Gifted Issues Discussion homepage Forums Twice Exceptional Dysgraphia

Agree with geofizz - and also want to add, there are other issues that can cause subtle issues with reading comprehension and fluency that *aren't* dyslexia. One of my dds was slow to develop her reading ability due to undiagnosed vision challenges (in her case the issue was double vision, limited peripheral vision, and tracking/convergence issues - all due to muscle weakness). Once she'd been through a few months of vision therapy her reading ability just took off, and she turned into one of those kids who lives with their nose buried inside a book. My other dd has a really subtle neurological challenge with associating symbols (sight) with sound... she's struggled tremendously with learning to read and had to be tutored to develop fluent reading.. but she was never really behind enough in school to raise red flags, and was a master at masking the challenge due to her intellectual ability.
For her, the WISC didn't really reveal the challenge but it showed up on the WJ-III Test of Cognitive Abilities (NOT the WJ-III Achievement), and showed up on detailed reading assessments (will have to look up those tests tomorrow - but it was an assessment given specifically by a reading specialist who remediates dyslexia, and included CTOPP, GORT, etc).

RE dysgraphia, here are a few assessments which were helpful for our ds:

1) Having achievement tests to compare to ability testing (ds had the WISC for ability, WJ-III for achievement on his initial diagnosis). The WISC shows a relative dip in processing speed subtests relative to other subtests, coding in particular. The reason for this is that coding relies on a hand-drawn mark and is timed. The achievement test subtests are helpful for showing the need for accommodation: when you group his achievement tests by response type (oral vs motor/untimed vs motor/timed) there are marked differences in scores based on response type: oral matches his ability, motor/untimed are about 30 percentile points lower, and motor/timed are much lower. Charting this made it really easy to show school staff that using handwriting significantly impacted ds' ability to show his knowledge in a reasonable amount of time. One thing to note re the achievement test groupings: these illustrate the impact of dysgraphia on handwriting speed, but they do *not* illustrate the impact on working memory - (ie, the physical act of handwriting takes up so much of the student's working memory that it impacts their ability to show their full knowledge - nothing left over to "think" with while writing).

2) Informal test of handwriting speed (letters per minute). I call this "informal" because we just did it at home and compared it to same-grade peers by googling for the info (and you'll find a range). It was helpful for me to have this info because ds' school staff tried to say his handwriting speed was middle-of-the-road for his grade, which it wasn't. It has also been interesting to watch over time, because it's stayed at roughly the same speed as he grew older. Imagine a 5th grader writing at the same speed he was in 2nd grade but trying to keep up with 5th grade classroom work.

3) Neuropsych eval - this was *invaluable* for us in understanding the root of ds' challenges (fwiw, we went through a neuropsych exam initially because his classroom teacher suspected ADHD). We had no clue that ds was dysgraphic and hadn't heard of it before the eval, even though in hindsight the signs were clearly there in his writing and classroom and homework output. The tests that the neuropsych performed that were key were, first the WISC, showing the discrepancy in processing speed. Second, a test called the Beery-VMI which looks at visual-motor integration - there are two subtests on the Beery VMI, and they will delineate whether or not the issue with low processing speed on the WISC is due to a fine motor or a visual issue. The neurospcyh also gave additional tests (for ds it was the NEPSY) which test a range of functions including executive function, rapid naming tasks, and brain-fine motor integration. One of the subtests is called "finger tapping" and it showed clearly that for ds, dysgraphia was fine motor in origin.

4) For me, reading up on dysgraphia, asking questions of the neuropsych, and learning everything I could about it - for instance, I would never have guessed that my ds would have difficulty with handwriting that was related to fine motor skills because when he was very young he drew absolutely amazing pictures of real-life things - the type of drawings that made adults go "WOW". He also made teeny-tiny extremely accurate figures out of clay. So he looked like he had really good fine motor control - and he does - for tasks that don't involve picking up and putting down a pencil tip onto paper, or for remembering how to form letters.

5) Knowing keys to look for in ds' handwriting. NOTE - these can be different to, depending on the type of dysgraphia. Like your dd, ds reversed his bs and ds long past the time his classmates did. His teachers, however, kept insisting that it's developmentally normal to have reversals in handwriting up until the end of 2nd grade. DS had extremely poor spelling while handwriting but aced spelling tests without studying. When you looked at papers ds had handwritten, the letters were different sizes, spacing was inconsistent, and pencil pressure was all over the place (light vs dark marks). In addition to that his papers almost always ended up crumpled and wrinkled due to the difficulties with pencil pressure. And then there were the papers that ended up crumpled up in balls and thrown across the room in frustration

5) Observing what my ds looked like *while* he was handwriting - he usually grabbed the wrist of the hand he was writing with with his other hand and held on. He would lean on his elbow (writing hand), and he had a really odd pencil grip.

6) My ds was too young to really be able to tell me this when he was in early elementary, but your dd may be old enough for you to ask - does her wrist hurt when she writes? DS still has wrist pain if he writes for more than a few minutes. This isn't true for all dysgraphics, but it's something to watch for.

7) Difference between oral and written output, or difference between handwriting and typed output (for a child who's used the keyboard long enough to have some type of adaptive typing proficiency - and for dysgraphic kids, it doesn't have to be a really fast letters-per-minute, even slow typing speed can be much faster than handwriting). I did this type of comparison at home - the school never did, but I used the comparisons I had from home in advocating for typing/etc accommodations.

HOWEVER - there's a caveat on #7. My ds also had Disorder of Written Expression (and an Expressive Language Disorder) which was unrecognized until his dysgraphia was appropriately accommodated for and this can occur together with dysgraphia. What it means is that my ds has an additional challenge of being able to generate written expression even when he's using accommodations such as typing or oral response - so once his dysgraphia was accommodated, he went through a long process of speech language therapy to remediate expressive language. I'll spare you the details on that challenge, except for one thing - which I think is somewhat common with LDs - there were situations where it appeared ds did *not* have a challenge with written expression, other times when it appeared he could not produce any written output. Performance seemed to be spotty, and it was easy for a teacher to relate that to trying vs not trying - but when you looked at it in more detail, it was actually related to the type of writing assignment.

Sorry for the long reply - hopefully some of it helps a bit! Feel free to ask if you have questions about it -

Best wishes,

polarbear

ps - forgot to mention that in looking for dysgraphia, punctuation, capital letters incorrectly used (or not used), spelling mistakes, spacing of letters etc. If you google dysgraphia + symptoms you'll find lists of what might be seen in handwriting samples.