What is dysgraphia

Dysgraphia is a learning disability and a neurological disorder that affects writing abilities that is characterized by difficulty with handwriting, spelling, and thinking and writing at the same time and trouble putting thoughts on paper ¹. Dysgraphia causes a person’s hand writing to be distorted or incorrect. In children, dysgraphia generally emerges when they are first introduced to writing. Children make inappropriately sized and spaced letters, or write wrong or misspelled words, despite thorough instruction. Children with dysgraphia may have other learning disabilities; however, they usually have no social or other academic problems. Cases of dysgraphia in adults generally occur after some trauma to the brain. In addition to poor handwriting, dysgraphia is characterized by wrong or odd spelling, and production of words that are not correct (i.e., using “boy” for “child”). The cause of dysgraphia is unknown, but in adults, it is usually associated with damage to the parietal lobe of the brain.

Learning disabilities affect how a person learns to read, write, speak, and do math ². They are caused by differences in the brain, most often in how it functions but also sometimes in its structure. These differences affect the way the brain processes information ³.

Learning disabilities are often discovered once a child is in school and has learning difficulties that do not improve over time. A person can have more than one learning disability ⁴. Learning disabilities can last a person’s entire life, but he or she can still be successful with the right educational supports ³.

A learning disability is not an indication of a person’s intelligence. Learning disabilities are different from learning problems due to intellectual and developmental disabilities, or emotional, vision, hearing, or motor skills problems ³.

Because writing requires a complex set of motor and information processing skills, saying a student has dysgraphia is not sufficient. A student with disorders in written expression will benefit from specific accommodations in the learning environment, as well as additional practice learning the skills required to be an accomplished writer.

There are many ways to help a person with dysgraphia achieve success. Generally strategies fall into three categories:

1. Accommodations: providing alternatives to written expression. Accommodations are changes to how your child is learning. 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.
2. Modifications: changing expectations or tasks to minimize or avoid the area of weakness. Modifications are changes to what your child is learning. Examples of modifications include allowing a student to write shorter papers or answer fewer or different test questions than his classmates.
3. Remediation: providing instruction for improving handwriting and writing skills. 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.

Each type of strategy should be considered when planning instruction and support. A person with dysgraphia will benefit from help from both specialists and those who are closest to the person. Finding the most beneficial type of support is a process of trying different ideas and openly exchanging thoughts on what works best.

There is no medication for treating dysgraphia. However, children who also have attention deficit hyperactive disorders (ADHD) sometimes find that medication for attention deficit hyperactive disorders (ADHD) alleviates symptoms of dysgraphia.

What can make your child’s dysgraphia journey easier?

Whether you’re just learning about dysgraphia, this site can help you find support your child.

• Know your child’s issues. If your child hasn’t been identified with dysgraphia, consider having him evaluated by the school or by an outside professional. Knowing which issues your child has is the first step toward getting the best help.
• Request an evaluation. If your child is found to have dysgraphia, consider asking your school district if he qualifies for an Individualized Education Program (IEP) (https://www.understood.org/en/school-learning/special-services/ieps/understanding-individualized-education-programs) or 504 plan (https://www.understood.org/en/school-learning/special-services/504-plan/understanding-504-plans). A 504 plan is a blueprint for how the school will provide supports and remove barriers for a student with a disability, so the student has equal access to the general education curriculum. plan. Follow these steps to request a free school evaluation (https://www.understood.org/en/school-learning/evaluations/evaluation-basics/6-steps-for-requesting-a-school-evaluation):
  1. Find out where to send your request. Ask your child’s teacher who to address your request for an educational evaluation to. If he doesn’t know, ask the principal or your school’s special education director.
  2. Write a formal letter. Download a sample letter to give yourself a model to follow. Modify it based on your concerns and observations of your child.
  3. Be specific about why you’re requesting the evaluation. Write as much as you need to about your concerns. Don’t be afraid to say things like, “I’m requesting my child be evaluated to see if she has dyslexia.”
  4. Consent to your child being evaluated. Say explicitly in your letter that you are giving consent for your child to be evaluated. Request a “Consent to Evaluate” form to sign.
  5. Make sure the letter arrives. Hand-deliver it or send it via certified mail (“return receipt requested”). If you hand-deliver the letter, ask for a date-stamped, signed copy for your records.
  6. Follow up. After five days, if you haven’t heard anything, check in with the school. You can do this by phone, but send an email or letter to confirm the next steps that were agreed upon in that conversation. 
• See it through your child’s eye. Get a better sense of what your child is experiencing. The more you understand, the more you can help.
• Connect with other parents. Remember that you’re not alone. You can visit an online community (https://www.understood.org/en/community-events/parents-like-me) to find other parents who are dealing with the same issues.
• Get advice from experts. Use Parenting Coach (https://www.understood.org/en/tools/parenting-coach) to help navigate behavior and emotional issues that may come up along the way.

Difficulty with writing doesn’t need to hold your child back. Explore and experiment with different tools and strategies. Eventually, you’ll find ways to help your child succeed.

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.

Are there other learning disabilities besides dysgraphia?

Dysgraphia is one type of learning disability. Other learning disabilities besides dysgraphia include the following:

• Dyscalculia – a mathematical disability in which a person has unusual difficulty understanding math concepts and solving arithmetic problems and doing addition, multiplication, and measuring ⁵.
• Dyslexia. People with dyslexia have problems with reading words accurately and with ease (sometimes called “fluency”) and may have a hard time spelling, understanding sentences, and recognizing words they already know.
• Attention Deficit Disorder (ADD) and Attention Deficit Hyperactive Disorders (ADHD) can and do impact learning but they are not learning disabilities. An individual can have more than one learning or behavioral disability. In various studies as many as 50% of those diagnosed with a learning or reading disability have also been diagnosed with attention deficit hyperactivity disorder (ADHD). Although disabilities may co-occur, one is not the cause of the other.
• Apraxia of speech. This disorder involves problems with speaking. People with this disorder have trouble saying what they want to say. It is sometimes called verbal apraxia ⁶.
• 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.
• Central auditory processing disorder. People with this condition have trouble understanding and remembering language-related tasks. They have difficulty explaining things, understanding jokes, and following directions. They confuse words and are easily distracted ⁷.
• Nonverbal learning disorders. People with these conditions have strong verbal skills but difficulty understanding facial expression and body language. They are clumsy and have trouble generalizing and following multistep directions ⁸.

Because there are many different types of learning disabilities, and some people may have more than one, it is hard to estimate how many people might have learning disabilities.

What is the difference between dyspraxia and dysgraphia?

Dyspraxia and dysgraphia, both of these learning issues can affect fine motor skills and impact handwriting. But they’re two distinct conditions, even though they can co-occur in some kids. This chart can help you understand the areas where dyspraxia and dysgraphia overlap and where they differ.

	Dyspraxia	Dysgraphia
What is it?	An issue that can impact fine and gross motor skills. Trouble with fine motor skills in particular can affect handwriting. Dyspraxia also typically affects a person’s conception of how his body moves in space. Kids with dyspraxia can have other learning and attention issues, such as dysgraphia, dyscalculia and ADHD, but dyspraxia isn’t the cause for these.	An issue that impacts written language. It can affect both information and motor processing (which can impact handwriting). And it can cause trouble with many aspects of writing, usually because of language-based weaknesses. Kids with dysgraphia can have other learning issues. The two that co-occur most often with dysgraphia are dyslexia and dyspraxia.
Signs you may notice	Trouble riding a bike or throwing a ball A tendency to bump into and drop things Delayed development of right or left hand dominance Trouble grasping a pencil correctly Poor letter formation Slow and messy handwriting Trouble using buttons, snaps, zippers, utensils	Trouble organizing thoughts and putting them into writing Unreadable handwriting Slow, labored writing Odd spacing of words and letters Poor spelling and grammar Trouble with grasping a pencil correctly Poor punctuation skills Run-on sentences and lack of paragraph breaks
Possible emotional and social impact	Kids with dyspraxia may avoid games and sports that call attention to their physical awkwardness. They may also experience anxiety at a higher rate than other kids, for unknown reasons.	As can happen with any learning issue, kids with dysgraphia may feel frustrated or angry about their challenges. They can also have trouble with self-esteem.
What can help	Occupational therapy (OT) or physical therapy can strengthen gross and fine motor skills. OT can also help with balance and body awareness. Therapists can also work on breaking down physical tasks (such as brushing teeth) into smaller steps.	Graphic organizers can help kids organize their thoughts. A checklist can make it easier to review and edit written work. Assistive technology or word processing can make writing easier. OT can strengthen fine motor skills and support motor coordination.
Accommodations	Teaching physical skills in small parts before they’re taught to rest of class Repeating activities to help develop motor pathways, which can help kids get better at carrying out specific movements Multisensory instruction to help students remember the steps for motor actions Use of a keyboard for taking notes in class; use of a word processor in school Keyboarding instruction Extended time on tests and assignments that involve writing Permission to record class lectures Access to another student’s or the teacher’s notes Option to respond in alternative ways rather than writing Sentence starters to show how to begin a writing assignment Breaking writing assignments into steps Worksheets, notes and textbooks with larger print	Option to respond in alternative ways rather than writing Sentence starters to show how to begin a writing assignment Breaking writing assignments into steps Use of a keyboard for taking notes in class; use of a word processor in school Keyboarding instruction Extended time on tests and assignments that involve writing Permission to record class lectures Access to another student’s or the teacher’s notes
What you can do at home	Provide lots of opportunities for physical activity like running or swimming to develop gross motor skills, muscle strength, coordination and “muscle memory.” (You can even turn your living room into an obstacle course using pillows or wastebaskets to help with motor planning.) Have your child play with jigsaw puzzles to help with visual and spatial perception. Toss beanbags and balls to practice hand-eye coordination. Have your child work on keyboarding skills. Use speech-to-text tools to translate your child’s speech into writing. Provide many opportunities for practice and repetition.	Have your child work on keyboarding skills. Use speech-to-text tools to translate your child’s speech into writing. Use clay, shaving cream and other materials to practice forming letters at home. Have your child shake or rub his hands to relieve tension before writing or as a break while writing.

If your child has trouble with writing, a full evaluation can help to determine the exact cause.

Talk to your child’s teacher about what you’ve been seeing, and find out what’s been happening in the classroom. Together, you can come up with a plan to help your child improve his skills. That plan may include classroom accommodations for dyspraxia or dysgraphia.

Does dysgraphia occur alone or with other specific learning disabilities?

Children with impaired handwriting may also have attention-deficit disorder (ADHD)–inattentive, hyperactive, or combined inattentive and hyperactive subtypes. Children with this kind of dysgraphia may respond to a combination of explicit handwriting instruction plus stimulant medication, but appropriate diagnosis of ADHD by a qualified professional and monitoring of response to both instruction and medication are needed.

Dysgraphia may occur alone or with dyslexia (impaired reading disability) or with oral and written language learning disability (also referred to as selective language impairment).

Dyslexia is a disorder that includes poor word reading, word decoding, oral reading fluency, and spelling. Children with dyslexia may have impaired orthographic and phonological coding, rapid automatic naming and focused, switching, and/or sustained attention.

Oral and written language learning disability (selective language impairment) is impaired language (morphology–word parts that mark meaning and grammar; syntax–structures for ordering words and understanding word functions; finding words in memory, and/or making inferences that go beyond what is stated in text). These disorders affect spoken as well as written language. Children with these language disorders may also exhibit the same writing and reading and related disorders as children with dysgraphia or dyslexia.

Why is diagnosis of dysgraphia and related learning disabilities important?

Without diagnosis, children may not receive early intervention or specialized instruction in all the relevant skills that are interfering with their learning of written language. Considering that many schools do not have systematic instructional programs in handwriting and spelling, it is important to assess whether children need explicit, systematic instruction in handwriting and spelling in addition to word reading and decoding. Many schools offer accommodations in testing and teaching to students with dysgraphia, but these students also need ongoing, explicit instruction in handwriting, spelling, and composition. It is also important to determine if a child with dysgraphia may also have dyslexia and require special help with reading or oral and written language learning disability (selective language impairment) and need special help with oral as well as written language.

Dysgraphia and dyslexia

Dyslexia and dysgraphia are both learning issues. Dyslexia primarily affects reading. Dysgraphia mainly affects writing. While they’re different issues, the two are easy to confuse. They share symptoms and often occur together. If your child is struggling with reading or writing, it can be difficult to know exactly what the problem is. Talking to your child’s teacher about what she has observed is a good starting point. Together you can develop a plan. There are lots of ways to help kids with reading and writing issues succeed in school. This simple table can help you tell dyslexia and dysgraphia apart.

	Dysgraphia	Dyslexia
What is it?	An issue that involves difficulty with the physical act of writing. Kids may also find it hard to organize and express their thoughts and ideas in written form.	An issue that involves difficulty with reading. It can also affect writing, spelling and speaking. Kids may find it hard to isolate sounds, match sounds to letters or blend sounds into words.
Signs you may notice	Illegible handwriting Slow, labored writing Mixing print and cursive letters Spacing letters and words oddly Poor spelling and grammar Difficulty gripping a pencil Incorrect punctuation Run-on sentences and lack of paragraph breaks Trouble organizing information when writing	Struggling with reading Trouble sounding out words Difficulty memorizing sight words Avoiding reading aloud Poor spelling and grammar Not understanding what he’s read Confusing the order of letters Trouble following a sequence of directions Difficulty organizing thoughts when speaking
Possible emotional and social impact	Messy written work that’s full of mistakes may lead kids to hear they’re “lazy” or “sloppy.” Confusion or frustration at school can make them anxious. They may avoid taking risks and may have low self-esteem.	Not meeting expectations can make kids feel inadequate. Missing verbal jokes, sarcasm and subtle meaning in language can affect them socially. So can struggling to come up with the right word or timely answer to a question.
What can help	Occupational therapy to build fine motor skills and dexterity Having kids take a break before proofreading their work A checklist for editing their work—spelling, neatness, grammar, syntax, clear progression of ideas, etc. Using graphic organizers	Specific instruction on identifying sounds, understanding how letters represent sounds in speech and decoding words Specialized instruction, either one-on-one or in a small group A reading program that focuses on using all the senses to learn (a number of programs use a multisensory approach)
Accommodations	Extended time on tests that involve writing Access to the teacher’s lesson notes Sentence starters showing how to begin a written response Being able to respond in other ways besides writing Breaking writing assignments into steps The use of a word processor in school Instruction in keyboarding skills	Extra time for reading and writing Access to the teacher’s notes from the lesson to reduce the amount of note-taking Simplified directions Books on tape Shortened assignments
What you can do at home	Work on keyboarding skills. Use speech-to-text tools that allow your child’s speech to be translated to text. Try a handwriting program such as Handwriting Without Tears. Work on correct letter formation using techniques that don’t require writing, like finger writing in the air or in shaving cream.	Read aloud so your child hears stories above his reading level. Encourage your child to listen to audiobooks. Help your child use spell-check programs designed for people with dyslexia. Use speech-to-text tools. For younger kids, recite nursery rhymes and sing memory songs.

Dyslexia is a specific learning disability in reading words accurately and with ease (sometimes called “fluency”) and may have a hard time spelling, understanding sentences, and recognizing words they already know ⁹. Kids with dyslexia have trouble reading accurately and fluently. They may also have trouble with reading comprehension, spelling and writing.

While dyslexia can make reading more difficult, with the right instruction, almost all individuals with dyslexia can learn to read. Many people with dyslexia have gone on to accomplish great things. Among the many dyslexia success stories are Thomas Edison, Stephen Spielberg, F. Scott Fitzgerald and Charles Schwab.

Dyslexia is a neurological condition caused by a different wiring of the brain. There is no cure for dyslexia and individuals with this condition must learn coping strategies. Research indicates that dyslexia has no relationship to intelligence. Individuals with dyslexia are neither more nor less intelligent than the general population. But some say the way individuals with dyslexia think can actually be an asset in achieving success.

In public school settings where many teachers are not knowledgeable about this condition, students with dyslexia may be considered stupid or lazy. Parents who have children diagnosed with dyslexia should seek out reading instruction that is based upon a systematic and explicit understanding of language structure, including phonics. This reading instruction goes by many names, Structured Literacy, Orton- Gillingham, Simultaneous Multisensory, Explicit Phonics, and others. If you think you or your child may be dyslexic, you can take International Dyslexia Association’s test which will evaluate the chance that you have this condition. To take the International Dyslexia Association’s Dyslexia Test please click here (https://dyslexiaida.org/dyslexia-test/).

For additional Ages Specific Dyslexia Tests

• Dyslexia Screener for Preschoolers: https://dyslexiaida.org/screening-for-dyslexia/dyslexia-screener-for-preschoolers
• Dyslexia Screener for School-Age Children: https://dyslexiaida.org/screening-for-dyslexia/dyslexia-screener-for-school-age-children
• Dyslexia Screener for Adults: https://dyslexiaida.org/screening-for-dyslexia/dyslexia-screener-for-adults

Dyslexia signs and symptoms

Dyslexia impacts people in varying degrees, so symptoms may differ from one child to another. Generally, symptoms show up as problems with accuracy and fluency in reading and spelling. But in some kids, dyslexia can impact writing, math and language, too.

A key sign of dyslexia in kids is trouble decoding words. This is the ability to match letters to sounds and then use that skill to read words accurately and fluently.

One reason kids have difficulty decoding is that they often struggle with a more basic language skill called phonemic awareness. This is the ability to recognize individual sounds in words. Trouble with this skill can show up as early as preschool.

In some kids, dyslexia isn’t picked up until later on, when they have trouble with more complex skills. These may include grammar, reading comprehension, reading fluency, sentence structure and more in-depth writing.

One potential sign of dyslexia is when kids avoid reading, both out loud and to themselves. Kids may even get anxious or frustrated when reading. This can happen even after they’ve mastered the basics of reading.

Signs of dyslexia can look different at different ages. Here are some examples of signs of dyslexia:

• Preschool
  • Has trouble recognizing whether two words rhyme
  • Struggles with taking away the beginning sound from a word
  • Struggles with learning new words
  • Has trouble recognizing letters and matching them to sounds
• Grade School
  • Has trouble taking away the middle sound from a word or blending several sounds to make a word
  • Often can’t recognize common sight words
  • Quickly forgets how to spell many of the words she studies
  • Gets tripped up by word problems in math
• Middle School
  • Makes many spelling errors
  • Frequently has to re-read sentences and passages
  • Reads at a lower academic level than how she speaks
• High School
  • Often skips over small words when reading aloud
  • Doesn’t read at the expected grade level
  • Strongly prefers multiple-choice questions over fill-in-the-blank or short answer.

Dyslexia doesn’t just affect learning. It can impact everyday skills and activities, as well. These include social interaction, memory and dealing with stress.

Causes of dysgraphia

Dysgraphia is a type of learning disability and it is as common as other learning disorders. 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.” Orthographic coding refers to the ability to store unfamiliar written words in the working memory while the letters in the word are analyzed or the ability to create permanent memory of written words linked to their pronunciation and meaning. As a result, he/she may have a hard time remembering how to print or write a letter or a word. Research to date has shown orthographic coding in working memory is related to handwriting and is often impaired in dysgraphia.

Children with dysgraphia do not have primary developmental motor disorder, another cause of poor handwriting, but may have difficulty planning sequential finger movements such as the touching of the thumb to successive fingers on the same hand without visual feedback. Children with dysgraphia may have difficulty with both orthographic coding and planning sequential finger movements.

There may also be a genetic link, with dysgraphia running in families.

A child can have dysgraphia only or along with other learning disabilities, such as:

• Developmental coordination disorder (includes poor handwriting)
• Expressive language disorder
• Reading disorder
• Attention deficit hyperactivity disorder (ADHD)

Different groups may define “learning disability” differently, often depending on the focus of the organization. You can read more at the U.S. Department of Education (https://sites.ed.gov/idea/parents-families/), which provides statutes, regulations, and policies on the Individuals with Disabilities Education Act; the Learning Disabilities Association of America (https://ldaamerica.org/support/new-to-ld/); and https://www.understood.org/en, which is maintained by the National Center for Learning Disabilities.

Dysgraphia signs and symptoms

Warning signs of dysgraphia

Just having bad handwriting doesn’t mean a person has dysgraphia. Since dysgraphia is a brain processing disorder, difficulties can change throughout a lifetime. However since writing is a developmental process – children learn the motor skills needed to write, while learning the thinking skills needed to communicate on paper – difficulties can also overlap.

If a person has trouble in any of the areas below, additional help may be beneficial:

• Tight, awkward pencil grip and body position
• Illegible handwriting
• Avoiding writing or drawing tasks
• Tiring quickly while writing
• Saying words out loud while writing
• Unfinished or omitted words in sentences
• Difficulty organizing thoughts on paper
• Difficulty with syntax structure and grammar
• Large gap between written ideas and understanding demonstrated through speech.

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 ¹⁰.

Symptoms of dysgraphia

• May have illegible printing and cursive writing (despite appropriate time and attention given the task)
• Shows inconsistencies: mixtures of print and cursive, upper and lower case, or irregular sizes, shapes or slant of letters
• Has unfinished words or letters, omitted words
• Inconsistent spacing between words and letters
• Exhibits strange wrist, body or paper position
• Has difficulty pre-visualizing letter formation
• Copying or writing is slow or labored
• Shows poor spatial planning on paper
• Has cramped or unusual grip/may complain of sore hand
• Has great difficulty thinking and writing at the same time (taking notes, creative writing.)

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:

Visual-Spatial Difficulties

• 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 margins
• Has 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.

How can you tell if your child has dysgraphia?

The child will probably be much better able to communicate ideas through speech rather than through writing. Other signs may include:

• An awkward pencil grip
• Unusual position of the wrist, body, or paper
• Quickly becoming tired from writing and/or complaining of discomfort
• Poorly formed and inconsistently formed letters
• Copying or writing that is slow or labored • Avoiding writing or drawing tasks
• Saying words out loud while writing or carefully watching the hand that is writing
• Failing to finish words or omitting words from sentences
• Difficulty following spelling and grammar rules
• Poor spatial planning on paper, with uneven spaces between letters or words, difficulty keeping writing on the line, or difficulty maintaining left and right margins
• Orienting letters incorrectly
• Difficulty organizing thoughts on paper
• Inability or difficulty performing tasks that require thinking and writing at the same time, such as taking notes.

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.

Dysgraphia diagnosis

Dysgraphia cannot be diagnosed solely by looking at a handwriting sample. A qualified clinician must directly test the individual. 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.

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.

Special education teachers and school psychologists can help determine the emotional or academic impact the condition may be having on your child.

Dysgraphia test

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 ¹¹.

Such a test includes writing self-generated sentences and paragraphs and copying age-appropriate text. The examiner assesses not only the finished product, but also the process, including posture, position, pencil grip, fatigue, cramping, or tremor of the writing hand, eyed-ness and handedness, and other factors. The examiner may assess fine-motor speed with finger tapping and wrist turning.

Dysgraphia treatment

There are many ways to help a person with dysgraphia achieve success. Generally strategies fall into three categories:

1. Accommodations: providing alternatives to written expression. Accommodations are changes to how your child is learning. 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.
2. Modifications: changing expectations or tasks to minimize or avoid the area of weakness. Modifications are changes to what your child is learning. Examples of modifications include allowing a student to write shorter papers or answer fewer or different test questions than his classmates.
3. Remediation: providing instruction for improving handwriting and writing skills. 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.

	Accommodations	Modifications
Classroom instruction	Accommodations can help kids learn the same material and meet the same expectations as their classmates. If a student has reading issues, for example, she might listen to an audio recording of a text. There are different types of classroom accommodations, including presentation (like listening to an audio recording of a text) and setting (like where a student sits).	Kids who are far behind their peers may need changes, or modifications, to the curriculum. For example, a student could be assigned shorter or easier reading assignments. Kids who receive modifications are not expected to learn the same material as their classmates.
Classroom tests	Testing accommodations can be different from those used for instruction. For example, using a spell-checker might help a student with writing difficulties take notes during class but wouldn’t be appropriate during a weekly spelling test. However, this student might benefit from having extra time to complete the spelling test or using typing technology if the physical act of writing is difficult.	Modifications in testing often involve requiring a student to cover less material or material that is less complex. For example, in the case of the spelling test, if the class was given 20 words to study, the student with modifications might only have to study 10 of them. Or she might have a completely different list of words. With the modification, what the student is tested on is different.
Standardized testing	Statewide assessments allow certain accommodations like extra time or taking a computerized exam. Ideally these are the same accommodations a child uses to take class tests.	Some students take an “alternate assessment” of their statewide test, which includes modifications to the regular test. The questions in this type of alternate assessment might not cover the same materials as the standard exams. Also, the results would be interpreted differently. Before you agree to an alternate assessment, find out how the results will be interpreted and what (if any) implications there will be for your child.
Gym, music and art class	Accommodations for “special” classes like gym, music and art can be helpful. These are similar to accommodations for classroom instruction. Kids might get extra time to complete assignments or be allowed to complete them in a different format.	If the school believes that an assignment within a class like gym, music or art is unreasonable for your child, modifications to that assignment are made. The gym teacher might modify the number of laps a student needs to run; the music teacher might not require a child to participate in the final performance. In some cases, students are even excused from certain classes in order to make time for one-on-one time with a specialist.

Each type of strategy should be considered when planning instruction and support. A person with dysgraphia will benefit from help from both specialists and those who are closest to the person. Finding the most beneficial type of support is a process of trying different ideas and openly exchanging thoughts on what works best.

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 Individualized Education Program (IEP), another option is to request a 504 plan. A 504 plan is a blueprint for how the school will provide supports and remove barriers for a student with a disability, so the student has equal access to the general education curriculum.

But even without an Individualized Education Program (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.

Accommodation Strategies

• Suggest use of word processor
• Avoid chastising student for sloppy, careless work
• Use oral exams
• Allow use of tape recorder for lectures
• Allow the use of a note taker
• Provide notes or outlines to reduce the amount of writing required
• Reduce copying aspects of work (pre-printed math problems)
• Allow use of wide rule paper and graph paper
• Suggest use of pencil grips and /or specially designed writing aids
• Provide alternatives to written assignments (video-taped reports, audio-taped reports)

Instructional activities for improving the handwriting of children with dysgraphia

Initially, children with impaired handwriting benefit from activities that support learning to form letters:

• playing with clay to strengthen hand muscles;
• keeping lines within mazes to develop motor control;
• connecting dots or dashes to create complete letter forms;
• tracing letters with index finger or eraser end of pencil;
• imitating the teacher modeling sequential strokes in letter formation; and
• copying letters from models.

Subsequently, once children learn to form legible letters, they benefit from instruction that helps them develop automatic letter writing, using the following steps to practice each of the 26 letters of the alphabet in a different order daily:

• studying numbered arrow cues that provide a consistent plan for letter formation
• covering the letter with a 3 x 5 card and imaging the letter in the mind’s eye
• writing the letter from memory after interval that increases in duration over the handwriting lessons
• writing letters from dictation (spoken name to letter form).

In addition, to developing handwriting speed, they benefit from writing letters during composing daily for 5 to 10 minutes on a teacher-provided topic.

Students benefit from explicit instruction in spelling throughout K-12:

• initially in high frequency Anglo-Saxon words;
• subsequently in coordinating the phonological, orthographic, and morphological processes relevant for the spelling of longer, more complex, less frequent words; and
• at all grade levels in the most common and important words used for the different academic domains of the curriculum.

Throughout K -12, students benefit from strategies for composing:

• planning, generating, reviewing/evaluating, and revising
• compositions of different genre including narrative, informational, compare and contrast, and persuasive
• self-regulation strategies for managing the complex executive functions involved in composing.

Instructional strategies for improving spelling of children with dysgraphia

If children have both handwriting and spelling problems, the kinds of handwriting instruction described earlier should be included along with the spelling instruction.

Are educators in public schools identifying children with dysgraphia and providing appropriate instruction in public schools?

In general, no. Although federal law specifies written expression as one of the areas in which students with learning disabilities may be affected, it does not clearly identify the transcription problems that are the causal factors in dysgraphia–impaired handwriting and/or spelling–for impaired written expression of ideas. Some of the tests used to assess written expression are not scored for handwriting or spelling problems and mask the nature of the disability in dysgraphia. Content or ideas may not be impaired. All too often, the poor writing or failure to complete writing assignments in a timely fashion or at all is misattributed to lack of motivation, laziness, or other issues unrelated to the real culprit–dysgraphia. Children who are twice exceptional–gifted and dysgraphic–are especially under-diagnosed and underserved. Teachers mistakenly assume that if a student is bright and cannot write it is because the student is not trying.

1. Dysgraphia Information Page. https://www.ninds.nih.gov/Disorders/All-Disorders/Dysgraphia-Information-Page[↩]
2. About Learning Disabilities. https://www.nichd.nih.gov/health/topics/learning/conditioninfo[↩]
3. LD Basics. What is a learning disability? http://www.ldonline.org/ldbasics/whatisld%C2%A0[↩][↩][↩]
4. Learning Disabilities Information Page. https://www.ninds.nih.gov/Disorders/All-Disorders/Learning-Disabilities-Information-Page[↩]
5. Understanding Dyscalculia. https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/dyscalculia/understanding-dyscalculia[↩]
6. Apraxia of Speech. https://www.nidcd.nih.gov/health/apraxia-speech[↩]
7. Auditory Processing Disorder. https://ldaamerica.org/types-of-learning-disabilities/auditory-processing-disorder/[↩]
8. Non-Verbal Learning Disabilities. https://ldaamerica.org/types-of-learning-disabilities/non-verbal-learning-disabilities/[↩]
9. Dyslexia At a Glance. https://dyslexiaida.org/dyslexia-at-a-glance/[↩]
10. Von Dresner, Kara Sandor. “Criteria and Assessment of Dyslexia and Dysgraphia.” Cba-va.org. Chesapeake Bay Academy.[↩]
11. Dysgraphia Info. http://www.brainhe.com/staff/types/dysgraphiastaff.html[↩]