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Dysgraphia in Children

Cara Koscinski, MOT, OTR/L

August 1, 2018

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Question

What is dysgraphia and how can occupational therapy practitioners help?

Answer

Children with dysgraphia have difficulty with writing, spelling, and grammar. It is a learning disability where the writing skills fall substantially below the student's IQ. You know the student knows these letters and words, but they can not reproduce them on paper. For a student with dysgraphia, their handwriting may look different depending on the day. For example, they may mix capital and lower case letters together haphazardly, they use printing and cursive interchangeably, the letters are slanted and shaped differently, there is no consistency. In addition, these students have trouble holding a writing utensil. They hold the pencil all different kinds of ways, because they have difficulty with stress, and they want to control everything. Sometimes you see a tight grip. It is also a motor planning issue.

There are a few different types of dysgraphia, including:

  • Dyslexic dysgraphia: With this disorder, spontaneously written text is illegible, especially when the text is complex. Oral spelling is poor, but drawing and copying of written text are relatively normal. Finger-tapping speed (a measure of fine-motor speed) is normal.
  • Motor dysgraphia: With this disorder, both spontaneously written and copied text may be illegible, oral spelling is normal, and drawing is usually problematic. Finger-tapping speed is abnormal.
  • Spatial dysgraphia: Individuals with this disorder display illegible writing, whether spontaneously produced or copied. Oral spelling is normal. Finger-tapping speed is normal, but drawing is very problematic.

OTs have an important role to play with the performance components of handwriting, including:

  • Postural control and other neuro-musculoskeletal components in the pelvis, trunk, shoulder, and neck
  • Level of arousal, attention span, sequencing and other cognitive components; visual perception
  • Perception of touch, body position and movement
  • Motor planning and motor control
  • Hand preference and integration of the two sides of the body
  • Visual-motor integration
  • Basic function of the hand including wrist stability, arch formation and finger dexterity

As OTs, we have a special role to play in helping children with handwriting. We are not handwriting experts; however, we are frequently viewed as such. Some specific components of handwriting that we work on with learning disabled students include:

  1. Postural control and other neuro-musculoskeletal components in the pelvis, trunk, shoulder, and neck
  2. Level of arousal, attention span, sequencing and other cognitive components
  3. Visual perception
  4. Perception of touch, body position and movement
  5. Motor planning and motor control
  6. Hand preference and integration of the two sides of the body
  7. Visual-motor integration
  8. Basic function of the hand including wrist stability, arch formation and finger dexterity
  9. Remedial and preventive interventions include:
    1. collaborating with others to modify students’ seating
    2. designing or procuring assistive technology devices
    3. training teachers, students and families to use them


cara koscinski

Cara Koscinski, MOT, OTR/L

Cara Koscinski, MOT, OTR/L, author of The Pocket Occupational Therapist Book Series, is a pediatric occupational therapist with over 20 years’ experience. She specializes in Sensory Processing Disorder, trauma-informed care, behavior, advocacy, and autism. As a speaker, Cara brings her expertise as a pediatric occupational therapist and mother of two children with autism to parents, caregivers, families, and educators in an easy-tofollow format. She has published six books which are sold globally.

Cara obtained her Master of Occupational Therapy degree in 1997 from Duquesne University. She is currently attending university to obtain her doctorate degree in occupational therapy. In addition to her longstanding work as a private practice OT, Cara is a successful entrepreneur. She founded two pediatric occupational therapy companies. Her products can be found in special needs catalogues and websites across the US and UK.

In addition to her books, Ms. Koscinski regularly blogs and creates fun products for those who work with children who have special needs. This February, her blog was rated as number six in the top fifty blogs for therapists and teachersin the world by Feedspot. Cara also speaks regularly across the US and provides OT consultations, trainings, and seminars as The Pocket Occupational Therapist. She serves on the Advisory Board of Autism Asperger’s Digest Magazine and Asperkids. Articles and courses authored by Cara are featured in many special needs publications such as Autism File, Harkla, Chewigem, Autism Society of America, Advance for OTs, OccupationalTherapy.com, Autism Parenting Magazine, Autism Asperger’s Digest and NewsLine. Cara is also a children’s YOGA instructor and Certified Irlen screener.


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