Issue 15: Is it Dysgraphia, or Is it Missed Learning? | Kelli Fetter

REALITY CHECK

We are now three years post-COVID and beginning to see the ramifications and impacts on our children. I won't be all gloom and doom and say that all impacts were negative. I saw children bonding with siblings and families through their extended time at home. I also saw children taking up hobbies that they may not have otherwise. However, I am now seeing some major missed learning, particularly when it comes to handwriting.

Some kids spent a year or more participating in lackluster virtual schooling and NEVER picked up a pencil. For some kids in K-3rd grades, that meant those crucial years of foundational writing were missed. Now the expectation is to go into 4th grade and write essays when they struggle to effectively hold a pencil or place letters on a line. I am definitely not disapproving of virtual learning. We have GREAT success with virtual tutoring here at my practice, Handwriting Solutions, because we are intentional and purposeful in creating a virtual environment nearly identical to in-person learning. In contrast, many schools were thrust into virtual learning with ZERO clue on how to make it work.

For other kids, it isn't the missed learning from COVID per se but a systemic issue where their school is not spending adequate time instructing on writing. Standards are now unrealistic, and teachers are being driven to push more and more, leaving little to no time for foundational skills such as handwriting. Kindergarteners are now expected to write sentences when they may have never learned letter formations or how to hold a pencil properly. Or even worse, they weren't given opportunities to build up their motor skills for these more advanced academic skills.

Lack of Quality Instruction or Dysgraphia?

So how do we know if it is lack of quality instruction or if there is a diagnosis such as dysgraphia causing our child to struggle with handwriting?

First, we dive a little deeper. A handwriting assessment by a qualified professional is the best first step to dive into underlying barriers with handwriting. Breaking down writing into individual skills helps pinpoint where the barriers exist with writing and gives us a bigger picture of our child's learning and current performance. The assessment also guides remediation as we have a plan of action and areas we need to intervene.

Depending on what the assessment reveals, a full-scale neuropsychological or psychoeducational exam is recommended to seek out an official dysgraphia diagnosis. The comprehensive handwriting assessment can be used as a tool for support during these evaluations.

However, often we begin handwriting remediation before we decide to pursue a diagnosis. We want to see how a student responds to tutoring, and if they make notable gains quickly, then chances are the lack of instruction was the barrier. Likewise, children who make quick progress are not going to experience symptoms of dysgraphia, such as spelling difficulties, grammatical errors, avoidance of writing, difficulty transferring thoughts to paper, and such. Other underlying issues, such as developmental delays, weakness, etc., may impact handwriting. But it wouldn't necessarily indicate a specific learning difference.

Likewise, the diagnostic criteria for a specific learning disorder in writing (dysgraphia) states that the symptoms should persist for at least six months with appropriate interventions in place and targeted help. Symptoms might include both the ability to physically write as well as the thought processes that go into writing. Basically, our brain generates the "idea" for writing, and then directs the hand to produce the written output. When someone has dysgraphia, the neural connections (within the brain and body) for this process may be slower or disrupted. Therefore, the child presents with specific symptoms that have persisted for at least six months despite the provision of extra help or targeted instruction; the child's academic skills are substantially and quantifiably below expected norms for their age; the age of onset is during school years, although the impact may not be fully manifested until young adulthood; and that other disorders (such as intellectual disabilities) are ruled out.

Some Signs and Symptoms

Some signs and symptoms that may indicate that a student's struggles are beyond a lack of instruction include:

• Fatigue when writing
• Poor legibility
• Incorrect spelling or sentence skills
• Slow, labored writing
• Awkward hand positions when writing
• Omitting letters/words in sentences
• Frustration/avoidance with writing
• Awkward grip on pencil
• Difficulty forming letters
• Difficulty following a line or staying within margins
• Trouble following grammar rules when writing
• Difference between written output and verbal output
• Mixing capital and lower-case letters
• Reversing letters and numbers
• Difficulty recalling how to form letters
• Trouble organizing thoughts onto paper

A note that if your child struggles with some of these areas, that does not indicate dysgraphia. Again, the diagnosis looks at the bigger picture and rules out underlying difficulties.

For example, your child might struggle with writing letters on a line or reversing letters, but rather than dysgraphia, they may have a visual perceptual/oculomotor deficit.

The key here is that the assessment is VITAL to understanding the child's strengths and barriers. The intervention will depend on the findings from the assessment. Whether the child has dysgraphia or simply missed opportunities for quality instruction, it is critical to map out the learning profile of the student to guide how we will help. Finding a qualified professional to complete a handwriting assessment is just as critical as finding a diagnostician to diagnose. Because when you have knowledge of your student's strengths and challenges, knowledge is power, and you and the team will be better equipped to approach and overcome the barriers. Now the child can get the individualized help they NEED, no matter the "cause".

Kelli Fetter

Kelli Fetter is the founder of Handwriting Solutions, LLC. She is a Certified Handwriting Specialist and has previously practiced occupational therapy for 10+ years. She has extensive experience in pediatrics as well as specific training in learning disorders and specific writing curriculums, methodology, and research. As a parent, Kelli understands the struggles of handwriting firsthand, as her daughter has been diagnosed with both dyslexia and dysgraphia. As a professional, she is on a mission to bridge the gap between a child's struggles and barriers and their participation and performance with writing, both in and out of school. Kelli is passionate about helping children who struggle with writing as well as educating and guiding families, teachers, and therapists who support these struggling students.

Extracts from the Magazine