What is Dysgraphia? Symptoms, Treatment and 17 IEP Accommodations

IEP for Dysgraphia

“Dysgraphia? What’s is dysgraphia? I’ve never heard of it!” This is a scenario that has come up many times to parents in our online chat group. As parents become more informed, we are better able to advocate for our kids.

If you go back even 10-20 years, not many parents had even heard of specific learning disabilities like dysgraphia.

The symptoms for dysgraphia are listed below.

But thanks to social media and groups like mine, parents are able to network and better serve our kids.

Many parents have heard of dyslexia, but there are three other Ds–dysgraphia, dyscalculia and dyspraxia. I have a separate post on getting your child tested for dyscalculia.

Dysgraphia and Dyslexia

As stated above, there are 4 D learning disabilities. These are the 4 Ds, with a very brief explanation of what they are.

  • Dyslexia-person has trouble reading
  • Dysgraphia-person has trouble writing
  • Dyscalculia-person has difficulty with math and numerical concepts
  • Dyspraxia-person has trouble with speech

I was able to find many statistics about prevalence of dysgraphia or dyslexia, but was unable to find solid numbers on the overlap. I also am unable to find valid statistics on how many adults with dysgraphia are out there. Since awareness of dysgraphia is relatively new, I would expect that there are many undiagnosed adults out there.

Dysgraphia and dyslexia get compared often, because reading and writing go hand in hand. Yes, it possible to only have one and not the other. It is also possible to have both.

But, as my friend Judi often says, “Learning disabilities rarely travel alone.” I have yet to meet a child who only has 1 disability. All options should be considered if you are having your child evaluated. Dysgraphia and ADHD can be common, and the same for dyslexia.

As an advocate, I don’t know everything. Nor do I claim to. However, I make it a point to try to track down people who know things that I don’t know.

Luckily for me, my advocacy path enabled me to cross paths with Cheri Dotterer, MS, OTR/L. She has made it her life’s work to know about dysgraphia. So I can’t thank her enough for providing us with this information.

child writing in a notebook

Let’s take a look at what dysgraphia is.

Dysgraphia Definition

The NIH lists the definition of dysgraphia as:

Dysgraphia is a disorder of writing ability at any stage, including problems with letter formation/legibility, letter spacing, spelling, fine motor coordination, rate of writing, grammar, and composition.

From ncbi.nlm.nih.gov

No one is certain what causes dysgraphia. There appears to be a genetic component and found to run in families.

Dysgraphia is not in the DSM by itself. It would be included under the umbrella of “specific learning disorders.” This is not to be confused with the IEP eligibility category of SLD Specific Learning Disability.

As if the whole “medical vs educational” concept wasn’t confusing enough, the entities use similar terms to make it more complicated.

5 Types of Dysgraphia

Most clinicians and experts in the field adhere to the concept of there being 5 types of dysgraphia.

They are:

  • Dyslexic Dysgraphia (so you can see where confusion with dyslexia happens!)
  • Motor Dysgraphia
  • Spatial Dysgraphia
  • Phonological Dysgraphia
  • Lexical Dysgraphia

This kind of deep dive into the characteristics of dysgraphia would happen if your child is found to have a dysgraphia diagnosis.

Dysgraphia Symptoms Checklist

The following list (provided by Karnik & Karnik, 2012) may confuse parents as much as it helps parents.

Dysgraphia signs and symptoms overlap many other learning disabilities.

What does dysgraphia look like?

  • Writing slower than typical students of the same age.
  • Odd positions of the wrist or paper
  • Mixing up upper and lowercase letter forms
  • Inconsistency in forming letters
  • Cramping fingers or hands
  • Irregular letter formation, size, sequencing, or line placement
  • Poor letter organization
  • Unorganized thought processes when writing paragraphs
  • Difficult managing margins
  • Inefficient pencil pressure
  • Poor spelling
  • Intentionally watching their hand write letters
  • Awkward pencil grasp
  • Poor fine motor skills
  • Avoiding writing tasks
  • Letter and number reversal
  • A difficulty with written expression
  • Need extended time to complete tasks

And, according to the Cleveland Clinic, you should be aware of the following signs of dysgraphia.

Dysgraphia can also look like:

  • Difficulties writing in a straight line.
  • Difficulties with holding and controlling a writing tool.
  • Writing letters in reverse.
  • Having trouble recalling how letters are formed.
  • Having trouble knowing when to use lower or upper case letters.
  • Struggling to form written sentences with correct grammar and punctuation.
  • Omitting words from sentences.
  • Incorrectly ordering words in sentences.
  • Using verbs and pronouns incorrectly.

Who diagnoses Dysgraphia?

This is tricky, because it’s not in the DSM.

The diagnosis of dysgraphia is typically made in an educational setting by an IEP team assessment, which can include the following specialists:

  • Occupational therapists
  • Special education teachers
  • School psychologists
  • Speech therapists
  • Neuropsychologists– Neuropsychs are not typically employed by schools and in most cases requires an IEE to acquire.

How is Dysgraphia Diagnosed?

A team of teachers and/or clinicians will assess your child. The specific assessments vary and most include a parent input form of some kind.

If you have concerns about your child and diagnosing dysgraphia, the team will want to see dysgraphia writing samples. If your child’s handwriting and writing (content) is of concern, keep examples to provide to evaluators.

Testing for dysgraphia will likely take place over several sessions so as not to fatigue the child or upset them and cause anxiety.

Dysgraphia testing will likely include assessments and evaluations for the child that are already difficult for the child to do. That’s why it’s important to keep their psyche in mind and their self-esteem intact.

Dysgraphia Treatment

You’d be surprised at how many parents have kids with dysgraphia (and maybe even have it themselves) but they have never heard the word. It happens!

Their gut is telling them that something isn’t right. They can see their child struggling. Yet they struggle themselves to define it, label it and therefore have it addressed properly.

So let’s dig in. Here’s how to help a child with dysgraphia.

First, take a look at the list of dysgraphia symptoms, and see if they match what you are seeing in your child.

If you think your child may have dysgraphia, then they should receive a thorough evaluation in all suspected areas of disability, including a thorough OT eval.

Is Dysgraphia a form of Autism?

The short answer is no. Autism is a spectrum disorder. Dysgraphia is also a spectrum disorder.

This does not mean that the child has autism. It means that dysgraphia has different levels and scattered skills and abilities. Some students can have very mild dysgraphia and some can be very severe.

A child can have both autism and dysgraphia.

It’s important to find a professional who is very familiar with it and knows what to look for. (Yes, of course, I recommend Cheri, her info is at the bottom of the post)

Dysgraphia

This infographic about dysgraphia includes dysgraphia writing samples.

What is Dysgraphia?

There is a developmental heterarchy that is present that begins with the ability to process information. The information is taken into the body to the brain (sensory) and processed.

Approximately 50% of the information is visual. Auditory and tactile information is next. Taste and smell follow on behind. Processing sensory information must be coordinated in several areas of the brain.

Since most are visual, let’s start there. If the person has difficulty understanding the pictures, letters, numbers, etc., they also will have trouble drawing simple shapes, coring, and writing symbols like letters.

Students with dysgraphia may also have difficulty with coordinating the motor output to write or they are clumsy.

Motor control and planning are their predominant issue. Then we have those who cannot remember what they just saw.

Their working memory is interfering with their ability to learn. Language and cognitive development also impact their word and paragraph formation ability.

Children here have a lack of ability to form sentences and cohesive paragraphs.

A student with dysgraphia will avoid writing tasks and assignments.

It is a heterarchy because some areas of each may work well and at any moment in time while the neural pathway for another area is inefficient.

IEP Goals for Dysgraphia

Many students will have an IEP if they have dysgraphia. While there are 14 eligibility categories, SLD or specific learning disability is common.

But, a 504 plan for dysgraphia is not uncommon either.

You can find IEP Goals and Accommodation for Dysgraphia in my IEP goal bank.

Dysgraphia IEP Accommodations

The most useful accommodations for the child will change depending on age/grade, writing expectations, and growth with OT.

  1. Use of a laptop at school and for homework (keyboard instead of writing).
  2. For written homework, use of a scribe. This can be done by a parent, sibling or someone hired.
  3. Provide the student with a copy of notes.
  4. Access to a word processor.
  5. Oral answers instead of written.
  6. Do not penalize handwriting or spelling errors.
  7. Pencil Grips.
  8. Allow use of a student made “dictionary” that contains frequently misspelled words to use as a reference.
  9. Use of a slant board.
  10. Speech to text software, then allow the student to edit work.
  11. Prefilled study guides
  12. Worksheets on the computer, not paper.
  13. Extra time for all work.
  14. Oral or video presentations instead of paper projects.
  15. Allow the student to record verbal lessons/directions/lectures.
  16. Graphic Organizers.
  17. Assistive Technology-The Student should receive a full evaluation and what meets their needs.

Please note that these are accommodations, not interventions. Accommodations do not teach.

Dysgraphia Interventions

Speak with your child’s team, particularly those who are knowledgeable about dysgraphia. Some schools will assign OT services to the child as an intervention.

Others will use programs such as Learning Without Tears/Handwriting Without Tears or Orton Gillingham. Whatever your child is receiving, make sure that you are monitoring their goals and progress.

Any official program (such as OG) will have their program and protocols listed online. Remember that the school is required to use evidence-based practices to address this.

Advice that is commonly given to parents by advocates: If a child does not have the skill, you either need to teach the skill, or accommodate the lack of the skill. Make sense?

So, as you progress, remember that. You don’t want to be offering accommodations when you think the child can learn the skills. At the same time, some kids will max out and need accommodations to be successful. It’s not black and white. Always engage your child in the process and teach them to self-advocate.

About Cheri

Cheri Dotterer, MS OTR/L specializes in Dysgraphia. Cheri has a book. Find it at Barnes & Noble and other places books are sold. I will let you know as soon as it’s on Amazon. I can’t thank her enough for sharing this information with us.

Handwriting Brain-Body DisConnect: Adaptive teaching techniques to unlock a child’s dysgraphia for the classroom and at home
152 Reviews
Handwriting Brain-Body DisConnect: Adaptive teaching techniques to unlock a child’s dysgraphia for the classroom and at home
  • Dotterer, Cheri L (Author)
  • English (Publication Language)
  • 240 Pages - 03/07/2019 (Publication Date) - Author Academy Elite (Publisher)

And yes, of course, Cheri is for hire. She also does IEEs for this and other conditions. Give her a call or visit her website for more information.

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