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Dysgraphia Explained

By Anna Witkin, Medical Consultant |
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Dysgraphia Definition

Dysgraphia is a learning difference in writing that, like most learning differences, is conceptualized in two different ways. Under the discrepancy model (traditionally used by psychology professionals), dysgraphia is a term used to describe a weakness in writing relative to an individual’s overall cognitive abilities. Many educational systems employ the absolute model of learning differences, which will consider students’ dysgraphia if they consistently perform below grade level in writing, regardless of their capabilities in other academic subjects.

It should be noted that while dysgraphia is not defined in either of the primary classification systems used in psychology (the DSM-5 and ICD-11), there is considerable overlap between dysgraphia and a Specific Learning Disability (SLD) in writing as defined by the DSM-5. Because these terms are sometimes used interchangeably, the DSM-5 criteria for SLD in writing will be outlined below.  

What Is Dysgraphia?

Dysgraphia has been estimated to affect 7-15% of school-aged children, but diagnostic ambiguity makes it difficult to ascertain the true prevalence (Hawke et al., 2009). While studies suggest dyslexia and dysgraphia may be equally common, there is much less awareness of and research devoted to dysgraphia.

The DSM-5 does not define dysgraphia but defines an SLD in writing as an impediment to the ability to learn writing.

To meet the criteria for this SLD, the impairment must be sufficient to cause the student to perform significantly behind their grade level in writing for at least 6 months and persist even after receiving targeted help. These difficulties must not be better explained by a lack of proper instruction, other developmental disabilities, or other neurologic or sensory deficits.

Dysgraphia Symptoms

Children with dysgraphia in preschool and kindergarten may struggle to form letter shapes, have difficulty gripping a pencil, or have trouble difficulty organizing or articulating thoughts on paper. 

People with dysgraphia generally have trouble with writing and exhibit other motor impairments, while dysgraphia in adolescents and adults manifests as difficulties with syntax, grammar, and writing thoughts down.

It must be emphasized that although the above symptoms are quite common in individuals with dysgraphia, many are also common in the general population. Furthermore, formal diagnoses are not made based on the subjective experience of struggling with writing. The primary utility in recognizing these symptoms is prompting appropriate formal testing.

Dysgraphia Testing

One of the essential features of an accurate diagnosis of dysgraphia is a synthesis of the individual’s overall academic capabilities across different domains and throughout time. Because there is so much potential for confounding factors influencing an individual’s academic performance in writing, as much data should be obtained from as many different sources as possible. These sources should likely include the student, parents, teachers, and formal testing. Another important factor to consider is the presence or absence of a marked discrepancy between performance in other subjects and writing. Strong students performing well below their baseline in one subject may be especially likely to benefit from targeted interventions.

It should be noted that given the lack of understanding of the underlying neurologic processes and the many combinations of factors that produce the same result (such as poor academic performance in writing), it is difficult to ensure an accurate diagnosis of dysgraphia.

What Happens After Diagnosis?

After being diagnosed with dysgraphia, individuals will generally be offered accommodations. They may also benefit from more individual instruction. Because each student with dysgraphia may struggle most with different aspects of learning writing, there is no one teaching strategy that will be most effective for everyone. Successful interventions may require trial and error and ongoing communication with the learner.

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Anna Witkin, Medical Consultant

Anna Witkin is a contributing writer for Polygon. Anna holds a BA from UC Berkeley, a Masters in Biomedical Science from Tufts, and researched ADHD, dyslexia, and other learning differences during her time at Dartmouth School of Medicine studying for her MD.

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