Dysgraphia - Types, Causes and Symptoms

What is Dysgraphia? 

NCBI describes ‘Dysgraphia’ as a challenge or inability to express oneself accurately and clearly in writing. The patient’s age and educational level also have an effect on it. Syntaxis mistakes, unreadable handwriting, odd spelling, and incorrect word usage are prevalently seen in such individuals. Writing is a challenging endeavour that calls for the flawless synchronisation of several advanced cognitive areas, including fine motor skills and expressive language.

Dysgraphia is a neurological condition that affects written expression and inhibits fine motor control. This learning condition impacts the brain and impairs writing. Dysgraphia affects both children and adults. It obstructs nearly every aspect of writing, including spelling, readability, word spacing and size and expression. Dysgraphia is common in individuals with ADHD, as it is with all learning disabilities.

Types of Dysgraphia 

Dyslexic Dysgraphia 

Dyslexic dysgraphia is the form that manifests as illegible writing. In comparison, plagiarised work may be correct or excellent. Spelling is frequently impacted. A child with this type of dysgraphia faces challenges in coming up with letter formations and shapes on their own. For fine motor skills, speed and dexterity are typically considered normal. Dysgraphia and dyslexia are unrelated diagnoses. They may, however, occur together.

Characteristics

• Poor spontaneous written work
• Minimal and minor lack of fine motor skills
• Copied work

Motor Dysgraphia 

Motor dysgraphia is the type of dysgraphia that occupational therapists will most likely notice and identify as it is most frequently seen. Sometimes there is a need to analyse the written work and the writing process. The kind of effort or energy required for the kid to write is also evaluated.

Deficient fine motor skills are typically the cause of motor dysgraphia. They could be clumsy with their motor skills and may lack muscle tone.

For these kids, any written work is subpar to illegible, affecting both original work and work that has been reproduced, even if it has been done by sight from another source. 

These kids’ letter formation may be acceptable in very short writing samples, but one can tell that it requires a lot of work or extra time from them, and they are unable to maintain this letter formation or neat writing for very long. These students frequently also lack understanding. 

The writing may be skewed if the pen or pencil is held incorrectly. Since their fine motor skills have decreased, they might be applying too much pressure, writing may be darker, or the pressure may be inconsistent.

Characteristics 

• Lacking fine motor skills
• Lack of legibility in written work
• Plagiarism noticeable
• With extra effort and time, short samples can be acceptable.
• Weak grasp
• Spelling usually unacceptable

Spatial Dysgraphia 

Spatial dysgraphia is the next category of dyslexia. Visual-spatial impairment is frequently the cause of spatial dysgraphia. The work of these students is poorly copied and poorly written on their own. Both types of writing are impacted. 

These students often have normal spelling and fine motor skills, but they struggle to keep their writing within the lines and have issues spacing out their sentences. It is also evident in their drawing abilities as well.

Characteristics

• Visual-spatial impairment
• Both original and plagiarised work is subpar
• Grammar and fine motor skills are typically acceptable
• Poor baseline positioning and spacing.

Phonological Dysgraphia 

The fourth type is called phonological dysgraphia. It manifests as difficulty with writing and spelling in which the spelling of unique words, non-words, and phonetically irregular words is compromised. These kids have trouble remembering phonemes and mixing them in the right order to create the desired word.

Characteristics

• Particularly notable while spelling unfamiliar words, non-words, and phonetically unusual words.
• Having trouble combining the right phonemes together.

Lexical Dysgraphia 

Lexical dysgraphia is the final type. The child has the ability to spell, but they frequently misspell irregular words and rely on conventional sound-to-letter patterns. This occurs more often in less phonetic languages like English or French as opposed to languages like Spanish. The prevalence of this kind of dysgraphia in children is relatively low.

Characteristics

• Focuses on sound-to-letter patterns
• Spelling errors in irregular words.

Causes of Dysgraphia 

Developmental Dysgraphia

Developmental dysgraphia’s root cause remains unknown. Developmental issues are common in children with dysgraphia.

Even though they receive adequate training in school and are at the proper cognitive level to learn, they may struggle to learn how to write.

Acquired Dysgraphia

Acquired dysgraphia develops due to neural disruption in the brain. The following are some factors that may contribute to dysgraphia.

• Neurological disease - Dysgraphia may be caused by vascular disease, cancer or brain disorders.
• Degenerative conditions - Alzheimer’s and Parkinson’s disease can impair the ability to write and communicate.
• Brain Injury - Head trauma or a shortage of oxygen to the brain can both result in injury.
• Metabolic dysgraphia - A study showed that low blood sugar in a teenager with Diabetes resulted in dysgraphia. Dysgraphia was addressed by controlling blood sugar levels.

Is Dysgraphia a form of Dyslexia? 

The Dyslexia is a specific learning problem with neurological causes. It is characterised by difficulty with accurate and fluent word recognition as well as poor decoding and spelling skills. In essence, dyslexia is a neurological disorder that makes it difficult to write, read and spell words. 

Dysgraphia is a learning disorder in which people struggle to write properly, frequently use the incorrect term, and inappropriately space letters and words. Also, handwriting is often illegible.

Dysgraphia Symptoms

Pain and frustration from handwriting

Dysgraphic children often report that writing by hand pains them. Although dysgraphia does not specifically hinder learning, it does have an impact on fine motor abilities. 

They might be unable to hold a pen or pencil using the tripod grip because of the uncomfortable manner their wrist and elbow are positioned. They could bear down too hard because they find it challenging to apply the proper amount of pressure, allowing the paper to slip out from under them.

These distractions make it difficult for them to put their ideas into writing. Watch out for awkward motions and hunched-over postures as well. Pencil and pen grips that increase girth are among the tools that can be useful.

Low self-esteem and negative self-perception. 

Dysgraphia, like other unique learning difficulties, can affect a person’s self-esteem and confidence. Students could be reluctant to work in groups or pairs because they feel self-conscious about their handwriting and writing skills. A youngster may eventually develop a negative attitude toward school if they are routinely marked negatively for written work while having to work twice as hard to create a block of text.

Poor letter formation

For a child with dysgraphia, comprehending how lines and curves combine to make letters can be very challenging. They can have trouble with spacing and size, as well as copying the pen strokes necessary to create a letter. It is initially noticeable that a youngster with a particular learning problem frequently writes letters differently from peers of their own age.

Lowercase letters are generally more difficult as not all letters are made equal. Letters may be written in reverse, in all caps, unable to write in cursive and generally have bad handwriting that is difficult to read.

Poor spelling 

Spelling errors are more likely to occur for children with dysgraphia since writing requires a lot of cognitive effort. Also, keep in mind that English is a challenging language to spell.

Unorganised writing

For a youngster with dysgraphia, it might be challenging to perform the higher-order activities of writing, such as planning and creating grammatically proper sentences. Run-on phrases are commonly seen, punctuation errors or omissions may occur, and teachers will typically find written work difficult to follow. This is particularly evident when comparing a child’s verbal capacity to relate knowledge.

Having trouble spacing out text

This can be the space that exists between letters, words or even phrases. Math problems’ spacing of numbers and equations, as well as writing in a straight line and from right to left, may present difficulties.

Teachers may observe that students frequently split words, write in the margins and run out of space at the end of a page. Writing in little boxes, which is a regular requirement of organising charts from classroom activity sheets, is one of the hardest things for students with dysgraphia to complete.

Avoiding schoolwork 

Most classroom-based activities necessitate writing, which is also an essential skill for tests, projects and even homework assignments. Children with dysgraphia may be reluctant to finish assignments, act uninterested in a project or even refuse to participate outright since they are aware of their poor writing abilities. 

Teachers often observe students who turn in unfinished written assignments, fail to complete their homework and show little enthusiasm for class lessons. This is especially true when writing assignments are given in cursive.

When the disease is untreated, children may start to doubt their own abilities. Children must be informed about the nature of their learning differences in order to give them access to the resources and coping mechanisms they require to overcome obstacles. Although dysgraphia is referred to as a learning problem, it is not necessarily a barrier to a child’s development.

Risk factors of Dysgraphia 

Sometimes certain diseases, degenerative conditions or brain injuries can cause dysgraphia to develop. As a result, a youngster or an adult may lose their ability to write.

Dysgraphia is linked to an activity in the brain called orthographic coding or processing. It refers to the brain’s capacity to temporarily retain words and letters in working memory until they can either be processed or saved in the permanent memory. A word’s meaning and pronunciation are also recorded in addition to its spelling.

Orthographic coding skills in kids with dysgraphia are frequently compromised. They struggle to mentally store words indefinitely. Those who lack fine motor skills or struggle with sequential finger movements may also be among them.

Diagnosis of Dysgraphia 

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies dysgraphia as a ‘specific learning problem’. However, it is not defined as a separate illness and does not have a set of diagnostic criteria. Due to this, dysgraphia may be challenging to diagnose, but not impossible.

An evaluation of a child’s academic performance and an IQ test may be part of the dysgraphia test process. Looking at the child’s particular schoolwork will also be helpful.

Similar to the evaluation procedure for dyslexia, an evaluation for dysgraphia involves carefully evaluating a child’s

• Strengths and weaknesses of learning
• Level of writing difficulty
• Educational history
• Type of writing problem the child has 
• The way use of support and target teaching has affected their present levels of academic performance.

Dysgraphia examples of written work or tests given by a doctor in writing may be reviewed for adults. The patient will be watched as they write so that any issues with fine motor abilities can be found. To determine if there are issues with language processing, the patient can be asked to copy words from one source to another.

Dysgraphia Treatment

Occupational therapy

Occupational therapy is a type of treatment that aids in the improvement, maintenance or development of daily essential skills. By focusing on motor function, muscle memory, providing verbal instruction, managing posture and more, occupational therapists can assist children in developing better handwriting.

Pencil grips

Numerous young people with dysgraphia have trouble holding a pencil. As a result, their handwriting can be sloppy and can’t make out what they’ve written. A child may occasionally benefit greatly from additional assistance in modifying the way they hold their pencil. Pencil grips are helpful in this situation.

These orthographic tools can be useful to a struggling writer, and there are several makers of them. These are special writing instruments that are specially made for each hand, but most grips are designed to operate for both left-handed and right-handed individuals.

Since pencil grips are made to be enjoyable and simple to use, kids typically like having them.

The Handwriting without Tears programme

Handwriting without Tears is a multi-sensory method using audio, visual and kinesthetic skills. Prekindergarteners and youngsters up to the age of six will benefit from this extracurricular activity.

The curriculum seeks to promote handwriting automaticity, increase vocabulary and alphabet knowledge, and lay the foundation for each child to have a hindrance-free writing experience.

Slant Boards

Slant boards assist kids in positioning their hands and wrists correctly for easier writing. The best tool for helping dysgraphic kids with their handwriting is slant boards.

The youngster can hold the pencil firmly, copy from the board more quickly, and maintain good posture.

Here is a list of advantages of slant boards for kids with dysgraphia.

• Wrist extension
• Good posture
• Visual processing and learning
• Improved copying abilities
• Increased fine motor skills

Tools for text to speech

Numerous text-to-speech assistive technology apps enable students to carry out fundamental reading-related tasks. These apps have unique characteristics that may convert any written text into an oral recording, whether it can be to read an SMS, an online product description, an email or a study guide.

Most devices, including Android, iOS, laptops and screen readers, support text-to-speech software.

Conclusion 

Dysgraphic children often experience worry and tension due to their writing difficulties. Due to their strong verbal abilities, parents and teachers want them to write at a similar level to how they speak. If they don’t, they are likely to be unmotivated or irresponsible.

Dysgraphia can exist on its own or in children who also have ADHD, dyslexia or other language impairments. It is essential to determine the underlying issues that cause dysgraphia. Dysgraphic children require support and therapy.