Dysgraphia In Children: Signs, Diagnosis, Treatment And Prevention

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Writing is a basic life skill that enables a child to communicate and learn new things. Most children learn to handwrite in their elementary years. But, even after trying hard, if a child writes untidily (messy handwriting), can’t understand word spacing, and makes frequent spelling mistakes, it may indicate an underlying issue called dysgraphia (1) (2).

Dysgraphia is a neurological disorder that affects a child’s fine motor skills, which are essential for writing. It may affect their academic performance and may even cause them to struggle with daily activities, such as buttoning the shirt. It could cause the child to feel frustrated, anxious, and unconfident. Hence, learning about dysgraphia in children is vital for parents to better understand their child’s writing problems.

This post shares the signs and symptoms, causes, diagnosis, and treatment for dysgraphia in children.

Signs And Symptoms Of Dysgraphia In Children

The most common sign of dysgraphia in children is poor handwriting, which at times is impossible to read. However, writing messy alone doesn’t mean a child has dysgraphia. A child is suspected of having dysgraphia when they manifest additional issues, such as (3)(4):

  • Strange position of the wrist, body, or paper/book
  • Cramped gripping of the writing tool, causing hand pain
  • Irregular or inconsistent shape, size, or slant of letters
  • Improper spacing between the letters in a word
  • Writing words with several letters missing
  • Poor grammatical structure of the sentences
  • Difficulty thinking and writing simultaneously
  • Difficulty pre-visualizing letter formation, causing slow or labored writing

If you observe several of these signs in your child and their writing style, consult a pediatrician for a thorough evaluation.

Causes Of Dysgraphia In Children

The precise cause of dysgraphia in children is unknown. However, the causes of learning difficulties are multifactorial (hereditary, environmental) and can be caused by developmental factors such as preterm infarction, asphyxia, infections, central nervous system infections or central nervous system injuries.

Experts suggest that dysgraphia could often occur with other learning disabilities, such as dyslexia and ADHD (5). Genetic inheritance and issues in prenatal development, such as premature birth, may also play a role.

Another possible cause is a problem with orthographic coding. Orthographic coding is the ability of the working memory to remember written words with their pronunciation and meaning (6). It also involves remembering ways in which one’s hand or fingers move to write words.

When a child has dysgraphia, they struggle with the pre-visualization of letter and word formations. As a result, the child can’t write what they think even when they technically know how to identify letters and read (and spell) words.

Diagnosis Of Dysgraphia In Children

The doctor will first note the child’s signs and symptoms and gather their family and medical history. Doing this is essential to rule out other learning disabilities that can also cause problems in writing.

If initial findings suggest that the child may have dysgraphia, a mental health specialist (psychologist) will give them some writing assignments or tests. These tests will evaluate the child’s fine motor skills and writing ability to express thoughts in words. While the child writes, the doctor will examine their following attributes (7).

  • Body and hand position
  • Hand movement
  • Pen/pencil grip
  • Handwriting, including letter formation, word formation, spellings, and spacing between letters and words

A thorough evaluation of these writing aspects can help a doctor or healthcare provider know what treatment modalities or therapies could help a child improve or overcome their writing problems.

Note: A child can be diagnosed with dysgraphia while in preschool. However, the condition may go unnoticed until the child is in elementary or middle school, where writing is complex. If a young child has dysgraphia, they are likely to struggle to hold crayons, scribble, draw, trace, or perform simple motor tasks.

Treatment For Dysgraphia In Children

There’s no cure for dysgraphia. However, parents can help their child improve and manage the condition using certain treatment modalities. The treatment modalities that suit the child depend on the severity of dysgraphia and the presence of other learning disabilities. Nonetheless, here are the two most common treatment modalities that can help children with dysgraphia (8).

  1. Occupational therapy (OT): OT helps improve the child’s fine motor skills using different activities. The activities teach the child the right way to hold a pen/pencil (pincer grasp) and maintain the correct arm and body posture while writing. A few activities that therapists may try are clay modeling, tracing letters on their palm/hand or desk, or practicing connect-the-dots puzzles.
  1. Educational therapy (ET): ET focuses on helping children work on other areas of writing where the child is struggling. It will help a child feel less stressed and anxious about writing. So, the therapist will help a child understand the writing process, identify those problems, and then devise a plan to overcome them. They will also encourage children to make reasonable goals and teach them ways to reach them.

Several children learn to write properly with proper guidance and support. However, for some, it may continue all life-long. 

Tips To Help Children With Dysgraphia

There are several ways you can help your child at home build writing skills. For instance, you can help your child hold a pencil properly and maintain a firm grip. Alternatively, you can check with the doctor about special pens/pencils with a special grip that makes writing easier (8).

You can give them a wide-ruled paper to practice writing letters and learn word alignment. Additionally, you can give your child a stress ball that they can squeeze to alleviate stress and improve their hand-muscle strength and coordination. Furthermore, if the child feels too stressed before writing, ask them to rub their hands together quickly to have a favorable distraction.

It is a good idea to create the necessary routines together with the child to do the homework. Creating routines takes time, perseverance, and compassion from both parent and child. It is important that you do not do everything for the child, but instruct the child to do, create, and learn the necessary school routines. To learn routines, a child needs a lot of practice, repetition, and encouragement. It also takes time to learn away from bad practices.

Whatever way you support your child, remember to talk to your child to help them vent their pent-up feelings. Listen to their concerns patiently and assure them you have their back. In addition, praise their efforts and put their errors to correction using positive reinforcement.

Classroom Strategies

Aside from home, schools and teachers can also play a vital role in motivating children to learn writing. Here are some classroom strategies that schools can adopt to let children with dysgraphia perform better at school.

  • Allow a note-taker in the classroom. It’s crucial for children who struggle to listen and write simultaneously.
  • Let the child use a computer to take notes and do assignments.
  • Permit the child to have extra time in written examinations and tests.
  • Give lectures or lessons as printouts or recorded audios/ videos.

Dysgraphia is a learning disability that can make writing difficult for a child. While there’s no cure for this neurological problem, timely detection and initiation of therapies focussing on fine motor skills improvement can help. If your child isn’t improving, don’t lose hope. Instead, be strong support for your child and keep your child motivated to try again and again.


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Swati Patwal

Swati Patwal is a clinical nutritionist and toddler mom with over eight years of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children. Then she worked as a nutrition faculty and clinical nutrition coach in different organizations. Her interest in scientific writing... more