Dysgraphia: Recognizing the Signs and Providing Effective Support for Struggling Writers

What is Dysgraphia?

Dysgraphia is a lesser-known disability which primarily affects writing skills. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes Dysgraphia as a "Specific Learning Disorder" which impairs written expression.

“In second grade, my teacher used to take my writing assignments and tape them to the board along with the assignments from three other kids. Then she had the whole class line up and critique our handwriting. I was really trying my best and was devastated when I lost all the time. I can still remember sitting at my desk watching the kids looking at my paper. “ - Patty DeDurr (Health care worker and Author)

"...well, I have Dysgraphia, and the truth is that most people don’t even know what it is. As I am typing this very sentence, the word “Dysgraphia” was underlined red by my spell check. Most of the time, when I tell people I have Dysgraphia, they either ask me what it is or they google it on their phone." – Sammy (Student at Brooklyn Technical High School)

“During my struggle to learn to read (and lasting long after it) was the greater struggle, writing. I don’t think there are words to describe what I felt when a girl in the second grade handed her paper to me to pass to the front. I held her paper in my right hand and mine in my left for a moment, and it was all I could do to hold the tears in until I got home that night. I still get teary just remembering. There was shame, frustration, humiliation, and a sense that no matter how hard I tried, I would never be able to write something beautiful. And there was pain, real physical pain, when I wrote. The effort it took to grip the pencil and control it, especially for long periods, left my wrist and hand sore. I assumed that everyone experienced that. I thought it was normal.” - E. L. Lyons (published a 493-page epic fantasy novel)  

For most of us, learning to write happened naturally, and we can’t even remember how it all started. Children usually begin with scribbling, painting, and drawing, and over time, their writing becomes clearer and neater. However, for children with Dysgraphia, writing is a difficult and frustrating challenge. They struggle to spell words, form sentences, and organize their thoughts properly, even when they have good intelligence and receive proper instruction.

The signs of Dysgraphia include messy handwriting, uneven letter shapes, trouble spelling, and difficulty putting ideas on paper. Children with Dysgraphia exhibit problems in handwriting, spelling, or both, either separately or together. These kids usually have strong verbal skills, although they struggle with writing, therefore, in early years these signs may go unnoticed till the child reaches elementary school as demands of written work in school increase.

How to recognize the signs early?

Kids in preschool may struggle with how to hold a pen or pencil. They might grip it awkwardly or sit in a strange position while writing. As a result, they may get tired quickly or feel frustrated, which can lead them to avoid tasks that involve writing or drawing. Moreover, the writing would look inconsistent, often using both upper- and lower-case letters in the same word or writing the text in varying sizes or shapes, spilling out of the margins or looking jumbled, slanted, or hard to read. The child grips the pen tightly and holds it too close to the paper owing to the motor difficulties. The pace of writing is slow as they struggle to remember and visualize the letters.

Dysgraphia is not just a problem of bad handwriting; it is much deeper. It is a condition linked to the way the brain works, affecting both writing skills and motor coordination. Children with Dysgraphia find it hard to complete written assignments on time or keep up with their classmates. This can lead to frustration, low self-esteem, and falling behind in school. These kids need extra support and teaching methods tailored to their needs to make progress.

What is the Cause of Dysgraphia?

There are different ideas about why dysgraphia develops.

The Role of the Brain in Writing Difficulties

Problems in certain areas of the brain can lead to difficulties with writing. The cerebellum, a part of the brain, is responsible for important tasks such as controlling movement, learning motor skills, maintaining clear vision, keeping balance, maintaining posture, and supporting cognitive functions like language and decision-making. If the cerebellum is not functioning properly, it can result in writing difficulties. Cerebellar dysfunction is the reason why kids with dysgraphia struggle to hold a pencil correctly or form letters neatly, as their brain has trouble coordinating the fine motor skills needed for writing.

The Genetic Influence on Language and Literacy Skills

Genetics also plays a role in how we learn and process language. For example, the gene, chromosome 6 is linked to the ability to recognize and work with the individual sounds in words (phonemes). This ability is essential for learning to read in languages that use an alphabet. Another gene, chromosome 15, has been linked to difficulties with reading and spelling.

Early Development and Its Impact on Brain Health

The brain's development is especially sensitive during pregnancy and right after birth. Factors like drinking alcohol during pregnancy, being born too early, or experiencing neglect or abuse can harm brain development. Research also shows that issues with the cerebellum are connected to other conditions, like dyslexia, autism, and anxiety.

What is the Writing Process, and How Does Dysgraphia Interfere?

When we engage in writing we require several mental and physical skills, such as forming letters, organizing ideas, and turning thoughts into words. Children start by learning how to write letters and symbols, then move on to creating sentences and paragraphs. This process requires motor skills, spatial awareness, and language abilities. While most children with dysgraphia can read, they often struggle to write clear and coherent sentences.

Here are some common types of dysgraphia:

• Dyslexic Dysgraphia: Children with this type write messy or illegible work but can copy text more clearly. However, they usually struggle with spelling.
• Motor Dysgraphia: This type involves weak hand coordination or poor motor skills. Children have trouble forming letters, and writing is very tiring for them, even when copying. Spelling is usually not a problem.
• Spatial Dysgraphia: This occurs when children have trouble understanding space and positioning. Their writing might have uneven spacing between words or difficulty staying on the lines.
• Phonologic Dysgraphia: Children with this type have difficulty telling apart made-up words from real ones. They struggle to sound out words and often have poor verbal memory.

What is the Likelihood and Consequences?

Dysgraphia is estimated to affect 4-20% of school-aged children, with varying degrees of severity. It is often underdiagnosed, as many assume poor handwriting is simply a lack of effort or practice. There is no specific medical test to diagnose dysgraphia, but it’s important to check for other conditions like ADHD, autism, or mood disorders because these often happen alongside dysgraphia.

This condition can lead to frustration and low self-esteem, particularly in an academic environment where written expression is heavily emphasized. Teachers and peers may misinterpret the child’s difficulties as laziness or lack of ability, further eroding their confidence. Over time, untreated Dysgraphia can result in anxiety, avoidance of writing tasks, and a reluctance to participate in academic or social activities.

Children with Dysgraphia may also develop secondary mental health issues, such as social anxiety or depression, due to repeated criticism and perceived failure. They may feel isolated, struggling to communicate their thoughts effectively through writing, even if they excel in other areas.

What are the Treatments?

There is no one-size-fits-all cure for Dysgraphia, it is a lifelong process of identifying and developing ways to cope with tasks that require writing. A combination of different approaches, often tailored to suit the child’s writing abilities and confidence is utilized to treat Dysgraphia.

Treating dysgraphia is complicated and requires an Occupational Therapist (OT). An OT helps children develop motor skills, hand strength, and coordination, improving their handwriting. A skilled therapist would utilize various exercises to assist the child to improve their gross motor skills (arm, shoulder, and core strength) and fine motor skills (hand and finger coordination) and posture.

Practice and repetition of is essential to remember how to write as these children find it hard to remember how to form letters. Visualizing the letters, tracing letters with a finger or pencil, connecting dots to form letters, copying letter shapes, or drawing letters in the air assist the person to learn how to form letters clearly. However, continuous practice is necessary to write naturally.

Additionally, Tools like speech-to-text software, typing programs, or digital notebooks allow children to bypass the physical act of writing and focus on expressing their ideas.

Remediation, or in other words targeted support and interventions are necessary to help individuals overcome learning difficulties with the likes of Dysgraphia. In school, students with dysgraphia should receive extra support, such as one-on-one educational therapy. This therapy helps students develop strategies to manage their challenges and improve their work. Educational therapy often happens outside the classroom and focuses on the child’s specific needs, helping them build new skills to work around their difficulties with writing.

Moreover, support from parents and teachers is equally vital. Encouraging a child with Dysgraphia to use alternate methods of communication, such as verbal presentations or drawings, can help them build confidence and showcase their abilities. A supportive environment where mistakes are viewed as lessons and opportunities for growth is lucrative to stimulate the child’s self-esteem and confidence.

If there are concerns or indications of the symptoms, the child might need to be seen by a specialist, such as a child neurologist or psychiatrist, for further evaluation. In certain schools, a team of professionals like teachers, therapists, and psychologists usually work together to assess the child and decide if they have a specific learning disability, which can lead to an Individualized Education Plan (IEP) to support the child’s learning needs.

Author

Sasitha Edirisinghe (Aspiring Psychologist, Adv. Diploma in Psychology and Counselling)

References

Chung, P. J., Patel, D. R., & Nizami, I. (2020). Disorder of written expression and dysgraphia: Definition, diagnosis, and management. Department of Pediatrics, University of California Irvine; Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine.

Dysgraphia Life. (n.d.). Success stories: Teens & adults. Retrieved January 14, 2025, from https://www.dysgraphia.life/for-teens-adults/success-stories-teens-adults

Edgewood Independent School District. (2020). Dysgraphia handbook (Updated November 2020). Edgewood ISD. https://cdnsm5-ss11.sharpschool.com/UserFiles/Servers/Server_8034479/File/District/Special%20Programs/District%20Testing/Edgewood%20ISD%20Dysgraphia%20Handbook.pdf

Gary, A., Moore, A., Hilliard, W., Day, M., Boswell, B., & Barnhill, M. (2023). Understanding dysgraphia. Nursing Made Incredibly Easy!, 21(2), 50–55. https://doi.org/10.1097/01.nme.0000913956.02847.5a

Yuniari, N. M. (2023). Learning disability (dysgraphia): A case study on a second-grade student at elementary school. Jurnal Pendidikan Bahasa Inggris Undiksha, 11(2), 159–166.