Dysgraphia

What is dysgraphia? 

“Dysgraphia” is a Greek word. The base word “graph” refers both to the hand’s function in writing and to the letters formed by the hand. The prefix “dys” indicates that there is impairment. Graph refers to producing letter forms by hand. The suffix ia refers to having a condition. Thus, dysgraphia is the condition of impaired letter writing by hand, that is, disabled handwriting. Impaired handwriting can interfere with learning to spell words in writing and speed of writing text. Children with dysgraphia may have only impaired handwriting, only impaired spelling (without reading problems), or both impaired handwriting and impaired spelling.

What causes dysgraphia?

Research to date has shown orthographic coding in working memory is related to handwriting and is often impaired in dysgraphia. Orthographic coding refers to the ability to store written words in working memory while the letters in the word are analyzed or the ability to create permanent memory of written words linked to their pronunciation and meaning. Children with dysgraphia do not have primary developmental motor disorder, another cause of poor handwriting, but may have difficulty planning sequential finger movements such as the touching of the thumb to successive fingers on the same hand without visual feedback. Children with dysgraphia may have difficulty with both orthographic coding and planning sequential finger movements.

Does it occur alone? Or with other learning disabilities?

Children with impaired handwriting may also have attention-deficit disorder (ADHD)–inattentive, hyperactive, or combined inattentive and hyperactive subtypes. Children with this kind of dysgraphia may respond to a combination of explicit handwriting instruction plus stimulant medication, but appropriate diagnosis of ADHD by a qualified professional and monitoring of response to both instruction and medication are needed.

 Dysgraphia may occur alone or with dyslexia (impaired reading disability) or with oral and written language learning disability (OWL LD, also referred to as selective language impairment, SLI).

 Dyslexia is a disorder that includes poor word reading, word decoding, oral reading fluency, and spelling. Children with dyslexia may have impaired orthographic and phonological coding, rapid automatic naming and focused, switching, and/or sustained attention.

 OWL LD (SLI) is impaired language (morphology–word parts that mark meaning and grammar; syntax–structures for ordering words and understanding word functions; finding words in memory, and/or making inferences that go beyond what is stated in text). These disorders affect spoken as well as written language. Children with these language disorders may also exhibit the same writing and reading and related disorders as children with dysgraphia or dyslexia.

Why is diagnosis of dysgraphia and related learning disabilities important?

Without diagnosis, children may not receive early intervention or specialized instruction in all the relevant skills that are interfering with their learning of written language. Considering that many schools do not have systematic instructional programs in handwriting and spelling, it is important to assess whether children need explicit, systematic instruction in handwriting and spelling in addition to word reading and decoding. Many schools offer accommodations in testing and teaching to students with dysgraphia, but these students also need ongoing, explicit instruction in handwriting, spelling, and composition. It is also important to determine if a child with dysgraphia may also have dyslexia and require special help with reading or OWL LD (SLI) and need special help with oral as well as written language.

What kinds of instructional activities improve the handwriting of children with dysgraphia?

Initially, children with impaired handwriting benefit from activities that support learning to form letters:

  • playing with clay to strengthen hand muscles;
  • keeping lines within mazes to develop motor control;
  • connecting dots or dashes to create complete letter forms;
  • tracing letters with index finger or eraser end of pencil;
  • imitating the teacher modeling sequential strokes in letter formation; and
  • copying letters from models.

 Subsequently, once children learn to form legible letters, they benefit from instruction that helps them develop automatic letter writing, using the following steps to practice each of the 26 letters of the alphabet in a different order daily:

  • studying numbered arrow cues that provide a consistent plan for letter formation
  • covering the letter with a 3 x 5 card and imaging the letter in the mind’s eye
  • writing the letter from memory after interval that increases in duration over the handwriting lessons
  • writing letters from dictation (spoken name to letter form).

 In addition, to developing handwriting speed, they benefit from writing letters during composing daily for 5 to 10 minutes on a teacher-provided topic.

 Students benefit from explicit instruction in spelling throughout K-12:

  • initially in high frequency Anglo-Saxon words;
  • subsequently in coordinating the phonological, orthographic, and morphological processes relevant for the spelling of longer, more complex, less frequent words; and
  • at all grade levels in the most common and important words used for the different academic domains of the curriculum.

Throughout K -12, students benefit from strategies for composing:

  • planning, generating, reviewing/evaluating, and revising
  • compositions of different genre including narrative, informational, compare and contrast, and persuasive
  • self-regulation strategies for managing the complex executive functions involved in composing.

Do children with dysgraphia make reversals or other letter production errors?

Some children do make reversals (reversing direction letter faces along a vertical axis), inversions (flipping letters along a horizontal axis so that the letter is upside down), or transpositions (sequence of letters in a word is out of order). These errors are symptoms rather than causes of handwriting problems. The automatic letter writing instruction described earlier has been shown to reduce reversals, which are less likely to occur when retrieval of letters from memory and production of letters have become automatic.

What kind of teaching strategies improve spelling of children with dysgraphia?

If children have both handwriting and spelling problems, the kinds of handwriting instruction described earlier should be included along with the spelling instruction.

Are educators in public schools identifying children with dysgraphia and providing appropriate instruction in public schools? 

In general, no. Although federal law specifies written expression as one of the areas in which students with learning disabilities may be affected, it does not clearly identify the transcription problems that are the causal factors in dysgraphia–impaired handwriting and/or spelling–for impaired written expression of ideas. Some of the tests used to assess written expression are not scored for handwriting or spelling problems and mask the nature of the disability in dysgraphia. Content or ideas may not be impaired. All too often, the poor writing or failure to complete writing assignments in a timely fashion or at all is misattributed to lack of motivation, laziness, or other issues unrelated to the real culprit–dysgraphia. Children who are twice exceptional–gifted and dysgraphic–are especially under-diagnosed and underserved. Teachers mistakenly assume that if a student is bright and cannot write it is because the student is not trying.

Are there research-supported assessment tools for diagnosing dysgraphia?

Yes. See Barnett, Henderson, Scheib, and Schulz (2007), Berninger (2007a), Milone (2007), and Slingerland assessment below for assessing handwriting problems associated with dysgraphia. Also, see Berninger (2007b) and Berninger, O’Donnell, and Holdnack (2008) for using these tests and other evidence-based assessment procedures in early identification, prevention, and diagnosis for linking assessment results to evidence-based handwriting and spelling instruction (also see Troia, 2008).

 In summary, dysgraphia is a specific learning disability that can be diagnosed and treated. Children with dysgraphia usually have other problems such as difficulty with written expression. It is important that a thorough assessment of handwriting and related skill areas be carried out in order to plan specialized instruction in all deficient skills that may be interfering with a student’s learning of written language. For example, a student may need instruction in both handwriting and oral language skills to improve written expression. Although early intervention is, of course, desirable, it is never too late during the school age years to intervene to improve a student’s deficient skills and provide appropriate accommodations.

References

Balmuth, M. (2009). The roots of phonics. A historical introduction (Revised ed.). Baltimore, MD: Paul H. Brookes. 

Berninger, V. (2008). Evidence-based written language instruction during early and middle childhood. In R. Morris & N. Mather (Eds.), Evidence-based interventions for students with learning and behavioral challenges. Philadelphia: Lawrence Erlbaum Associates.

Berninger, V., O’Donnell, L., & Holdnack, J. (2008). Research-supported differential diagnosis of specific learning disabilities and implications for instruction and response to instruction (RTI). In A. Prifitera, D. Saklofske, & L. Weiss (Eds.), WISC-IV Clinical Assessment and Intervention, Second Edition (pp. 69-108). San Diego, CA: Academic Press (Elsevier).

Berninger, V., & Wolf, B. (2009a). Teaching students with dyslexia and dysgraphia: Lessons from teaching and science. Baltimore, MD: Paul H. Brookes.

Brooks, A., Berninger, V., Abbott, R., & Richards, T. (2011) Letter naming and letter writing reversals of some children with dyslexia: Symptoms of inefficient phonological and orthographic loops of working memory? Developmental Neuropsychology, 36, 847-868.

Henry, M. (2010). Unlocking literacy. Effective decoding and spelling instruction. (2nd ed.). Baltimore: Paul H. Brookes.

Moats, L. C. (Winter, 2005/2006). How spelling supports reading: And why it is more regular and predictable than you think. American Educator, 12-22 , 42-43.

Troia, G. (Ed.). (2008). Instruction and assessment for struggling writers: Evidence- based practices. New York: Guilford.

Yates, C., Berninger, V., & Abbott, R. (1994). Writing problems in intellectually gifted children. Journal for the Education of the Gifted, 18, 131-155.

Wolf, B. (2011). Teaching handwriting. In J. Birsch (Ed.), Multisensory teaching of basic language skills: Theory and practice, Revised Edition. Baltimore, MD: Paul H. Brookes.

Resources for Assessment and Instruction

Barnett, A., Henderson, S., Scheib, B., & Schulz, J. (2007). Detailed Assessment of Speed of Handwriting (DASH). UK: Pearson.

Benbow, M. (1990). Loops and groups: A kinesthetic writing system. San Antonio, TX: Therapy Skill Builders. [For cursive.]

Berninger, V. (2007a), Process Assessment of the Learner, 2nd Edition. Diagnostic for Reading and Writing (PAL-II RW) and Berninger (2007b), User’s Guide (CD format ISBN 0158661818) with writing lessons from UW research program that can be downloaded. San Antonio, TX: The Psychological Corporation.

Berninger, V., & Wolf, B. (2009b). Helping students with dyslexia and dysgraphia make connections: Differentiated instruction lesson plans in reading and writing. Baltimore, MD: Paul H. Brookes. [Teaching plans from University of Washington Research Program.]

Bregman, C. (2009). Move into writing. A lowercase handwriting program. Self published. In consultation with Kristi Komai. Mail to cheryl@miwtherapy.com ISBN: 978- 0-692-00235- 3.

Fry, E. (1996). Spelling book. Level 1-6. Words most needed plus phonics. Westminster, CA: Teacher Created Materials. Retrieved from www.teachercreated.co 

Getty. B., & -Dubay, I. Productions website: www.handwritingsuccess.com [10 books, materials, and DVD including Write Now for italic writing. DVD distributor is www@allport.com, 1-800-777-2844 (2337 NW York, Portland OR 97210).]

Graham, S., Harris, K., & Loynachan, C. (1994). The spelling for writing list. Journal of Learning Disabilities, 27, 210-214.

Milone, M. (2007). Test of Handwriting Skills- Revised. Novato, CA: Academic Therapy. [Distributed by ProEd, Austin, TX.]

Rubel, B. (1995). Big strokes for little folks. Tucson, AZ: Therapy Skill Builders.

Slingerland InstituteTrademark [Instructional (manuscript and cursive) and assessment materials and teacher training from Slingerland Institute for Literacy. See www.slingerland.org or call 425-453-1190.]

Slingerland, B., & Aho, M. (1985). Manual for learning to use manuscript handwriting. Cambridge, MA: Educators.

Slingerland, B., & Aho, M. (1985). Manual for learning to use cursive handwriting. Cambridge, MA: Educators.

Zaner-Bloser handwriting programs for use in general and special education. Available at www.zanerbloser.com/fresh/handwriting- overview.html Also see spelling programs 

The International Dyslexia Association (IDA) thanks Virginia W. Berninger, Ph.D., and Beverly Wolf, M.Ed., for their assistance in the preparation of this fact sheet.

© Copyright The International Dyslexia Association (IDA).

Dyslexia

Dyslexia

What is Dyslexia?

In simple terms, dyslexia is a problem that makes learning to read hard and makes reading in general an activity to avoid at all costs. Young children begin life excited at the prospect of learning how to read and write. For many children, going to kindergarten means they are going to learn to read. Some of these children are predisposed to dyslexia and are unknowingly at “high-risk” for developing reading failure. Dyslexia is found in very smart people who have achieved great things. There is an impressive list of high achievers with dyslexia.

Dylexia Basics

from The International Dyslexia Association®

Dyslexia is a language-based learning disability. Dyslexia refers to a cluster of symptoms, which result in people having difficulties with specific language skills, particularly reading. Students with dyslexia usually experience difficulties with other language skills such as spelling, writing, and pronouncing words .  Read more . . .

Learning to Read

Learning how to speak . . . is something all of us achieve, but not all of us learn how to read naturally and easily. Reading backwards, upside down or words jumping around on the page is not dyslexia. Wearing colored glasses or tracking activities for the eyes is not going to teach a person how to read. Our brains have to be able to work with the “sounds” of the language that we speak when we read. Yes, letters are something that we see when we read, but they are symbols for sound. Turning sounds into words is reading. Turning sounds into printed symbols for those sounds is spelling. For example:  Many people think we look at a word like was and remember it in our visual system as a neat little chunk of letters that says ‘wuz’. Not so. Our visual system sees the squiggles and sends the information to the back of our brain that wakes up and screams, “letters, meaningful information has come our way.” Within 150 to 250 milliseconds of seeing a word the visual processor has turned over the job to the “phonological-sounding out brain” to read it.  Read these words: ‘Reflicmuntional’ ‘Broumps’ How did you figure out the word? Didn’t you have to rely on your brain turning letters into sound? Unlocking the sound code of the English Language in a way that is effortless and unconscious is where good reading begins. Reading is not a skill that all of us naturally “do”. Some of the brightest individuals will have trouble learning how to read. Dyslexia is no longer a mystery and the ways in which children and adults are taught to read and overcome dyslexia is not “voodoo”. Explicit, systematic research-based methods to teach individuals the “code” of our language allows them to learn how to read efficiently and accurately.

Dyslexia is an Inherited Genetic Trait

Not all brains learn how to read as easily as other brains. Dsylexia is an inherited genetic trait and may or may not be “expressed” in an individual. A person may be predisposed or at “high risk” for experiencing dyslexia, but it is not entirely genetic. A combination of environmental exposure and genetic endowment are responsible for what kind of reader a child will ultimately become. Because dyslexia is inherited it runs in families and should be identified and treated as early as possible. Remember though it is never too late to learn how to read.

The probability of inheriting dyslexia is between 25 to 50 percent if a parent or a sibling is diagnosed with dyslexia. Often a parent has not been formally diagnosed with dyslexia, but comes to the realization once their child is diagnosed. If one sibling in a family is diagnosed, the chances are almost fifty percent that the other siblings will be diagnosed with dsylexia as well. Early, rich exposure to language and the quality of reading instruction plays an enormous role in a child’s reading success regardless of dyslexia.

The technical research definition for dyslexia is as follows:

“Dyslexia is a specific learning disability that is neurobiological in origin. It is characterized by difficulities with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom intstruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.”

People with dyslexia have trouble spelling and rely heavily on their memories for both reading and writing. Many dyslexic people, especially those people who have a capacity to memorize words can “read”. The problem is they don’t read well and don’t like to read. If they don’t know the word already they have no way to figure out a new word. They are locked into a very inefficient visual memory system that breaks down whenever the phonological or sounding out system is needed to figure out how to “say” the new word.

Spelling difficulties and difficulty with reading comprehension are often secondary weaknesses that result from undiagnosed and untreated dyslexia. Not every person who is dyslexic is the same and each person recovers at their own rate and within their own ability. The earlier a person is treated the better the outcome.

Is My Child Dyslexic?

from The International Dyslexia Association®

Individuals with dyslexia have trouble with reading, writing, spelling and/or math even though they have the ability and have had opportunities to learn . . . read more about symptoms

Stress, Anxiety and Dyslexia

Anxiety comes in many forms. It can be situational (that is, specific to one kind or class of worry, like traveling or being in social situations). Individuals with dyslexia may experience stress and anxiety in situations in which they feel they will make mistakes, be ridiculed, or made to feel foolish in front of others.  Read more about stress, anxiety, and dyslexia . . .

Social and Emotional Problems and Dyslexia

from The International Dyslexia Association®

According to research done by Samuel T. Orton, MD,the majority of dyslexic preschoolers are happy and well adjusted. Their emotional problems begin to develop when early reading instruction does not match their learning style . . . read more about Social and Emotional problems

What is MultiSensory Teaching?

Multisensory teaching is one important aspect of instruction for dyslexic students that is used by clinically trained teachers. Effective instruction for students with dyslexia is also explicit, direct, cumulative, intensive, and focused on the structure of language. Read more about Multisensory Teaching

Understanding Dysgraphia

Dysgraphia is a specific learning disability that affects how easily children acquire written language and how well they use written language to express their thoughts . . . read more about Dysgraphia . . . 

What is the Best Method for Teaching Children with Dysgraphia?

As yet, there is no certifiably best method for teaching children who experience reading difficulty (Mathes et al., 2005). For instance,

research does not support the common belief that Orton-Gillingham–based approaches are necessary for students classified as dyslexic (Ritchey & Goeke, 2007; Turner, 2008; Vaughn & Linan-Thompson, 2003).

Reviews of research focusing solely on decoding interventions have shown either small to moderate or variable effects that rarely persist over time, and little to no effects on more global reading skills. Rather, students classified as dyslexic have varying strengths and challenges, and teaching them is too complex a task for a scripted, one-size-fits-all program (Coyne et al., 2013; Phillips & Smith, 1997; Simmons, 2015). Optimal instruction calls for teachers’ professional expertise and responsiveness, and for the freedom to act on the basis of that professionalism.  (International Literacy Association, Research Advisory: Dyslexia, 2016.  Read the full article . . . )

Intervention

Intervention for Reading

Do You Need Reading Help for Your Student?

Struggling readers are under a lot of stress.  It is important to address the deficit skills as soon as possible and as early in a child’s academic career as possible.  Most children, however, are not identified and treated earlier than third grade.  The truth is that how that child was reading in first grade would have strongly predicted what kind of reading success the student would have as a third grader!

Difficulty learning how to read is often a shock for those eager to learn and for those who love and support them.  Bright, verbal people sometimes experience difficulty learning how to read fluently.  For those of us who never had trouble learning how to read, it is easy to forget how unnatural this process actually is for the human race.

The Science of Reading

from "The Science of Reading (A Response to the New York Times", by David Hurford, the IDA Examiner Vol 9, Issue 1 https://dyslexiaida.org/the-science-of-reading-a-response-to-the-new-york-timesIt...

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What is Common Core?

What Parents Should Know from Common Core State Standards InitiativeTo ensure all students are ready for success after high school, the Common Core State Standards establish clear, consistent...

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Adolescents: Web-based Resources

21st Century Skills www.p21.org Alliance for Excellent Education www.all4ed.org Alliance for Excellence in Education www.all4ed.org/adolescent_literacy/ Bill and Melinda Gates Foundation...

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Adolescent Literacy

Truths about Adolescent Literacy Adolescence is not too late to intervene.  Interventions do benefit older students. Older students with reading difficulties benefit from interventions focused at...

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Effective Reading Instruction

from The International Dyslexia Association, "Effective Reading Instruction", www.dyslexiaida.org/effective-reading-instruction/ The most difficult problem for students with dyslexia is learning to...

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Resources for ADHD

ADHD Basics: ADHD: The Basics (National Institute of Mental Health) New ADHD Guidelines: 5 Things You and Your Child's Doctor Need to Know New ADHD Guidelines: American Academy of Pediatrics...

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Symptoms of Dyslexia

Is My Child Dyslexic? Individuals with dyslexia have trouble with reading, writing, spelling and/or math even though they have the ability and have had opportunities to learn. Individuals with...

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We specialize in intervention for Dyslexia, Dysgraphia, Dyscalculia (math deficits), Reading Comprehension (with or without Dyslexia), spelling, written language, and ADHD/EF Comorbidity.  If your child is struggling or has fallen behind in school, we can help!

All of us really love what we do and it shows. We are here to help make learning rewarding, and lift the stress and shame that occurs when a student experiences failure. As a team, we are passionate about evidenced-based instruction. We’re committed to maintaining a command of best practices and to promoting learning and mastery. HGA has cultivated hundreds of successful and confident learners in our years of practice.

Services at HGA include one-to-one expert reading intervention for dyslexia and related language based difficulties (writing), vocabulary or math struggles. Our intervention includes homework and academic support for improved executive function. . .

As clinicians and part of your team of professionals (teacher, administrators, physician, psychologist, Speech Pathologist, etc.), our intervention gives your student the tools he/she needs to overcome and manage the challenges of an academic career.

“Statistically, more American children suffer long-term life-harm from the process of learning to read than from parental abuse, accidents, and all other childhood diseases and disorders combined. In Purely economic terms, reading related difficulties cost our nation more than the war on terrorism, crime, and drugs combined.”

Children of the Code, www.childrenofthecode.org; National Institute for Family Literacy, www.nifl.org

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