A dual-task paradigm involving concurrent finger tapping and line orientation judgment was used to investigate brain processing differences in early adolescent good readers/poor spellers (dysgraphia), poor readers/poor spellers (dyslexia) and good readers/good spellers. Whereas all groups were similarly affected during the left-hand tapping condition, in the right-hand tapping condition the good spelling group displayed significantly less tapping disruption than both poor spelling groups, who did not differ significantly from each other. From these results, it can be inferred that individuals with dyslexia and dysgraphia share a left-hemisphere processing limitation that is not confined to written language. In light of other relevant research findings, I suggest that this limitation is due to the absence of a disembedding scanning mechanism for converting spatial arrays (e.g., spelling patterns) to temporal form-an impairment putatively caused by attempting to teach written language to children who are late in establishing left-hemisphere motor dominance.
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. 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 and sometimes spelling. Impaired handwriting can interfere with learning to spell words in writing. Occasionally, but not very often, children have just spelling problems and not handwriting or reading problems.
Research to date has shown orthographic coding in working memory is related to handwriting. Orthographic coding refers to the ability to store unfamiliar written words in working memory while the letters in the word are analyzed during word learning 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 they may have difficulty planning sequential finger movements such as the touching of the thumb to successive fingers on the same hand.
Specific 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 and rapid automatic naming and switching. Phonological coding refers to coding sounds in spoken words in working memory. Phonological coding is necessary for developing phonological awareness-analyzing the sounds in spoken words that correspond to alphabet letters. If children have both dysgraphia and dyslexia, they may also have difficulty in planning sequential finger movements.
OWL LD (SLI) are disorders of 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.
I knew my son had a problem with writing when I saw that his first-grade journal contained mostly drawings and only a few sentences. In second grade, Austin was still reversing the letters b and d, something most of his peers had outgrown.
His teachers called it laziness, but as he did his homework, I saw him labor to form letters correctly. He worked slowly, erased a lot, and cried. One day, after he’d struggled with a paragraph for two hours, I had him type it at the computer. He was finished in 20 minutes.
Austin has dysgraphia, a learning disability that can accompany attention deficit disorder (ADD ADHD). Dysgraphia affects handwriting, spelling, and the ability to put thoughts on paper. It makes the process of writing maddeningly slow, and the product often illegible. Forming letters requires such effort that a child may forget what he wanted to say in the first place.
The act of writing something down helps most of us to remember, organize, and process information, but children who struggle with the mechanics of writing learn less from assignments than do their peers. Work often goes unfinished, and self-esteem suffers. Fortunately, there are strategies for helping children with dysgraphia, in school and at home.
DYSGRAPHIA AND RELATED LEARNING DISABILITIES
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.
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); and
- writing letters during composing for 5 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;
- 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; and
- Self-regulation strategies for managing the complex executive functions involved in composing.
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.
Instructional 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.
It is critical that students do not totally avoid the process of writing, no matter how severe their dysgraphia. Writing is an important life skill necessary for signing documents, filling out forms, writing checks, taking telephone messages or writing a grocery list. Therefore, students need to be able to write, even if they cannot maintain writing for long periods of time.
Young students should receive remediation in letter form, automatically, and fluency. They need specific multi-sensory techniques that encourage them to verbalize the motor sequences of the form of letters (for example, b is big stick down, circle away from my body). Students should also use large air writing to develop a more efficient motor memory for the sequence of steps necessary in making each letter. This is because air writing causes students to use many more muscles than they use when writing with a pencil. Multi-sensory techniques should be utilized for teaching both manuscript and cursive writing. The techniques need to be practiced substantially so that the letters are fairly automatic before the student is asked to use these skills to communicate ideas.
Some students may be able to copy and write single sentences with a fair degree of ease, but they struggle tremendously with paragraph writing. These students will need to be taught techniques that enable them to perform each subpart prior to pulling together all the parts. Substantial modeling will be necessary at each stage for the student to be successful. For example, when writing a paragraph students can be taught the following eight steps:
- Think about your ideas and elaborate on each part of the ideas.
- Organize the ideas you want to express. This type of organization is easily performed using visual graphic organizers. For example, you can create a mind map so that the main idea is placed in a circle in the center of the page and supporting facts are written on lines coming out of the main circle, similar to the arms of a spider or spokes on a wheel. Many visual organizer formats can be used, with different formats appropriate for different situations.
- Analyze your graphic organizer to determine if you included all of your ideas. If you have difficulty with spelling, make a list of the more difficult or important words you may want to include in your writing. Having this reference list will help your writing flow more because you will not have to stop to think of how to spell the big words.
- Now, write a draft of your paragraph (or paper), focusing on the content or ideas. If you have a computer, it is best if you type your draft directly on the keyboard. This will make it much easier to proofread and revise.
- Proof and editing: you will need specific techniques and strategies to proofread your paper, checking for appropriate use of punctuation, capitalization, and grammar. Then use a spell checker to fix your spelling.
- Revise your paragraph, incorporating the corrections you determined above.
- Proofread your paragraph again, editing and revising if necessary.
- Develop a final product, either in typed or written form.
An easy way to remember these steps is to think of the word POWER.
- P – plan your paper (step 1)
- O – organize your thoughts and ideas (steps 2 and 3)
- W – write your draft (step 4)
- E – edit your work (steps 5, 6, and 7)
- R – revise your work, producing a final draft (step 8)
The student may need substantial modeling at each stage to be successful.
Some dysgraphic students have great difficulty with spelling, especially if sequencing is a major issue for them. Additionally, many dysgraphic students experience dyslexia, a sequential processing problem that affects reading and spelling. These students need very specific remedial assistance in learning to spell phonetically. It is critical that they are able to represent unknown words using good phonetic equivalences. If they are able to spell logically and phonetically, they will be able to use a phonetically-based spell checker, such as a spell checker in one of the Franklin resource products. These handheld devices recognize words using phonetic logic rather than relying on the orthographic sequence, as do most spell checkers on a computer word processing program. The sidebar below presents a poem this author found on the Internet which exemplifies why a computer spell checker may not be sufficient for some students with spelling struggles.
A little poem regarding computer spell checkers…
- Eye halve a spelling chequer It came with my pea sea It plainly marques four my revue Miss steaks eye kin knot sea.
- Eye strike a key and type a word And weight four it two say Weather eye am wrong oar write It shows me strait a weigh.
- As soon as a mist ache is maid It nose bee fore two long And eye can put the error rite Its rare lea ever wrong.
- Eye have run this poem threw it I am shore your pleased two no Its letter perfect awl the weigh My chequer tolled me sew.
(author unknown; obtained from Internet)
Another vital aspect of remedial assistance that is especially important for young children, involves the student’s pencil grip. Students should be helped and encouraged to use a consistent and efficient pencil grip right from the beginning of their writing experience. The distance from the student’s finger to the pencil point should consistently be between 3/4″-1″. Pressure on the pencil should be moderate, not too heavy and not too light. The angle of the pencil should be approximately 45% with the page and slanted toward the student’s writing arm. The long edge of the student’s paper and his writing arm should be parallel, like railroad tracks. With some young students, pencil habits can be changed to a more appropriate form by using a plastic pencil grip (many of which are on the market in a variety of shapes and formats), It is much easier and more efficient to encourage students at the very beginning of their writing experience to develop these appropriate habits through frequent modeling and positive feedback. Older students who have developed firm habits, even if the habits are not efficient, find that it is very time consuming to make changes. Therefore, when making a decision on adapting a student’s habits, it is extremely important to consider the time/energy ratio. Is it worth the amount of time necessary to make the change to help the student be more efficient? If not, it is critical to make sure the student has efficient and automatic compensatory strategies.
Many students with dysgraphia are extremely slow in their writing performances. When this is the case, it is critical to determine what is causing the slowness. Is it the formulation of ideas? or the organization of ideas? If so, more work needs to be done on pre-organization strategies and this student’s language formulation skills need to be thoroughly assessed by a speech and language pathologist. Is the student’s slowness a result of slowness in actually making the letters? If this is the case, the student needs much more remedial practice in forming letters independently, without having to think about content. This should be done using multi-sensory techniques, including saying the letter and/or the sequence of movements while writing the letter; using large air writing techniques (writing the letter in the air using two fingers, with wrist and elbow fairly straight, though not rigid); writing letters in texture, such as on fine sandpaper or in pudding; and writing large letters using a squirt bottle of colored water against an outside wall.
Some students struggle with writing and become readily fatigued with the process of writing because of their inefficient pencil grip and poor motor sequencing. Many times an occupational therapist, especially one using a sensory integration philosophy, can help in the remedial process with such students. There are also temporary remedial techniques a teacher or parent can use as warm-ups or as a writing break. Some suggestions for helping relieve stress and relaxing the writing hand follow. Students can perform any of these for about 10 seconds before writing or in the middle of writing.
- Shake hands fast, but not violently.
- Rub hands together and focus on the feeling of warmth.
- Rub hands on the carpet in circles (or, if wearing clothing with some mild texture, rub hands on thighs, close to knees)
- Use the thumb of the dominant hand to click the top of a ballpoint pen while holding it in that hand. Repeat using the index finger.
- Perform sitting pushups by placing each palm on the chair with fingers facing forward. Students push down on their hands, lifting their body slightly off the chair.
The overall goal of compensations is to help the student perform more automatically and still participate in and benefit from the writing task. The goal is to allow the student to go around the problem so that she can then focus more completely on the content. Some example strategies include:
- Understanding–Understand the student’s inconsistencies and performance variability.
- Print or cursive–Allow the student to use either form. Many dysgraphic students are more comfortable with manuscript printing.
- If getting started is a problem, encourage pre-organization strategies, such as use of graphic organizers.
- Computer–Encourage student to become comfortable using a word processor on a computer. Students can be taught as early as 1st grade to type sentences directly on the keyboard. In doing so, do not eliminate handwriting for the child: handwriting is still important but computer skills will be invaluable for longer and important tasks.
- For older students, encourage use of a speech recognition program combined with the word processor so the student can dictate his papers rather than type them. This increases speed and efficiency and allows the student to focus more completely on complex thoughts and ideas.
- Encourage consistent use of spell checker to decrease the overall demands of the writing task and encourage students to wait until the end to worry about spelling.
- Encourage use of an electronic resource such as the spell check component in a Franklin Language Master® to further decrease the demands. If student has concurrent reading problems, a Language Master® with a speaking component is most helpful because it will read/say the words. This author prefers the Language Master 6000 because of its large font size and speech clarity.
- If necessary, shorten writing assignments.
- Allow extra time for writing activities.
- Note taking: Provide student with copy of completed notes (perhaps through a note taking buddy who can use carbon paper) to fill in missing parts of his own notes.
- Note taking: provide a partially completed outline so the student can fill in the details under major headings. As a variety, provide the details and have student fill in headings while listening.
- Allow student to tape record important assignments and/or take oral tests.
- Staging: have students complete tasks in logical steps or increments instead of all at once.
- Prioritization: stress or de-emphasize certain task components during a complex activity. For example, students can focus on using descriptive words in one assignment, and in another, focus on using compound sentences. Also, design assignments to be evaluated on specific parts of the writing process (prioritization).
- Remove neatness as a grading criterion, except on computer-generated papers.
- Reduce copying aspects of tasks, such as providing a math worksheet rather than requiring student to copy problems from the book. A copying buddy can be helpful in copying the problems using carbon paper.
- Reinforce the positive aspects of student’s efforts.
- Be patient.
- Encourage student to be patient with himself.
Educators in public schools identifying children with dysgraphia and providing appropriate instruction in public schools
In general, 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.
A note regarding development of word processing skills
Many dysgraphic students have difficulty with correct fingering in keyboarding skills. However, it is important to expose students to the correct fingering to develop quick visual locating skills for letters on the keyboard, ideally without having to look each time. One important strategy is to have the student practice keyboarding skills approximately 10 minutes a day (this can be part of a homework assignment). The student should use a variety of child-oriented typing tutor programs and work to develop appropriate skills to the best of her ability. At the same time, whenever the student types for ideas or content, whether a word, a sentence or a whole paragraph, she should be allowed to use whatever fingering she wants. Eventually, the goal is for the student to automatically incorporate at least some correct keyboard fingering when typing content. This author has seen dysgraphic students use a combination of correct keyboard fingering with their own style and reach typing speeds of 60 wpm. With this degree of speed and efficiency, it is unnecessary to force a student to use standard keyboarding techniques. However, many students do begin to use the correct techniques, as this is often much more efficient. However, if practice with correct fingering is avoided or not used frequently enough, the student will never have the opportunity to incorporate the correct skills.
RESEARCH-SUPPORTED ASSESSMENT TOOLS FOR DIAGNOSING DYSGRAPHIA
Yes. See Berninger (2007a) and Milone (2007) 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 treatment planning and linking them to evidence-based handwriting and spelling instruction (also see Troia, 2008).
A case of pure dysgraphia is presented in which the patient could accurately copy letters which she could not write. The patient did not show any evidence of significant reading or speech impairment or any buccofacial or limb apraxia. Both oral and “block spelling” perfor- mance were intact. The writing impairment, which was bilateral, appeared to consist of a memory difficulty for the motor movements associated with letters. The dysgraphia was shown to be specific to letters as the patient was able to transcribe certain numbers and patterns which were similar to letters in their visuospatial complexity. It is suggested that dysgraphia for letters may represent a specific type of motor memory deficit, dissociable from copying skills and the ability to draw letter-like forms.
David S. Mather. University of Victoria, Victoria, British Columbia, Canada,
Berninger, V. (2007a). Process Assessment of the Learner, 2nd Edition. Diagnostic for Reading and Writing (PAL-II RW). San Antonio, TX: The Psychological Corporation.
Berninger, V. (2007b). Process Assessment of the Learner II User’s Guide. San Antonio, TX: Harcourt/PsyCorp. (CD format) ISBN 0158661818. Second Edition issued August, 2008.
Berninger, V., & Wolf, B. (in press-a). Teaching students with dyslexia and dysgraphia: Lessons from teaching and science. Baltimore: Paul H. Brookes.
Graham, S., Harris, K., & Loynachan, C. (1994). The spelling for writing list. Journal of Learning Disabilities, 27, 210–214.
Henry, M. (2003). Unlocking literacy. Effective decoding and spelling instruction. Baltimore: Paul H. Brookes Publishing.
Milone, M. (2007). Test of Handwriting Skills-Revised. Novato, CA: Academic Therapy. Distributed by ProEd, Austin, TX.
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.
 Assistant Professor, Dept. of Computer Education, Sree Rama College of Education, Tirupati.
 Head & Professor, Dept. of Lingistics and Foreign Languages, S.V University, Tirupati.