The term dysgraphia is taken from the Greek word, (dys) meaning “bad” or “difficult” and (graphia) meaning “writing.” Thus, “dygraphia” literally means “bad writing”.
For a student with no difficulties with written expression but with generally hard to read and illegible handwriting there is no internationally recognised diagnostic criteria, such as in ICD-10 or DSM V, that a clinician can refer to. According to DSM-V, Dysgraphia would fall under the specific learning disorder category but it is not defined as a specific learning difficulty by itself. There is no professional consensus on specific diagnostic criteria. Some professionals’ take on this is that the dysgraphia label is now obsolete. Consequently you can find many definitions of dysgraphia. They can refer to difficulties with fine motor co-ordination, organisation and presentation of written material, letter reversals, grammar, spelling and punctuation errors, in addition to writing that is difficult to read.
To help guide the underpinning reasons for a difficulty with handwriting is a classification of dysgraphia proposed by Deuel (1995).
Deuel distinguishes three sub-types of this disorder:
(1) dyslexic dysgraphia for when spontaneously written text is illegible while the copy of a written text is relatively preserved;
(2) spatial dysgraphia, which is due to a defect in the understanding of space and characterized by illegible writing, whether spontaneously produced or copied, while handwriting velocity remains normal; and
(3) motor dysgraphia for when both spontaneously written and copied text may be illegible, reflecting motor impairments. In this type of dysgraphia, the handwriting velocity as well as the drawing are abnormal.
Furthermore, and helpful is (2010) Nicholson and Fawcett’s work that concluded that whilst dyslexia and dysgraphia both reflected a lack of automaticity at the cognitive level attributed to impaired circuits of procedural learning located at the cerebellum that a helpful means of understanding the difference was how ‘pure’ dysgraphia reflected an impairment of the cerebellar-motor circuit and ‘pure’ dyslexia reflected an impairment of the cerebellar language circuit.
How we approach Dysgraphia:
Our take on Dysgraphia is that it can be a very useful descriptor for the isolated character of handwriting being so hard to read that it is generally illegible. But this can also be described as a ‘specific and significant difficulty with handwriting’, and we will often use this term as it gets straight to the point!
Our take on labels generally, whilst recognising that they can be useful, is less about the label but what is underpinning the specific difficulty that warrants the label, and that is generally the aim of our assessments: to find out what is underpinning the difficulty. This then leads to specific understanding and therefore guides interventions appropriately.
So with regards to dysgraphia/specific and significant difficulty with handwriting, our assessments will make insightful comments on the child/young person’s handwriting e.g. the pressure, letter sizing, spacing, fluency, legibility etc and conclude as to the degree of difficulty and the impact it is having, and then give recommendations for developing the handwriting and/or developing the child/young person’s use of typing and/or assistive technology.
One of these recommendations may well be for a referral to an Occupational Therapist. This is because a key requirement for handwriting are the motor skills, and this lies most of all within the expertise of an Occupational Therapist. An Occupational Therapist assessment can establish the specific motor and balance reasons that may be contributing to the poor handwriting, and then recommend the relevant motor exercise programme that will help develop the necessary motor strength and control.
Refs:
