Talk to me about dysgraphia

[silver]

I recently came across this: https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/dysgraphia/dysgraphia-what-youre-seeing-in-your-grade-schooler

It describes my son so well. He really struggles with spelling, even at 11-years-old. His handwriting is bad (h and n look similar, r and v look similiar, letters don't always line up, they aren't always a consistent size). He often forgets to put proper spacing between words. Forgetting capitals and end marks is very common, especially when I dictate a single sentence. Writing assignments really frustrate him (more so a few years ago, but it is still something he complains about). There isn't much improvement in handwriting, word spacing, remembering to capitalize, etc. despite copywork always being a part of our homeschool. The other day he asked me to spell two words ("piece" and "foil") while writing a single sentence down. I spelled them both orally for him, but he wrote both down incorrectly ("pice" and "foyl"). 

But my son is also a lefty. And a boy. And not really into telling stories or creative things like that (which might impact desire to write). So I wonder how much of what I see is "normal" or to be expected. He doesn't reverse letters. He can write fairly small, it's just super sloppy. He's good at fine motor tasks like building lego, wood carving, etc. 

Looking into it, I'm not sure what a diagnosis could do for him as long as we're homeschooling. It seems mostly it would open up accommodations. But I already have him type most of his work. I already give him graph paper to use during math. I don't give him timed tests. I already let him do a lot of work orally. 

Are there interventions or treatments that an OT could provide that I'm missing in my searching? 

Edited August 7, 2018 by silver

[Lecka]

There are possibly things an OT could do, it just depends.  Sometimes there are things that are helpful.  

My older son has a dysgraphia diagnosis.  He can also do legos and he also enjoys wood carving.  You wouldn’t know from those things that he has such poor handwriting.  

He has done OT and he did improve with it.  He still has poor handwriting, though.  He did not only have handwriting goals in OT, I had hoped for more handwriting improvement, but he improved in some other areas that made it worthwhile.  For only handwriting I can’t say it made a huge difference, but a little can go a long way, too.  Definitely it doesn’t go as far as him having effective handwriting for his age.  

But anyway — I think it sounds like you are doing great accommodations.  Maybe in the future you need to get formal accommodations for some outside class, maybe not.  

Sometimes kids will have something where OT does help more, it depends on what exactly is going on.  So I would never say “don’t consider OT.”  But I would not place high hopes on it.  Though — with just an eval they might be able to tell you a lot, and that is not a big commitment.  

 

 

 

[Storygirl]

Dysgraphia sounds possible, from your description. But also dyslexia, due to the spelling issues. The two are often comorbid.

DS14 and DD13 both have a diagnosis of dysgraphia, but the root cause is different for each.

DD13 is dyslexic, which obviously affects her spelling but also impacts the legibility of her handwriting. In her case, the poor handwriting is because her brain is focused on the other aspects of writing, and she just can't use her brain power for handwriting at the same time. Orton-Gilliingham tutoring has helped her spelling and eased the strain on her handwriting. She will always be a poor speller and a messy writer, but she is improving.

DS14 has a host of diagnoses, including a super low processing speed, which often goes along with dysgraphia. His handwriting is sloppy, and he has trouble writing on lines and lining up math problems, but his greatest issue is getting his thoughts onto paper.

There is no single test for dysgraphia. It is diagnosed by observation by the evaluator, so the diagnosis is very subjective. For example, DS was diagnosed by a neuropsychologist but did not get the SLD written expression (what the school calls dysgraphia) when evaluated by the school for his IEP. But DD WAS given the SLD by the school. And was NOT given the diagnosis by the neuropsychologist.

Subjective.

It's great that you are using accommodations at home. The trouble is that your son will not always be learning at home, right? He may go to college. Or perhaps circumstances could change, and he might enroll in school for high school (my kids are all in school now, though my plan was to homeschool them all the way through, so this can happen!). And he may have a career in which he will need to do some writing. Getting an evaluation and having the disability documented may help him get accommodations on the SAT/ACT. And he could then use his accommodations in college classes.

Plus, I think it can be really helpful for some people to be able to have an explanation for why they struggle. DS doesn't seem to care much about his diagnoses, though he knows about them, but I can see that knowing she has dyslexia has empowered DD to understand and advocate for herself.

So I am generally pro having evaluations.

OT may be helpful. DS was in OT, and I'm not sure I saw improvements, really, though the private OT did give us many ideas of things we could try with him. The public school OT evaluated him for his IEP, and he did not qualify for any OT services through the school. They said that by his age (fifth grade at the time), handwriting was usually set and therapy would not improve it. But they did provide a huge (as in two pages long) list of accommodations to put in his IEP.

Interestingly, DS plays bass guitar and is talented!! Even though he can't use a knife to cut a piece of chicken and has trouble tying his shoes. So dysgraphia is weird.

[silver]

He reads well (both nonsense words and real words), which is why I wasn't considering dyslexia, despite his poor spelling. 

I was figuring we'd want to get him evaluated at some point later (for accommodation purposes if he were to go to school rather than homeschool, need to take the SAT/ACT, or go onto college), but wasn't sure if it would be worth doing now. I know with the SAT/ACT, there needs to be a diagnosis/confirmation of diagnosis within a few years of the testing date. If we were to do testing now, it would be for access to OT.

His handwriting is bad, but I was more hoping that there could be something to help him enough so that he would have some processing ability left while writing to put some focus on spelling and mechanics. I've written up a checklist for after he's done writing/typing; he goes back and uses it to see what errors to look for. He finds almost all his missing capitals, periods, and commas at that point, so I know he's capable of applying mechanics rules. I'm not looking for perfect handwriting so much as hoping that he could get to a point where it took less effort on his part to get the words down.

[Pen]

I de-emphasized the aspects of writing you are describing and emphasized composition aspects of writing. The physical mechanics seemed to take more time and energy than they were worth given what technology can help with. 

[exercise_guru]

Since you homeschool you have a lot of options.  Which handwriting method did you teach him with? Does he write with the lefty hook? if so then definitely turn the paper ninety degrees and have him pull the pen down. Do a search on whole shoulder writing as well. Look up "left handed italic writing" 

Here are some of the most important resources I used.  

Kate Gladstone She is a mine of information and worth consulting. She turned me onto the Getty and Dubay technique, shoulder writing, rotating the paper, writing on a board on the wall  or a glass door to improve shoulder strength, She taught me that a T does not go straight up and down but is slightly at an angle and far more natural. This helped my son so much. The recommendations she gave were so helpful and I wish I had found her when my son was 5. She also recommended these mechanical pencils Paper Mate 1862168 Mates 1.3mm Mechanical Pencils She said even switching to these, rotating the paper and using the helper hand would improve my sons handwriting immediately over what he was doing. She was right. I have bought packs and packs of them because the dumb eraser falls out but it is exclusively what what my son has used in school for the last two years and saved us hours and hours of frustration. I provide the pencils and it is in my sons 504 plan. They don't roll, they don't break and he brings them home for me to refill them. If only the stupid eraser would stay in. I am contacting papermate to see if I can just buy the erasers we have so many of the pencil bodies since they are refillable but they really have been a life saver. It didn't fix his handwriting difficulty but it made the most of what he had. The remediation was painstaking and time consuming and has spanned 24 months. We pressed through with 30 minutes 3-4 times a week for two years to get where we are. Along the way we have also used Vision Therapy, Retained Reflexes ( pyramid of potential) , Integrated Listening Systems with OT exercises.

[PeterPan]

16 hours ago, exercise_guru said:

She also recommended these mechanical pencils Paper Mate 1862168 Mates 1.3mm Mechanical Pencils She said even switching to these, rotating the paper and using the helper hand would improve my sons handwriting immediately over what he was doing. She was right. I have bought packs and packs of them

I just stocked up on them on amazon!! They are nice, with the fat barrels HeighHo is talking about.

[sweet2ndchance]

A dysgraphia diagnosis could give your son testing accomodations if he is still homeschooled when it comes time to take standardized tests.

My second oldest son, who was diagnosed dysgraphic, had a scribe for tests. He could tell his scribe (usually a teacher's aide or the teacher herself on the big tests) what he would write if he could and she would write, verbatim, what he said. This didn't really come into play much until he was junior high or high school age but having the history of dysgraphia diagnosis made it much easier to get these accomodations approved when the time came.

Even if he never takes a standardized test until college, having that history of dysgraphia diagnosis will make getting accomodations for his disability much easier than trying to get it diagnosed at the same time as trying to get the accomodations.

[silver]

I have some of those paper mate pencils around, as they're what I use when starting my kids with writing. My son doesn't like them, because he likes a narrower tip, so he prefers his 0.7mm mechanical pencil. I've been looking at pencils today (separate from this thread). My son always presses so hard when he writes because he wants a dark line. We've tried pens, but they've all smudged horribly for him. He also likes being able to erase to correct errors. The erasable pen we tried dried out way too quickly. So I've been looking into softer lead refills for his pencil. I can find 2B, and that should get a darker line with less pressure, which should relieve hand strain while writing. 

I had first taught him letter formation using instructions from WRTR (clock face instructions). For cursive, I used HLTL vertical cursive. He prefers print over that, so we've dropped cursive. My husband wants to try remediation for his handwriting, possibly with some sort of lefty-writing-coach, before trying to find an OT, so the tips about helping a lefty are useful. I was looking at HWT cursive today. Between Getty-Dubay or HWT Cursive, which would be easier to master?

[PeterPan]

OT covers handwriting, and a "coach" wouldn't have the training to identify WHY he's having a hard time with writing. You can have dysgraphia (SLD) and have some physical issues going on. Those physical issues are what the OT would hit. So you're wanting an OT who specializes in handwriting. We had one last semester and she was AMAZING.

And, fwiw, as an OT specializing in handwriting, she said the best things we could do for his handwriting had nothing to do with handwriting. She was able to identify that we needed to back up and work on gross motor, do drawing/doodling, that kind of thing. Then she slowly started working up just single letters, making codes, playing games. 

Edited August 9, 2018 by PeterPan

[silver]

Thanks for the details. I'll pass it on to my husband and see if it helps change his mind about how to attack this.

[exercise_guru]

If your son can copy a line of text that is a different kind of dysgraphia and a lefty handwriting coach wouldn't cure the dysgraphia but probably stimulate that motor cortext part that is needed for handwriting.  For example if I write a line of text on line 1 and then ask my son to copy it on line 2 his handwriting was still horrible. I think it was called spatial dysgraphia. He couldn't copy shapes etc. When I worked on switching from HWT to G&D all I did was observe his writing. Any letter that was fluid and legible I left as is. The letters that were labored or difficult I taught him using their materials.  

On the other hand he can spell in writing as long as I can read it so over time getty and dubay has signficantly improved his legibility. 

As for writing method it would be cool to email getty and dubay and ask for their tips for lefties because their method is so fluid and easy on the hand. Or email Kate Gladstone as she is a genius with that stuff. Her book was very helpful to me( fair warning she really hates HWT and isn't a huge fan of cursive for kids who struggle with basic handwriting). 

My son can now  write a reasonable paragraph. There is still a glitch ( spacing between words)  I haven't totally solved but we will circle back to it this fall. I am not familiar with the clock face but getty is a more slightly angled comfortable angle in writing. like writing your T starting at 3 minutes rather than at 12 oclock its just enough angle that the hand feels comfortable. The shoulder writing keeps the hand sweeping accross the page rather than tiny motion with the fingers. This was a huge help for my son ( right handed but tried to write with a hook) as was turning the page so he could better see the letters. We always start writing with some swivels and lines to make sure our paper is nicely set up. 

those particular mechanical pencils grip well, don't break and make a nice clear defined line.  I would hope they wouldn't smudge for a lefty.  I am trying to come up with a trick to keep the eraser in place as I have lost so many of those which is very frustrating. They are the only pencil my son uses and I even made them write it into his 504. 

 

But I think it would be worth looking for left handed products and tricks as well because accomodation could help a lot

 

 

Also I would be remiss if I didn't mention the hours of mazes and dot to dots that we did to work on eye tracking and pen control. 

left handed stabilo

left handed ball point pen or marker

Edited August 9, 2018 by exercise_guru

[PeterPan]

On August 8, 2018 at 10:38 PM, exercise_guru said:

If your son can copy a line of text that is a different kind of dysgraphia and a lefty handwriting coach wouldn't cure the dysgraphia but probably stimulate that motor cortext part that is needed for handwriting. 

Just as a total aside, that explains why the new (phd, woo-woo!) OT yesterday had ds copying words and longer phrases that she spelled. For him the breakdown is how hard it is to do all the tasks at once (think up the answer, spell it, get it down). I suspect his formation with models looked ok. He was pretty motivated to try hard for her too, because he seemed to like her. 

[4KookieKids]

nm

Edited December 26, 2018 by 4KookieKids

[sweet2ndchance]

My first stop for suspected dysgraphia would be an occupational therapist, preferably one with lots of experience with dysgraphia. I wasn't able to get anyone to listen to me about my son's dysgraphia until he was in 6th grade and even the occupational therapist he was working with couldn't improve his handwriting. Once even a trained professional couldn't produce results with him, that was when we started getting him help in the form of scribes and testing accommodations. Before that, I just documented every professional I talked to about his writing problems... his doctor, teachers we had contact with when we were homeschooling, anyone really who had a chance to see him try and fail at writing and what we did to try to do to help him.

For my son, it was the obvious discrepancy between what he could verbalize and what he could write that was the determining factor for his diagnosis. It wasn't where he started his letters, it was that every time he started them some where different. Sometimes he would write entire sentences in mirror image. No amount of telling him and having him repeat the letter formation instructions improved his writing. It was his frustration at not being able to write his thoughts on paper or even write his simple 4 letter first name legibly.

A child who has dysgraphia is going to have dysgraphia no matter what you try to do differently. Tactile input for handwriting is great for any child as well as gross motor handwriting exercises (use big arm motions to write letters in the air while reciting the motions needed and work down to fine motor exercises for handwriting). Consistent letter formation scripts and plenty of guidance when they are young will help any child learn to write letters well. Your plan of ruling out things like reflexes and vision as it becomes appropriate is a good one but it is unlikely, at least in my experience, that anyone will suggest possible dysgraphia until she is at least in late second grade at the earliest. I would just treat her as you would any other young learner until she starts missing milestones. Most five year olds are just getting started writing, if after a year or so of instruction she shows no improvement whatsoever, then I would start looking at the possibility of dysgraphia.

[PeterPan]

5 hours ago, 4KookieKids said:

In the last few months, he complains less about it hurting him, but that has been accompanied by a significant decline in readability as well.

We are back with our joyful OT who only works on handwriting via games. This week she had ds make a game board, which had him drawing squares, etc. etc., so he got in her targets but viewed it as a game. Not practical, only saying the dragon writing can shut the kids down.

We got more mileage out of working on retained reflexes that affect the hands than we did with ANY OT. Very little of what OTs do is evidence-based, and you might dig in on handwriting research and be surprised at the lack of evidence for improvement with forced writing methods. I think I read 3 years was the line, that after they've been writing 3 years move on.

We've had multiple kids on the board here who started writing on their own later, like in their teens, because it all came together and they were ready.

I think you can't go wrong working on retained reflexes, because they cost you nothing and MIGHT help. Beyond that, move on to tech. It's so clearly a disability for some kids and the world has moved on. The world doesn't give a flip if your kid can't write. Phones, dictation tech, etc. are just too ubiquitous.

[Kanin]

On 12/22/2018 at 6:06 PM, sweet2ndchance said:

For my son, it was the obvious discrepancy between what he could verbalize and what he could write that was the determining factor for his diagnosis. It wasn't where he started his letters, it was that every time he started them some where different. Sometimes he would write entire sentences in mirror image. No amount of telling him and having him repeat the letter formation instructions improved his writing. It was his frustration at not being able to write his thoughts on paper or even write his simple 4 letter first name legibly.

Wow... that sounds incredibly frustrating! Thank goodness we live in the age of technology - I can't imagine a kid like that in a classroom in 1950. How is your son doing now?