Much more than simply poor handwriting, dysgraphia is a learning disability of unknown aetiology, which causes extreme difficulties with written expression.
Many people may find it difficult to get their thoughts down on paper but individuals with dysgraphia have wide-ranging problems relating to both the creation of the letters, the arrangements of the words and translating their ideas into writing.
Dysgraphia is a type of learning difficulty which can cause significant problems with writing, even though there may be no other academic or social delays. It may accompany another learning disability or present in isolation.
A neurological condition, dysgraphia causes a number of difficulties and can be split into either language-based or non-language based sub-categories.
Dysgraphia should not be confused with dyslexia, although they can sometimes present together. While dysgraphia relates to the difficulties with the formulation and physical writing of words, dyslexia refers primarily to problems with reading.
In order to write, a long sequence of complex neurological actions must occur, from the formulation of thoughts in the head, the organisation into coherent sentences suitable for communication and then the voluntary muscular control in the hands and fingers to be able to create the letters and words appropriately to express the intended idea.
For individuals with dysgraphia, carrying out this complex neurological string of actions is difficult, if not overwhelming and may be impossible.
Dysgraphia may first be identified when a child is learning to write, when they fail to make progress as expected.
Many children take some time to be able to confidently form letters and words, or to write neatly, but dysgraphia is a collection of difficulties which far surpass the range for a typical childhood developmental curve.
The condition may be described as either language based or non-language based and may present with some or all of the following features:
- Reversed writing
- Difficulty forming letters
- Problems differentiating use of lower and upper cases
- Difficulties with grammar and punctuation
- Incorrect use of verbs, pronouns, suffixes and word endings
- Incorrect ordering of words
- Omission of words
- Clear discrepancy between verbal ability to communicate and written expression
- Illegible writing
- Inconsistent spacing or positioning
- No single identifiable writing style
- Unusual grip
- Unusual positioning of the paper or body
- Narrating whilst writing while observing the hand that is moving
- Labored writing
- Problems with organising thoughts into writing
Although the condition most commonly arises in children, dysgraphia can suddenly present in adults too.
The cause for the condition during childhood is unknown, yet for adults who are diagnosed with dysgraphia, it is usually due to some kind of brain trauma, typically to the parietal lobe. It is considered to be a neurological disorder but early interventions can limit the severity or improve functioning.
Dysgraphia which is non-language based are triggered by difficulties which arise within the fine motor skills; these are essential for being able to write. The term apraxia is generally applied but this can cover a wide spectrum of problems all relating to the voluntary execution of complex motor movements and the impairments, which arise. Either a longer sequence of continuous movements such as writing a word, or a single movement, such as writing a solitary letter can be described by apraxia.
For types of dysgraphia which arise from a language disorder, there may be problems with differentiating the version of the spelling which is appropriate for each word or difficulty in the translation of the sound of words into the written expression of such.
The diagnosis of dysgraphia is usually overseen by either a educational psychologist or an occupational therapist.
A series of tests can be carried out to both establish whether dysgraphia is present, and also the type of dysgraphia the individual is suffering from.
Dysgraphia which is language based is typically dealt with by an educational psychologist while the non-language based form requires the assistance of occupational therapy.
Treatment and prognosis
There are a number of different approaches, which can be taken to try and alleviate the difficulties associated with dysgraphia. Regardless of which path is followed, early intervention is almost universally seen as key to achieving a positive outcome.
Three common strategies are generally used:
- Accommodations - where alternatives are provided for the written word
- Modifications - where the tasks are adjusted or expected outcomes are changed so that the impact of the area of difficulty is either reduced or avoided
- Remediation- where coaching is provided to help improve written expression and handwriting skills
Supporting an individual with dysgraphia requires assistance from not just the professionals but also those who are closest in their everyday life.
Other interventions may include treatment to address any motor impairment, which is impinging on the ability to write, or any memory deficits.
The prognosis for those with dysgraphia is mixed. Some individuals will find that their written expression and handwriting improves with treatment, especially when started early, but for others, difficulties will continue, regardless of any interventions.