Without diagnosis, children may not receive early intervention or specialized instruction in all the relevant skills that are interfering with their learning of written language. Considering that many schools do not have systematic instructional programs in handwriting and spelling, it is important to assess whether children need explicit, systematic instruction in handwriting and spelling in addition to word reading and decoding. Many schools offer accommodations in testing and teaching to students with dysgraphia, but these students also need ongoing, explicit instruction in handwriting, spelling, and composition. It is also important to determine if a child with dysgraphia may also have dyslexia and require special help with reading or OWL LD (SLI) and need special help with oral as well as written language.
What kinds of instructional activities improve the handwriting of children with dysgraphia?
- Initially, children with impaired handwriting benefit from activities that support learning to form letters:
- playing with clay to strengthen hand muscles;
- keeping lines within mazes to develop motor control;
- connecting dots or dashes to create complete letter forms;
- tracing letters with index finger or eraser end of pencil;
- imitating the teacher modeling sequential strokes in letter formation; and
- copying letters from models.
- Subsequently, once children learn to form legible letters, they benefit from instruction that helps them develop automatic letter writing, using the following steps to practice each of the 26 letters of the alphabet in a different order daily:
- studying numbered arrow cues that provide a consistent plan for letter formation
- covering the letter with a 3 x 5 card and imaging the letter in the mind’s eye
- writing the letter from memory after interval that increases in duration over the handwriting lessons
- writing letters from dictation (spoken name to letter form).
- In addition, to developing handwriting speed, they benefit from writing letters during composing daily for 5 to 10 minutes on a teacher-provided topic.
- Students benefit from explicit instruction in spelling throughout K-12:
- initially in high frequency Anglo-Saxon words;
- subsequently in coordinating the phonological, orthographic, and morphological processes relevant for the spelling of longer, more complex, less frequent words; and
- at all grade levels in the most common and important words used for the different academic domains of the curriculum.
- Throughout K -12, students benefit from strategies for composing:
- planning, generating, reviewing/evaluating, and revising
- compositions of different genre including narrative, informational, compare and contrast, and persuasive
- self-regulation strategies for managing the complex executive functions involved in composing.
Do children with dysgraphia make reversals or other letter production errors?
Some children do make reversals (reversing direction letter faces along a vertical axis), inversions (flipping letters along a horizontal axis so that the letter is upside down), or transpositions (sequence of letters in a word is out of order). These errors are symptoms rather than causes of handwriting problems. The automatic letter writing instruction described earlier has been shown to reduce reversals, which are less likely to occur when retrieval of letters from memory and production of letters have become automatic.
What kind of teaching strategies improve spelling of children with dysgraphia?
If children have both handwriting and spelling problems, the kinds of handwriting instruction described earlier should be included along with the spelling instruction.
Are there research-supported assessment tools for diagnosing dysgraphia?
Yes. See Barnett, Henderson, Scheib, and Schulz (2007), Berninger (2007a), Milone (2007), and Slingerland assessment for assessing handwriting problems associated with dysgraphia. Also, see Berninger (2007b) and Berninger, O’Donnell, and Holdnack (2008) for using these tests and other evidence-based assessment procedures in early identification, prevention, and diagnosis for linking assessment results to evidence-based handwriting and spelling instruction (also see Troia, 2008).
In summary, dysgraphia is a specific learning disability that can be diagnosed and treated. Children with dysgraphia usually have other problems such as difficulty with written expression. It is important that a thorough assessment of handwriting and related skill areas be carried out in order to plan specialized instruction in all deficient skills that may be interfering with a student’s learning of written language. For example, a student may need instruction in both handwriting and oral language skills to improve written expression. Although early intervention is, of course, desirable, it is never too late during the school age years to intervene to improve a student’s deficient skills and provide appropriate accommodations.