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ICD-10 F81.1, R48.8
ICD-9 315.2, 784.61, 784.69
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Agraphia (or dysgraphia) is a difficulty writing coherently, if at all, regardless of ability to read. People with dysgraphia often can write, and may even have a higher than average IQ, but lack co-ordination, and may find other fine motor tasks such as tying shoes difficult (It often does not affect all fine motor skills). They can also lack basic spelling skills (having difficulties with p,q,b,d), and often will write the wrong word when trying to formulate thoughts (on paper). In children, the disorder generally emerges when they are first introduced to writing. They make inappropriately sized and spaced letters, or write wrong or misspelled words despite thorough instruction. Children with the disorder may have other learning disabilities; however, they usually have no social or other academic problems. Cases of dysgraphia in adults generally occur after some neurological trauma or it might be diagnosed in a person with Autism such as Asperger's or ADHD. The DSM IV identifies dysgraphia as a "Disorder of Written Expression" as "writing skills (that) ...are substantially below those expected given the person's ...age, measured intelligence, and age-appropriate education".

Disagreements about dysgraphia

Types of dysgraphia

Even though most sources currently list three types of dysgraphia, many who research dysgraphia find evidence for several more types. One of the things which makes arguments for more types of dysgraphia fairly strong is that not all dysgraphics fit the descriptions of the types listed below.

Definitions of dysgraphia

Many organizations and standard tests cannot agree on definitions of what dysgraphia is, and on what should be classified as dysgraphia, and what should have some other classification.


Many define dysgraphia as "a defect in the understanding of space". Previous books are usually given as the source, however all actual research that has been done to test this theory has shown that most dysgraphics have no defect in the understanding of space, or visual-motor delay.

Types of dysgraphia

Dyslexic dysgraphia

With dyslexic dysgraphia, spontaneously written work is illegible, copied work is fairly good, and spelling is bad. Finger tapping speed (a method for identifying fine motor problems) is normal, indicating the deficit does not likely stem from cerebellar damage. A Dyslexic Dysgraphia does not necessarily have dyslexia. (dyslexia and dysgraphia appear to be unrelated)

Motor dysgraphia

Dysgraphia due to motor clumsiness has illegible spontaneously written work, illegible copied work, normal spelling, and abnormal finger tapping speed.

Spatial dysgraphia

Dysgraphia due to a defect in the understanding of space has illegible spontaneously written work, illegible copied work, normal spelling, but normal tapping speed.

Phonological dysgraphia

Where the person has difficulty spelling nonwords or unfamiliar words. In deep dysgraphia semantic errors no seen in phonological dysgraphia are seen

Lexical dysgraphia

With Lexical Dysgraphia an individual can spell but relies on standard sound-to-letter patterns which leads to the mispelling of irregular words. This is more common in languages such as French and English which are not always phonetically accurate. Some individuals may have a combination of symptoms from any of the forms of dysgraphia; and may also display additional symptoms to those listed here.

Symptoms of dysgraphia

A mixture of upper/lower case letters, irregular letter sizes and shapes, unfinished letters, struggle to use writing as a communications tool, odd writing grip, many spelling mistakes (some times), pain when writing, decreased or increased speed of writing and copying, talks to self while writing, and general illegibility.

Lesser known symptoms of dysgraphia

Pain while writing

Many people who are dysgraphic will experience pain while writing. The pain usually starts in the center of the forearm and then spreads along the nervous system to the entire body. This pain can get worse or even appear when a dysgraphic is stressed. Few people who do not have dysgraphia know about this, because many with dysgraphia will not mention it to anyone. There are a few reasons why pain while writing is rarely mentioned:

  • Sufferers do not know that it is unusual to experience this type of pain with writing.
  • If they know that it is different from how others experience writing, they know that few will believe them.
  • Those that do believe that the pain while writing is real will often not understand it. It will usually be attributed to muscle ache or cramping, and it will often be considered only a minor inconvenience.

Common problems that are often associate with dysgraphia


There are some common problems not related to dysgraphia but often associated with dysgraphia, the most common of which is stress. Often children (and adults) with dysgraphia will become extremely frustrated with the task of writing (and spelling); this frustration can cause the child (or adult) a great deal of stress and cause stress related illnesses. Common environmental sources of stress in the classroom setting are (a) high levels of environmental noise, and (b) over-illumination.


Treatment for dysgraphia varies and may include treatment for motor disorders to help control writing movements. Other treatments may address impaired memory or other neurological problems. Some physicians recommend that individuals with dysgraphia use computers to avoid the problems of handwriting.

Occupational therapy should be considered. Dysgraphic children should also be evaluated for ambidexterity, which can delay fine motor skills in early childhood.

Learning related vision problems

The neutrality of this section is disputed.

People who struggle with symptoms of dysgraphia can benefit from vision therapy. Seventy percent of what a child learns in school is processed through the visual system. Even a minor visual processing problem will interfere with a child or adult performing to their potential and could cause symptoms of dysgraphia.

Symptoms of Vision Problems:

  • Avoidance of near work
  • Frequent loss of place
  • Omits, inserts, or rereads letters/words
  • Confuses similar looking words
  • Failure to recognize the same word in the next sentence

If you or your child experiences any of the above, P.A.V.E.® (Parents Active for Vision Education) recommends a learning related vision examination by a behavioral optometrist.

Optometric visual training, frequently called vision therapy or VT, is that part of optometric care devoted to developing, improving and enhancing people's visual performance. Clinical studies on the use and effectiveness of vision therapy are available.

Any struggling student should have a complete evaluation by a behavioral optometrist. Testing should be done at distance and nearpoint to assure that both eyes are working together as a team. Vision is more than clarity, and is a complex combination of learned skills, including tracking, fixation, focus change, binocular fusion and visualization. When all of these are well developed, children and adults can sustain attention, read and write without careless errors, give meaning to what they hear and see, and rely less on movement to stay alert.

See also


External links

Jason Alster -work book for teaching dysgraphics to paint- Creative Painting For The Young Artist -ISBN 9659025122 Jason Alster - Book with cursive handwriting help- BEING IN CONTROL ISBN 9659025114

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