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Writing & Spelling

The following are past questions and answers from Dr. Larry Silver on this topic.

Is dysgraphia an official learning disability or a functional diagnosis?

I'm an occupational therapist and was recently reading up on dyslexia on the LD OnLine site and had some additional questions about it. Is dysgraphia an official learning disability or a functional diagnosis? Are occupational therapists allowed to diagnose dysgraphia? Who else can diagnose dysgraphia? What are the precise diagnostic criteria, if any, of dysgraphia?

The official diagnostic manual (DSM-IV-TR) lists only one Motor Skills Disorder — "Developmental Coordination Disorder." The task force planning DSM-V is aware that there will be a need to identify dysgraphia. Psycho-educational testing will identify a child with a written language disability based on fine motor coordination. Certainly OTs can do this.

I do not know if there are uniformly established criteria. If a student has difficulty with spelling or with language arts (grammar, punctuation, capitalization), he or she is seen as having a learning disability. If the difficulty relates to fine motor coordination and the ability to form letters and words properly or quickly, he or she is seen as having a grapho-motor problem or dysgraphia.

Is LD passed on to offspring?

I was diagnosed with LD in math and reading when I was in eighth grade. Recently, my daughter has had problems with reading and writing. She is 6 years old and I was just wondering if LD is passed on to offspring.

There is a strong family pattern for learning disabilities. I would encourage you to keep a close eye on your daughter. If she continues to struggle, ask the school to evaluate her for possible learning disabilities.

My daughter takes AP classes and gets good grades but shows signs of a learning disability. How do we get her tested?

I have a 12-year-old daughter who has shown signs of dyslexia for the past six years. She was finally tested and diagnosed through our school this year.

I also have a 15-year-old daughter who will be going into the tenth grade and is very concerned about also having symptoms of dyslexia. She has always been in honors classes and is presently in all AP classes for next year. She works extremely hard to make A's, but struggles with spelling and her handwriting has been bad in the past (although it is improving).

She always gets a bad grade when she has to write an essay. She says she struggles at putting her thoughts together, etc. She also had trouble in geometry — she had to check the formulas over and over because she transposed numbers very easily.

She is very concerned about having to take the PSAT and SAT and worried she'll get a bad grade on the essay portion of the test. She took the SAT in seventh grade as part of the Duke Talented Identification Program and scored very well except on the survey part.

What can I do to get her tested? Considering she makes A's in honors classes, I doubt that the school district would readily test her. This is the problem I had with my youngest daughter. She compensated well and we had tutors, and it would take us hours to do homework, but she would make A's. It wasn't until this year, when she didn't pass the standardized mandated Texas test and was failing, that the district finally tested her.

You are correct that formal testing would be the only way to clarify if your older daughter has a disability. It might be that she has learning disabilities that are reflected in a different way than with your younger daughter.

Since she is doing so well in public school, I doubt you could get these studies done there. You will have to find a private psychologist (or diagnostic team) to do the psycho-educational testing. The results will help you find out what your daughter might need. These data would be required if you requested accommodations for the PSAT or SAT.

How can I get an accommodation at work for my difficulty with handwriting?

I'm a 28-year-old male and am currently a head of department at a school of media and design. I suffer from a form of dysgraphia (at least I think that's what it is) in that I have terrible handwriting. I actually draw the shape of the word rather than spell it out (my spelling is terrible) and I cannot control the placement of capital and lowercase letters if I write by hand (though with a keyboard I don't have a problem).

I've recently enrolled in an advanced assessors course where all the work submitted has to be hand-written. It takes me hours to write out a single page, which is then only mostly illegible. And although each sentence starts with a capital letter, extra capitals crop up throughout the sentence.

I just wanted to know if there is a specific name or diagnosis for this so that I can plead my case.

Thanks in advance,


You need appropriate accommodations — possibly permission to use a computer to write responses. First, you must document your motor-based writing disability. This can be done by a psychologist who does psycho-educational testing. Once documented, you are entitled under the Americans with Disabilities Act to such accommodations.

Meet with the Office of Disability Services at the institution you are attending. Explain your problem. Possibly, they can arrange for such studies. If not, they can direct you to the right person to do this assessment.

What treatment is needed for a teenager with dysgraphia?

I have a 17-year-old daughter who will be a junior this coming school year. She was diagnosed in elementary school with dyslexia and language processing disorder. A few years ago, writing became more difficult. When she goes to write, she can't seem to put the pen down and when she does, it is very scribble-like. They did an MRI and didn't find anything and diagnosed her with an intention tremor.

I mentioned dysgraphia to the doctor and he wasn't familiar with this. Can dysgraphia not appear until later in a child's life? Is there anything (occupational therapist, etc.) that can help? I have some accommodations in school but that won't help in the work world. She struggles just to sign her name.

Dysgraphia (difficulty with fine motor coordination resulting in difficulty writing) is difficult to treat. It is unusual for someone to develop writing problems at age 17. And, the description you give sounds like more than what is usually seen as dysgraphia. I encourage you to follow-up with the neurological workup.

If she has dysgraphia, occupational therapy might be able to help her with gripping and hand strength. Often, the treatment that works best is to switch to the gross motor skill of typing. If she can use the keyboard and type quickly and neatly, she should be allowed to use a laptop in class and when doing homework.