dysgraphia

Generality

Dysgraphia is a specific learning disability that, in the carrier subject, determines numerous problems in writing letters and numbers.

These are typical problems of those suffering from dysgraphia: the difficulty in holding a pen or pencil, the inability to respect the lines present in the notebooks, the tendency to make spelling mistakes, etc.

Like other specific learning disorders (dyslexia, dyscalculia, etc.), dysgraphia is an innate and permanent disability, which usually arises shortly before or immediately after the start of elementary school.

Most likely, the onset of dysgraphia is linked to a deficit of so-called working memory.

Today, those suffering from dysgraphia can count on a support program for the specific strengthening of writing skills.

What is dysgraphia?

Dysgraphia is a specific learning disability, which, in the carrier person, causes difficulty in writing and graphic reproduction of alphanumeric characters .

The dysgraphia - that is, those who suffer from dysgraphia - has problems with holding a pen or pencil, is unable to align the letters of a word or phrase, writes in a very disordered manner, makes numerous spelling mistakes and, finally, he is unable to bring his thoughts back into a clear and organized written language.

In general, dysgraphia is a problem that emerges at a young age - or just before school or in the early years of school - and that is maintained throughout life .

ORIGIN OF THE NAME

The word "dysgraphia" comes from the Greek and is, to be precise, the result of the union of the pejorative prefix "dis" (δυσ) with the word "grafia" (γραϕία), which means "writing".

Literally, dysgraphia means "bad writing".

IS IT AN INNATE DISORDER?

Doctors and experts believe that dysgraphia is an innate condition .

In other words, the individual with dysgraphia would be born with a low propensity to written expression.

DEFINITION ACCORDING TO THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS

Introduction: the Diagnostic and Statistical Manual of Mental Disorders (abbreviated as DSM) is a collection of all the peculiar characteristics of known mental and mental illnesses, including the respective criteria required for diagnosis.

The doctors and psychologists who drafted the last edition (the V) of the DSM considered that it was more correct to identify dysgraphia with a different wording, namely: disturbance of the written expression .

Anyone wishing to consult the aforementioned text, to understand the dysgraphia in detail, must take into account this change of name.

IS IT SYNONYMOUS OF AGRAFIA?

Dysgraphia and agraphia are two slightly different problems, therefore those who use the two terms indiscriminately make a mistake.

The disorder is an acquired disorder characterized by the complete loss of writing ability resulting from a brain injury, a stroke episode or a progressive neurological disease.

Epidemiology

The exact incidence of dysgraphia in the general population is unknown.

However, based on the results of the most recent surveys, this particular learning disability, which affects written expression, would be more common than one would think.

For reasons that are still unknown, dysgraphia is a problem encountered with a higher than normal frequency in subjects with dyslexia, ADHD (ie attention deficit hyperactivity disorder ) or dyspraxia .

LEARNING DISORDERS: WHAT ARE THEY?

The specific learning disabilities are disabilities (not diseases!) Which, in those who carry them, are cause for obvious problems in reading, writing and calculating.

Among the learning disabilities, in addition to dysgraphia, include the aforementioned dyslexia, dyscalculia and dysorthography .

Classification

Doctors and experts in specific learning disorders believe that there are three different subtypes of dysgraphia: dyslexic dysgraphia, motor dysgraphia and spatial dysgraphia.

Main features of dyslexic dysgraphia:

the spontaneous writing of texts is illegible, in particular if the text is complex; the ability to write orally dictated texts is very poor; the drawing and copying of written texts are relatively normal; the speed of fine motor movements (fine motor skills) is normal.

Main features of motor dysgraphia:

spontaneous writing and copying of texts are not legible; the ability to write under dictation can be normal; the drawing is quite problematic; fine motor movements are difficult.

Main features of spatial dysgraphia:

calligraphy is illegible in all writings (spontaneous and copied); oral spelling is normal; the design is very problematic.

Causes

The precise causes of dysgraphia remain, for now, a mystery.

According to the most reliable studies, a deficit of so-called working memory, a deficit through which an individual would be incapable of remembering and making his own the sequence of movements necessary for writing letters and numbers, would play a fundamental role.

In simpler words, the experts believe that the dysgraphic subjects lack the brain capacity that allows to memorize the movements for writing, in such a way as to reproduce them without problems, automatically.

Recently, some research has brought to light a possible correlation between dysgraphia and a genetic alteration (mutation) affecting chromosome 6. This discovery still presents several question marks, which deserve a proper investigation.

Symptoms and Complications

See also: Symptoms of dysgraphia

Dysgraphia causes a series of symptoms and signs, which, for convenience of consultation, experts group into 6 categories:

• Category 1: visuo-spatial difficulties . This category includes:
• The difficulty in recognizing the shape of similar alphanumeric characters and deciphering the spacing between the letters.
• The difficulty in organizing and planning on the page the words from left to right.
• The tendency to write letters in every direction.
• The tendency not to separate the various words. So, on the page, there is actually a very long sequence of letters.
• The difficulty to respect the lines of writing present on the pages or to remain within the margins.
• The difficulty in reading / deciphering maps or drawings.
• The difficulty in reproducing certain forms.
• A slowness evident in copying a written text.
• Category 2: difficulties related to fine motor skills . This category includes:
• The difficulty in correctly holding a pencil or pen, in properly using cutlery (in particular the knife), in lacing up shoes, in writing an SMS and / or typing keyboard buttons.
• The difficulty in using the scissors properly.
• The inability to color a figure without leaving the margins.
• The tendency to hold hand, wrist and / or arm in an uncomfortable position, during writing. This can lead to cramping of the aforementioned anatomical areas.
• Category 3: problems related to language processing . This category includes:
• The difficulty in writing down ideas and thoughts.
• The difficulty in understanding the rules of a game.
• The difficulty in following the instructions given.
• The tendency to lose the thread of thought.
• Category 4: spelling and handwriting problems . This category includes:
• The difficulty in understanding and appropriating spelling rules.
• The difficulty in identifying incorrect words.
• The tendency to make spelling mistakes, despite a correct oral language.
• The tendency to incorrectly spell words in many different ways.
• The tendency to incorrectly perform the spelling check.
• The tendency to mix uppercase and lowercase letters.
• The tendency to mix the italic font with the block letters.
• The difficulty in reading one's own writing.
• Preference for not writing, in order to avoid embarrassment.
• The tendency to erase written words.
• The tendency to tire easily while writing a very short text.
• Category 5: grammar problems . This category includes:
• Difficulty in using punctuation correctly.
• The tendency to insert commas even where not necessary (use of commas).
• The difficulty in using the right verbal time.
• The tendency not to use the capital letter at the beginning of a sentence and after a period.
• The difficulty in writing sentences with a complete meaning and the preference for writing in list format.
• Category 6: problems related to the organization of written language . This category includes:
• The difficulty in telling a story from the beginning.
• During the telling of a story, the tendency to leave out important facts or notions and to tell, instead, superfluous events.
• The tendency not to make the topic of discussion explicit, with the idea that others understand it from certain references.
• The tendency to describe facts, events or circumstances in a very vague manner.
• The tendency to write confusing sentences.
• The tendency not to "ever get to the point" of the situation or the tendency to get there repeatedly, reiterating the final concept.
• The tendency to express one's ideas and thoughts better through oral language.

WHEN DO THE FIRST EXHIBITIONS APPEAR?

Generally, an individual with dysgraphia manifests the first problems of disability when he begins to write, therefore towards the age of kindergarten or elementary school.

• In preschool, patients show a reluctance to write and draw. Moreover, compared to peers, they do not like to draw at all.
• In elementary school age, patients tend to: write illegibly; mix the italics with the block letters; do not stay on the writing lines of notebooks; write by continuously varying the size of the letters; read aloud while writing; finally, to encounter numerous difficulties in expressing oneself with written language.
• In adolescence, patients write only simple sentences, as sentences with subordinates are problematic. Moreover, they commit numerous grammatical errors, much more than those committed by an equal age.

CONSEQUENCES ON THE PSYCHO-EMOTIONAL SPHERE

Suffering from dysgraphia can have various consequences also on the psycho-emotional sphere .

In fact, people with this disability are aware of their difficulties and, feeling "different" from their peers, tend to isolate themselves socially and develop low self-esteem, low self-efficacy, a sense of inferiority, anxiety attacks, frustration (because, despite efforts do not get the desired results) and depression (in the most severe cases).

AS THE DISAGRAFIA INFLUENCES THE DEVELOPMENT OF A CHILD

The impact of dysgraphia on a child's development can be significant.

In fact, this disability can affect:

• Academic growth . As a result of the reduced writing skills, young people with dysgraphia are particularly slow in school work: they are unable to meet the time of delivery of homework in class, they spend a lot of time performing homework, cannot take notes, etc.
• The skills and abilities required in everyday life . Often, children with dysgraphia have motor problems, which prevent them from making very simple daily gestures such as buttoning up a jacket or shirt, compiling a trivial list of things, etc.
• The socio-emotional sphere . As mentioned, dysgraphia causes social isolation, low self-esteem, a sense of inferiority, frustration, etc.

DISGRAFY DOES NOT MEAN A LACK OF INTELLECT

Contrary to what many believe, dysgraphia is not an expression of reduced intellectual capacity or even laziness.

Individuals with dysgraphia, in fact, are subjects with an average intelligence, who can collect, in the scholastic and work context, the same success as a person who does not suffer from any specific learning disability.

CONDITIONS ASSOCIATED WITH DISGRAFIA

For reasons that are still unknown, dyscalculia is associated with: dyslexia, attention deficit hyperactivity disorder (ADHD), dyspraxia or specific language disorders .

At the present time, doctors and experts in the field of dysgraphia are trying to understand whether there is a link between the latter and the appearance of the aforementioned associated problems.

Diagnosis

In general, the diagnostic procedure for detecting dysgraphia involves a team of professionals (including doctors, speech therapists, psychiatrists, psychologists and experts in learning disorders) and provides a series of evaluation tests that measure:

• The skills of written expression.
• Fine motor skills.
• The impact of dysgraphia on academic growth and on the socio-emotional sphere.

WHAT ARE THE ASSESSMENT TESTS?

Evaluation tests used to diagnose dysgraphia include:

• Tests of writing and copying of a text.
• The observation of posture and position taken by the patient while writing.
• The observation of how the patient holds the pen or pencil.
• The observation of how tiring it is for the patient to engage in writing exercises (cramps in the hands, pain in the arms, etc.).
• The observation of the writing speed.
• The observation of how much the patient is affected by his disability.
• The observation of how much the patient is emotionally and socially affected by his disability.

TYPICAL AGE OF DIAGNOSIS

In most cases, dysgraphia emerges clearly around the third grade (9 years). Therefore, in general, the diagnosis occurs at this age.

Support tools

Premise: dysgraphia, like other specific learning disorders, is a permanent disability and not a disease. Therefore, talking about therapies or treatment techniques is inaccurate and could lead some readers to believe that recovery is possible.

In other words, an individual with dysgraphia will never be able to acquire the writing skills of a healthy person.

Today, individuals with dysgraphia can count on a support program with a dual objective: the strengthening of writing skills and the recovery, as far as possible, of the so-called basic automatisms (ie coordination of sight-movement, spatio-temporal organization, muscular relaxation, balance etc).

From a practical point of view, the support program envisaged in the case of dysgraphia includes: exercises for the improvement of the basic automatisms and the use of the so-called compensatory ("compensatory" tools and methods because they compensate the patient's gaps).

IMPROVEMENT OF BASIC AUTOMATION

The improvement of the basic automatisms includes exercises aimed at strengthening hand-eye coordination, muscular strength, dexterity in holding objects such as pens or pencils, balance, space-time organization, etc.

The task of subjecting the patient to these exercises lies with specialized therapists in the field of specific learning disorders.

INSTRUMENTS AND COMPENSATORY METHODS

The compensatory tools and methods provided in case of dysgraphia include: electronic writing instruments, special notebooks and changes to the school workload .

Electronic writing tools make it easier to perform homework in the classroom and collect notes during lessons.

Special notebooks are notebooks that have writing spaces delimited by colored lines (usually blue or yellow), so as to facilitate the spatial organization of a text written on the white pages. Among the special notebooks, the most used are the so-called Erickson notebooks .

Finally, the modifications of the school work load consist essentially in the granting of the possibility of writing shorter texts and answering fewer questions, during classroom exercises.

To describe the compensatory tools and methods (and their purpose) by comparison, experts in the field of dysgraphia and other specific learning disorders tend to define them as " like glasses for a short-sighted person ".

In Italy, the use of compensatory tools, as a support for people with dysgraphia, is also required by law (to be precise, law 170/2010).

Important note!

Some might think that compensatory tools facilitate the scholastic pathway of subjects with dysgraphia, making the study load less burdensome.

However, it should be pointed out that this is not the case at all: in the scholastic context, compensatory instruments represent neither a facilitation nor an advantage, therefore any criticism of their use is superfluous.

TIPS FOR PARENTS

The contribution that parents can provide to enhance their child's writing skills with dysgraphia is essential.

In general, experts advise fathers and mothers of dysgraphic children of:

• Observe and take note of what the writing difficulties of your loved one are. Every patient with dysgraphia represents a case in itself and, for therapists, knowing what the patient's precise difficulties are makes the planning of the support program easier.
• Accustom your loved one to practice some simple warm-up exercises. The purpose of these exercises is to reduce the stress and anxiety that writing can cause to the detriment of a dysgraphic subject.
• Let your loved one play games, aimed at strengthening motor skills. Through these games, the patient strengthens the hand muscles and increases the sight-movement (or visuo-motor) coordination skills.

Prognosis

For a permanent disability such as dysgraphia, discussing a positive prognosis may be inappropriate.

However, it is important to point out that the process of strengthening the capacity of writing letters and numbers is all the more effective, as soon as it begins.

In other words, a patient with dysgraphia who relies early on support strategies draws from them more benefits than a patient with dysgraphia who delays the onset of empowerment.