Understanding Dysgraphia

Having illegible handwriting, not being able to express ideas in writing, or experiencing cramps while writing are characteristics of a learning disorder we explore in this article.
Understanding Dysgraphia
Valeria Sabater

Written and verified by the psychologist Valeria Sabater.

Last update: 07 June, 2023

Frustration, problems in academic performance, and emotional distress are some of the consequences of dysgraphia. Therefore, recognizing this problem early should be one of the main objectives in educational settings. Indeed, there are many children who, despite having a normal or higher intelligence quotient, suffer school failure due to this disorder.

This condition, like dyslexia or dyscalculia, is an information-processing disorder. Its symptoms don’t heal. In fact, they remain in the sufferer for life and can affect them in many ways. Fortunately, there are some effective strategies that allow them to take advantage of their full potential and lead a normal life.

When diagnosing dysgraphia, several assessments are necessary. For example, analyzing the child’s fine motor skills, spatial processing, or planning skills of written composition.


Dysgraphia is a learning disorder of neurological origin that causes difficulties in handwriting. As we well know, an essential competence in the literacy and psycho-school development of the child is reading and writing. Therefore, if limitations in forming letters and numbers occur early on, this alteration will affect a good part of the school curriculum.

According to a study published in Frontiers in Psychology, between seven and 15 percent of children suffer from some developmental disorder in writing. Males are more affected than females. Dysgraphia can affect the sufferer’s abilities related to written expression, grammar, penmanship, and even mathematics.

In order to have a clearer and more accurate vision of this learning disorder, it’s essential to act as soon as possible.

How does dysgraphia manifest?

Dysgraphia makes the act of writing an exhausting, difficult, and slow process for the child or adult. It should be noted that the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) doesn’t include this term as a condition as such. However, it does mention the existence of certain neurological disorders that affect written expression.

Dysgraphia is a clinical reality that’s usually accompanied by the following characteristics:

  • Extremely careless writing.
  • Cramps in the hands.
  • Miswritten letters.
  • Skipping letters in words.
  • Frequent tiredness when writing.
  • Trouble holding a pencil.
  • Unconnected sentences.
  • Copying texts extremely slowly.
  • Difficulty writing in a straight line.
  • Impossibility of assembling puzzles.
  • Backward writing (mirror writing).
  • Difficulty in thinking and writing at the same time.
  • Difficulty in tying shoe laces.
  • Letters are written far apart from each other.
  • Inability to differentiate uppercase from lowercase in writing.
  • Difficulties in texting and typing on a keyboard.
  • Lack of punctuation or accent marks.
  • Poor fine motor skills.
  • Difficulties in mathematics and writing numbers.

The disorder has a significant psychological impact on the sufferer. In fact, research conducted by Johns Hopkins University (USA) notes that this neurological condition can completely condition the academic life of the student. Indeed, not only do they experience increased stress and distress, but they may also face limitations in their career choices.

When a child is only focusing on trying to write better, they concentrate all their cognitive resources in that area, leaving aside other tasks such as processing day-to-day academic information.

Different types of dysgraphia

The University of California Irvine (USA) differentiates between two basic types of dysgraphia: acquired and developmental. The first arises as a result of neurological damage such as an accident. The second appears in school-age children, as a consequence of factors in their own brain development, without the existence of external trauma.

These two modalities are manifested, in turn, in three specific ways detailed below:

Spatial dysgraphia

  • Extremely messy writing.
  • Different-sized letters and numbers.
  • Mirror writing (Writing with an orientation from right to left).

Dysorthography or dyslexic dysgraphia

  • Reading problems.
  • Problems in written expression.
  • Difficulties in speaking and expressing themselves.
  • Limitations in understanding what they read.

Motor dysgraphia

  • Difficulty in manipulating small objects.
  • Limitations in drawing lines and writing letters and numbers.
  • Inability to hold a pencil in their hand and make strokes.
  • Inability to pick up or manipulate small or medium objects.
  • Difficulties in fine motor skills.

The causes

This learning disorder has multiple etiological causes and doesn’t only appear in school settings. Often, a neurovascular accident leads to difficulty in written expression. These are its possible origins:

  • Suffering a stroke.
  • Cerebral vascular disorders.
  • Genetic and hereditary factors.
  • Neurodegenerative diseases.
  • Motor neuron disorders.
  • Delay in the development of brain areas related to fine motor skills.
  • Difficulties in fine motor coordination of the brain and working memory (where information is stored about how something is done).
  • Cranioencephalic trauma. For example, the journal, Language and Cognitive Processes mentions the case of a 24-year-old girl who developed dysgraphia as a result of an accident.

When diagnosing dysgraphia, it’s essential to know if the condition is also present in the parents.

Psychologist with girl working on dysgraphia
Educational psychologists are the professionals who must detect learning problems in students.

The evaluation of dysgraphia

Dysgraphia can appear in children, but also in adults as a result of neurological disease or cerebrovascular trauma. In both cases, it’s advisable to request the help of a neuropsychologist.

They’re the ideal specialist to evaluate and treat the patient. They’re professionals that diagnose and carry out treatments for all cognitive, emotional, and/or behavioral conditions, caused by malfunctions of the central nervous system due to injuries or developmental problems.

In the school environment, the educational psychologist is fundamental in the first detection of learning difficulties in students. They then refer them to specialized professionals. They can also develop curricular intervention programs to treat them at school.

How is dysgraphia diagnosed?

This condition can’t be diagnosed by merely assessing the individual’s writing. Indeed, it’s not enough for someone to write badly. An adequate diagnosis must be carried out to evaluate which rehabilitation mechanisms will be the most appropriate. For example, treatment won’t be the same for a child as for an adult who’s suffered a stroke.

Tests for making the diagnosis

When evaluating learning disorders, more specifically dysgraphia, different resources and batteries of tests are carried out. This helps the professional differentiate it from other conditions, such as dyslexia. The tests are as follows:

  • Drawing tasks.
  • Family history.
  • Student’s academic history.
  • Evaluation of phonological skills.
  • Medical history.
  • Evaluation of graphomotor coordination.
  • Dictation of words and pseudowords.
  • Test to measure intelligence quotient (IQ).
  • Assessing the level of oral language development.
  • Standardized test for the evaluation of writing.
  • Evaluation of the planning skills of written compositions.
  • Neurological tests if applicable (when there’s been trauma or an accident).

It’s important to note that this disorder often co-occurs with other learning disabilities or other neurological or psychological conditions. For instance, ADHD. Therefore, a correct assessment is paramount.

Treatments for dysgraphia

This disorder isn’t cured, it’s rehabilitated. The sufferer can have a successful professional life if they manage the condition with appropriate strategies. They’re as follows:

  • Therapy to treat fine coordination disorder. Its purpose is to improve fine motor skills. The sufferer carries out exercises that favor the maturation of manual movements and posture. This won’t only impact their writing, but also any interaction they execute with their hands.
  • Individualized education program. The child or adult follows a program adapted to their needs, at school or in a rehabilitation clinic. In these spaces, different therapies are carried out that offer them strategies to establish new skills and learn how to manage their diagnosis.
  • Cognitive rehabilitation and psychological intervention. Cognitive rehabilitation aims to improve hand-eye coordination. For this, pattern recognition exercises and techniques are carried out that coordinate the movement of the hands with language, written and oral expression, etc.

From a psychological point of view, efforts are made to make the adult or child aware that they must be involved in these rehabilitation tasks. It’s appropriate to provide them with support in managing stress and frustration and improving their confidence and academic self-esteem.

Respect, empathy, and patience: the keys to treatment

To conclude, it must be remembered that learning disorders and the development of writing are common among the population. Early intervention, while important, isn’t the only action that helps.

In fact, we must be aware of these realities so those who are suffering are treated with respect and empathy. After all, problems with writing, calculation, or reading shouldn’t ever limit the potential of the human being.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.