Dysgraphia Explained: Definition, Symptoms, Diagnosis & Treatment

Over the years, researchers have been able to determine how well parts of our brains are functioning based on our handwriting. Handwriting requires an ability to match word sounds to their corresponding letters. 

When there is a disruption in this process, it directly affects a person’s ability to write or draw. When a trained professional reviews a person’s handwriting and detects certain specific and consistent errors, a diagnosis of dysgraphia may be considered.

What is Dysgraphia?

Dysgraphia (dis-graf-ee-uh) refers to a primary neurological difficulty in writing and spelling. Dysgraphia found in children–developmental dysgraphia–is typically a sign of a generalized learning impairment oftentimes co-occurring with a reading disorder such as dyslexia, ADHD, or a speech disorder. When dysgraphia occurs in adults, it’s typically a result of disease or trauma such as stroke or brain injury.  

Dysgraphia Symptoms

Dysgraphia can manifest in numerous ways, and its signs are often subtle yet impactful, influencing academic performance, self-esteem, and daily life. 

Examples of written errors commonly seen in dysgraphia include:

• Irregular letter sizes and shapes
• Unfinished letters or words
• Improper use of words or punctuation 
• Unusual grip on writing tool
• Decreased or increased speed of writing and copying
• General illegibility
• Experiencing physical pain in the hand and/or arm when writing
• Easily fatigued when performing written tasks
• Poor use of lines and spaces
• Missing the target purpose of the text (to inform/persuade, etc.)

Causes of Dysgraphia

The causes of dysgraphia are multifaceted and not entirely understood. It is believed to stem from a combination of neurological, physical, and environmental factors.

• Neurological Factors: Dysgraphia is often linked to dysfunction in specific brain regions responsible for fine motor skills, language processing, and memory. This neurological basis can affect the way individuals process and execute writing tasks.

• Physical Elements: In some cases, dysgraphia is associated with underdeveloped fine motor skills or poor hand-eye coordination. This can impact the physical act of writing, making it difficult to form letters or write fluently.

• Environmental Influences: Factors such as inadequate instructional methods or exposure to trauma can contribute to or exacerbate dysgraphia. These environmental elements can influence how individuals learn and perform writing tasks.

Dysgraphia Diagnosis

The diagnosis of dysgraphia is a comprehensive process that requires careful consideration of an individual’s writing skills in relation to their overall intellectual abilities. It typically involves a multidisciplinary approach, combining insights from a team of educators, psychologists, and healthcare professionals. Key steps in the diagnostic process include:

Educational and Psychological Evaluations

These assessments help in identifying specific difficulties with writing, including the mechanics of handwriting, language processing, and the ability to organize and express thoughts in written form. Standardized tests and observational assessments are used to evaluate these skills.

Medical Examination

A healthcare professional may conduct a physical examination to rule out any other neurological or physical conditions that might impact writing skills. This can include checking for any specific motor skill deficiencies or other neurological disorders.

Analysis of Educational History

Reviewing the individual's educational records and writing samples provides context and insight into their writing development and struggles over time. This helps in understanding how dysgraphia has impacted their academic performance and progress.

Interviews and Questionnaires

Discussions with parents, teachers, and individuals experiencing dysgraphia offer valuable information about day-to-day challenges, educational experiences, and the individual’s own perceptions of their writing difficulties.

Observation in Natural Settings

Observing the individual in their typical writing scenarios, such as in the classroom or during homework, provides concrete insights into their writing process and struggles.

Once diagnosed, a personalized treatment plan is developed, focusing on the individual's specific needs and challenges. Early diagnosis and intervention are crucial for effectively managing dysgraphia, helping individuals improve their writing skills and gain confidence in their abilities.

Children and Dysgraphia

It’s commonly a caregiver or school that recognizes early signs of dysgraphia in children. A teacher will contact a parent to discuss the potential difficulties the child is experiencing in the curriculum and may suggest a referral to a Speech-Language Pathologist (SLP). Following an evaluation, the SLP may recommend therapy to help the child achieve developmental milestones avoiding sufferance of delays in their overall education. 

Therapy for dysgraphia may include individual sessions with an SLP, an Occupational Therapist (OT), other educational specialists who can provide personalized compensatory strategies that can be implemented at home or at school.

Adults and Dysgraphia

For adults, dysgraphia can be an effect of neurological problems such as stroke, traumatic brain injury, or progressive neurological diseases (i.e., Parkinson’s Disease or Dementia). It's not uncommon for dysgraphia to affect handwriting after brain injury or in some cases, to be the first sign that potential neurological problems are occurring.  In the case that an adult seeks medical treatment because of these difficulties, an investigation of the source of the problem will be performed. Once the cause is determined, a treatment plan and professional therapy may be recommended.

Dysgraphia Treatment

Treating dysgraphia involves a multifaceted approach, tailored to the individual needs of each person affected by this writing disorder. The primary goal is to improve writing skills while also addressing the underlying challenges that contribute to dysgraphia. Treatment includes:

Educational Interventions

Specialized educational programs or accommodations, such as allowing extra time for writing tasks or using technological aids like speech-to-text software can significantly assist individuals with dysgraphia. 

Therapeutic Support

Occupational therapists often play a key role in treating dysgraphia. They work on enhancing fine motor skills and hand-eye coordination, teaching proper grip and posture for writing, and introducing exercises to improve hand strength and dexterity. Speech Language Pathologists address difficulties in similar ways with additional goals to improve cognitive function.

Psychological Support

Since dysgraphia can affect self-esteem and emotional well-being, counseling or therapy may be necessary to address these aspects. It helps in building resilience, learning coping strategies, and encouraging a positive mindset toward writing and learning.

Regular monitoring and adaptation of these strategies are crucial, as the needs and abilities of individuals with dysgraphia can change over time. A collaborative approach involving educators, therapists, and families ensures the best outcomes in managing and treating dysgraphia and its associated challenges.

Practice and Learning 

The more practice a person has with a particular activity, the easier it becomes for the brain to carry out the task. With practice, the brain increases its effectiveness and efficiency. And the more the brain is challenged by learning to read and write unfamiliar letters and forms, the more it grows. It’s one of the great benefits of neuroplasticity—the brain’s ability to adapt and grow when stimulated.

Dysgraphia Home Treatment 

Most treatment for dysgraphia will occur with a therapist. But there are many other options you can do at home or during school to help improve writing abilities. Each person will be unique in their needs. It’s important to try several different adaptive strategies to find out what works best for the individual.

Assistive Devices (devices to support handwriting)

Assistive devices and compensatory strategies supplement professional help with dysgraphia. They’re initially used with specialists who explain the benefits and demonstrate correct use. Following instruction, they can be used independently at home or school to supplement professional therapy improving autonomy and increasing success in written tasks.They can be categorized as “low-tech” and “high-tech.” 

Low-tech assistive devices and strategies

Low-tech assistive devices and strategies for improving handwriting focus on simplicity and accessibility, often requiring minimal training or adjustment. These can include:

• Pencil grips to improve hand position
• Wide-ruled notebooks that allow more space to draw letters
• High-contrast notebooks with colored and/or bolded lines to help guide the letters
• Raised-line paper allowing the writer to sense where the lines begin or end
• Slant boards that provide a natural writing position of the hands
• Graphic organizers such as pie charts, Venn diagrams, bubble diagrams, and t-charts. These organizational strategies begin with single words or ideas that can be used to format longer written tasks.
• Keep work spaces free from clutter and noise, lessening visual or other sensory distractions.
• Certain lights can be an issue for people with dysgraphia. Fluorescent lights are ubiquitous with eyestrain and noise. Opt for warmer-toned or indirect lighting.
• Self-led at-home programs that can be completed without the assistance of a therapist. 
• Therapy Shoppe® sells many such assistive devices and offers suggestions and support for dysgraphia, sensory-motor improvement, and other cognitive tasks.

High-tech assistive devices

High-tech assistive devices and strategies leverage handwriting with advanced technology to aid those with writing challenges:

• Typing (improve character recognition and memory). Typing on a keyboard or tablet will allow a person to focus on the content of the writing without the sometimes laborious motor control needed to hold a pen or pencil. See Mavis Beacon Teaches Typing or Typing Club
• Applications to improve muscle memory for writing such as iTrace, which begin with the use of a finger to trace forms and letters and later move to the use of a stylus to mimic the use of a pencil or pen.
• Audiobooks with accompanying text to listen to stories and read at the same time which helps with word/letter recognition
• Speech-to-text softwares
• Multi-sensory training and biofeedback (using the brain’s own impulses to improve brain function)
  • Soundsory
  • Forbrain

Bilateral Coordination Exercises

Bilateral Coordination Exercises, also called Cross-Lateral Coordination, encourage both sides of the brain to work together to improve cognition and motor coordination; skills required for successful written expression.

• Exercises such as jumping jacks or jump rope
• Activities requiring following patterns with the use of scissors
• Games such as tic-tac-toe or Connect 4
• Hand-clapping games
• Specific types of Yoga and Tai Chi movements

Dysgraphia FAQs

Can dysgraphia be prevented?

Unfortunately, dysgraphia cannot be prevented. It is considered a neurological condition and learning difference or difficulty. Developmental dysgraphia in children can often be detected when learning to read or write, usually in a school-based setting. Informed parents may recognize symptoms before then, and should consult a professional as soon as possible. The earlier intervention can begin, the better the prognosis for academic and personal success. 

Does dysgraphia improve with age?

Dysgraphia will not spontaneously improve. Formal education will offer opportunities for improvement in cognitive function, memory, and language processing, but oftentimes this will not be enough for a person to overcome the difficulties it presents. Children have an advantage in overcoming dysgraphia as the brain responds more quickly to training and changes (neuroplasticity). Adults with cognitive issues resulting from brain injury, stroke, or progressive neurological diseases will require more time to overcome the challenges of dysgraphia. In both cases, early intervention, therapy, compensatory strategies and assistive devices will be essential to improve writing skills. 

Is Dysgraphia a Form of Dyslexia?

Dysgraphia is not a form of dyslexia but often they will co-occur. Dysgraphia is a difficulty with writing text and dyslexia is a difficulty with reading text. The areas of our brain and the processes required for writing and reading are closely related and for this reason, they sometimes share the same symptoms. Although they are both considered neurological learning disorders, they are distinctly different and can be easily confused. 

Is dysgraphia a form of ADHD?

Dysgraphia is not a form of ADHD, but many persons with ADHD will experience dysgraphia as well, since ADHD affects many of the same skills needed for successful writing such as concentration, working memory, motor control, etc. 

Final Words

Dysgraphia is a treatable disorder of handwriting and cognitive functioning that requires a variety of treatment strategies following an evaluation by a trained professional. However, there are many strategies and complementary treatments we can immediately implement at home to help prevent further learning difficulties. For more information check out the following resources:

International Dyslexia Association

Learning Disabilities Association of America

Peer-reviewed journal article (in English & French)

References

Are there any assistive technologies for dysgraphia ? (n.d.). LD OnLine. https://www.ldonline.org/ld-topics/writing-spelling/questions/are-there-any-assistive-technologies-dysgraphia

C. M. (n.d.). Dysgraphia. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/23294-dysgraphia

Ehmke, R. (2023, 18 décembre). Quick guide to dysgraphia. Child Mind Institute. https://childmind.org/guide/quick-guide-to-dysgraphia/

B. M. (2022, 7 November). Practical Strategies & Tools to help kids with dysgraphia. ADDitude. https://www.additudemag.com/how-to-improve-handwriting-dysgraphia-treatment/

Longcamp, M., Richards, T. L., Velay, J., & Berninger, V. W. (2016). Neuroanatomy of handwriting and related reading and writing skills in adults and children with and without learning disabilities: French-American connections. Pratiques, 171‑172. https://doi.org/10.4000/pratiques.3175