Gifted Issues Discussion homepage Forums Twice Exceptional Spelling/Grammar Issues - Dyslexia or Dysgraphia?

DS9 struggles with writing, fine motor, spelling, grammar, and punctuation. However he is an avid reader with no comprehension issues that is reading either at a high school or college level. While not officially diagnosed, I am positive he is dysgraphic, and teachers/professionals agree. From the reading I have done, both dyslexia and dysgraphia can cause issues with spelling and grammar. Outside of an official evaluation, are there ways to understand if the spelling/grammar issues are caused by the dysgraphia or if it is dyslexia?

I'll offer up a few suggestions based on my experience as a parent of a dysgraphic child and also as a parent of a child who has a reading challenge (not traditionally dyslexic) - but first I'll add that the singular most helpful thing to me was to have a diagnosis by a professional, and I believe that it was ultimately extremely helpful to my children too. Having a diagnosis meant they didn't have to wonder why they were struggling; having a diagnosis meant I was able to make sure they had appropriate remediation and accommodations. Having a diagnosis by a professional was also extremely helpful in advocating for resources, remediation and accommodation. Last thing - having a professional explain what was up with my kids was really important, because all the researching and really great guessing I was doing on my own didn't lead me down the right path.. but there was no way of knowing that without having a professional look at global functioning.

That said, what you've written sounds a lot like dysgraphia. It also sounds like he's been diagnosed with dysgraphia through a professional eval (?). A few things you could do at home to help determine whether or not the grammar issues your ds is dealing with reading challenge vs dysgraphia (or maybe dealing with both):

1) Does his grammar improve when he uses technology? If it does, that's a sign that the issues with grammar are due to dysgraphia. If he still has grammar issues when he's using keyboarding or oral response, it could be something more.

2) Do you know that his reading comprehension is as high as the level of books he's reading? Has he been tested for comprehension, or have you read the same books he's reading and had a discussion with him about the books? What is his oral reading like? If you have any questions about these, it might be more than dysgraphia.

Re spelling, it might improve with typing or might not (for dysgraphia). However, if the spelling challenge is solely due to dysgraphia, you might note that spelling individual words, such as during a spelling test, doesn't pose an issue, but spelling while writing (a paragraph, story, etc) is an issue.

Last thing I'll mention - if your ds has been evaluated by a professional, did they note any issues with fine motor specifically? Dysgraphia is an inability to develop automaticity of handwriting (i.e., a disconnect between what the finger muscles involved in fine motor need to do vs the brain instructing them to do it) whereas an actual fine motor disorder means there is an additional challenge with the fine motor functioning. My ds' primary diagnosis is Developmental Coordination Disorder, which impacts his fine motor functioning, and secondary to DCD he's dysgraphic. The impact of the DCD means that his dysgraphia isn't as easily resolved by giving him a keyboard as it is for kids who don't have a fine motor challenge. Hope that makes sense!

Best wishes,

polarbear

ps - fwiw, diagnosing and understanding my dd's reading challenge has been much more complex than recognizing/diagnosing/understanding my dysgraphic ds' challenges - when fine motor/etc is involved, it's not easy to slide under the radar. With the combination of a high ability child and a reading challenge, it's much easier for the child to compensate and come up with ways of not showing that there's a struggle. Personality also plays a part - my ds was quite open with acknowledging he was struggling, my dd does not want anyone to know she's not on top of the world in all areas of ability, so from an early age she went to great lengths to hide the fact that she wasn't comprehending what she was reading. I'm not saying that's the case with your ds at all - but it was around 3rd-4th grade that my dd's ability to keep ahead with her pretending everything was ok started to crumble as the pace of actual reading for learning in the classroom stepped up. If your ds is actually testing at a high level of reading comprehension then I wouldn't give it a second thought... but if you have any doubts about reading, I'd recommend an evaluation.

One should be very hesitant about self-diagnosing a child with dyslexia or dysgraphia, let alone differentially diagnosing between the two (unless one happens to be an assessment professional oneself, of course!--but even then, one should be cautious, as it is easy to lose objectivity as a parent). OTOH, I believe strongly in the intuition of involved parents that there is -something- going on. So if you feel there is some kind of obstacle to the free development/expression of your child's ability, I would agree that the first step is to pursue a comprehensive evaluation. If you already have such an evaluation in hand, I would follow-up with the evaluator regarding any questions you have with dyslexia/dysgraphia, and whether those are covered by your existing assessment data.

Just a quick response before I run out the door. I'll answer polarbear's questions a bit later...

aeh- I absolutely agree we need to get a professional involved, and we plan to do this. For a number of reasons, we can't do it right now and will have to wait just a little bit. This is more for my own knowledge until we can have the formal evaluation done as I'm just trying to understand the best that I can on my own what might be going on. Not only does my mommy-gut say something is going on, but the school agrees as well as it is obvious.

polarbear - Thanks for the long response.

He was officially diagnosed with Developmental Coordination Disorder but never officially diganosed with dysgraphia. However talking with the neuropsych after the eval as well as a tutor we have used for spelling/writing and OT for handwriting, they all said it fits him.

1) His grammar issues are written issues - capitalization, punctuation, and identifying parts of speech/parts of sentences. When speaking with him or even if you read what he writes on the computer (ignoring run-on sentences), there are no concerns or issues.

2) There is no question about his reading comprehension. This is based on not only testing such as the NWEA MAP where his lexile is in the high school range, but also in discussing with him what he has read. Most non-fiction books he reads these days are adult books, and this is by choice. He finds that the children level "don't have enough depth and aren't complex enough" - his words. I know he is comprehending them because of the conversations he will have with us after reading them. There is no way he could know/understand what he does if he didn't have the comprehension. His teachers for years have also commented on his advanced comprehension.

His spelling seems to be terrible whether writing individual words or writing a story/paragraph. I'm not clear if there is a significant difference in his spelling when typing vs handwriting vs oral.

When younger he did Handwriting Without Tears, and the OT told us at that time that he lacks automaticity in his handwriting.

As I mentioned in my response to aeh, I know we need to get an official eval to look into this more. We just can't do it right now, and I'm trying to figure out how to help him best until we can. Also having more insight into what is going on helps me.

Hi all. I'm new here. Trying to figure some things out...
Could I ask who would be best to diagnose dysgraphia?
My son who is 7.5 has very neat handwriting and is an above average speller but just hates having to write. He'll sometimes write in really tiny
print or he'll just stare at the page and cry that it's just so boring. He'll start to write and then fling his pencil across the room. He'll choose one word answers just to avoid a sentence. He reads and comprehends at a gifted level but when he is required to write he hits a wall. Literally & Figuratively. Could that still be dysgraphia?

All of these details sound more like dysgraphia than dyslexia to me, although I agree with aeh that he needs a full evaluation.

BlessedMommy, everything you've written fits with a diagnosis of Developmental Coordination Disorder, and nothing raises a red flag outside of DCD which might indicate Dyslexia - so, jmo, based on this additional info, I think you have what you need to move forward with accommodations and remediation. The DCD diagnosis combined with observations by yourself and teachers re academic work should be sufficient to get your ds the accommodations and help he needs at school (and should be what is needed to advocate for either an IEP or a 504 plan).

Dysgraphia is limited to an impact on development of automaticity of handwriting; People with DCD often have issues with development of automaticity of handwriting but also are challenged by a wider umbrella of symptoms. The accommodations for the handwriting challenges due to DCD or dysgraphia are essentially the same, although some people with DCD, like my ds, are not able to develop quick keyboarding skills due to the additional fine motor challenges of DCD.

For grammar: does your ds understand grammar concepts when they are taught independently of writing essays/stories/etc? If so, let him learn grammar that way, and provide him with keyboarding or voice-to-text or scribing (while he's young) when writing paragraphs etc.

For spelling, study spelling as it's own subject, but for writing assignments let him keyboard and use word prediction and auto-spell-correct. This won't eliminate 100% of his spelling errors; proof-read his work for him. Ask for an accommodation that allows for him to not be marked off on grades due to spelling errors when using handwriting.

The fact that he's a strong reader is also going to help him tremendously with spelling and grammar and eventually will help him with written composition.

If the school thinks it's important to understand whether or not dysgraphia is also a diagnosis (in addition to DCD), then request an evaluation through the school. They *should* be able to provide this. Our ds wasn't diagnosed through the schools, but I'll list his diagnosis history here because it illustrates how the path to an absolute diagnosis isn't necessarily straightforward, and how the names of diagnoses can get confusing based on who is diagnosing. And... I'll repeat... even though it might not sound like it after you read this, ds' diagnosis was *much* more straightforward than my dd who has reading challenges

DS' first diagnosis was DCD, thru a neuropsych eval at the end of 2nd grade. After receiving the neuropsych's report I found information about dysgraphia for the first time online, it seemed to fit, so I returned to the neuropsych and asked if he might have dysgraphia. The neuropsych said "yes". Nothing official on paper, just that acknowledgement that his DCD symptoms fit dysgraphia. I believe that the neuropsych diagnosis didn't mention dysgraphia specifically because it wasn't included in the DSM when he was diagnosed. The neuropsych also mentioned that she used the language she did in her report because it was the language school staff would recognize and acknowledge. As part of ds' recommended remediation, he was referred for an OT evaluation for handwriting OT. That evaluation did *not* diagnose him with dysgraphia, but instead found him to be a good candidate for handwriting remediation based on his fine motor abilities. If you look at that report, it looks like he's a-ok but the report is actually stating that he has enough fine motor ability to benefit from handwriting remediation. It doesn't mention that he is dysgraphic, but if he didn't have DCD and dysgraphic challenges, he would not have needed handwriting OT. A few years later, when it became clear ds had difficulties with expressive language, he went through an evaluation by an SLP who diagnosed him with dysgraphia as well as an expressive language disorder. If he hadn't had the expressive language challenge, he never would have had a report from any professional stating that he has dysgraphia - but the DCD diagnosis was useful and appropriate from the start for advocating for and understanding his needs re support and accommodations for handwriting/spelling/grammar/punctuation/etc.

Hope that makes sense!

DS is now a teen almost out of high school, and he'll be the first to tell you, he's dysgraphic He also still relies on keyboarding, word prediction, spell-check and proof-reading

Ethinx, it's possible it could be dysgraphia, but often with dysgraphia a child will have poor legibility of handwriting, an odd pencil grip, will hold their wrist or sit in an odd position while writing, have uneven pencil pressure, mix caps and lower case, can't spell while writing etc. There are different types of dysgraphia which you can read about by googling and see if any seem to fit.

That said, another thing that *might* be at play (and please understand, I'm a mom, not a professional!)... is that he's having difficulty with forming the expressive language needed to write. My dysgraphic ds also has challenges with expressive writing, and his behavior when tasked with a writing assignment at the same age was very similar, although he had the added issue of obvious dysgraphia. One thing you might try at home (if you haven't already) is to have him scribe his writing to you or use a keyboard and see if his total volume of output increases and if his stress/frustration/refusal to write decreases. If it *doesn't* I'd suggest seeking out an evaluation through a Speech Language Pathologist and also ask that he be evaluated using the Test of Written Language (TOWL) - this is a test that is widely used by schools when evaluating for writing LDs.

Best wishes,

polarbear

Thank you polarbear. We've given both dictation and typing a try with little success. I think what you describe in difficulty forming expressive language sounds very much like what he struggles with. He's seeing a speech pathologist now (she's auditory testing him). I'll definitely request the TOWL.
He has difficulty expressing his emotions so I wonder if there is a connection.
Thanks again...sounds like you've been through a lot!

Ethinx