(part of a series on Specific Learning Disability types)
This post will explore the basics of Dysgraphia, also known in some contexts as Writing Disability. I'll cover some basic descriptions of the condition, its roots and treatment, and an example of a (fictional but based in reality) child with Dysgraphia and how he was treated.
Definitions and Root Causes
The Diagnostic Statistical Manual Fifth edition, which is used by psychologists and other mental health professionals worldwide, defines these as the core criteria for Dysgraphia
“Difficulties with spelling” or “written expression” in the domains of grammar, punctuation, organization etc.
Being “substantially and quantifiably” below expectations based on age.
These difficulties may go undetected until the students abilities are overtaxed by new academic demands.
The difficulties aren’t better explained by other variables (eg, vision acuity, lack of language proficiency, inadequate teaching etc)
These symptoms may be related to a number of different underlying problems - possibly psychomotor coordination issues, possibly related to dyslexia (which in turn as described above often entails phonological awareness deficits), or in the case of students who struggle only with punctuation and organization, working memory and inhibitory skills. One confounding element is that any of these may cause the student to avoid writing, leading to other writing domain issues (eg, painful handwriting resulting in difficulty in spelling and organization).
Determining which of these (or which set of them) is an important first step. If a student’s primary difficult is psychomotor dysfunction then they need to be referred to an occupational therapist, along with academic interventions to help alleviate the surface symptoms if they’ve developed.
If a student struggles only minimally with handwriting but finds spelling difficult would probably benefit from focused direct instruction in spelling - practice with phonemic awareness as described in the section on dyslexia, and also spelling specific strategies like CCC (Cover, Copy, Compare). On the other hand, if organization and editing are the primary difficulties, as is often the case with late elementary and junior high students, the Self Regulated Strategy Development has been shown to be effective for learning disabled and neurotypical students.
What it looks like
A student with dysgraphia may have messy illegible handwriting, hold pencils or crayons very tightly to the point where it’s clearly painful, and/or may exhibit difficulties with other fine motor skills like using buttons or zippers. They may drop letters or endings for words, or over-rely on simple phonetic rules, or avoid writing because they’re worried about using misspelled words.
Tests of handwriting fluency can reveal dysgraphia, as can simple spelling tests. The TOWL4 is primarily used to assess higher order thematic writing skills, while basic motor skills such as the pegboard test may be used to check for psychomotor dysfunction.
Working with Amadi
Amadi is a 10 year old who struggles with spelling. He was referred to me by his teacher, who has concerns that his verbal abilities aren’t reflected in his writing. He is a gifted artist, skilled with pencils and crayons, which suggests to me his difficulties don’t stem from fine motor dysfunction. He is also fairly capable of copying words accurately if slowly, needing to look up every letter or two. But when asked to spell an unfamiliar word or phonetic nonsense word, his answers bear little resemblance to the correct answers (eg “derg” for “drag”).
My recommendation for this student is direct instruction addressing any phonological awareness deficits, as I would with a student with dyslexia. This will hopefully give him a better grasp of the orthographic rules underlying English spelling, as well as a better ability to decompose spoken words into phonemes. The other half of the instruction would use the CCC method to build his visual memory encoding.
I’d also recommend that they pursue dictated answers as an accommodation - if he is being assessed on something other than spelling, but the spelling is preventing him, the assessment isn’t doing its job. If he prefers typing answers, that should be an accommodation as well.