Dysgraphia is a functional disorder that makes it difficult to learn and perform handwriting. Affecting 10% of children, it is a transcription handicap due to an inability to do any work in writing, beyond graphics. Handwriting is either too slow, illegible, or tiring, requiring in all cases a major cognitive effort. 

Most often the dysgraphia is isolated, without neither a neurological nor intellectual deficit, in the absence of psychological disorders, in a child evolving in a socio-cultural environment normally stimulating and following ordinary schooling. 

Dysgraphia can sometimes be secondary to a neurological pathology present from birth or progressive.

It is integrated with other dys- pathologies- with which it is frequently associated (dyslexia, dyspraxia, dysorthography). Dysgraphia is more or less severe, but it is most often a lasting and persistent disorder.

Causes of dysgraphia

Writing is a complex fine motor activity, of long and difficult construction, the mastery of which requires several years for any child. Children with dysgraphia are unable to automate writing to make it a profitable tool for accessing learning.

Most often, in children, dysgraphia is isolated, that is to say without associated neither a neurological or intellectual deficit. Certain factors are mentioned to explain this dysgraphia:

  • Immaturity at the time of learning
  • Lack of finger control while writing
  • Non-resolved laterality problems
  • Poor pen holding

But it can also be associated with certain pathologies, in particular neurological: visual or hearing disability, cerebral pathology (BMI, brain tumor, stroke, head trauma, etc.).

Types of dysgraphia

There are several types of dysgraphia:

  • Dyslexic dysgraphia: patients with this type of dysgraphia will have spontaneous sequences of illegible words, but the written work is generally understandable.
  • Motor dysgraphia: caused by a lack of motor skills and muscle tone, this type of dysgraphia makes writing physically demanding for the patient. Patients can form sentences, but it takes a lot of effort and dedication. Proper and recopied sentences are often illegible.
  • Spatial dysgraphia: as the name suggests, the patient is not able to understand the concept of spacing. They, therefore, mash sentences together and have difficulty respecting line spaces and margins. However, the sentences are understandable and the letters follow a consistent order.
  • Phonological dysgraphia: this type of dysgraphia is characterized by difficulty in writing and spelling new complex words. These children are not able to memorize phonemes.
  • Lexical dysgraphia: This is a very rare form of dysgraphia in which the child understands written words as they are pronounced, but not irregular words.

Symptoms of dysgraphia

Generally, dysgraphia makes writing skills difficult, but it also changes the consistency of written words. A combination of the following symptoms is often a sign of dysgraphia.

  • Unable to form letters correctly.
  • Struggles to place spaces consistently between letters.
  • Cannot keep a straight line.
  • Inconsistent letter size throughout the text.
  • Continuous erasure of written things.
  • Complications in maintaining spelling patterns: This includes incomplete words, misspellings, placement or missing letters.

Besides the problems reflected in the handwriting itself, a child’s posture says a lot about their writing skills. This is because a child with dysgraphia will tend to hold their pencil in an unusual way, their positions will be slightly crooked while writing or their paper will be misdirected.

Effects of dysgraphia

Dysgraphia will have measurable consequences for the child’s intellectual development. Indeed, when the child writes, even if they end up doing it in a relatively satisfactory way, it will come at the cost of a lot of effort, control, and attention. 

Their attention will focus on the writing, at the expense of learning activities (understanding, memorizing, synthesizing, making connections, etc…) which are however the essential school objectives.

Therefore, the real problem is not that the child writes poorly, but it is that their writing is not automated and requires massive attentional effort. 

Dysgraphia is in most cases a severe, lasting, and persistent disorder.

Some numbers

The frequency of dysgraphia is estimated to be around 10% of school-aged children. It mostly affects boys. Severe dysgraphias are detected from nursery school (especially if they are associated with dyspraxia).

Diagnosing dysgraphia

When dysgraphia is suspected, therapy is usually performed. A broader multidisciplinary assessment (neuropediatric, neuropsychological, psychological, psychomotor, etc…) is most often necessary to confirm the specificities of the disorder, to assess its severity, and to detect associated pathologies: dyslexia, dyspraxia, or neurological pathology.

In cases of mild dysgraphia, rehabilitation can be carried out, most often by a speech therapist, psychomotor therapist, or occupational therapist. 

A first assessment will be carried out involving a series of tests: a writing test, a test of graphic motor skills during writing, a writing speed test, a calculation of graphomotor age, and a classification of the disorder. 

Then the rehabilitation will consist of a series of gestural relaxation techniques and playful graphic exercises, adapted to the age of the child. Work will be done writing gestures, posture, the holding of the pen, the shape of the letters, and fine motor skills. 

Only children with mild disorders will be able to respond to rehabilitation.

Treatment of dysgraphia

Unfortunately, dysgraphia is an incurable pathology that will stay with the child throughout their life. The approach, at home and at school, is therefore to encourage the practice and development of the young person’s capacities. However, this condition cannot be resolved with medication or surgery.

However, this does not mean that the dysgraphia cannot improve. In this case, it is recommended to resort to occupational therapy, in which the therapists will help the child to write better and adopt more effective postures. In addition, the school must provide specific development cycles according to the needs of the child.

Consequences dysgraphia of on school life

Children with dysgraphia may show warning signs as early as kindergarten, but it is not until around 7-8 years of age that teachers often find out that handwriting is difficult and problematic.

In classes, the dysgraphic child is very handicapped by the ineffectiveness of their writing which makes them too slow. Indeed, either they try to follow the rhythm and are then illegible and dysorthographic, or they try to write well and are then left behind. 

This disorder prevents them from keeping pace with their classmates and from focusing on learning.

These writing problems can lead to behavioral disturbances and loss of confidence in children, leading to academic failure. The efforts made are often in vain and lead to discouragement.

When to see a specialist

If you think of seeing a specialist if your child is showing the following signs: illegible, academic difficulties, too much effort to write, tension, cramps, and fatigue when writing, lack of care in notebooks, writing too fast or too slow, anxiety when writing, degradation of the handwriting as the task progresses, bad pen holding, bad position, badly positioned sheet.

Keep in mind that some children will improve their writing which will be more readable and faster by injecting a major attentional effort. The child will then focus on their writing efforts at the expense of listening, understanding, reasoning, and memorizing the school material. Too focused on their writing efforts, they are then unable to progress academically. The cognitive energy spent on writing is not available for another task and tires the child. 

These children will gradually fail at school despite their writing progress. It is these children who are the most difficult to detect. As a parent or as a teacher, you must be careful not to value writing at the expense of learning, not to privilege form at the expense of substance. 

How to improve the school life of children with dysgraphia

Children with dysgraphia can benefit from school arrangements both in their daily schooling and for taking tests and exams (additional third time for exams, etc.). 

A specialized plan can be developed allowing the implementation of schooling arrangements (support during school time), educational arrangements (school reduction, photocopies of lessons, etc.), the allocation of material adapted to the child’s needs, and obtaining additional third-party time. 

It is also important to re-motivate the child and to value them so that they regain self-confidence. It will not be enough for the child to apply or train their handwriting more to get there, despite clear progress. Indeed, the imposition of handwriting can be deleterious in these children and it is necessary to break free enough to devote enough attention to the acquisition of knowledge. 

For some children, copy exercises may be avoided and photocopies provided. The handicap can also be compensated by the use of computers which can be proposed early enough when the dysgraphia is severe or forms part of a neuromotor disorder. 

The use of the computers will be useful if it is necessary to write quickly or if it is necessary to write and simultaneously perform another task (thinking about spelling, understanding, analyzing, etc…). 

Handwriting can be maintained for certain exercises that do not require concurrent learning.

Tips for improving the writing of a child with dysgraphia

  • Give the child a piece of paper with established lines that will make it easier for them to follow a consistent writing pattern.
  • Allow them to try different types of pencils and pens until they find the most comfortable one for them.
  • Start a writing session with the child by recording their ideas in the form of drawings and recordings.
  • Teach the child several writing techniques and verbal tenses. This will allow them to adapt to whichever is easiest for them.
  • Reduce homework consisting of recopying sentences, as it is better to promote autonomy and practice.

Last Words

The early recognition of writing problems, the regularity of specific follow-up, and the implementation of adapted educational measures will allow children with dysgraphia to avoid academic failure and to follow a normal school course, without compromising their social and professional integration. The challenge is therefore to screen these students so that the care is optimal.

Jenny Zhang

Jenny holds a Master's degree in psychiatry from the University of Illinois and Bachelors's degree from the University of Texas in nutritional sciences. She works as a dietician for Austin Oaks Hospital in Austin, Texas. Jenney writes content on nutrition and mental health for the Scientific Origin.