By Susan E. Miller, Director of the Robinowitz Education Center
Introduction
In a world where words are our primary means of communication, struggling with writing is a monumental challenge for 8-10% of the population. This struggle stems from a lesser-known learning disability called Dysgraphia. Here at the Robinowitz Education Center, we have found through our work with hundreds of families and educators throughout New Jersey, that the focus is often on identifying Dyslexia, a specific learning disability impacting word reading accuracy and fluency. An individual’s struggles to spell and/or compose a complete sentence, maintain stability in their chair and hold a pencil is either dismissed as “not important,” or ignored due to ignorance of this specific learning disability.
Affecting up to 10% of children, Dysgraphia often goes undiagnosed, leaving many individuals to grapple with its symptoms without understanding the root cause. The DSM-5 manual does not even identify Dysgraphia as a distinct disorder; it falls under the category of specific learning disorder. Another fact that impedes its identification in school is Dysgraphia’s absence in many higher education programs that prepare individuals to become educational diagnosticians.
“I’m not into writing” and “I hate writing,” are two of the most frequent quotes from clients when they come to us for evaluation. This blog post aims to shed light on Dysgraphia, offering strategies to identify, intervene and accommodate this “more common than you think” disability.
Understanding Dysgraphia
Before identifying the characteristics, assessments, and strategies to support individuals with Dysgraphia, it’s crucial to define it. Dysgraphia is a neurological disorder characterized by writing difficulties. The word consists of “dys” meaning difficult, and “graph,” meaning to write. It affects handwriting, spelling, and organizing written thoughts. While it frequently co-exists with other learning disabilities, it stands unique in its negative impact on written expression. Dysgraphia is not just reversing letters like b and d.
Did you know that medical testing is not required to identify Dysgraphia? From our experience here at the Robinowitz Education Center, Dysgraphia frequently co-exists with ADHD, Autism Spectrum Disorder, Developmental Language Disorder, and/or Dyslexia. Assessing and addressing Dysgraphia involves deep knowledge and experience with language, orthography, and letter formation. There is no one program that remediates Dysgraphia, nor one person that can identify Dysgraphia.
Statistics and Impact
According to the National Center for Learning Disabilities, Dysgraphia affects approximately 4-20% of the population, depending on the diagnostic criteria used. It can lead to academic challenges, reduced self-esteem, and social withdrawal if not identified and appropriately addressed by skilled therapists. We hear from many families and educators that requests to use the bathroom or go to the nurse increase among individuals that present with the characteristics of Dysgraphia!
Strategy 1: Observe Handwriting
Explanation
One of the most direct ways to identify Dysgraphia is through careful observation of an individual’s handwriting, pencil grip, posture while seated and while writing. Look for inconsistencies like poor spacing, difficulty forming letters, or both feet not grounded/touching the floor resulting in unstable posture.
Practical Tips
- Collect several writing samples over a period of time.
- Compare the samples to see if there’s any consistent struggle – are there certain letters and/or numbers that require intervention.
- Engage a professional, such as an occupational therapist, to analyze these samples.
Strategy 2: Evaluate Fine Motor Skills
Explanation
Dysgraphia is often linked to poor fine motor skills. Testing these skills can help identify the disorder.
Practical Tips, Tests and Resources
- Conduct simple tests like asking the individual to button a shirt or use scissors.
- Engage in activities like clay modeling to observe hand-eye coordination.
- Use tests like the Beery Visual Motor Test of Integration and the Feifer Assessment of Writing include measures that tap into a child’s underlying visual/motor skills.
- Check out one of our favorite resources is the OT Toolbox where you will find many ideas to support students who are found to have difficulties with visual-motor integration.
Strategy 3: Evaluate Oral and Written Expression
Explanation
Individuals with Dysgraphia often find it easier to express their thoughts orally than in writing. Do you know of a student whose oral language skills are superior, but their written output is not??
Practical Tips
There is no “I” in team – engage the expertise of a Speech/Language therapist to contribute to the identification of Dysgraphia. There are many assessments to choose from to measure oral and written expression such as the Peabody Picture Vocabulary Test-4th Edition, the Test of Integrated Language and Literacy Skills, Feifer Assessment of Writing, and the new subtests in the Woodcock-Johnson Tests of Achievement/Cognitive batteries.
Real-World Example
Woodcock-Johnson IV Tests of Oral Language – Above Average ability in Expressive Language versus Woodcock-Johnson IV Tests of Achievement – Below Average in Written Expression; Poor range for Sentence Writing Fluency.
Strategy 4: Implement Structured Writing Programs
Explanation
Structured Literacy programs help individuals organize their thoughts and improve writing skills, including providing explicit letter formation and developing handwriting fluency. Did you know that when individuals write in cursive, there are less letter reversals? For the individual that struggles with visual-motor integration and processing weaknesses, cursive handwriting reduces the need to constantly pick up the pencil and reorient it on the paper since the production is one fluid movement.
Real-World Example
Have you ever heard of Simultaneous Oral Spelling, or SOS, for short? Here is an example, “spell the word jump, and remember to tell your hand what to write.” The individual then picks up their pencil, and while writing in cursive, they orally name the letters of the word jump.
Strategy 5: Utilize Assistive Technology
Explanation
For those open to using digital tools, assistive technology can make writing less daunting and allow the student’s voice to shine through to their readers! Assistive technology is especially important beginning in mid-elementary school given the increasing amount of writing required throughout the curriculum, including math.
Practical Tips
- Encourage the use of speech-to-text software.
- Explore apps designed to support spelling and grammar.
Strategy 6: Specialized Tutoring
Explanation
Specialized intervention delivered by an experienced instructor can address specific difficulties associated with Dysgraphia.
Practical Tips
- Choose tutors with experience in learning disabilities, preferably a Dyslexia Practitioner/Therapist since their training requires them to learn how to teach letter formation, including cursive, in a multimodal manner.
- Focus on personalized goals and progress monitoring.
- Connect with the individual’s teacher(s) and/or therapist to ensure that everyone is using the same instructional language.
Real-World Example
The Robinowitz Education Center offers workshops for parents and educators, to deepen knowledge about the reading-writing connection, fostering collaboration, and deepening understanding the identification and remediation of Dysgraphia. The center has a team of tutors that have specialized training to address the needs of individuals with Dysgraphia.
Conclusion
Dysgraphia is real, many individuals in our schools have it, and with appropriate, and timely assessment, paired with the implementation of research-informed strategies, Dysgraphia can be managed effectively. One of the biggest hurdles right now is establishing awareness and understanding of this common, but undiagnosed learning disability. It’s complex, we get it, so it’s critically important to engage the right team to identify it. By recognizing the signs like poor pencil grip and/or difficulty in recalling the sequence of letters when spelling, conducting appropriate assessments, and implementing supportive measures, we can empower individuals, regardless of age, to confidently express themselves in writing.
Questions?
Need Professional Learning to dive deeper into Dysgraphia? https://robinowitzcenter.org/
Email smiller@robinowitzcenter.org