His OT and PT reviewed his results with neuropsych who said there was enough there to diagnose. We then talked to developmental pediatrician who said same thing as well as enough to diagnose dysgraphia. Bit both were mild and I wouldn't gain anything as code for insurance is same as what they coded him already for the PT and OT...so I decided not to ha e the label officially slapped on him.
N., I understand the reluctance to add a "label", but fwiw there are a few reasons I'd reconsider it. My list is a little long - it's probably things you've thought through already, but I decided to post the full list anyway in case someone else reads this who is thinking through the same thought process and has the same concerns re "labels".
First, I think it's really important to understand what dysgraphia is. OT and PT can absolutely help dyspraxic children - going through OT helped my ds develop legible handwriting, correct pencil grip, good posture while writing, eliminated wrist pain while writing, and he became able to write with a reasonably constant and light pressure on the paper so he no longer crumpled up papers while he wrote. That was all good! But what's important to understand is what OT/PT *can't* remediate. At the heart of dysgraphia is a challenge with automaticity of either brain-motor or brain-visual control. Dysgraphic children do not develop automaticity of handwriting, no matter how legible and neat their printing/cursive etc looks. Every time they form a letter on paper with handwriting, their brain is spending much more time and effort on that action than a neurotypical child's brain does. Even children with sky-high percentiles on working memory still only have a limited amount of working memory - that's the memory that is used while writing etc. For dysgraphic children, most (if not all) of that wm is taken up by forming the letters since they aren't automatic - hence there is very little left over for spelling, grammar, punctuation, etc - much less anything left over for actual composition and organization of thoughts. Hence most writing for dysgraphics is not anywhere near as complete, complex or detailed as it is when typed or given verbally. Dysgraphics rarely can rely on handwriting to show their full knowledge.
Next reason - school. Your ds is still very young, but as he goes upward in grade level, the need to be able to express his thoughts in writing is going to go up considerably - and continue to go up, based on expectations of neurotypical children. His handwriting and written content is going to be compared to neurotypical children. That gets harder and harder for dysgraphics to cope with without AT as the years go by and expectations increase.
Limitations of OT - I mentioned above that OT helped our ds tremendously. The catch is - it didn't stick. Some of it did - he still has the same legibility of handwriting he did when he left OT and good posture/correct grip etc are still present, but his wrist pain has returned and he can't write for more than just a few minutes without pain. DS also learned how to write in cursive in 4th/5th grade - and had really *nice* looking cursive - according to his teacher his classmates were jealous it was that neat - but one year later he'd forgotten how to make any cursive letters except for the letters in his name. At this point in time, several years later, he's also given up signing his name in cursive. I am really glad he went through OT, and honestly, if he wanted to, I'd send him again since for another round of OT in hopes of helping with wrist pain, but at this point he's happiest using AT (and by far more productive).
Testing accommodations in school - it's possible you might get standardized testing accommodations that apply without a dysgraphia diagnosis. I've found that accommodations like extended time are given out as common accommodations in our school district if a teacher sees a need even if there is not a diagnosis. That's not the case in each individual classroom, however. Having a 504 plan or IEP with a specific and correct diagnosis is really really helpful here in school - and it's absolutely necessary when applying for college board testing if you want *any* accommodations - and from what I've heard and read re college board - you need to be able to show a history of the diagnosis and accommodations - you can't just decide to get the official diagnosis in high school for the specific reason of applying for college board accommodations.
One of the accommodations that is crucial for most dysgraphic students is use of a word processor for essay questions, and that's the accommodation that is very difficult to get (either in school or college board) without the correct diagnosis and documentation of the diagnosis.
Last reason to give a child a "label" - my children (I have two 2e kids) - valued having the label. It was like taking the weight of the world off their shoulders to be able to explain to them that they were dysgraphic and dyslexic and that it had a name. My ds is not the most outgoing/sharing person in the world when it comes to personal information, but he is old enough now that he has to advocate for himself at school, and in doing so he explains to teachers/etc up front that he is dysgraphic and will explain to them what that means and how it impacts him at school. It would be much more difficult for him to attempt to advocate for his needs without being able to say he has dysgraphia.
Last thought - I've rarely found any negative push-back from my kids having their "labels". What I have seen is a *lot* of negativity happens when my kids are in situations where adults or other students aren't aware of their dysgraphia or reading challenges - and judgments are made based on the quality of their handwriting or reading. You can choose to think of a label as a big red scarlet A burnished on a child's head that sets them apart and ridicules them, or you can choose to see a label as the type of label you put on boxes stored in the garage with gear that you can't see from the outside. I chose the second way to look at it, and we treat it that way. To be honest, our experience has been that LDs and ADHD/etc are fairly common in school now, and having a label of clarity is not the Scarlet A type of situation at all, but rather it's just not really seen as much of anything at all, except for when it's needed to understand what's "stored inside the box". My kids have faced ridicule in school - but that was before they were able to explain for themselves that "I am dysgraphic and that is why ____" or "I am dyslexic and that is why _____". Same for me as their advocate/parent.
Just my 2 cents!
Best wishes,
polarbear
