What Is Dysgraphia? When Bad Handwriting Is a Sign of Something More Serious
When your child is learning to write, messy letters may seem normal. But for kids with dysgraphia, no amount of practice will make perfect. Here's what to know about dysgraphia symptoms, diagnosis, and treatment.
"Hi moms," began the post in our neighborhood Facebook group. "I'm looking for advice on how to improve my son's handwriting. It's sloppy and unintelligible. We make him erase and write over, but nothing helps. He doesn't seem to care."
Immediately, my spidey senses began tingling. My daughter was the same way. In kindergarten, she brought home lined handwriting sheets to practice forming letters. The skyline, plane line, grass line, and worm line (terminology used to help young children form capital and lowercase letters) seemed like mere suggestions rather than something she should use. No amount of erasing and re-writing did any good, but it wasn't until third grade I discovered she has a condition called dysgraphia.
Dysgraphia is the inability to produce clear handwriting in a timely manner "despite sufficient teaching, motivation, and mental and physical health," as authors Brock Eide, M.D. and Fernette Eide, M.D. explain in their book, The Mislabeled Child. They also note that dysgraphia is far from uncommon; as many as one in five children have serious difficulties expressing themselves through handwriting.
But despite the condition being quite common, it's rarely talked about in most parent groups. So if you've never heard the term before, you're not alone. Here's everything you need to know about dysgraphia.
It's important to note not all kids with dysgraphia have poor handwriting. Some can focus intently enough to make their letters neat, but eventually, when kids shift from learning how to write (grades K-2) to writing to demonstrate thought and copy notes or assignments (grade 3), they can't keep up.
Beth King, Ph.D., is a neuropsychologist specializing in dysgraphia and also happens to be a mother to a daughter with the condition. Here, she lists the possible signs a child has dysgraphia:
- The spacing of words is irregular and unpredictable. Some words may be crammed together while others are spaced apart. Writing may start in the center of the page rather than the left.
- Writing wanders above and below lines.
- Children may throw random capital letters in the middle of words or won't capitalize words at the beginning of sentences, even though they know the capitalization rules.
- They complain their hand hurts after writing. They may grip the pencil strangely or write with their bodies in an unusual position.
- They resist writing assignments.
- Spelling mistakes are common (but not always).
Dysgraphia vs. Dyslexia
While kids with dysgraphia can also have dyslexia (my daughter), the two don't necessarily go hand-in-hand. Dyslexia is a learning disorder characterized by difficulty reading, trouble hearing sounds, connecting letters to the sounds they represent (phonics), word decoding, oral reading fluency, and spelling.
"Dysgraphia is an output disorder that has nothing to do with reading," says Dr. King. "These children have trouble getting the thoughts in their heads out on paper because letter formation isn't automatic. They are concentrating on how to write vs. what to write."
My daughter never wrote more than three words to answer a question until I started scribing for her during remote school. I tried it as an experiment, and once I took writing out of the equation, she gave long and creative answers to assigned work. Dr. King says this is common.
Dysgraphia Testing and Diagnosis
If you suspect your child may have dysgraphia or an issue with written expression, the first step is to notify your child's school in writing that you want to have your child evaluated. If there is evidence to support your concern, the school is required to investigate as part of the Individual with Disabilities Education Act (IDEA).
Typically a school will have an occupational therapist (OT) evaluate your child, but many OTs aren't trained in recognizing dysgraphia. Dr. King notes the school will tailor your child's needs to what the school can offer, which is fine, but you may want to consider hiring a neuropsychologist with dysgraphia knowledge if you can.
A private evaluation will determine what's best for your child and will also look at other potential learning disabilities or underlying issues.
Dysgraphia Treatment and Accommodations
There's no cure for dysgraphia, but there are ways your child can thrive in a school environment. Dr. King runs a Facebook group called Thriving with Dysgraphia: Tips, Tricks, Strategies to Help Your Child Soar which is a great ongoing resource for support and tips. When it comes to tactical changes you can make now for a child with dysgraphia, here are accommodations help the most:
- Start keyboarding as early as possible. Dr. King prefers adaptive typing over standard keyboarding. Because they struggle with automaticity and working memory, they should look at the keyboard as they type and use whichever fingers are most comfortable. Their typing speed will progress with their workload.
- Kids should use lined or 1/4" graph paper for math.
- Kids with mild dysgraphia can benefit from learning cursive (but not all find this easier) or using a slant board.
- Allow use of spell check (Dr. King recommends Co:Writer), and don't mark off for spelling or punctuation mistakes. Work should be graded based on intellectual content alone.
- If a writing assignment can't be done on the computer, reduce the scope of the work and allow for extra time to complete.
- Some schools may allow the use of talk-to-text software, but talk-to-text is error-prone, especially when it comes to recognizing pre-pubescent voices. Kids also can't use it in the classroom when other children are present (it's embarrassing), and it doesn't help with math or science.
As a parent, it's heartbreaking to see your child struggle. Handwriting is so public. It's not something she can hide from her classmates, and I worry they'll make fun of her. Yet, I'm learning to let go of the fantasy I can cure her or protect her from every challenge.
"The goal is to get them to a place where they feel good about themselves," says Dr. King. "Most of these issues work themselves out as they grow."