Dysgraphia?

[SierraNevada]

Testing results are back (Wisc and WJ only). DS was given a tentative diagnosis of dysgraphia or dyspraxia --based on abysmal coding scores (6 SD below IQ). They noted all written tasks were painfully slow and much complaining about hand pain. I knew he wasn't advanced in handwriting but had no idea how bad it was for him. Now what? Do I get an official diagnosis from a dev ped? Do I just keep going with most his output being typed, on whiteboard, or dictated. He has no issues with composing writing. Just writing speed and hand pain. He only ever had reversed one letter set (b/d) and always recognizes as soon as he does it. Any ideas, advice...what to do next?

[PeterPan]

I don't think you need another diagnosis if you already had a psych eval.  Have you had an OT eval yet to see if there's a physical explanation for the hand pain?  It might be something obvious (holding it really tight, whatever), but there might be something they could improve.  My dd had hand pain, and turned out she was low tone and had all her weight going onto her wrist when she wrote.  1-2 months of OT and she could write without pain.  

[Julie of KY]

I'd just keep going for now. Having typed output is fine.Consider an OT eval for the hand pain with writing.

Accommodate, separate handwriting out as a separate subject, Reevaluate (yourself) as you go along and things may or may not fall into place better with some time and.

[Heathermomster]

An OT can perform a one hour eval that looks at a number of things including pincer and core strength.  If a problem is noted, the OT can set up an exercise routine to strengthen those areas.  I took DD to an OT for an assessment when she was in Kindie.  DD had hand pain with poor pincer/core strength.  DD saw the OT for about 6 weeks, and the OT gave us an exercise list that included wheelbarrow walks and yoga ball exercises.  I started to question the reliability of the OT, so I met a ped PT who agreed to evaluate my DD.  My DD is low tone and had a retained reflex.  The PT worked with DD, and DD can now write without hand pain.  She did not achieve handwriting fluency until late 1st grade.

 

My DS is dysgraphic and hand pain has never been his issue.   OT/PT work has improved son's balance, posture, overall strength, and reintegrated his prim reflexes, but the processing issues associated with dysgraphia are still present, so his handwriting is accommodated.

Edited December 7, 2015 by Heathermomster

[geodob]

SierraNevada,

Their are some simple exercises that can help with this?

Which can also be used as a test?

What it basically involves, is touching 'finger to thumb'.

Going from finger to finger, back and forth.

 

Which you could first try doing yourself?

Also try doing it at different speeds, from fast to very slow.

 

Though the important thing, is how we actually make these movements with our fingers and thumbs?

A crucial factor, is that all of our muscles work in teams of 2.

So that if you extend and contract a finger?

One muscle contracts to extend it, and it's opposite contracts, to contract your finger.

 

But an essential part of how this works?  

Is that as one muscle contracts, its opposite extends in precise unison.

Though perhaps you consider the situation, of extending your finger?

Where a muscle will contract to make this movement.

But if its opposite muscle wont relax and extend in unison?

 

To cope with this ?  The contracting muscle will 'stretch' it's opposite muscle.

Where it's not hard to understand, how stretching a muscle could be painful?

 

The stretching is felt in the 'tendons' that join the muscles to the finger bones.

But our fingers don't actually have any muscles.

They are remotely controlled by muscles in our forearm.

Our fingers only have tendons, which are formed much like rope.

So that with hand pain from writing?

It is the stretched tendons that cause the pain. 

 

Though the way that muscles actually work?

When we contract and extend a muscle?

Muscles can't think, so they can't follow instructions to make a movement?

Our muscles actually use an 'electrical system'.

Which uses 'micro-volts'.

Where each muscle has a sort of 'volume control'?

So that as we increase the electrical signal, a muscle contracts.

 

At birth, we only have an 'On/Off' control of muscles, which are termed as 'Primitive Reflexes'.

From relaxed to contracted.

Where we then develop a 'Volume Control' for each muscle.

But this development occurs in muscle groups, so that they can work in coordination.

 

Though coming back to this 'touching finger to thumb' exercise?

As the finger contracts and extends.

It can help to develop and refine the 'volume control' for each finger.

[kbutton]

At birth, we only have an 'On/Off' control of muscles, which are termed as 'Primitive Reflexes'.

From relaxed to contracted.

Where we then develop a 'Volume Control' for each muscle.

But this development occurs in muscle groups, so that they can work in coordination.

 

 

You've probably said this before, and I didn't catch it. Interesting explanation. 

 

We are waiting to see if reflex integration helps, or if we'll have trouble processing on top of that. We're continuing with accommodations, having handwriting practice be separate, and getting my son typing. One way or another, he'll probably always have access to a scribe and/or written notes because he has CAPD, and multi-tasking while listening is not recommended. 

[SierraNevada]

Thanks all. We did go to an OT over a year ago. They looked at his writing and said he had an odd grip but that nothing beyond that out of range for his age. He was given a lot of exercises- which he balks at doing. He does have low core strength. They said nothing about dysgraphia but said it "could" be minor dyspraxia at the time. Also some some minor verbal apraxia. But they gave no official diagnosis. Is it worth tracking down an official diagnosis? Does it matter if we call it dyspraxia versus dysgraphia? He seems to be very coordinated they said, but just lacks some motor planning or motor mirroring skills. His gross motor skills are all fine. What tree should I be barking up?

[PeterPan]

Those are some pretty serious things to be told and then have them go oh mild, don't worry.  

[shinyhappypeople]

Yes, its worth getting a more specific dx. My understanding about dysgraphia is that it's not just a fancy name for "struggles with handwriting.". As I understand it, it encompasses a lot more than that, especially composition and grammar. I know for my DD, the handwriting aspect is the least of her struggles. I mean yeah, her handwriting is not good usually, but lots of people have lousy handwriting but don't struggle with written output.