Every parent or teacher has witnessed a child's messy handwriting at one point or another. But when is this issue just poor penmanship and when is it a more serious problem? It may be a neurological learning disability called dysgraphia.

This guide unpacks what dysgraphia is, how to recognize the signs of this learning disorder, and provides a roadmap on how to treat it at home and in school. 

What is dysgraphia?

Many take writing for granted in our digital world and forget it's a skill. It requires the ability to organize thoughts in the mind and bring the muscles in the hands and fingers to construct those ideas, letter by letter, on paper.

According to the International Dyslexia Association, dysgraphia is a neurological learning disability that affects writing and usually appears when children first learn to write. This disorder can interfere with learning to spell words in writing and the speed of writing text. Children with dysgraphia may have:

•  impaired spelling (with or without reading issues) 
•  impaired handwriting 
• both impaired handwriting and impaired spelling
  

Dysgraphia may happen alone or together with dyslexia (an impaired reading disability). It can also occur with a general speech or language disorder or alongside an oral and written language learning disability, such as  selective language impairment (SLI). Children with these language disorders may also exhibit the same writing, reading, and related disorders as children with dysgraphia or dyslexia. 

Dysgraphia is considered a specific learning disability (SLD), an umbrella term for reading, mathematics, and written expression disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Ed.  (DSM-5). Students identified with a SLD may receive special education services under the Individuals with Disabilities Education Act (IDEA), a law that provides free and appropriate public education to children with disabilities. To determine if a child has dysgraphia and any co-occurring disorders, a comprehensive evaluation and proper diagnosis from a qualified professional is essential.

Signs of dysgraphia

So, what causes dysgraphia? The truth is, experts are unsure. However, it is typically thought of in two ways: acquired and developmental. When a person loses their (already learned) skills in writing due to a brain injury, disease, or degenerative condition, this is considered acquired dysgraphia. Developmental dysgraphia is when a child has problems attaining writing skills, which we focus on in this article.

Dysgraphia is usually diagnosed by a psychologist specializing in learning disorders. The process may also involve a team of experts, including occupational therapists, language therapists, and educational psychologists. The group uses different tools to determine a diagnosis, including:

• school reports, including grades, behavior, and response to writing interventions
• examination of the child's medical, developmental, and family history
• neuropsychological and cognitive tests
• standardized writing assessments
• Standardized achievement assessments
• Speech and language assessments
• Occupational therapy assessments
  

So, what signs should a parent or teacher watch for that indicate a child should be assessed for dysgraphia? According to Understood.org and Childmind.org, some of the most common red flags include motor and cognitive challenges.

Motor issues may look like:

• difficulty holding pencils and forming letters correctly
• finding writing tiring 
• awkward, tight, or painful grip on a pencil
• illegible or slow handwriting
  

Cognitive (language processing skills) issues may look like:

• struggling with spelling, grammar, sentence structure, and overall written expression 
• difficulty translating ideas onto paper
• writing complete words without skipping letters
• spacing letters correctly
• mixing up the sizes of letters—such as writing some capital letters while others are lowercase
  

Other indicators of dysgraphia may appear as spatial issues or other problems, including:

• difficulty staying within margins or following a line
• trouble following rules of grammar when writing but not when speaking
• noticeable difference between spoken and written understanding of a topic
  

Children can either experience the motor or cognitive side of the disorder or both. Dysgraphia can also look different at various age levels. For example, children with dysgraphia generally struggle with writing mechanics and exhibit other fine motor impairments. In teens and adults, the learning disorder manifests as problems with grammar, syntax, comprehension, and putting thoughts on paper.

Treatment and intervention

Experts find that dysgraphia tends to be poorly understood and can often go undiagnosed for years. Writing problems are also associated with continuous academic struggles and low self-esteem, which can persist into adulthood. With this in mind, evaluating and diagnosing a child early is pivotal to their academic success. Once diagnosed, the next step is for parents and teachers to collaborate with specialists, such as occupational therapists, speech and language therapists,  and special education teachers. These professionals can provide valuable insights and tools for managing dysgraphia in the classroom and beyond. 

Treatment methods include interventions, accommodations, and special services to manage writing-related tasks and enhance writing abilities. Under IDEA, students with learning disabilities like dysgraphia may be found eligible and in need of special education services , and if so, parents will have the opportunity to work with the child's school to develop an individualized education plan (IEP).

Writing interventions can vary based on the student’s specific concern. For example, one student may need special exercises to increase hand strength and improve muscle memory. Another student with dysgraphia may take tests by typing their work instead of writing it. Other dysgraphia treatment options may include:

• utilizing larger pencils and writing aids with special grips or other writing instruments
• using paper with raised lines to help with margins
• having extra time on writing-related assignments and tasks
• using speech-to-text software, note-taking apps, and specialized keyboards to sidestep the obstacles of handwriting and enable students to express their thoughts more easily
• providing prewritten notes or having students use fill-in-the-blank worksheets
  

Treatment measures also include parents doing activities with their children at home. Some exercises may include:

• regular practice of fine motor skills, such as playing with building blocks or threading beads, which can strengthen the muscles used in handwriting
•  daily writing practice to improve handwriting fluency 
• sensory activities like playing with kinetic sand or finger painting to provide the tactile feedback needed to develop better control over writing movements
  

A journey to success

It's important to remember that dysgraphia in no way means a student is lazy, lacks intelligence, or is incapable of success. In fact, with the right support and resources, children with dysgraphia can learn to write and do very well in school. 

Treating dysgraphia is collaborative, requiring understanding and support from parents, teachers, and the broader educational community. With early intervention, specialized instruction, and a nurturing environment, children with dysgraphia can overcome their challenges and become fluent writers.