DYSGRAPHIA (PROBLEMS
WITH WRITING)
Dysgraphia is a difficulty writing coherently,
if at all, regardless of ability to read. People with dysgraphia
often can write, and may have a higher than average IQ, but lack
co-ordination, and may find other fine motor tasks such as tying
shoes difficult, although it often does not affect all fine motor
skills. They can also lack basic spelling skills (having difficulties
with p,q,b,d), and often will write the wrong word when trying to
formulate thoughts (on paper).
In children, the disorder generally emerges when they are first
introduced to writing. They make inappropriately sized and spaced
letters, or write wrong or misspelled words despite thorough instruction.
Children with the disorder may have other learning disabilities;
however, they usually have no social or other academic problems.
Cases of dysgraphia in adults generally occur after some neurological
trauma or it might be diagnosed in a person with autism, Asperger’s
Syndrome, Tourette
syndrome or ADHD.
The DSM IV identifies dysgraphia as a “Disorder of Written Expression”
as “writing skills (that) ...are substantially below those expected
given the person’s ...age, measured intelligence, and age-appropriate
education”.
Types of dysgraphia
Dyslexic dysgraphia
With dyslexic dysgraphia, spontaneously written
work is illegible, copied work is fairly good, and spelling is bad.
Finger tapping speed (a method for identifying fine motor problems)
is normal, indicating the deficit does not likely stem from cerebellar
damage. A Dyslexic Dysgraphic does not necessarily have dyslexia
(dyslexia and dysgraphia appear to be unrelated).
Motor dysgraphia
Dysgraphia is due to deficient fine motor skills,
poor dexterity, poor muscle tone, and/or unspecified motor clumsiness.
Generally, written work is poor to illegible, even if copied by
sight from another document. Letter formation may be acceptable
in very short samples of writing, but this requires extreme effort
and an unreasonable amount of time to accomplish, and cannot be
sustained for a significant length of time. Spelling skills are
not impaired. Finger tapping speed results are below normal.
Spatial dysgraphia
Dysgraphia due to a defect in the understanding
of space has illegible spontaneously written work, illegible copied
work, normal spelling, but normal tapping speed.
Some children may have a combination of any two or all three of
these. Symptoms in actuality may vary in presentation from what
is listed here.
Symptoms of dysgraphia
A mixture of upper/lower case letters, irregular
letter sizes and shapes, unfinished letters, struggle to use writing
as a communications tool, odd writing grip, many spelling mistakes
(sometimes), pain when writing, decreased or increased speed of
writing and copying, talks to self while writing, and general illegibility.
Reluctance or refusal to complete writing tasks.
Many people who are dysgraphic will experience pain while writing.
The pain usually starts in the center of the forearm and then spreads
along the nervous system to the entire body. This pain can get worse
or even appear when a dysgraphic is stressed. Few people who do
not have dysgraphia know about this, because many with dysgraphia
will not mention it to anyone. This may be because they think pain
in normal when writing, or that people won’t believe them.
Treatment of dysgraphia
Treatment for dysgraphia varies and may include
treatment for motor disorders to help control writing movements.
Other treatments may address impaired memory or other neurological
problems. Some physicians recommend that individuals with dysgraphia
use computers to avoid the problems of handwriting.
Occupational therapy should be considered to correct an inefficient
pencil grasp, strengthen muscle tone, improve dexterity, and evaluate
eye-hand coordination. Dysgraphic children should also be evaluated
for ambidexterity, which can delay fine motor skills in early childhood.
Vision therapy
People who struggle with symptoms of dysgraphia
usually benefit from vision therapy. Seventy percent of what a child
learns in school is processed through the visual system. Even a
minor visual processing problem will interfere with a child or adult
performing to their potential and could cause symptoms of dysgraphia.
Symptoms of vision problems include:
• Avoidance of near work
• Frequent loss of place
• Omission, insertion, or rereading of letters and words
• Confusion with similar looking words
• Failure to recognize the same word in the next sentence.
Any struggling student should have a complete evaluation by a behavioral
optometrist. Testing should be done at distance and nearpoint to
assure that both eyes are working together as a team. Vision is
more than clarity, and is a complex combination of learned skills,
including tracking, fixation, focus change, binocular fusion and
visualization. When all of these are well developed, children and
adults can sustain attention, read and write without careless errors,
give meaning to what they hear and see, and rely less on movement
to stay alert.
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