Gifted Issues Discussion homepage Forums Twice Exceptional Please tell me about dysgraphia

I think my DD may have dysgraphia. She has always hated the physical act of writing and struggled with it. Her oral spelling is quite good but her written spelling is abysmal. She writes things like "5iften" (fifteen). If I have her verbally spell while writing she will say one thing but still write something else. It's like her hand is not connected to her brain!

Her teachers have noticed the discrepancy between her oral and written output. She can read aloud at a sixth grade level with adult sounding expression and pronunciation. She gets 100% on most spelling tests. But when she tries to write sentences/paragraphs/stories it becomes a mess of misspelled, written-over words, left out letters and words, etc. She will still reverse letters occasionally. Is this really normal for an 8 year old?

She is above grade level in all subjects except writing where she is just getting "satisfactory".

She has trouble completing writing-intensive assignments at school and has to bring them home. Last week she had to copy problems from her math book onto a separate sheet of paper and then complete the problems. It took her longer to copy them than it did to do the problems.

Any advice or experience in this area would be helpful!

Cathy

Hi Cathy!
You daughter certianly has a handwriting issue. It may or may not be actual dysgraphia, because for so many gifted kids, getting the brain to slow down to child handwriting speed is just plain difficult. Tell us more! What's her status with keyboarding? How is she with Art? Is perfectionism at work here - either "It's terrible so I won't even try" or "endless erasures?"

And lastly, sure it took her longer to copy the problems than to do the questions, that almost goes without saying - but did it take her longer to copy the problems than agemates?

Best Wishes,
Grinity

My son recently went back to a developmental pediatrician about his handwriting. The doctor told us if there are any reversals after the age of seven it is dysgraphia.

My son is nine. Orally he can spell thousands of words correctly from the spelling bee booklet he is using to prepare for our state's Pee Wee Spelling Bee. I found a lot of these words online on an 8th grade spelling list. He will type these words correctly without a problem. But sometimes when he writes, especially when he takes notes, he will reverse letters or numbers and then he can't believe he did it. He says his hands don't do what he wants them to do sometimes. When he was tested at age seven his visual-motor integration was a few years lower than his actual age but his visual perceptual was a few years higher than his actual age and at that time he had tracking issues which were helped by vision therapy. We were told to try Handwriting without Tears. He did and when the doctor had him write a few sentences for her later that year, he seemed to have improved. I also looked at the handwriting of another gifted boy his age and it didn't seem that different so we thought his handwriting was good enough. My son could write legibly if he wrote slowly but his had would tire easily (but he also has hypotonia) and that was more of a problem. For that reason the doctor told me to teach him to type and this worked really well for him so I didn't have him practice handwriting as much.

Like you said, there were times I thought it was like his hand was not connected to his brain. The strange thing was that he would not reverse letters all the time and I thought if I took him back to the doctor he would just take his time and there wouldn't appear to be any big handwriting problems.

I took him back to the doctor when I realized there was enough of a problem that it embarrassed him to write anything in front of other kids and I worried that this also might be a problem when he has to take tests in the future. He had enough of a problem coloring in the bubbles quickly and without going outside the lines on the practice test for the Explore that I knew I needed a diagnosis to get accommodations for this kind of thing--too late for this year though.

His dysgraphia definitely caused problems with doing math. We also had to copy problems from workbooks on to another piece of paper and he could only do one or two long division or multi-digit multiplication problems per page and math was such an unpleasant experience for him because of the handwriting difficulties that he said he hated it. I had to have him do just one multiplication and one division problem instead of a whole page but I would pick the hardest one I could find on the page. Otherwise it would take him too long to do math and it was just too stressful for both of us. He learned to do mental math wherever he could and he played math games online. He figures out the answers to math problems in ways that are different from the way I was taught, but I think he needs to be allowed to do this, to find a way to compensate for this disability. I was so happy when we started using aleks.com for math. It doesn't care how he got the answers, just that he enters the right answer. He only has to get three correct and it lets him move on to the next concept. He always learned new concepts quickly and easily and this allowed him to move at a pace he was comfortable with without being held back by the dysgraphia.

People just assume that gifted kids can write. Even Davidson wanted us to submit something that he had written in his own handwriting to go along with his portfolio that I had already submitted even though I am almost positive I mentioned his handwriting difficulties. I knew this would be too difficult so I didn't even have him try. It was not worth it for us.

We even decided not to do the Explore test this year, even though I already paid for it, partly because of the dysgraphia.

The spelling bee requires a written test to qualify for the oral test. He will have to write 30 of the words and if there are erasures on any word, that word is counted as incorrect. So even though he spent many hours learning thousands of words, his dysgraphia might cause him to not qualify for the oral part of the spelling bee which I am sure he would do well in.

We are still waiting to see an OT, so I don't know anything about that yet.

I remember the doctor said something about therapy helping create "new neural pathways." That sounds hopeful and interesting.

What's her status with keyboarding? She is not a fast typist but she prefers keyboarding to writing when given the choice.

How is she with Art? She loves art and is very creative. She says, "I like art because art is never wrong. If it doesn't come out the way I wanted I can make it into something else."

Is perfectionism at work here - either "It's terrible so I won't even try" or "endless erasures?" This could be part of it. See quote above.

And lastly, sure it took her longer to copy the problems than to do the questions, that almost goes without saying - but did it take her longer to copy the problems than agemates? I'm not really sure but since her teachers have remarked on it, she may be slower than average.

But sometimes when he writes, especially when he takes notes, he will reverse letters or numbers and then he can't believe he did it. He says his hands don't do what he wants them to do sometimes. Yes. This is what DD experiences.

when the doctor had him write a few sentences for her later that year, he seemed to have improved. Her handwriting does improve, albeit much more slowly than other subjects.

Like you said, there were times I thought it was like his hand was not connected to his brain. The strange thing was that he would not reverse letters all the time and I thought if I took him back to the doctor he would just take his time and there wouldn't appear to be any big handwriting problems.
I alternate between thinking there's a problem and thinking this is just not a strength area. DD will spell the same word in several different ways within the same paragraph. If I then ask her to spell it orally, she spells it correctly. What do I think about that? At first I thought she was being lazy but now I don't think so.

I was so happy when we started using aleks.com for math. It doesn't care how he got the answers, just that he enters the right answer. DD rocketed ahead in math when we did EPGY over the summer. She didn't have to spend mental effort on writing answers and was much more motivated and excited about math.

Hi there. It's me responding as an OT again!

From my standpoint, when a parent brings in a child and has concerns about handwriting these are the things I look at:

1)vision - I screen for near point focusing/convergence problems and other developmental vision issues that warrant a referral to an optometrist

2)overall motor coordination - I check for signs of dyspraxia and motor coordination issues that can be one source of handwriting issues. This includes bilateral motor coordination, the ability to cross midline, how the pencil is held, etc. Both gross and fine motor abilities assessed.

3) eye/hand and visual motor integration skills - standardized assessments (Beery Developmental Test of Visual-Motor Integration, aka VMI) and informal observations. Important to separate out whether there is a visual issue, motor issue or both. The VMI has vision and motor subtests to help isolate which is the problem

4)perceptual skills - how is visual information interpreted. It is one thing to *see* it but another to understand it. Again, there are standardized assessments for this area of function. It's important to see if there is laterality and directionality developed (understanding of r/l and top/bottom, etc). Other skills are also included in this testing (figure ground, visual closure, and others).

5) quality of handwriting and effort for handwriting - is it labored, difficult, slow, etc all the time or only at certain levels of challenge. Is it easy to do some parts of writing but not others? Are the letters formed and spaced properly on the page? Lots and lots of stuff to look at informally.

I believe that dysgraphia is considered a learning disorder of written expression. Sometimes the dysgraphia is linked to generalized dyspraxia. So treating the dyspraxia for the whole body really helps with the handwriting. But sometimes the issue is more left brain dysfunction and then harder to treat. An OT can't actually diagnose dysgraphia, that needs to come from a psychologist.
Good luck as you look at what is going on and what can help. I'm sure you'll find some answers. Accomodation and/or intervention are both helpful, so you should look at both options. The important thing is that she be able to produce the written work in the easiest, least stressful manner possible.

Thank you, Debbie!

It really helps to know what we should be looking at. Her large motor skills are actually above average for her age. She is a fantastic reader, but not so good at sounding out new words. I think she just has a huge vocabulary of sight words. When I read an article by Linda Silverman on Visual-Spatial learners, many of the characteristics fit DD. Does that correspond to a left-brain problem?

I am planning to have her assessed by a psychologist but it will probably take a while to make the arrangements.

Debbie-

We're so lucky to have you on this board! I really enjoy reading your thoughts on OT related things.

FWIW, my son was diagnosed with add, dysgraphia and a visual processing issue three years ago. He has made huge strides with his writing through HWT and their cursive books in particular. He still balks at writing, but it is slowly becoming less and less of a BIG issue. I think that near daily repetition is really important for these kids.

I've heard a lot of people recommend Handwriting Without Tears--maybe I'll check that out.

Cathy

We have the endless erasure problem, too. My DD6's papers are so messy because she doesn't erase completely. It's so frustrating.

We had an endless erasure phase about 6 months ago. It drove me absolutely crazy. DS7 would take SO long to do any worksheet he brought home. I kept reminding him it was all "practice writing" and it didn't need to be perfect, but he could not be swayed.

But on the upside, he is past the erasing phase and is actually a very neat writer for a first grade boy! I like to joke that DS prints better than DH. So maybe they'll grow out of it in a few months?

Edited to say - our school uses Handwriting without tears in 1st grade, and his writing is much improved since the start of the school year.

DD is going in for the first part of her assessment tomorrow. I hope we get some good info!

Fingers crossed for you and DD!

I'm really happy with how well the testing went. DD had a good rapport with both the testers--she had one tester for WISC and another for ach. tests. I don't have scores yet but whatever we get should be a good indicator of her abilities.

I have an appointment for the 20th to talk about the results.

Cathy

Ha, ha, for what it cost us we should have the scores tomorrow! We decided to go with private testing and find out sooner (and with better reliability...)

Cathy

Well, it's official... DD is 2E. But they gave her a diagnosis of "learning disability not specified." I'm not sure how useful that is...

So she definitely has her stengths and weaknesses.... I'm sure the school will say, "Above average in everything...looks great!"

Cathy

I'm sorry, my first response was to laugh at how ridiculous that is. Then I was sad, because it is so true. GS8's school counselor who started the IQ test, then stopped, has been playing phone tag with me. He left a message restating what GS8 said he was told, that IQ testing is done for the kids who are doing poorly in school.
So, you, and all of us, are left to make educational decisions for the children that we had all hoped the trained educators would be able to make. In a world where 'average' is the goal, you can't let the trained educators make the decisions.

Well, at least her teacher this year "gets" DD. That has been so good for DD's self-esteem and has really made her more willing to work on writing. Unfortunately, today is her teacher's last day. She is going on maternity leave and DD will have a long-term sub after spring break. This sub is a retired teacher who taught DD in first grade. I'm afraid that this is not a good teacher-student match. Sigh. I'm hoping things will be better this time around.

Yes, I bet it is the scatter that led to the LD diagnosis.

I haven't gone back to read the beginning of this thread, and I probably confuse everyone on this board, but Cathy, have you already had her evaluated for vision issues (as in, by a behavioral optometrist)? Besides the more obvious clue of dysgraphia, the reason that vision comes to mind is that her scores on the perceptual reasoning are so different from the scores on verbal comp (but then, I wasn't aware until Dottie mentioned it that this might not be unusual among gifted kids?) My dd's scores on the WISC likewise had a lot of scatter, and even though her perceptual reasoning and verbal comp scores were much closer together than that (I think my dd's overall perceptual reasoning score was higher than the overall verbal), the tester had expected her to do better on the block design portion than she did (she kept skewing the designs or something), which they said suggested a vision issue (sure enough, dd has an eye tracking problem and is in vision therapy now - 5 weeks to go, sigh). After all you've been through, a vision eval by the right kind of optometrist should be easy http://www.covd.org/ Or perhaps I merely see vision issues in everyone LOL.

My dd also has similarly lower scores for working memory and processing speed, and is a definite visual-spatial learner. I have found a number of tips on the website to be quite helpful. You probably already have this, but from the website, here is a checklist for diagnosing dysgraphia http://www.visualspatial.org/Articles/chklist.pdf and another article about handwriting http://www.visualspatial.org/Articles/poorhand.pdf

Another article recommends calculating the GAI "if the 4 composite scores vary by 23 or more points, and if the Verbal Comprehension Index and the Perceptual Reasoning Index vary by less than 23 points." http://www.gifteddevelopment.com/About_GDC/whoaregiftd.htm However, I don't quite understand the second part, about varying less than 23 pts between verbal comp and perceptual reasoning.

Now that I have spewed out a bunch of random thoughts that are probably helpful to no one, I better clean up the house while I can.....

I'm glad you got results, and I hope the 2E diagnosis gets your DD what she needs. I have nothing useful to contribute beyond my well-wishes, but I do offer those.

I think the diagnosis was based on the overall spread of her scores and the discrepancy between IQ and achievement scores.

I asked about the GAI, but the psychologist said that the GAI would not be meaningful since her VCI/PRI spread is 25 points.

I do suspect some kind of visual perception issue...I'm not really sure if or how to pursue that, yet.

They gave her the Beery-Buktenica Developmental Test of Visual-Motor Integration.

Oh, and she said she substituted Cancellation for Coding because Coding was a possible problem area for DD since it involves drawing symbols in little boxes.

Cathy, I haven't read this whole thread but I did pick up on your comment about visual perception issue. My DS10 has been in therapy for visual perception/tracking issues since October and it has been such a help for him. You can pm me if you'd like some information on this (I've posted it a bunch of times so I hate to bore everyone else out there!!)

Cathy - if you go to the website I left, covd.org, you can put in your zip code and find an optometrist in your area who does this type of evaluation (it's different from a regular eye exam). That's how you get started - you just call for an appt. That's the easy part The hard part is if she needs therapy - for us the therapy visits are weekly, but the daily homework can be trying, especially at the beginning.

Thanks, snowgirl. I'll check it out.

Dottie, I don't have the tables. What would her processing speed standard score and her FSIQ be if you used symbol search (11) and cancellation (14)?

Thank you, Dottie! That's very interesting. I specifically asked the psychologist if she substituted something and she emailed me that she substituted cancellation for coding. Maybe she just typed them into the computer wrong?

I asked her about the extended scoring on Vocab. (18) DD's raw score was not high enough that it would change with extended scoring.

I think the psychologist thinks I'm a little nuts for being interested in how the numbers work out. But I like numbers!

For now, it doesn't really matter and most programs would accept DD's 140 VCI as proof of GTness, I think.