Dysgraphia

Dysgraphia is essentially a nervous system problem that impacts fine motor skills that are necessary for a child to write.  Evaluations at Brain and Body Integration include writing samples to examine the child’s writing patterns, although we tend to assess for more than just writing ability within our evaluations.  As a clinical psychologist I use the diagnosis, Specific Learning Disorder, with impairment in written expression to assess for more general impairments in writing.  This is the diagnosis used by the DSM-5 to describe a pattern of problems involving writing.  It is defined by impairments in spelling accuracy, grammar and punctuation accuracy, and clarity or organization of written expression.  As you can see, it does not include problems with handwriting (dysgraphia) that are generally a result of fine motor difficulty, but we make sure to assess for this capacity as well.

Learning Disorder AssessmentsHow do you know if your child has Dysgraphia, or a Specific Learning Disorder in
Written Expression? The first line of evidence generally occurs when you notice
your child struggles with writing, spelling, and/or handwriting at home or at
school.  Despite adequate opportunities to learn and practice these
skills, your child struggles with writing and/or handwriting. Once you notice
your child struggles with writing, you can communicate with your child’s school
to explore the possibility of a response to intervention plan.  This is a
strategy that offers various levels of instruction and research-based
interventions that occur in the classroom.  Often, a child can be
diagnosed with Dysgraphia or a Specific Learning Disability in Written
Expression based on their performance within the response to intervention
context. 

However, formal assessment can also diagnose specific learning disorders.  In my opinion, the advantage of formal assessment is that it can more adeptly identify the cognitive factors that contribute to a specific learning disability in writing, and a diagnosis can be obtained without having to wait for your child to pass through the stages of response to intervention.  In addition, formal assessment not only identifies the factors that contribute to difficulties with writing, it can also offer research-based interventions to address difficulties with these different factors.

There are different ways to assess for a Specific Learning Disorder in written expression.  The Individuals with Disabilities Act identifies three methods: discrepancy between cognitive ability and academic performance, the response to intervention classroom strategy, and other research-based methods such as the strengths and weakness model. Based on your professional of choice, compelling arguments can be made for many different assessment models.  Thus, I am always slightly wary of the expert that claims to have the “right way” to assess for a specific learning disorder and discredits other research-based approaches.  The bottom line is that the field of assessment for specific learning disorders is still emerging and growing, and we don’t have the perfect assessment model yet.  However, a lot of research has been conducted and has identified different areas of cognitive ability that are associated with writing performance or writing ability.  Thus, if we are looking for the same underlying deficits, our different assessment models should still lead us to the same goal. At the end of the day, our job is to do the best evaluation we can perform-given the current research at our disposal and evidence-based assessment tools-in order to help your child succeed in the academic arena.