Dysgraphia
Introduction[edit | edit source]
Dysgraphia is a developmental disorder referring to the impairment of the acquisition of writing skills. It manifests itself in various aspects of writing, including spelling, handwriting (legibility), spacing between letters, and expression. Dysgraphia is not a reflection of a child's intellectual capabilities and is one of the more common learning disorders. Despite the prevalence of this disorder, it is under-researched and under-diagnosed. It has a high co-morbidity rate with other learning disorders.[1]
Definition[edit | edit source]
Developmental dysgraphia is a disorder of writing ability at any stage. Writing ability includes not just components of spelling, but includes grammar, letter spacing, difficulty holding a pencil/poor grip, writing fatigue, poor punctuation, inconsistent sentence structure, and difficulty with writing out concepts.[2]
There are two subtypes of dysgraphia:
- motor dysgraphia: this refers to the difficulty with the actual process of holding a pencil and the production of written text. People with the motor component may fatigue due to lack of motor strength or coordination.[3]
- dysorthography or dyslexic dysgraphia: this subtype focuses on the language processing aspect of dysgraphia. Word spelling is highly deficient, usually as a direct result of dyslexia.[4]
Prevalence[edit | edit source]
It is estimated that between 10% to 30% of children have difficulty with writing.[5] The exact prevalence of dysgraphia depends on which definition (motor or dysorthography) is used. It is more common in boys than girls.[6] Students are usually screened and referred for occupational therapy services in schools to address any writing deficits.
Co-morbidities[edit | edit source]
Dysgraphia can occur alone but is more commonly found as a co-morbidity with other learning disorders such as dyslexia, ADHD, developmental coordination disorder, and autism. It is estimated that 30% to 47% of children that demonstrate problems with writing will demonstrate problems with reading. [1]
Etiology[edit | edit source]
The current research about developmental dysgraphia is formulated from research done on patients diagnosed with acquired dysgraphia, or the inability to produce written language due to neurological damage (e.g., post-CVA). Since writing is a multi-component function of the brain that involves working memory, organization, and comprehension, and motor planning, people with dysgraphia can have a deficit in one of more of these brain functions.
Current research attempts to determine how the cerebellum plays a role. Another area of research determining if genetics accounts for difficulties with writing and spelling. MRI studies on family members with similar learning disabilities suggest possible genetic components to writing difficulties.[7]
Characteristics/Clinical Presentation[edit | edit source]
Because handwriting, spelling, and reading are developing during the primary years, dysgraphia is not easily discerned by educators or parents. Signs and symptoms can vary, but generally include the following[1]:
- awkward grip/body position when writing
- tire quickly when writing
- avoidance of writing and drawing tasks
- inconsistency with written letters: inconsistent spacing between letters, reversing letters, or inversing (rotating) letters
- cannot stay in the margins
- illegible handwriting
- writing a mixture of cursive and print
- difficulty with word finding, sentence completion, and comprehension
- young adults: difficulty with written organization of thought and written syntax and grammar
Medical Management[edit | edit source]
If dysgraphia is suspected, it is usually screened in a school setting by a child study team. If a formal diagnosis is warranted, a student is referred for an evaluation outside of the school system. In the United States, dysgraphia is not listed as a separate disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, but it is included under the specific learning disorder category.[1]
Multiple
Physiotherapy Intervention[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 Chung PJ, Patel DR, Nizami I. Disorder of written expression and dysgraphia: definition, diagnosis, and management. Translational pediatrics. 2020 Feb;9(Suppl 1):S46.
- ↑ McCloskey M, Rapp B. Developmental dysgraphia: An overview and framework for research. Developmental Dysgraphia. 2019 Dec 13:1-8.
- ↑ Tseng MH, Chow SM. Perceptual-motor function of school-age children with slow handwriting speed. The American Journal of Occupational Therapy. 2000 Jan 1;54(1):83-8.
- ↑ Berninger VW, Wolf BJ. Dyslexia, dysgraphia, OWL LD, and dyscalculia. Baltimore, MD: Paul H. Brookes Publishing Co; 2016.
- ↑ Kushki A, Schwellnus H, Ilyas F, Chau T. Changes in kinetics and kinematics of handwriting during a prolonged writing task in children with and without dysgraphia. Research in developmental disabilities. 2011 May 1;32(3):1058-64.
- ↑ Berninger VW, O'Malley May M. Evidence-based diagnosis and treatment for specific learning disabilities involving impairments in written and/or oral language. Journal of Learning Disabilities. 2011 Mar;44(2):167-83.
- ↑ Rosenblum S, Livneh-Zirinski M. Handwriting process and product characteristics of children diagnosed with developmental coordination disorder. Human movement science. 2008 Apr 1;27(2):200-14.
