Diagnosis Of Dysgraphia

The Diagnosis of Dysgraphia
The term dysgraphia is taken from the Greek word, (dys) meaning "bad" or "difficult" and (graphia) meaning "writing." Thus, "dygraphia" literally means "bad writing". In contemporary terms, this has been defined by DSM-IV (2000) – now superseded by DSM-V (2013) - as a learning disability with impairment in written expression: the inability to write primarily referring to handwriting, but also in terms of coherence.

DSM V does not offer diagnostic criteria for dysgraphia, but does include difficulties with written expression within the criteria for diagnosing specific learning disorder. For a student with no difficulties with written expression but with generally hard to read and illegible handwriting there is no internationally recognised diagnostic criteria, such as ICD-10 or DSM V, that a clinician can refer to.

Searches of the internet reveal many definitions of dysgraphia which include difficulties with: fine motor co-ordination, organisation and presentation of written material, writing to be distorted or incorrect, letters and numbers may be backwards and out of order, expressing thoughts in writing, not understanding the spellings of words, having trouble with punctuation, more than simply “untidy” writing; it affects people’s ability to write effortlessly, a neurological condition that impairs writing and memory processing.

Using the latest DSM 5 definition of specific learning disorder most of the above would now fall within the diagnostic criteria for specific learning disorder, except for difficulties with the act of writing by hand. Because of this some practitioners now consider dysgraphia to be defunct as a diagnosis.

Dysgraphia is a very useful descriptor for handwriting that is so hard to read that it is generally illegible. Wadeson Street Dyslexia Centre use a very simple criteria: If a free writing sample is more than 25% illegible; that is more than one out of four words are illegible, or can only be read by reading around the target word to deduce what the word is, then the person’s handwriting is considered to be dysgraphic. We use a technique whereby the sample is read from the bottom in reverse, which helps to ensure that each word is read in isolation.

Wadeson Street Criteria for dysgraphia

More than 25% of handwriting sample hard to read or illegible when the sample is read from the bottom backwards.

Two samples of dysgraphic handwriting.