Can2K, my ds was diagnosed 8 years ago, so some of what went into his diagnosis may be out-of-date, but this is what went into his diagnosis. The first note - he wasn't diagnosed with "dysgraphia", but instead with "Disorder of Written Expression" per DSM-IV. I'd never heard of dysgraphia until I did some googling to learn about DOWE. I then asked his neuropsych if he had dysgraphia, and she said yes, but that DOWE was the diagnosis recognized by schools (at that time).

The things that the neuropsych used to make the diagnosis:

* Review of handwriting samples from his classwork
* Discrepancy between ability measured by WISC-IV and WJ-III Achievement test
* Scatter in WJ-III Achievement subtests (scatter occurred between tests that required oral vs handwritten response)
* Scatter in WISC-IV subtests (difference of greater than 1.5 standard deviation between processing speed subtests and subtests that went into the GAI)

In addition to the above testing/review that correlated with a dysgraphia diagnosis, the neuropsych refined the diagnosis to show that the dysgraphia was related to fine motor issues rather than visual with these two tests:

* Scatter between subtest in the Beery VMI
* Low scores on a subset of the NEPSY (finger-tapping test)

I'm sure you've already done this, but googling types of dysgraphia might be helpful for you when trying to determine what's up with your ds. It sounds like his dysgraphia (if he's dysgraphic) may have had a visual component, and there is one type of dysgraphia in which spelling isn't impaired (I suspect it's the visual dysgraphia, but I haven't looked at the definitions recently enough to remember. If you're having a tough time finding those definitions let me know and I'll find a link for you).

My ds has also been given the TOWL twice (once through school for IEP eligibility and once later on privately). Although it isn't a direct test for dysgraphia, it can be extremely helpful in determining specific areas of challenge with written expression.

When my ds was diagnosed with DCD and DOWE, he'd landed at the neuropsych because his teacher was convinced he had ADHD. There are many overlaps in behaviors and symptoms between DCD, ADHD, and ASD (my neuropsych has a chart showing this - I wish I could find it online somewhere!). Teachers will often make a guess or in some cases an assumption based on what they has seen in the past - and if your area is like ours was 8 years ago, most teachers will have had students with ADHD in their classrooms but won't be familiar with dysgraphia. DS' neuropsych eval included behavior screens filled out by both parents and teacher, as well as a computer test that screened for ADHD. The neuropsych asked for us to have the behavior screens filled out by *any* adults who spent a significant amount of time with ds during the day, not just his primary teacher - unfortunately that one other person for our ds was a student teacher, and his primary teacher vetoed letting her fill it out (picture me knocking my head against the wall). When the results came in, ds' teacher was seeing a very different child than we saw at home, but that didn't line up with ADHD according to the neuropsych's observations of ds or the screening test. Combining that with the results of the neurospych testing supporting dysgraphia led the neuropsych to conclude that the behaviors of concern to the teacher were more likely due to a combination of DCD/DOWE and anxiety resulting from the impact of those disabilities in the classroom.

I hope some of that helps - again, it was just our experience, and it's very outdated at this point in time. DS has had semi-recent testing to support accommodations for SAT/ACT, but those evals were much less thorough and were designed to show current impact in a student who already had a recognized diagnosis. FWIW, the diagnosis he uses for accommodations (at school and for standardized testing) is DCD, not dysgraphia.

Best wishes,

polarbear