When Karan, who spoke upon condition of anonymity, was pulled up by teachers in class, it was often to do with his handwriting – which bore a marked resemblance to unconscious ants on the page. Turns out though, this wasn’t him being a difficult child – it was him struggling with a condition called dysgraphia.
Ruby Singh, Occupational Therapist at the Dubai-based Little Kids Rehabilitation Centre, explains that dysgraphia is a writing disorder, in which children fail to organise and coordinate their handwriting, making it difficult to read. “This disorder affects about 10 per cent of children, especially boys, and is usually seen in children who are new to writing,” she adds. However, it can appear at any age in relation to certain pathologies such as Dupuytren’s disease, which presents as abnormal thickening of the skin of the palm; or brain disorder Parkinson’s Disease.
Dysgraphia is an amalgamation of two Greek words. United Nations Educational, Scientific and Cultural Organisation (Unesco) and Mahatma Gandhi Institute of Education for Peace and Sustainable Development (MGIEP) explains that the term dysgraphia comes from the words ‘dys’, which means ‘impaired’, and ‘graphia’, which translates into ‘letter forms by hand’.
Are there different types of dysgraphia?
Yes. And these are classified based on quality and speed of handwriting.
Singh explains that there are three types of dysgraphia:
Dyslexia dysgraphia: In this form of dysgraphia, copied words or drawings may be clear but those generated by the child are illegible. Spelling is poor even though an individual’s fine motor skills are normal. Despite the name, a person with dyslexia dysgraphia does not necessarily have dyslexia.
Motor dysgraphia: This form of dysgraphia happens when a person has poor fine motor skills. They may also have poor dexterity. Written work, including copied work and drawings, tend to be poor or illegible. With extreme effort from the student, short writing samples may be somewhat legible. Spelling abilities are usually within the normal range.
Spatial dysgraphia: This results from issues arising with spatial awareness. It is expressed as a difficulty in staying within the lines on a piece of paper or using a correct amount of spacing between words. All forms of handwriting and drawings from individuals with this type of dysgraphia are usually illegible. Spelling skills are not typically impaired.
Signs your child suffers from dysgraphia
These issues may point to the condition:
- Struggling to copy letters or numbers
- Poor or illegible handwriting
- Incorrect or odd spellings
- A mix of cursive and print writing styles
- Using incorrect words
- Omitting words from sentences
- Slow writing speed
- Fatigue after writing short pieces
- Inappropriate letter sizing and spacing
- Difficulty with grammar and sentence structure
- Consistent spelling mistakes despite spending time and effort in learning how to spell words. This includes letter omission, insertion or guessing.
- Unusual position of the body or hands when writing
- Saying words aloud when writing them down
- Watching the hands while writing
- Difficulty in taking notes at school or work
- Difficulties structuring thoughts on paper either at sentence level or paragraph level for older kids
- Overall poor writing outcome compared to what the individual can express orally
“Those with dysgraphia often have other learning disabilities or mental health issues,” warns Singh. “Sometimes, the challenge of living with dysgraphia can lead to anxiety and low self-esteem.”
At what age can it be diagnosed?
It can be spotted as early as four to five years of age, says Singh.
Rudolf Stockling, educational psychologist and head of the Assessment Unit at Dubai-based Lexicon Reading Centre, says: “We always advise parents to give the child more time, that is until they approach seven years of age or are a little older before investigating the possibility of dysgraphia. This is primarily because writing is a very complex process in itself, so writing skills may take longer to develop.”
How is a child diagnosed with a dysgraphia?
You need a team to diagnose and aid a child with this condition. Specialists include:
- Family doctor or paediatrician,
- Occupational therapist, and
“The occupational therapist will observe the child’s pencil grip, hand and body position and writing process. To diagnose a case, a set of symptoms should be present for at least six months, while appropriate interventions are in place,” she adds.
As with most conditions, early intervention can make a big difference.
Is there any treatment for the condition?
While there is no ‘cure’ for the disorder – therapy can improve a person’s ability to communicate and deal with any difficulties that may arise in daily life.
Treatment and management techniques that can help include:
Medications for co-occurring conditions. “Those who have both dysgraphia and attention-deficit hyperactivity disorder (ADHD) may notice improvements in both conditions when they take ADHD medications,” says Singh.
Occupational therapy. With this therapy, people can learn specific skills and techniques to make writing easier. They can learn to improve their fine motor skills and may relearn how to hold a pen or pencil to facilitate better writing, she adds.
Stockling adds: “Research shows that multisensory teaching of writing skills has the greatest impact of helping people with Dysgraphia develop writing skills smoothly up to age and grade level. The principles of the multisensory approach go back to 1920 in the United States, namely the Orton-Gillingham multisensory approach of teaching literacy skills.”
How is dysgraphia different from dyslexia?
“Dysgraphia affects the writing abilities and the child will need occupational therapy as a remedy while dyslexia affects the reading ability and requires speech therapy,” says Singh.
Is dysgraphia indicative of other issues such as ADHD or Autism?
Dysgraphia is one of many disorders that are often seen in children who have autism and ADHD, says Singh.
“Autism and learning disabilities can occur together, but they are distinct from one another. They can also be exclusive, you can have one without the other. However, one study on ADHD has found a 59 per cent association with dysgraphia. The take away point here is that any child with dysgraphia should be examined to look out for autism and ADHD,” she suggests.
How to support a child with dysgraphia at home
Unesco and MGIEP suggest the following:
Observe and take notes. Watch for patterns and triggers that once spotted can be used as teaching points. The notes can also help you communicate more clearly with teachers, doctors or anyone else you enlist to help your child.
Use positive reinforcement: Focus and acknowledge the effort your child is putting in. Explain that drawbacks are just part of the learning curve and stress the importance of keeping at it.
Confidence-boosting activities: Identify your child’s strengths and build on them - use these as a tool to build self-worth.
Use thick writing instruments such as chalks and colour pencils to make gripping easier.
Use lined paper: Or create lines yourself, using highlighters or sketch-pens for the kid to practice on.
Make a ‘spacebar’: If spacing is the issue, use a cut-out or eraser to help the child. Once they finish writing a word, they can place the cut-out then write the next word and so on. This will get them used to the concept.
Subject matters: Is your child trying to get you to say ‘yes’ to a movie or outing? Use it to your advantage, by asking them to write their argument ‘for it’.
Stress-busting exercises: Flexing hand-muscles or using stress-balls can help relax the hand.
Tactics and tasks: Help your child break down assignments into small activities and complete them one by one.
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