Dysgraphia

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Dysgraphia
Classification and external resources ICD-10 ICD-9 MeSH F81.1, R48.8 315.2, 784.61, 784.69 D000381

Dysgraphia is a deficiency in the ability to write,[1] primarily in terms of handwriting, [2] but perhaps also in terms of coherence.[3] It occurs regardless of the ability to read and is not due to intellectual impairment.[citation needed] Acquired dysgraphia is known as agraphia.[4] People with dysgraphia usually can write on some level, and often lack other fine motor skills and may be cross dominant, finding tasks such as tying shoes difficult. It often does not affect all fine motor skills. They can also lack basic grammar and spelling skills (for example, having difficulties with the letters p, q, b, and d), and often will write the wrong word when trying to formulate thoughts (on paper). In childhood, the disorder generally emerges when the child is first introduced to writing. The child may make inappropriately sized and spaced letters, or write wrong or misspelled words despite thorough instruction. Children with the disorder may have other learning disabilities, but they usually have no social or other academic problems. Cases of dysgraphia in adults generally occur after some neurological trauma. Dysgraphia may also be diagnosed in a person with Tourette syndrome, ADHD, learning disability or an autism spectrum disorder such as Asperger syndrome. 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 ageappropriate education." Dysgraphia is known as one of the most common learning disabilities with a prevalence between 4% and 10%. The higher the prevalence, the more chance there is that it overlaps with other learning disabilities such as speech impairment, attention deficit, or developmental coordination disorder. [5]

Contents
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1 Types of dysgraphia o 1.1 Dyslexic dysgraphia o 1.2 Motor dysgraphia o 1.3 Spatial dysgraphia 2 Symptoms of dysgraphia 3 Common problems that are often associated with dysgraphia

o 3.1 Stress 4 Treatment 5 See also 6 References o 6.1 Notes o 6.2 General references 7 External links

[edit] Types of dysgraphia

Three principal subtypes of dysgraphia are recognized. Some children may have a combination of two or all three of these, and individual symptoms may vary in presentation from what is described here.

[edit] 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 but are often found together.)[citation needed]

[edit] Motor dysgraphia

Example of motor dysgraphia in a 30-year-old female. Motor dysgraphia is due to deficient fine motor skills, poor dexterity, poor muscle tone, or unspecified motor clumsiness. Motor dysgraphia may be part of the larger problem of motor apraxia. 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. Writing long passages is extremely painful and cannot be sustained. Letter shape and size becomes increasingly inconsistent and illegible. Writing is often slanted due to holding a pen or pencil incorrectly. Spelling skills are not impaired. Finger tapping speed results are below normal.

[edit] Spatial dysgraphia

A person with dysgraphia due to a defect in the understanding of space has illegible spontaneously written work, illegible copied work, but normal spelling and normal typing speed.

[edit] 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, muscle spasms in the arm and shoulder (sometimes in the rest of the body), inability to flex (sometimes move) the arm (creating an L-like shape), and general illegibility. Many people who are dysgraphic 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. There are a few reasons why pain while writing is rarely mentioned:

Sufferers do not know that it is unusual to experience this type of pain with writing. If they know that it is different from how others experience writing, they feel that few will believe them. Those who do not believe that the pain while writing is real will often not understand it. It will usually be attributed to muscle ache or cramping, and it will often be considered only a minor inconvenience. For some people with dysgraphia, they no longer write, and just type everything, so they no longer feel this pain.

Dysgraphics who experience this pain may exhibit reluctance or refusal to complete writing tasks.

[edit] Common problems that are often associated with dysgraphia

[edit] Stress
There are some common problems not related to dysgraphia but often associated with dysgraphia, the most common of which is stress. Often children (and adults) with dysgraphia will become extremely frustrated with the task of writing (and spelling); younger children may cry, pout, or refuse to complete written assignments. This frustration can cause the child (or adult) a great deal of stress and can lead to stress-related illnesses. This can be a result of any symptom of dysgraphia.

[edit] Treatment
Treatment for dysgraphia varies and may include treatment for motor disorders to help control writing movements. Educational therapy, especially neuro-sensory educational therapy, can be effective as it helps to develop proprioception. 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 could be considered to strengthen muscle tone, improve dexterity, and evaluate eyehand coordination. Dysgraphic children should also be evaluated for ambidexterity, which can delay fine motor skills in early childhood. Diagnosing dysgraphia can be challenging but can be done at facilities specializing in learning disabilities.

[edit] See also

Alexia without agraphia Dyslexia Learning disability Dyspraxia Dyscravia Character amnesia

[edit] References
[edit] Notes
1. ^ http://www.merriam-webster.com/medical/dysgraphia 2. ^ http://www.dyslexiaa2z.com/learning_difficulties/dysgraphia/dysgraphia_definition.h tml 3. ^ http://oxforddictionaries.com/view/entry/m_en_gb0251940#m_en_gb0251940 4. ^ http://www.merriam-webster.com/dictionary/agraphia 5. ^ Nicolson, Roderick, I.; Fawcett, A.J. (2011). "Dyslexia, dysgraphia, procedural learning and the cerebellum". Cortex 47 (1): 117-127. doi:10.1016/j.

[edit] General references

International Dyslexia Association on http://www.interdys.org/.

[edit] External links

NINDS Dysgraphia Information Page An Online Spelling Correction Resource Assisting Dysgraphia & Dyslexia Dysgraphia

Dysgraphia - In Detail Dysgraphia is a learning disability that affects writing abilities. It can manifest itself as difficulties with spelling, poor handwriting and trouble putting thoughts on paper. 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.

Just having bad handwriting doesn't mean a person has dysgraphia. Since dysgraphia is a 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.

What strategies can help?

There are many ways to help a person with dysgraphia achieve success. Generally strategies fall into three categories: Accommodations (providing alternatives to written expression), Modifications (changing expectations or tasks to minimize or avoid the area of weakness) and Remediation (providing instruction for improving handwriting and writing skills).

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. Below are some examples of how to teach individuals with dysgraphia to overcome some of their difficulties with written expression.

Early Writers

Use paper with raised lines for a sensory guide to staying within the lines.

Try different pens and pencils to find one that's most comfortable.

Practice writing letters and numbers in the air with big arm movements to improve motor memory of these important shapes. Also practice letters and numbers with smaller hand or finger motions.

Encourage proper grip, posture and paper positioning for writing. It's important to reinforce this early as it's difficult for students to unlearn bad habits later on.

Use multi-sensory techniques for learning letters, shapes and numbers. For example, speaking through motor sequences, such as "b" is "big stick down, circle away from my body."

Introduce a word processor on a computer early; however do not eliminate handwriting for the child. While typing can make it easier to write by alleviating the frustration of forming letters, handwriting is a vital part of a person's ability to function in the world.

Be patient and positive, encourage practice and praise effort - becoming a good writer takes time and practice.

Young Students

Allow use of print or cursive - whichever is more comfortable.

Use large graph paper for math calculation to keep columns and rows organized.

Allow extra time for writing assignments. Begin writing assignments creatively with drawing, or speaking ideas into a tape recorder

Alternate focus of writing assignments - put the emphasis on some for neatness and spelling, others for grammar or organization of ideas.

Explicitly teach different types of writing - expository / personal essays, short stories, poems, etc.

Do not judge timed assignments on neatness and spelling.

Have students proofread work after a delay - it's easier to see mistakes after a break.

Help students create a checklist for editing work - spelling, neatness, grammar, syntax, clear progression of ideas, etc.

Encourage use of a spell checker - speaking spell checkers are available for handwritten work

Reduce amount of copying; instead, focus on writing original answers and ideas

Have student complete tasks in small steps instead of all at once.

Find alternative means of assessing knowledge, such as oral reports or visual projects

Encourage practice through low-stress opportunities for writing such as letters, a diary, making household lists or keeping track of sports teams.

Teenagers & Adults

Provide tape recorders to supplement note taking and to prepare for writing assignments.

Create a step-by-step plan that breaks writing assignments into small tasks (see below).

When organizing writing projects, create a list of keywords that will be useful.

Provide clear, constructive feedback on the quality of work, explaining both the strengths and weaknesses of the project, commenting on the structure as well as the information included.

Use assistive technology such as voice-activated software if the mechanical aspects of writing remain a major hurdle.

Many of these tips can be used by all age groups. It is never too early or too late to reinforce the skills needed to be a good writer. Though teachers and employers should make efforts to assist individuals with learning disabilities, they may not be aware of how to help. Speak to them about dysgraphia, and explain the challenges you face as a result of your learning disability.

How to Approach Writing Assignments

Plan your paper. Pull together your ideas and consider how you want them in your writing.

Organize your thoughts and ideas. Create an outline or graphic organizer to be sure youve included all your ideas. Make a list of key thoughts and words you will want to use in your paper.

Write a draft. This first draft should focus on getting your ideas on paper dont worry about making spelling or grammar errors. Using a computer is helpful because it will be easier to edit later on.

Edit your work. Check your work for proper spelling, grammar and syntax; use a spell checker if necessary. Edit your paper to elaborate and enhance content a thesaurus is helpful for finding different ways to make your point.

Revise your work, producing a final draft. Rewrite your work into a final draft. Be sure to read it one last time before submitting it.

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