WOW! If you are on any social media groups for Dysgraphia, you know that this diagnosis can be misunderstood and bring about a wide range of opinions! Opinions of what dysgraphia really is, if and how it is different from written expression disorder, etc. But why the constant disagreement?? I really do not understand. What matters MOST is that children exhibiting the below signs or symptoms get the individualized help that they need, REGARDLESS of what we call it.
True... in order to receive some services, often a child needs a "diagnosis." Whether that be a medical diagnosis for insurance purposes, or an educational diagnosis for school based services.
Thus it is important that we get a proper evaluation and diagnostics. This can happen through a neuropsychologist or educational psychologist.
But even still, I have seen MANY evaluation reports that include labels such as dysgraphia, DOWE (disorder of written expression), SLD in writing (specific learning disability), etc.
Here is what the research and the Diagnostic & Statistical Manual of Mental Disorders says:
"‘Dysgraphia’ and ‘specific learning disorder in written expression’ are terms used to describe those individuals who, despite exposure to adequate instruction, demonstrate writing ability discordant with their cognitive level and age." (Chung, Patel, & Nizami, 2020)
"DSM V does not offer diagnostic criteria for dysgraphia, but does include difficulties with written expression within the criteria for diagnosing specific learning disorder. 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 ICD-10 or DSM V, that a clinician can refer to."
"The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) does not use the term dysgraphia, but uses the phrase ‘impairment in written expression’, a term frequently used by doctors and psychologists."
According to the American Psychiatric Association, to qualify for a diagnosis, an individual must...
1. Have difficulties in at least one of the following areas for at least six months despite targeted help:
Difficulty with spelling.
Difficulty with written expression (e.g., problems with grammar, punctuation or organization).
2. Have academic skills that are substantially below what is expected for the child’s age and cause problems in school, work or everyday activities.
3. The difficulties start during school-age even if some people don’t experience significant problems until adulthood (when academic, work and day-to-day demands are greater).
4. Learning difficulties are not due to other conditions, such as intellectual disability, vision or hearing problems, a neurological condition (e.g., pediatric stroke), adverse conditions such as economic or environmental disadvantage, lack of instruction, or difficulties speaking/understanding the language.
Signs & symptoms of Dysgraphia according to Chung, Patel, & Nizami (2020):
Awkward grip or body position when writing
Tires easily with writing
Avoidance of writing and drawing tasks
Written letters are poorly formed, inversed, reversed, or inconsistently spaced
Difficulty staying within margins
Difficulty with word-finding, sentence completion, and written comprehension
Difficulty with written organization of thought
Difficulty with written syntax and written grammar that is not duplicated with oral tasks
What does all of this mean?
Dysgraphia and SLD in written expression can be used interchangeably. Some children present with motor delays leading to illegible writing, other kids present with adequate legibility but difficulty getting their thoughts onto paper.
Our intervention, remediation, and accommodation is NOT based on diagnosis, but rather on what the child's strengths and areas of difficulty exist. Individually assessing and addressing each student to give them the tools and resources to ensure their "output" shows their knowledge in an efficient and effective manner. PERIOD.
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