Dysgraphia: Symptoms, Causes, Treatments

In terms of dysgraphia, it is used as a child or as a problem in both calligraphy and spelling (disortography).

The learning of reading will involve a wide variety of knowledge, skills and abilities that in many cases will be really complicated to master by many children who may have a written expression disorder (Matute, Roselli and Ardila, 2010).

Disorders of written expression are part of specific learning disorders and refer to the presence of writing skills  below what was expected for the child’s age, intellectual level and school year (Matute, Roselli and Ardila, 2010).

Dysgraphia Symptoms

Written expression implies a set of motor skills and information processing that can be altered and therefore manifest  with difficulties in spelling, calligraphy, spacing, composition, or organization on paper (Learning Disabilities Association of  Ameria, 2016).



All alterations in written expression will significantly infer school performance and all those activities that require  writing as a fundamental tool (Matute, Roselli and Ardila, 2010).

Relationship between written expression and dysgraphia

Although most children do not usually present significant difficulties in writing, more and more problems in written expression are being detected  , many of which may be due to the educational system, family environment, socioeconomic level and even to neurobiological factors.  and genetic (Ventura et al., 2011).

Writing is a fundamental tool in daily life, it allows us to express ideas, knowledge, through graphic signs. In addition, it is not  an easy process to acquire, until it reaches an optimum level of automation requires continuous practice in addition to the provision of various  cognitive resources to respond simultaneously to all the demands presented by this skill (Ventura et al., 2011).

To achieve a legible calligraphy, a spelling without errors or build a text with a coherent structure, it is essential that we master several  subsystems of writing (Matute, Roselli and Ardila, 2010):

  • The graphic stroke.
  • The graphic composition of the word and the orthographic aspects.
  • The separation between words.
  • The accent spelling.
  • The score
  • The grammar.
  • The coherence between the texts.

On the other hand, there will also be a series of cognitive prerequisites when dealing with the learning of writing (Matute, Roselli and Ardila,  2010):

  • Language and metalanguage : a minimum linguistic level will be necessary to build compositions – phonological skills, semantic aspects, unit  processing.
  • Memory and attention : the efficient control of attentional resources will facilitate the task of selecting the important elements and, on the other  hand, the operational memory will allow us to keep the topic of the text. In addition, long-term memory will allow us to recover all the semantic knowledge  related to the construction of language.
  • Reading : writing and reading will share processes, however, a good reader will not necessarily be a good writer.
  • Executive functions : they will be essential for the planning and organization of the text, for the selection of the appropriate construction strategy 
    and, in addition, the simultaneous management of all the linguistic subsystems.
  • Affective variables : different clinical reports have related variables such as anxiety, worry and motivation with writing.

What is dysgraphia?

In dysgraphia we will be able to observe different deficiencies that will cause a child’s writing skills to be  substantially lower than expected.

It is common to see difficulty to understand written texts, grammatical errors, punctuation errors in the elaboration of grease, poor organization  of paragraphs, spelling errors and bad calligraphy.

If we look at the characteristics described in the Diagnostic and Statistical Manual of mental illness (IV), the written expression disorders  are characterized by:

A. Skills to write, evaluated through standardized tests and administered individually, are significantly below  those expected for the chronological age of the individual, his IQ and the schooling of his age.

B. Criterion A disorder significantly interferes with academic performance or activities of daily living that involve the  writing of written texts (eg, writing grammatically correct grasses and / or organized paragraphs).

C. If there is a sensory deficit, the difficulties of the ability to write exceed those usually associated with it.

How many children suffer?

Currently, it is not known exactly how many children suffer from this type of disorder; However, specialists in this area estimate that  the figure may be parallel to that obtained in cases of reading disorder.

Different studies have shown a prevalence that varies around 1.3% for calligraphy problems, 3.7-4% orthographic problems and 1-3%  difficulties in writing narratives. Others point out that the frequency of students with difficulties oscillates between 6-22% (Matute, Roselli and Ardila,  2010).

In spite of these, in a more recent investigation realized in the USA by the University of Maryland (2002) it was observed that approximately between 3-10%  of the schooled children presented / displayed some disorder of the written expression, presented / displayed problems when spelling; errors in punctuation, grammar and, in  addition, poor writing (Ventura et al., 2011)

Associated pathologies

It is not strange to observe the alterations of the written expression associated with other disorders specific learning disorders (Matute, Roselli and  Ardila, 2010):

  • Learning learning disorder.
  • Disorder of the calculation or dyscalculia.
  • Deficit in the language.
  • Perceptual deficit.
  • Deficit in motor skills

In addition, it is also possible to observe the alterations of written expression in many children affected by attention deficit  hyperactivity disorder (ADHD) or delay in mathematical performance. On the other hand, non-verbal learning disorder (Matute, Roselli and Ardila, 2010) can also be part of the Gesterman syndrome of development  .

Causes of dysgraphia

In general, as in other learning disorders, we can consider that there are etiological factors, both genetic, neurobiological,  perinatal and environmental.

At the neurological level, different investigations have shown that there is not a single region responsible for writing, but that the development of this  activity is achieved through a wide network of cortical regions.

In this way, depending on the different stages that make up the act of writing we can highlight the participation of different verbal areas (Matute,  Roselli and Ardila, 2010):

  • Perception and compression of the message : bilateral primary auditory cortex, left associative temporal cortex and occipital areas.
  • Transcodification of the message : angular gyrus and supramarginal gyrus.
  • Motor act : sensory areas, associative motor cortex, hippocampus, prefrontal areas.

Several authors suggest that the origin of the disorders of the written expression can be found in a dysfunction of the right cerebral hemisphere. However  , others assume that it underlies language alterations mediated by the verbal left hemisphere (Matute, Roselli and Ardila, 2010).

Does dysgraphia disappear in adults?

The American Psychiatric Association (2003) has pointed out that currently there is little information about the long-term evolution of these  alterations.

Generally, it usually persists throughout the first and secondary school years and sporadically can also be observed in older children or  adults (Matute, Roselli and Ardila, 2010).

Alterations of written expression can be observed from an early age, usually in calligraphy, while in older children the  deficiencies will be fundamentally related to the skills of text composition and the expression of ideas (Matute, Roselli and Ardila, 2010) .

Types of dysgraphia

We can perform classifications of written expression disorders depending on the type of writing subsystem that is affected or  presents difficulties: motor digraphs, dystortography, other disorders of written expression.

  • Motor Dysgraphs : Difficulties in the motor mechanisms involved in the graphic stroke – pencil grasp, position, body posture  , strokes, coordination, spatial organization, rhythmic movements.
  • Disortography (developmental dysgraphia) : difficulties in the acquisition of spelling-substitution, omission, exchange of letters, phoneme substitution, etc.-
  • Other disorders of written expression : separation between words, punctuation, grammar, coherence of texts.

Despite this classification, it is very common to find grouped disorders of written expression under the generic heading of dysgraphia .

The Learning Disability Association of America defines dysgraphia as the presence of difficulties in writing in children when doing school work  or activities that require the use of writing. It affects both the writing ability and the final motor skills (Learning Disabilities  Association of Ameria, 2016).

In addition, he points out that it is possible for a child with dysgraphia to present specific problems such as: difficult reading, inconsistencies in the distribution of  space, poor spatial planning, poor spelling and / or difficulty in composing a text (Learning Disabilities Association of Ameria, 2016).

In this way, these are some of the signs and symptoms that we can identify in writing (Learning Disabilities Association of Ameria, 2016):

  • Illegible or italic writing.
  • Mix of different strokes, lowercase-capitals, irregular shapes or sizes and / or tilt of the letters.
  • Words or letters inconclusive or omitted.
  • Unbalanced space between words and / or letters.
  • Abnormal position of the wrist, body or paper.
  • Difficulty in copying letters, pre-visualization.
  • Slow and difficult writing.
  • Distribution of space on paper.
  • Unusual pencil grip.
  • Difficulty taking notes to dictation or creative writing.

Treatments for dysgraphia

With an early and adequate intervention it is possible that the majority of children suffering from this type of alterations achieve an efficient and functional execution  of their writing.

In the intervention with this type of alterations we can use different strategies:

  • Accommodation : provide alternatives to written expression-oral evaluations-
  • Modification : make changes in expectations and tasks to avoid a loss of confidence and self-esteem.
  • “Treatment” : is the fundamental intervention, providing strategies to improve writing skills and correction of errors.

Although there are different approaches to the intervention of this disorder, they are usually intervened through educational programs. These tend to  address the specific alterations of the writing presented by the student, along with the cognitive areas that may present a performance less than  expected (Matute, Roselli and Ardila, 2010).

In the case of younger children, it is common to intervene fundamentally in the motor and calligraphic aspects, while in older children  textual aspects that facilitate their academic performance are usually worked on (Matute, Roselli and Ardila, 2010).


Disorders of written expression often go unnoticed or are underestimated compared to other types of alterations. It is common that we  associate many symptoms of this disorder with the daily difficulties or problems that may appear in the normal course of learning to write.

Also Read : The Theory of Child Cognitive Development (Jean Piaget)

From the early stages of children’s lives we must pay special attention to all aspects related to communication and language since  it will be the fundamental basis for the development of other cognitive skills as well as social and emotional development.