My kid has been diagnosed with dysgraphia- Now what?

Dysgraphia is considered a specific learning disability and interestingly it is not really about handwriting. It’s a deficit in the process of writing. It is not merely a poor end product or end result.

Typically, to be diagnosed with dysgraphia, one would be seen by a psychologist, developmental pediatrician or other specialist who can diagnose. OT’s can’t do any diagnosing. We may note deficits and allude to red flags indicating dysgraphia, but we don’t diagnose.

Often families come to me with a list of specialists and recommendations from the evaluation. These can be recommendations for seeing medical specialists such as an OT or SLP. It may also suggest a reading specialist or educator with a background in writing disorders. I’ve also seen recommendations for specific remediation programs such as reflex integration. The question is where to start?

How to prioritize when given a diagnosis of dysgraphia

As an OT of 25 years, I can honestly tell you that my experience has shown getting a good reading/ writing teacher with a back ground in writing disorders is the place to start. A reading and writing teacher will help the child learn some specific skills to be able to organize their thoughts and improve fluency for writing. Not to mention they specialize in reading….and the writing process.

So, when do I contact a speech therapist?

A child may have dyslexic dysgraphia which overlaps with dyslexia. These children struggle with reading and will have trouble with writing. Usually, motor is not impacted as this is a more language-based disorder. Spontaneous reading can be illegible but writing is legible. Typically, drawing is very intact.

Here, the speech therapist is an essential member of your team. You may want to speak to an occupational therapist to discuss accommodations and assistive technology.

Where does an Occupational therapist come in??

An OT is helpful if the child has challenges with grapho-motor dysgraphia

Grapho-motor dysgraphic results in deficits in fine motor, motor integration, muscle tone, and postural supports. It can affect a wide range of motor-based tasks and often coincide with dyspraxia. Often times, spelling is not typically affected. Spontaneous and copy work are poor to illegible. There is a breakdown between the language centers of the brain and the motor map signals being sent to the fingers.

Children who have grapho-motor dysgraphia often demonstrate uneven, slanted writing with poor directionality. They may have difficulty with using intrinsic finger musculature to create small enough letters to fit in between the lines.

OT’s can help with Spatial dysgraphia.

This dysgraphia is mostly about visual processing rather than visual motor difficulties. Drawing and writing are difficult. Spelling is typically not affected. There is a general weakness in understanding space. Children write off the page, have poor letter sizing, start in the middle of the page. Typically, it is seen with children who have sensory processing disorders and body awareness does difficulties. There may be poor spacing.

Children may have multiple executive functioning deficits when they have dysgraphia.

Written expression is one of the most complex academic tasks each child will be asked to do. It is the Apex of mental and physical multi function. Writing involves memory, attention, organizational thought planning, prioritizing, inhibiting, and emotional control.

Any breakdown will result in likely challenges. We often see writing struggles with children who have ADHD. They would rather tell you than write it.

Also, dysgraphia often overlaps with sensory processing difficulties.

Resulting in writing that is poorly formed, pencil grip that is too hard or too light, and poor spacing and alignment. An OT can help with all these issues. G