Difficulty with handwriting frequently occurs in children with dyslexia. When Texas passed dyslexia legislation, the co-existence of poor handwriting with dyslexia was one reason why dysgraphia was called a related disorder. Subsequently, dyslexia and dysgraphia have been found to have diverse co-morbidities, including phonological awareness (Döhla and Heim, 2016). However, dyslexia and dysgraphia are now recognized to be distinct disorders that can exist concurrently or separately. They have different brain mechanisms and identifiable characteristics.
Dysgraphia is related to dyslexia as both are language-based disorders. In dyslexia, the impairment is with word-level skills (decoding, word identification, spelling). Dysgraphia is a written language disorder in serial production of strokes to form a handwritten letter. This involves not only motor skills but also language skills—finding, retrieving and producing letters, which is a subword-level language skill. The impaired handwriting may interfere with spelling and/or composing, but individuals with only dysgraphia do not have difficulty with reading (Berninger, Richards, & Abbott, 2015).
A review of recent evidence indicates that dysgraphia is best defined as a neurodevelopmental disorder manifested by illegible and/or inefficient handwriting due to difficulty with letter formation. This difficulty is the result of deficits in graphomotor function (hand movements used for writing) and/or storing and retrieving orthographic codes (letter forms) (Berninger, 2015). Secondary consequences may include problems with spelling and written expression. The difficulty is not solely due to the lack of instruction and is not associated with other developmental or neurological conditions that involve motor impairment.
The characteristics of dysgraphia include the following:
• Variably shaped and poorly formed letters
• Excessive erasures and cross-outs
• Poor spacing between letters and words
• Letter and number reversals beyond early stages of writing
• Awkward, inconsistent pencil grip
• Heavy pressure and hand fatigue
• Slow writing and copying with legible or illegible handwriting (Andrews & Lombardino, 2014)
Additional consequences of dysgraphia may also include:
• Difficulty with unedited written spelling
• Low volume of written output as well as problems with other aspects of written expression
Dysgraphia can be due to:
• Impaired feedback the brain is receiving from the fingers
• Weaknesses using visual processing to coordinate hand movement and organize the use of space
• Problems with motor planning and sequencing
• Difficulty with storage and retrieval of letter forms (Levine, 1999)
Despite the widespread beliefs that handwriting is purely a motor skill or that only multisensory methods are needed to teach handwriting, multiple language processes are also involved in handwriting. Handwriting draws on language by hand (letter production), language by ear (listening to letter names when writing dictated letters), language by mouth (saying letter names), and language by eye (viewing the letters to be copied or reviewing for accuracy the letters that are produced from memory) (Berninger & Wolf, 2016).
Sources for Definition and Characteristics of Dysgraphia
Andrews, J. and Lombardino, L. (2014). Strategies for teaching handwriting to children with writing disabilities. ASHA SIG1 Perspectives on Language Learning Education. 21:114-126.
Berninger, V.W. (2004). Understanding the graphia in dysgraphia. In Developmental Motor Disorders: A Neuropsychological Perspective. D. Dewry and D. Tupper (Eds.), New York, NY, US: Guilford Press.
Berninger, V.W. (2015). Interdisciplinary frameworks for schools: Best practices for serving the needs of all student. Washington, D.C.: American Psychological Association.
Berninger, V.W., Richards, T.L. and Abbott, R. D. (2015) Differential Diagnosis of Dysgraphia, Dyslexia, and OWL LD: Behavioral and Neuroimaging Evidence. Read Writ. 2015 Oct;28(8):1119-1153.
Berninger, V., & Wolf, B. (2016). Dyslexia, Dysgraphia, OWL LD, and Dyscalculia: Lessons from Science and Teaching (Second ed.). Baltimore, Maryland: Paul H Brookes Publishing.
Döhla, D. and Heim, S. (2016). Developmental dyslexia and dysgraphia: What can we learn from the one about the other? Frontiers in Psychology. 6:2045.
Levine, M.D. (1999). Developmental Variation and Learning Disorders. Cambridge, MA: Educators Publishing Service, Inc.