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DYSGRAPHIA: Difficulty in WritingDefinition and techniques to overcome it

Rantissi George & Abu Hamad Ziad

Communicating through writing is considered to be a complex human task toincorporate cognitive, perceptual and motor aspects (Rozenblum, Shankar &Gal, 1994). In fact, one of the prime tasks expected of a child in school is towrite. In the moment that this skill has been acquired, it develops to become acrucial tool in the learning process and in our daily life. Writing serves asmeans of communication, used in order to express and report of ideas andopinions. In the learning process, writing serves in organizing the learnedmaterial and in its memorization. Although, in recent years there is an increasein use of advance technological equipments, primarily of word processors,hand writing is still regarded the most accessible and available mean ofcommunication to be used by the majority of the people.

Writing is regarded to be the forth language skill to develop within a childafter three prime developmental prerequisities: understanding, speaking andreading (Ezer, 1991; Sandbeck et al., 1995). A child who is not capable ofwriting will have difficulty to communicate using this channel, andconsequently this may effect his/her school performance along with the negativeeffect on the child’s self-esteem (Sassoon, 1990).

Difficulty in writing may be expressed in a number of ways: irreadablehandwriting (Stott et al., 1986), slow writing (Amundson et al., 1996), badorganization of the written content and either light or too stressed handwriting

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(Cunningham-Amundson, 1992; Sovik, Arntzen & Thygesen, 1987). Difficultyin writing is called Dysgraphia. Dysgraphia is a Latin word. ‘Dys’- meansdifficulty with. ‘Graphia’ refers to the writing process. According to O’Hareand Brown (1989;80) dysgraphia is ‘retarded development or an acquired lossin the skill of writing’. It is one of the many aspects of a learning disability ora learning difference.

According to O’Hare and Brown (Ibid.:80), difficulty in writing may besubdivided into three groups:

1. Abnormalities in motor learning and execution, i.e. penmanship.2. Difficulties with the syntactical aspects of written language, i.e.

spelling, sentence construction (grammar) and punctuation.3. Abnormal content of what is written, i.e. semantic aspects.

This article will focus on the first group of writing difficulties, abnormalitiesin the motor skills and its consequences on the writing process. The other twogroups of writing difficulties will require a separate section for furtherdiscussion.

Shore (1998) notes that dysgraphia is a difficulty in automatically rememberingand mastering the sequence of muscle motor movements needed in writingletters or numbers. This difficulty is out of harmony with the person’sintelligence, regular teaching instruction, and (in most cases) the use of thepencil in non-learning tasks. It is neurologically based and exists in varyingdegrees, ranging from mild to moderate. It can be diagnosed, and it can beovercome if appropriate remedial strategies are taught well and conscientiouslycarried out. An adequate remedial program generally works if applied on adaily basis.

Beginning to WriteThe request to write begins at a very early age in school, usually starting at thefirst days of school, where children are taught to write their names. The basic

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goals of handwriting instruction are to help students develop writing that islegible and can be produced quickly with little conscious attention (Graham etal., 1991). In the early elementary grades, considerable attention is directed atteaching students to form accurately and quickly individual letters. To promoteaccuracy and fluency in context, students also receive considerable practicecopying or composing words, sentences, or longer sections of connecteddiscourse containing the target letters. At this point, teachers often emphasizethe importance of the overall appearance of students’ writing, because factorssuch as neatness can affect other person’s judgments concerning the quality ofa composition (Graham, 1982). It is equally important to help students, assoon as possible, develop a comfortable and effective pencil grip and posturefor writing.

Difficulties with writing often leads to misunderstandings from the part of theteachers, parents and consequently of the students themselves. This is especiallytrue for the bright, linguistically fast students who encounter a major stumblingblock when dealing with written expression due to the lack of smooth, efficientautomaticity in letter and word formation. These students struggle to translatetheir thoughts and knowledge, which then denies their teachers the opportunityto understand what they know.

Marks for Writing DifficultiesA teacher or parent may suspect cases of dysgraphia within a pupil by observingdirectly his/her writing performances. All too often, however, the pupil’sperformance is interpreted as poor motivation, carelessness, laziness, orexcessive speed. While these observations may be very real, they are on thesurface, and the underlying cause may be a dysgraphic pattern which is notwithin the pupil’s control. According to Rief et al., (1996) and Harwell (1989)deficits in writing may result from cramped fingers holding the pen/cil (seefigure 1); odd wrist, and body and paper positions.

Difficulties in writing that could indicate cases of disgraphia may be seen

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during excessive erasures; mixture of upper and lower case letters; mixture ofprinted and cursive letters; spelling mistakes; inconsistent letter formationsand slant; irregular letter sizes and shapes; inconsistent spaces between lettersand words, cases of letters being written one on the other; unfinished cursiveletters; misuse of line and margin; poor organization on the page; inefficientspeed in copying; general illegibility; decreased speed of writing; decreasedspeed of copying; inattentiveness about details when writing; frequently needsverbal cues and sub-vocalizing; relies heavily on vision to monitor what thehand is doing during writing; slowly implements verbal directions that involvesequencing and planning; expressing few ideas less than expected; absenceuse of punctuation; difficulty in forming correct and simple sentences; wronguse of connectors; and last not least, writing too general far from the expectedspecific topic.

Figure 1: Different types of wrong pen/cil holding. (After Benbow et al., 1992).

Who could Diagnose the Pupils?There are two prime steps that the pupils with writing difficulties should gothrough. First, the class teacher should conduct a series of small tests whichcould indicate the existence of difficulties in writing. In case that the classteacher finds that a certain child is hindering in writing and is confrontingmotor and/or visual problems in coping with written assignments, it isrecommended to refer the pupil to either the educational psychologist of the

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school, the occupational therapist through the local medical centers or thedidactic diagnoser (reference from the special education department in theschool). There are a number of school counselors who also received specialqualifications in the field and it would be possible to approach them too.

Exercises to Examine Writing DifficultiesThis section will present a number of didactic exercises to diagnose difficultiesin writing especially to those pupils learning in the early primary classes of theelementary school. This section will not deal with the exploring of writingdifficulties that relate to weaknesses in organization of thoughts, punctuation,formation of correct syntactical sentences and actual written material, a matterthat will require a separate section by itself.

The process of writing requires the integration of two major skills: the visualand motor skills along their integration. The following section will present theexercises based on these two skills to identify writing difficulties. For firstgraders, the class teacher is recommended to work for at least five monthsprior examining the child’s writing skills. For more mature pupils, the classteacher could begin the diagnoses as early as the first month of the academicyear. According to Reisman (1993) the diagnoses should comprise three majortests: visual perception, motor performance and coping a small text .

A. Visual PerceptionThis section of the diagnoses should entail a number of sub-test. First andmost important is to examine whether the child is capable of visuallydifferentiating shapes and letters (Chandler, 2000). In this test, the teacherexamines whether the child could differentiate visually between the differentshapes of the written language. It most recommended to use a similar exerciseas presented below:

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Circle all the shapes that are identical to

In this exercise the teacher requests from the child to identify a particularshape and asks the child to circle it. The teacher should take intoconsideration the time consumed. A child that could handle successfullythe exercise in few seconds has no difficulty in visual differentiation. Incases that a child consumes more than a minute or two along with the circlingof some wrong answers it is recommended to refer the child to furtherdiagnoses as mentioned above.

English teachers could design some tables that would include familiar lettersand words, and ask the child to identify specific information. An exampleof such an activity could be:

Circle the letters that are identical to the first letter:

p p q p q p b d p qa o a a o a u a o om m m n m m n v a mu a a u a u v a w ab d b b d d p q d bg g g g j j y j g py y y g y g p q y p

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A child that is capable in differentiating the shapes/letters/words couldproceed to the next stage.

The second step that the teacher could examine is the pupils’ capability inpinpointing on specific information found with in context. This exercise iscalled Background Differenciation. This exercise examines whether the childis capability in differentiating between the external features of letters/wordsand the background of the text . One example of such a test could be asfollows:

Circle the letter ____ in the following words:

r road run van bread door gear rabbitread fearb boat bear door bottlecub boot bread submarinen nose mouse no man son some earn fence angerh hair horse hot fish thief hen catch school father

In all cases, the letters that the pupils are requested to identify are located indifferent places with in the word. A pupil who could not identify the correctplace of the letter would seem to have visual perception problems and shouldbe referred to further diagnoses.

B. Motor PerformanceThe next step that the teacher should conduct is to examine the visual-motor perception of the pupil. The motor performances required during thewriting process include the coordination of the body, arm and hand musclesin order to produce some form of writing. In fact, the writing processesinvolves many gentile muscles found in the arm and hand that enable theproduction of neat, cursive and readable handwriting. It is hence importantfor the teacher to examine whether the child grasps correctly the pencil,

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and whether the child is capable to use the muscles of the arm and hand toenable proper flow of easy writing. Pupils that have difficulty in writingclaim to have muscle’s pain. Moreover, it is important to note that researchhas not found a 1:1 relationship between the type of grasping the pec/ciland the existence of writing disabilities.

There are a number of exercises that a teacher could conduct to examinethe pupil’s writing performance. In these exercises, the pupil is given apencil and asked to copy (as exactly as possible) the shape that s/he sees.An example of such an exercise is as follows:

Please copy the following shapes:

____________________________________________________________________

____________________________________________________________________

These picture move from the simple to the more difficult. It is expectedfrom a child to manage successfully in drawing the first four shapes. Moremature pupils are expected to draw the other shapes. In this exercise, theteacher must observe the way the pupil holds the pencil, where s/he beginsto draw and how many times does the pupil use the eraser. A pupil who

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succeeds in fulfilling this exercise has well developed motor skills.

The next stage to examine the motor skills of the pupil is to examine theextent to which s/he coordinates the visual perception with the motorperformance. Common exercises include the drawing of lines within theshapes as follows:

Draw the following lines in the shapes:

__________________________________________________________________________

It is important to note the drawing of lines within the shapes requires highcognitive functioning that many children in the elementary classes wouldhave not yet developed. The teacher should pay attention to the way thepupil copies the lines into the shapes. Difficulty in copying into the shapesas the trespassing of borders or the drawing of peculiar lines would indicatethe existence of either motor, visual or still unripe cognitive development.

C. Copying a textThe last test that a classteacher could use to identify writing difficulty is toask the pupil to either copy a small text built of a number of lines orconsequently write freely any sentences s/he wishes. In this test, the teachershould examine a number of writing aspects: the extent to which the pupilpresses on the pencil, the extent the pupil erases what is being written, thefrequency the pupil asks for a break in writing, the releasing and relaxingof the hand and fingers, the shape of the letters (Talbert-Johanson et al.,

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1991) and their readability (Modlinger, 1983), the distance between thewords and the ability to write on the line (Reisman, 1993), along with theability to begin and end on a certain margin (Tseng et al., 1991) are allindicators for writing difficulties. The following text (figure 2) is an exampleof a dysgraphic writing of a pupil studying in the twelveth grade.

Figure 2: Dysgraphic writing of a pupil in the 12th grade

This pupil was diagnosed for writing difficulties in December 2000. Thissample of a pupil’s writing does indicate that there are difficulties in a numberof fields. First and foremost, the pupil is seen to stress too hard on thepencil, and his writing is seen to be wide and bold. The size of the letters isnot consistent and towards the fourth line the pupil is seen to increase thesize of the letters. A number of letters were difficult to distinguish primarilythe letters ‘a’, ‘d’ and ‘e’. During the test, the pupil could not continuecopying after the fourth line and requested a break. This pupil claimed tohave muscle pains in his arm and needed a rest. A further examination ofthe copied text reveals that the child skipped from line 4 to line 5. He hasdone so in order to keep the order of the words the same as in the originaltext. Moreover, during the test the pupil was seen to write most of the letters

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beginning from the bottom and moving towards the top - the wrong techniqueto write most of the English letters.

Rehabilitative Writing MethodsThe literature offers a number of techniques to assist pupils coping with writingdifficulties (Rief et al., 1996; Shore, 1998). Here are the ten most commonremedial techniques that could be used with dysgraphic pupils:

1. Print or cursive: Allow the student to use either form. Many dysgraphicpupils are more comfortable with manuscript printing.

2. Computer: Encourage student to become comfortable using a wordprocessor on a computer. Students can be taught as early as first grade totype sentences directly on the keyboard.

3. Encourage consistent use of spell checker on the computer to decrease theoverall demands of the writing task.

4. Have student proofread papers after a delay and use strategies for editing.Pupils may need help to develop efficient editing techniques.

5. If getting started is a problem, the teacher should encourage visual pre-organization strategies, such as mind mapping.

6. Allow extra time for writing activities.7. If necessary, shorten writing assignments.8. Allow student to tape assignment and/or take oral tests.9. Reinforce the positive aspects of student’s efforts.10. Finally, the possibility of demanding from another person to copy down

exactly the answers of the pupil without making any changes, omissionsor additions.

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ReferencesAmundson, S.J. & Weil, M. (1996). “Prewriting and handwriting skills”. InJ. Case-Smith, A.S. Allen, & P.N. Pratt (Eds.), Occupational therapy forchildren (3rd ed.), pp. 524-541. St. Loius: Mobsy.

Benbow, M., Hanft, B., & Marsh, D. (1992). Handwriting in the classroom:Improving Written Communication. In AOTA Self Study Services. No. 4.Americam Occupational Therapy Association, Inc.

Chandler, D. (2000). ‘Visual Perception 2’. Lecture notes ED10510, http://www.homestead.com/eslflowes1flow/INT9SPEAK~NS4.HTML.

Cunningham-Amundson, S.J. (1992). “Handwriting: Evaluation andintervention in school setting”. In J. Case-Smith, & C. Pehoski (Eds.),Development of hand skills in the child, pp. 63-78. Rockville: theAmerican Occupational Therapy Association.

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Graham, S. (1982). ‘Compostion research and practice: A unified approach’,Focus Exceptional Children14, 1-16.

Graham, S., Harris, K., MacArthur, C. & Schwartz, S. (1991). ‘WritingInstruction’ in Wong, B. (Ed.) Learning about Learning Disabilities, pp.309-343. Academic Press, Inc.

Harwell, J. (1989). Complete learning disabilities handbook. The Centerfor Applied Research in Education, New York.

Modlinger, A. (1983). Kshaiy Ktiva: Eator Evkhon Ve-Darkhie Tipol(Hebrew: ‰·È˙Î ÈÈ˘˜ ÏÂÙÈË Èί„ ÔÂÁ·‡ ¯Â˙ȇ). Tel Aviv: Sefriat HaPoalim.

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O’Hare, A.E., & Brown, J.K. (1989). “Childhood dysgraphia: Part 1. Anillustrated clinical classification”, Child: care, health and development,15, pp. 79-104.

Reisman, J.E. (1993). “Development and reliability of the research versionof the Minnesota Handwriting Test”, Physical and Occupational Therapyin Pediatrics, 13(2), pp. 41-55.

Rief, S. & Heimburge, J. (1996). How to reach and teach all students inthe inclusive classroom. The Center for Applied Research in Education.New York.

Rozenblum, S., Shankar, R. & Gal, E. (1994). “Ktiva- markivim, harachave-tepol” (from Hebrew, Writing - components, assessment and treatment),The Israeli Journal for Occupational Therapy, 3 (4), pp. 169-191.

Sandbeck, A., Woldan, S. & Zailer, A. (1995). “Kekatvam Kelshonam”(Hebrew Written as intended), Beit Berl College and the Ministry ofEducation, Jerusalem.

Sassoon, R. (1990). Handwriting: A new perspective. Cheltenham: SlamlyThermes.

Shore, K. (1998). Special Kids Problem Solver. Prentice Hall.

Sovik, N., Arntzen, O., & Thygesen, R. (1987). “Writing characteristics of‘normal’, dyslexic and dysgraphic children”, Journal of MovementStudies, 13, pp. 171-187.

Stott, D.H., Moyes, F.A., & Henderson, S.E. (1986). Diagnosis andRemediation of handwriting problems. Cardiff: Drake Educational.

Talbert-Johanson, C., Salva, E., Sweeney, W.J., & Cooper, J.O. (1991).“Cursive handwriting: Measurement of function rather than topography”,Journal of Educational Research, 85, pp. 117-124.

Tseng, M.H., & Cermak, S.H. (1991). “The evaluation of handwriting inchildren”, Sensory Integration Quarterly 19, pp. 3-6.