Dysgraphia

Definition

Dysgraphia is a childhood disorder that results in impaired handwriting, impaired spelling, or both in a child of normal intelligence. It is not a mental health disorder, but rather a learning disability marked by difficulty expressing thoughts and ideas in writing. Dysgraphia is frustrating for the child and can cause great emotional difficulty and distress. A child with dysgraphia may have trouble learning to spell written words, and also have trouble writing at a normal speed, but will not necessarily have problems reading or speaking. Dysgraphia can occur on its own or with dyslexia, which is an impaired ability to read and comprehend written words, or with other selective language impairments that cause problems with learning written and oral language skills.

Symptoms

Signs of dysgraphia may include omitting words from sentences, poor sentence organization, incorrect word usage, poorly formed individual letters, lack of or incorrect punctuation and capitalization, awkward pencil grip or wrist position when writing, and attempts to avoid writing altogether. Because they have no difficulty reading or speaking, children who have dysgraphia but no other learning disorder are sometimes mistakenly thought to be lazy or unmotivated when it comes to handwriting. While not the cause of dysgraphia, children with ADHD are at higher than average risk of developing dysgraphia, and girls with ADHD appear to be at higher risk than boys with ADHD. 

Causes

Handwriting is a complicated process that involves controlled motor skills, using hand and finger movements in an appropriate sequence, working memory, word organization, thinking about words and their meanings, and generating ideas. Children with dysgraphia appear to have a problem with orthographic coding, which is the ability of working memory to store and permanently remember written words. While they do not have a primary developmental motor disorder, which can also cause poor handwriting, these children may have trouble planning sequential finger movements. Adults may develop acquired dysgraphia following a brain injury or stroke.

Treatments

Children with impaired handwriting ability require early intervention and specialized coaching in all skills related to written language. After an initial assessment of handwriting and other skills related to transcription and written expression, the child’s school most often handles the academic accommodations necessary for improvement. These interventions may involve physical exercises to strengthen hand muscles, reduced writing workload or extended time to complete written assignments, as well as writing activities that help them develop motor control and learn to write complete letters, write letters from memory or dictation, increase handwriting speed, spell the most common and important words they will need to use in and out of school. The team of helpers may include an occupational therapist, a speech and language therapist, special education teacher and, in some cases, a social worker or psychologist to help the child deal with anxiety and frustration. Treatment therapies vary with the type and degree of dysgraphia and may be different for adults with an acquired disorder due to underlying issues that may require very specific types of training.

References

International Dyslexia Association website. Accessed September 18, 2017.

Adi-Japha E, Landau YE, Frenkel L, et al. ADHD and dysgraphia: Underlying Mechanisms. Cortex. 2007;43(6):700-709.

Yoshimasu K, Barbaresi WJ, Colligan RC, et al. Written-language disorder among children with and without ADHD in a population-based birth cohort. Pediatrics. September 2011;128(3):

Thiel L, Sage K and Conroy P. The role of learning in improving functional writing in stroke aphasia. Disability and Rehabilitation. 2016;38(21):2122-2134.

Last reviewed 03/05/2018