Dysgraphia is a condition that causes trouble with written expression. The term comes from the Greek words dys (“impaired”) and graphia (“making letter forms by hand”). Dysgraphia is a brain-based issue. It’s not the result of a child being lazy.
For many children with dysgraphia, just holding a pencil and organizing letters on a line is difficult. Their handwriting tends to be messy. Many struggle with spelling and putting thoughts on paper. These and other writing tasks—like putting ideas into language that is organized, stored and then retrieved from memory—may all add to struggles with written expression.
Different professionals may use different terms to describe your child’s struggle with written expression. The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) doesn’t use the term dysgraphia but uses the phrase “an impairment in written expression” under the category of “specific learning disorder.” This is the term used by most doctors and psychologists.
Some school psychologists and teachers use the term dysgraphia as a type of shorthand to mean “a disorder in written expression.”
To qualify for special education services, a child must have an issue named or described in the Individuals with Disabilities Education Act (IDEA). While IDEA doesn’t use the term “dysgraphia,” it describes it under the category of “specific learning disability.” This includes issues with understanding or using language (spoken or written) that make it difficult to listen, think, speak, read, write, spell or to do mathematical calculations.
Whatever definition is used, it’s important to understand that slow or sloppy writing isn’t necessarily a sign that your child isn’t trying hard enough. Writing requires a complex set of fine motor and language processing skills. For kids with dysgraphia, the writing process is harder and slower. Without help, a child with dysgraphia may have a difficult time in school.
What causes dysgraphia?
Experts aren’t sure what causes dysgraphia and other issues of written expression. Normally, the brain takes in information through the senses and stores it to use later. Before a person starts writing, he retrieves information from his short- or long-term memory and gets organized to begin writing.
In a person with dysgraphia, experts believe one or both of the next steps in the writing process go off track:
- Organizing information that is stored in memory
- Getting words onto paper by handwriting or typing them
This results in a written product that’s hard to read and filled with errors. And most important, it does not convey what the child knows and what he intended to write.
Working memory may also play a role in dysgraphia. A child may have trouble with what’s called “orthographic coding.” This is the ability to store unfamiliar written words in the working memory. As a result, he may have a hard time remembering how to print or write a letter or a word.
There may also be a genetic link, with dysgraphia running in families.
What are the symptoms of dysgraphia?
The symptoms of dysgraphia fall into six categories: visual-spatial, fine motor, language processing, spelling/handwriting, grammar, and organization of language. A child may have dysgraphia if his writing skills lag behind those of his peers and he has at least some of these symptoms:
- Has trouble with shape-discrimination and letter spacing
- Has trouble organizing words on the page from left to right
- Writes letters that go in all directions, and letters and words that run together on the page
- Has a hard time writing on a line and inside marginsHas trouble reading maps, drawing or reproducing a shape
- Copies text slowly
Fine Motor Difficulties
- Has trouble holding a pencil correctly, tracing, cutting food, tying shoes, doing puzzles, texting and keyboarding
- Is unable to use scissors well or to color inside the lines
- Holds his wrist, arm, body or paper in an awkward position when writing
Language Processing Issues
- Has trouble getting ideas down on paper quickly
- Has trouble understanding the rules of games
- Has a hard time following directions
- Loses his train of thought
Spelling Issues/Handwriting Issues
- Has a hard time understanding spelling rules
- Has trouble telling if a word is misspelled
- Can spell correctly orally but makes spelling errors in writing
- Spells words incorrectly and in many different ways
- Has trouble using spell-check—and when he does, he doesn’t recognize the correct word
- Mixes upper- and lowercase letters
- Blends printing and cursive
- Has trouble reading his own writing
- Avoids writing
- Gets a tired or cramped handed when he writes
- Erases a lot
Grammar and Usage Problems
- Doesn’t know how to use punctuation
- Overuses commas and mixes up verb tenses
- Doesn’t start sentences with a capital letter
- Doesn’t write in complete sentences but writes in a list format
- Writes sentences that “run on forever”
Organization of Written Language
- Has trouble telling a story and may start in the middle
- Leaves out important facts and details, or provides too much information
- Assumes others know what he’s talking about
- Uses vague descriptions
- Writes jumbled sentences
- Never gets to the point, or makes the same point over and over
- Is better at conveying ideas when speaking
The symptoms of dysgraphia also vary depending on a child’s age. Signs generally appear when children are first learning to write.
Preschool children may be hesitant to write and draw and say that they hate coloring.
School-age children may have illegible handwriting that can be mix of cursive and print. They may have trouble writing on a line and may print letters that are uneven in size and height. Some children also may need to say words out loud when writing or have trouble putting their thoughts on paper.
Teenagers may write in simple sentences. Their writing may have many more grammatical mistakes than the writing of other kids their age.
What skills are affected by dysgraphia?
The impact of dysgraphia on a child’s development varies, depending on the symptoms and their severity. Here are some common areas of struggle for kids with dysgraphia:
Academic: Kids with dysgraphia can fall behind in schoolwork because it takes them so much longer to write. Taking notes is a challenge. They may get discouraged and avoid writing assignments.\
Basic life skills: Some children’s fine motor skills are weak. They find it hard to do everyday tasks, such as buttoning shirts and making a simple list.
Social-emotional: Children with dysgraphia may feel frustrated or anxious about their academic and life challenges. If they haven’t been identified, teachers may criticize them for being “lazy” or “sloppy.” This may add to their stress. Their low self-esteem, frustration and communication problems can also make it hard to socialize with other children.
While dysgraphia is a lifelong condition, there are many proven strategies and tools that can help children with dysgraphia improve their writing skills.
How is dysgraphia diagnosed?
Signs of dysgraphia often appear in early elementary school. But the signs may not become apparent until middle school or later. Sometimes the signs go unnoticed entirely. As with all learning and attention issues, the earlier signs of dysgraphia are recognized and addressed, the better.
Dysgraphia is typically identified by licensed psychologists (including school psychologists) who specialize in learning disabilities. They will give your child academic assessments and writing tests. These tests measure fine motor skills and written expression production.
During testing, the professional may ask your child to write sentences and copy text. They’ll assess not only your child’s finished product, but also his writing process. This includes posture, position, pencil grip, fatigue and whether there are signs of cramping. The tester may also test fine motor speed with finger tapping and wrist turning.
Special education teachers and school psychologists can help determine the emotional or academic impact the condition may be having on your child.
What conditions are related to dysgraphia?
Many children with dysgraphia have other learning issues. These conditions, which can also affect written expression, include:
Dyslexia: This learning issue makes it harder to read. Dyslexia can also make writing and spelling a challenge. Learn more about the difference between dysgraphia and dyslexia.
Language disorders: Language disorders can cause a variety of problems with written and spoken language. Children may have trouble learning new words, using correct grammar and putting their thoughts into words.
Attention-deficit hyperactivity disorder (ADHD): ADHD causes problems with attention, impulsivity and hyperactivity.
Dyspraxia: Dyspraxia is a condition that causes poor physical coordination and motor skills. It can cause trouble with fine motor skills, which can affect physical task of writing and printing. Learn about the differences between dysgraphia and dyspraxia.
How can professionals help with dysgraphia?
If your child is found to have dysgraphia and qualifies for special education services, you and a team of teachers and specialists at the school will develop an Individualized Education Program (IEP). This may include intensive instruction in handwriting as well as personalized accommodations and modifications.
If your child isn’t eligible for an IEP, another option is to request a 504 plan. This is a written plan that details how the school will accommodate your child’s needs.
But even without an IEP or 504 plan, you may be able to get help in other ways:
- Response to intervention (RTI) is an approach some schools use to screen students and provide small group instruction to those who are falling behind. If a child doesn’t make progress, he may receive intensive one-on-one instruction.
- Informal supports are strategies your child’s teacher can use, such as giving your child copies of class notes or using assistive technology tools like voice-to-text (dictation) software.
There are many ways to help a child with dysgraphia. Generally, support falls into these categories:
- Accommodations are changes to how your child learns. Accommodations include typing on a keyboard or other electronic device instead of writing by hand. Apps can help some children stay organized through voice-recorded notes.
- Modifications are changes to what your child learns. Examples of modifications include allowing a student to write shorter papers or answer fewer or different test questions than his classmates.
- Remediation is an approach that targets foundational skills your child needs to master. Some children may practice copying letters, using paper with raised lines to help them write in straight lines. An occupational therapist may provide exercises to build muscle strength and dexterity and increase hand-eye coordination.
There is no medication for treating dysgraphia. However, children who also have ADHD sometimes find that medication for ADHD alleviates symptoms of dysgraphia.
What can be done at home for dysgraphia?
There are many things you can do at home to help your child with dysgraphia. Here are some strategies to consider.
Observe and take notes. Taking notes about your child’s writing difficulties (including when they occur) will help you find patterns and triggers. Then you can develop strategies to work around them. Your notes will also be useful when you talk to your child’s doctor, teachers and anyone else helping your child.
Teach your child writing warm-up exercises. Before writing (or even as a break when writing), your child can do a stress-reliever exercise. He could shake his hands quickly or rub them together to relieve tension.
Play games that strengthen motor skills. Playing with clay can strengthen hand muscles. A squeeze ball can improve hand and wrist muscles and coordination.
It’s best not to try too many strategies at once. Instead, add one at a time so you know what is (or isn’t) working. Praise your child for effort and genuine achievement. This can motivate him to keep building skills. Many kids overcome and work around their writing difficulties. With support, your child can, too.
- Dysgraphia makes written expression challenging.
- There are resources available to get free or low-cost help for your child.
- When given the appropriate help, kids with dysgraphia can succeed.