What is dysgraphia?

Dysgraphia is a Greek word.

The base word graph refers both to the hand’s function in writing and to the letters formed by the hand. The prefix dys indicates that there is impairment. Graph refers to producing letter forms by hand. The suffix ia refers to having a condition. Thus, dysgraphia is the condition of impaired letter writing by hand, that is, disabled handwriting. Impaired handwriting can interfere with learning to spell words in writing and speed of writing text. Children with dysgraphia may have only impaired handwriting, only impaired spelling (without reading problems), or both impaired handwriting and impaired spelling.

What causes dysgraphia?

Research to date has shown orthographic coding in working memory is related to handwriting and is often impaired in dysgraphia. Orthographic coding refers to the ability to store written words in working memory while the letters in the word are analysed or the ability to create permanent memory of written words linked to their pronunciation and meaning.

Children with dysgraphia do not have primary developmental motor disorder, another cause of poor handwriting, but may have difficulty planning sequential finger movements such as the touching of the thumb to successive fingers on the same hand without visual feedback. Children with dysgraphia may have difficulty with both orthographic coding and planning sequential finger movements.

Kids with dysgraphia have unclear, irregular, or inconsistent handwriting, often with different slants, shapes, upper- and lower-case letters, and cursive and print styles. They also tend to write or copy things slowly.

Parents or teachers may notice symptoms when the child first begins writing assignments in school. Other signs of dysgraphia to watch for include:

Cramped grip, which may lead to a sore hand

Difficulty spacing things out on paper or within margins (poor spatial planning)

Frequent erasing

Inconsistency in letter and word spacing

Poor spelling, including unfinished words or missing words or letters

Unusual wrist, body, or paper position while writing

This learning disability also makes it hard to write and think at the same time. Creative writing tasks are often especially hard.


The first step is for your child’s pediatrician to rule out any other diseases or conditions that could cause writing difficulties.

A licensed  psychologist trained in learning disorders can diagnose dysgraphia. This could be your child’s school psychologist. The specialist will give your child academic and writing tests that measure his ability to put thoughts into words and his fine motor skills. For instance, he may be asked to tap his fingers or turn his wrist a certain way.

Your child also may be asked to write sentences or copy words and letters. The specialist will look at his:

Finished work

Hand and body position

Pencil grip


Writing process


There’s no cure for dysgraphia. Treatment varies from child to child and depends on whether he has any other learning disabilities or health conditions. Medication used to treat  ADHD has helped with dysgraphia in some kids who have both conditions.

How can I help my child?

Here are some things you can try:

Have your child use wide-ruled paper, graph paper, or paper with raised lines to help with letter and word alignment.

Try pencil grips or other writing aids for comfort.

Let her use a computer to type instead of write, and teach typing skills early.

Don’t criticise sloppy work. Praise her hard work and offer positive reinforcement.

Acknowledge the condition and talk to your child about it.

Teach her ways to relieve stress before writing. For example, have her shake or rub her hands together quickly.

Let her squeeze a

stress ball to improve hand-muscle strength and coordination.

Some things you might ask for include:

Shorter writing assignments or different questions from her classmates

Use of a computer to type instead of write

Copies of the class notes to limit writing work

Use of a voice-to-dictation machine or another electronic note taker

An option to record the teacher’s lectures

Video or audio reports instead of written homework assignments

Oral instead of written exams

Does dysgraphia occur alone or with other specific learning disabilities?

Children with impaired handwriting may also have attention-deficit disorder (ADHD)–inattentive, hyperactive, or combined inattentive and hyperactive subtypes. Children with this kind of dysgraphia may respond to a combination of explicit handwriting instruction plus stimulant medication, but appropriate diagnosis of ADHD by a qualified professional and monitoring of response to both instruction and medication are needed.

Dysgraphia may occur alone or with dyslexia (impaired reading disability) or with oral and written language learning disability (OWL LD, also referred to as selective language impairment, SLI).

What kinds of instructional activities improve the handwriting of children with dysgraphia?

Initially, children with impaired handwriting benefit from activities that support learning to form letters:

Playing with clay to strengthen hand muscles;

Keeping lines within mazes to develop motor control;

Connecting dots or dashes to create complete letter forms;

Tracing letters with index finger or eraser end of pencil;

Imitating the teacher modeling sequential strokes in letter formation; and

Copying letters from models.

Subsequently, once children learn to form legible letters, they benefit from instruction that helps them develop automatic letter writing, using the following steps to practice each of the 26 letters of the alphabet in a different order daily:

studying numbered arrow cues that provide a consistent plan for letter formation

covering the letter with a 3 x 5 card and imaging the letter in the mind’s eye

writing the letter from memory after interval that increases in duration over the handwriting lessons

writing letters from dictation (spoken name to letter form).

Do children with dysgraphia make reversals or other letter production errors?

Some children do make reversals (reversing direction letter faces along a vertical axis), inversions (flipping letters along a horizontal axis so that the letter is upside down), or transpositions (sequence of letters in a word is out of order). These errors are symptoms rather than causes of handwriting problems. The automatic letter writing instruction described earlier has been shown to reduce reversals, which are less likely to occur when retrieval of letters from memory and production of letters have become automatic.

What kind of instructional strategies improve spelling of children with dysgraphia?

If children have both handwriting and spelling problems, the kinds of handwriting instruction described earlier should be included along with the spelling instruction.

Accommodations offer alternatives to written assignments:

Providing additional time for note-taking, copying, and tests.

Starting projects or assignments early.

Providing the student with an outline so he can fill in details under major headings instead of taking notes.

Dictating some assignments or tests using a scribe.

Allowing abbreviations in some writing.

Not counting spelling on rough drafts.

Using a spell checker or having another student proofread his work. Allowing the student to print or write in cursive, whichever is most legible. Encouraging younger students to use paper with raised lines. Allowing older students to use a different line width. Allow students to use different color paper, pens, or pencils. Allowing the student use graph paper for math to help with lining up columns of numbers.

Source: Jones, S. (1999). Dysgraphia

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