Dysgraphia
From Wikipedia, the free encyclopedia
| ICD-10 | F81.1, R48.8 |
|---|---|
| ICD-9 | 315.2, 784.61, 784.69 |
Dysgraphia (or agraphia) is a difficulty writing coherently, if at all, regardless of ability to read. People with dysgraphia often can write, and may have a higher than average IQ, but lack co-ordination, and may find other fine motor tasks such as tying shoes difficult (It often does not affect all fine motor skills). They can also lack basic spelling skills (having difficulties with p,q,b,d), and often will write the wrong word when trying to formulate thoughts (on paper). In children, the disorder generally emerges when they are first introduced to writing. They make inappropriately sized and spaced letters, or write wrong or misspelled words despite thorough instruction. Children with the disorder may have other learning disabilities; however, they usually have no social or other academic problems. Cases of dysgraphia in adults generally occur after some neurological trauma or it might be diagnosed in a person with Autism (such as Asperger's), Tourette syndrome or ADHD. The DSM IV identifies dysgraphia as a "Disorder of Written Expression" as "writing skills (that) ...are substantially below those expected given the person's ...age, measured intelligence, and age-appropriate education".
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[edit] Types of dysgraphia
[edit] Dyslexic dysgraphia
With dyslexic dysgraphia, spontaneously written work is illegible, copied work is fairly good, and spelling is bad. Finger tapping speed (a method for identifying fine motor problems) is normal, indicating the deficit does not likely stem from cerebellar damage. A Dyslexic Dysgraphic does not necessarily have dyslexia. (dyslexia and dysgraphia appear to be unrelated)
[edit] Motor dysgraphia
Dysgraphia is due to deficient fine motor skills, poor dexterity, poor muscle tone, and/or unspecified motor clumsiness. Generally, written work is poor to illegible, even if copied by sight from another document. Letter formation may be acceptable in very short samples of writing, but this requires extreme effort and an unreasonable amount of time to accomplish, and cannot be sustained for a significant length of time. Spelling skills are not impaired. Finger tapping speed results are below normal.
[edit] Spatial dysgraphia
Dysgraphia due to a defect in the understanding of space has illegible spontaneously written work, illegible copied work, normal spelling, but normal tapping speed.
Some children may have a combination of any two or all three of these. Symptoms in actuality may vary in presentation from what is listed here.
[edit] Symptoms of dysgraphia
A mixture of upper/lower case letters, irregular letter sizes and shapes, unfinished letters, struggle to use writing as a communications tool, odd writing grip, many spelling mistakes (sometimes), pain when writing, decreased or increased speed of writing and copying, talks to self while writing, and general illegibility. Reluctance or refusal to complete writing tasks.
[edit] Lesser known symptoms of dysgraphia
[edit] Pain while writing
Many people who are dysgraphic will experience pain while writing. The pain usually starts in the center of the forearm and then spreads along the nervous system to the entire body. This pain can get worse or even appear when a dysgraphic is stressed. Few people who do not have dysgraphia know about this, because many with dysgraphia will not mention it to anyone. There are a few reasons why pain while writing is rarely mentioned:
- Sufferers do not know that it is unusual to experience this type of pain with writing.
- If they know that it is different from how others experience writing, they know that few will believe them.
- Those that do believe that the pain while writing is real will often not understand it. It will usually be attributed to muscle ache or cramping, and it will often be considered only a minor inconvenience.
[edit] Common problems that are often associated with dysgraphia
[edit] Stress
There are some common problems not related to dysgraphia but often associated with dysgraphia, the most common of which is stress. Often children (and adults) with dysgraphia will become extremely frustrated with the task of writing (and spelling); younger children may cry or refuse to complete written assignments. This frustration can cause the child (or adult) a great deal of stress and can lead to stress related illnesses. Other common environmental sources of stress in the classroom setting are (a) high levels of environmental noise, and (b) over-illumination.
[edit] Treatment
Treatment for dysgraphia varies and may include treatment for motor disorders to help control writing movements. Other treatments may address impaired memory or other neurological problems. Some physicians recommend that individuals with dysgraphia use computers to avoid the problems of handwriting.
Occupational therapy should be considered to correct an inefficient pencil grasp, strengthen muscle tone, improve dexterity, and evaluate eye-hand coordination. Dysgraphic children should also be evaluated for ambidexterity, which can delay fine motor skills in early childhood.
[edit] Learning related vision problems
People who struggle with symptoms of dysgraphia usually benefit from vision therapy. Seventy percent of what a child learns in school is processed through the visual system. Even a minor visual processing problem will interfere with a child or adult performing to their potential and could cause symptoms of dysgraphia.
Symptoms of Vision Problems:
Avoidance of near work
Frequent loss of place
Omits, inserts, or rereads letters/words
Confuses similar looking words
Failure to recognize the same word in the next sentence
If you or your child experiences any of the above, P.A.V.E.® (Parents Active for Vision Education) recommends a learning related vision examination by a behavioral optometrist.
Optometric visual training, frequently called vision therapy or VT, is that part of optometric care devoted to developing, improving and enhancing people's visual performance. Clinical studies on the use and effectiveness of vision therapy are available.
Any struggling student should have a complete evaluation by a behavioral optometrist. Testing should be done at distance and nearpoint to assure that both eyes are working together as a team. Vision is more than clarity, and is a complex combination of learned skills, including tracking, fixation, focus change, binocular fusion and visualization. When all of these are well developed, children and adults can sustain attention, read and write without careless errors, give meaning to what they hear and see, and rely less on movement to stay alert.
[edit] How to find a Behavioral Optometrist
To find a qualified Behavioral Optometrist, please visit the (COVD) and the (OEP) websites.
1.College of Optometrists in Vision Development (COVD) This organization serves as the certifying body for Doctors in the Optometric specialty called Behavioral/Developmental/Rehabilitative Optometry. If a doctor chooses, he/she may apply for COVD fellowship after successfully completing a Residency program in Vision Therapy or Binocular Vision or after three years as a Behavioral Clinician. Fellowship is difficult to obtain and is only granted after interviews, publishing and knowledge testing is completed and accepted by a committee. Fellows are certified specialists in vision therapy. If you would like to go directly to their membership directory, click here. http://www.covd.org/membersearch.php
2. Optometric Extension Program (OEP) Foundation The OEP Foundation is an international non-profit organization that serves the educational needs of behavioral optometrists by providing continuing education credits and provides public information about vision care. If you would like to go directly to their referral list of doctors, click here. http://www.healthy.net/oep/OEPSearch.htm
[edit] References
- International Dyslexia Association (2000). Just the facts... Dysgraphia: Fact Sheet #982. Retrieved Jan. 9, 2005.
- P.A.V.E.® Parents Active for Vision Education
4135 54th Place, San Diego, CA 92105-2303
- Telephone (619) 287-0081
- Toll Free (800) PAVE-988
- FAX (619) 287-0084
- Email info@pavevision.org
