Dysgraphia symptoms, types, causes, treatments

The dysgraphia it is a learning difficulty that consists of deficiencies that will cause a child's writing skills to fall substantially below expectations. Difficulty understanding written text, grammatical errors, punctuation errors in the preparation of sentences, poor organization of paragraphs, spelling errors and poor penmanship is common..

Learning to read will involve a wide variety of knowledge, skills and abilities that in many cases will be really difficult to master for many children who may have a written expression disorder (Matute, Roselli & Ardila, 2010).

Disorders of written expression are part of specific learning disorders and refer to the presence of writing skills below what is expected for the child's age, intellectual level and school year (Matute, Roselli & Ardila, 2010).

Written expression implies a set of motor skills and information processing skills that can be altered and, therefore, manifest with difficulties in spelling, handwriting, spacing, composition or organization of the text (Learning Disabilities Association of Ameria, 2016).

All alterations in written expression will significantly infer school performance and in all those activities that require writing as a fundamental tool (Matute, Roselli & Ardila, 2010).

Article index

• 1 Symptoms
• 2 Causes of dysgraphia
  • 2.1 Neurological level
• 3 Does dysgraphia disappear in adults?
• 4 Types of dysgraphia
  • 4.1 Motor dysgraphia
  • 4.2 Dysorthography (developmental dysgraphia)
  • 4.3 Other disorders of written expression
• 5 Treatments for dysgraphia
• 6 Relationship between written expression and dysgraphia
  • 6.1 Cognitive reading prerequisites
• 7 Associated pathologies
• 8 References

Symptoms

The Learning Disability Association of America defines dysgraphia as the presence in children of writing difficulties when they do school work or activities that require the use of writing. It affects both the ability to write and the final motor skills (Learning Disabilities Association of Ameria, 2016).

A child with dysgraphia may present specific problems such as: difficult to read handwriting, inconsistencies in the distribution of space, poor space planning, poor spelling and / or difficulty composing a text (Learning Disabilities Association of Ameria, 2016).

In this way, these are some of the signs and symptoms that we can identify in writing (Learning Disabilities Association of Ameria, 2016):

• Illegible or italic writing.
• Mix of different strokes, lowercase-uppercase letters, irregular sizes or shapes and / or inclination of the letters.
• Unfinished or omitted words or letters.
• Uneven space between words and / or letters.
• Abnormal position of the wrist, body, or paper.
• Difficulty copying lyrics, preview.
• Slow and difficult writing.
• Space distribution on paper.
• Unusual pencil grip.
• Difficulty taking notes when dictating or creative writing.

Causes of dysgraphia

In general, as in other learning disorders, we can consider that there are genetic, neurobiological, perinatal and environmental etiological factors.

Neurological level

At the neurological level, different investigations have shown that there is not a single region responsible for writing, but that the development of this activity is achieved through a wide network of cortical regions.

In this way, depending on the different stages that make up the act of writing, we can highlight the participation of different verbal areas in the brain (Matute, Roselli & Ardila, 2010):

• Perception and understanding of the message: bilateral primary auditory cortex, left associative temporal cortex and occipital areas.
• Message transcoding: angular gyrus and supramarginal gyrus.
• Motor act: sensory areas, associative motor cortex, hippocampus, prefrontal zones.

Various authors suggest that the origin of written expression disorders can be found in a dysfunction of the right cerebral hemisphere. However, others assume that it underlies language alterations mediated by the verbal left hemisphere (Matute, Roselli & Ardila, 2010).

Does dysgraphia disappear in adults?

The American Psychiatric Association (2003) has indicated that currently there is little information about the long-term evolution of these disorders.

Generally, it usually persists throughout the primary and secondary school stage, and sporadically it can also be observed in older children or adults (Matute, Roselli & Ardila, 2010).

From an early age, alterations in written expression can be observed, generally in calligraphy, while in older children the deficiencies will be mainly related to the skills of writing texts and the expression of ideas (Matute, Roselli & Ardila, 2010).

Types of dysgraphia

We can make classifications of written expression disorders based on the type of writing subsystem that is affected or presents difficulties: motor digraphs, dysorthography, other disorders of written expression.

Motor dysgraphia

Difficulties in the motor mechanisms involved in the graphic stroke: pencil pressure, position, body posture, strokes, coordination, spatial organization, rhythmic movements.

Dysorthography (developmental dysgraphia)

Difficulties in acquiring spelling - substitution, omission, exchange of letters, substitution of phonemes, etc..-

Other disorders of written expression

Word spacing, punctuation, grammar, text coherence.

Despite this classification, it is very common to find written expression disorders grouped under the generic heading of dysgraphia..

Treatments for dysgraphia

With early and appropriate intervention, it is possible for most children with dysgraphia to achieve efficient and functional execution of their writing..

In the intervention with this type of alterations we can use different strategies:

• Accommodation: provide alternatives to written expression - oral assessments-
• Modification: make changes in expectations and tasks to avoid a loss of confidence and self-esteem.
• "Treatment": is the fundamental intervention, providing strategies to improve writing and error correction skills.

Although there are different approaches to the intervention of this disorder, it is usually intervened through educational programs. These tend to attend to the specific alterations in the writing that the student presents, together with the cognitive areas that may present a lower performance than expected (Matute, Roselli & Ardila, 2010).

In the case of younger children, it is common to intervene fundamentally in the motor and calligraphic aspects, while in older children, textual aspects that facilitate their academic performance are usually worked on (Matute, Roselli & Ardila, 2010).

Relationship between written expression and dysgraphia

Although most children do not usually present significant difficulties in writing, more and more problems in written expression are being detected, many of which may be due to both the educational system, family environment, socioeconomic status and even neurobiological factors and genetic (Ventura et al., 2011).

Writing is a fundamental tool in daily life; allows us to express ideas and knowledge. In addition, it is not an easy process to acquire, until it reaches an optimal level of automation it requires continuous practice and the provision of various cognitive resources (Ventura et al., 2011).

To achieve legible handwriting, spelling without errors, or to construct a text with a coherent structure, it is essential that we master several writing subsystems (Matute, Roselli & Ardila, 2010):

• The graphic stroke.
• The graphic composition of the word and the spelling aspects.
• The separation between words.
• The orthographic accent.
• The score.
• The grammar.
• The coherence between the texts.

Cognitive reading prerequisites

On the other hand, there will also be a series of cognitive prerequisites when approaching the learning of writing (Matute, Roselli & Ardila, 2010):

• Language and metalanguage: a minimum linguistic level will be necessary to build compositions - phonological skills, semantic aspects, unit processing-.
• Memory and attention: the efficient control of the attention resources will facilitate the task of selecting the important elements, and on the other hand the operative memory will allow us to maintain the topic of the text. In addition, long-term memory will allow us to recover all semantic knowledge regarding the construction of language.
• Reading: writing and reading will share processes, however a good reader child will not necessarily also be a good writer.
• Executive functions: they will be essential for the planning and organization of the text, for the selection of the appropriate construction strategy and also, the simultaneous handling of all linguistic subsystems.
• Affective variables: different clinical reports have related variables such as anxiety, worry and motivation with writing.

Associated pathologies

It is not strange to observe the alterations in written expression associated with other specific learning disorders (Matute, Roselli & Ardila, 2010):

• Reading learning disorder.
• Stone disorder or dyscalculia.
• Language deficit.
• Perceptual deficit.
• Motor deficit.

In addition, it is also possible to observe the alterations of written expression in many children affected by attention deficit hyperactivity disorder (ADHD) or delayed mathematical performance.

References

1. DSF. (s.f.). What is Dysgraphia? Obtained from SPELD Foundation: dsf.net.au
2. LDA. (2016). Dysgraphia. Obtained from the Learning Disabilities Association of America:
   ldaamerica.org
3. National Center for Learning Disabilities. (2016). What is Dysgraphia? Retrieved from LD online- The educator's guide to learning disabilities and
   ADHD: ldonline.org
4. Roselli, Monica; Hooch, Esmeralda; Alfredo, Ardila ;. (2010). Neuropsychology of Child Development. Mexico: The Modern Manual.
5. Ventura, M., Martí, Y., Pechoabierto, N., & Gil, J. (2011). What is and how to deal with the disorder of written expression: practical guidelines.