Tips for Parents: An Overview of Language and Non-language Based Dysgraphia

Dr. Paul Beljan and Dr. Alison Reuter discuss tips for dealing with language and non-language based dysgraphia.

Recommendations

1. Factors in Developing Motivation to Write*
   1. Nurturing functional beliefs about writing
      1. Create a classroom community supporting writing and other literacy activities.
      2. Display the ways teachers and parents use writing themselves.
      3. Find writing tasks that assure students’ success.
      4. Provide opportunities for students to build expertise in areas they will write about.
      5. Use brief daily writing activities to encourage regular writing.
      6. Encourage writing in a wide variety of genres.
   2. Fostering student engagement through authentic writing goals and contexts
      1. Have students find examples of different kinds of writing.
      2. Encourage students to write about topics or personal interests.
      3. Have students write for a variety of audiences.
      4. Establish improved communication as the purpose for revision.
      5. Integrate writing into instruction in many disciplines (science, math, social studies).
   3. Providing a supportive context for writing
      1. Break complex writing tasks into parts.
      2. Encourage goal setting and monitoring of progress.
      3. Assist students in setting writing goals that are neither too challenging nor too simple.
      4. Teach writing strategies and helping students learn to monitor their use.
      5. Give feedback on progress toward writing goals.
      6. Use peers as writing partners and literacy communities.
   4. Creating a positive emotional environment
      1. Model positive attitudes towards writing.
      2. Create a safe environment for writing.
      3. Give students choices about what they will write.
      4. Provide feedback allowing students to retain control over their writings.
      5. Utilize natural outcomes (communication success) as a feedback source.
      6. Train students to engage in positive self-talk about writing.
      7. Help students reframe anxiety and stress as natural arousal that can enhance writing.
2. Rationale for teaching motivation
   A growing body of evidence suggests that highly motivated writers use a variety of approaches and strategies that are dependent on their purposes and audiences. Skilled writers tend to hold positive views about the utility of writing, engaging in their task with anticipation, feelings of control, and minimal anxiety. The development of motivation for writing is largely the responsibility of those who set the writing tasks and react to what has been written-namely, parents and educators. There is evidence that parents and teachers fail to develop students’ positive beliefs and motivation towards writing. Literacy research has long emphasized the need to help students learn that only how to write but also I want to write. The motivational challenge for teachers involves reassuring students that the benefits of effortful writing far outweigh its considerable risks.
   
   *Adapted from Bruning and Horn (2000).
3. Language-Based interventions
   The most important thing to consider when developing a remediation strategy is matching it with the student’s neurodevelopmental profile.
   
   1. Phonological Dysgraphia:
      1. Alphabet Phonics, based on Orton-Gillingham, uses visual, auditory, and kinesthetic activities to develop a coding pattern for language.
      2. Making Words-helps increase understanding of sound-letter relationships. Manipulation of letters helps students produce a variety of words. For example, students are provided with six to eight letters, then make two or three letter words using all the letters. Length of words increases until all letters are used in a single word.
      3. Writing to Read-based on the idea that children will learn to read words that they have composed more efficiently than words from another source that were written for them.
   2. Surface Dysgraphia
      1. Cover-Write Method-useful for students with surface dysgraphia (difficulty retrieving word images). This involves tracing. Air tracing provides kinesthetic feedback through large muscle movement.
      2. Fernald Method-also useful for surface dysgraphia. This involves pronouncing a word while simultaneously forming a visual image to facilitate recall of orthographic representations of words. It draws attention to the word, provides an auditory-visual link, and controls the direction of word inspection.
      3. Visual Spelling-based on Glazzard (1982), Visual Spelling pairs a word with a word picture to help students remember phonetically irregularly spelled words.
   3. Mixed Dysgraphia
      1. Musical Spelling-particularly useful for students with multiple perceptual deficits and who have experienced poor phonological processing and visual-spatial limitations. Musical spelling uses one sound classification system (music) to trigger another (alphabetic code). This approach is often more fun than rote, repetitive learning.
      2. Language Experience Approach-LEA involves having the student share an experience while someone else maps or types it, then having the student read the experience back.
      3. CAST Universal Design for Learning-this is a computer-based program that addresses pattern recognition (spelling, grammar, and composition), strategic functioning (penmanship, planning and organization), and motivation (self esteem, self-efficacy, sustained effort).
      4. Software Programs-There are numerous software programs available to help students in all areas of dysgraphia difficulty. For a thorough list, see Feifer and De Fina (2002).
   4. Semantic/Syntactic Dysgraphia
      1. Writing Skills for the Adolescent-extension of Orton Gillingham multisensory approach aimed at augmenting handwriting, spelling, and composition skills for kids with dysgraphia and dyslexia. Uses a ‘bottom up’ approach to address prerequisite skills before moving to more complex skills.
      2. Sentence Combining-increases syntactic maturity. There are several approaches. For example, have the student compose several sentences using his spelling and vocabulary words. Teach all unfamiliar words out of context, then have the student combine sentences in writing. Encourage creativity, and ensure grammatical correctness.
      3. Step Up To Writing-uses color coding to visualize and structure words into meaningful sentences or paragraphs.
      4. Sentence Writing Strategy-subcomponent of U. Kansas’ Strategic Instruction Model used to help students recognize and write 14 sentence patterns.
      5. Software Programs-There are numerous software programs available to help students in all areas of dysgraphia difficulty.
         For a thorough list, see Feifer and De Fina (2002).
   5. Executive Function Deficits
      1. COPS Strategy-helps plan and organize ideas through self-monitoring involving CAPITALIZATION, OVERALL appearance of work, PUNCTUATION, and SPELLING.
      2. SCAN Strategy-does the sentence make SENSE? Is the sentence CONNECTED to my beliefs? Can more be ADDED? Have I NOTED all the errors?
      3. SCOPE Strategy-is the SPELLING correct? Are the first words, proper names, and nouns CAPITALIZED? Is the syntax or word ORDER correct? Are there PUNCTUATION marks were needed? Does the sentence EXPRESS a complete thought? Does the sentence contain a noun and a verb?
      4. C-SPACE-prewriting strategies. After the student decides the audience and type of story, they decide: who is the CHARACTER? What is the SETTING? What is the PROBLEM or purpose? What ACTION occurs? What is the CONCLUSION? What is the EMOTION of the character?
      5. POWER-Plan, Organize, Write, Edit, Revise
   6. Working Memory Deficits:
      1. Story Maps-use of a graphic organizer for mapping the story
      2. Writing Wheels-another graphic representation to help with executive function issues related to writing
4. Non-language interventions
   Interventions for non-language based dysgraphia are typically administered by occupational therapists with an emphasis on the physical act of constructing the written word. The most important consideration when developing an intervention is not categorizing the specific problem by name, but by understanding the theoretical framework linking the specific behavior with the brain area(s) involved.
   
   1. Neurodevelopmental techniques for guided body movement to develop tone, proprioceptive, and kinesthetic feedback; midline awareness; and balance. For example, weight bearing and balance shift activities can help improve posture and upper body control.
   2. Sensory integration techniques that emphasize tactile and pressure awareness.
   3. Spatial temporal adaptation techniques utilizes purposefully changing the environment in which the child performs developmental motor tasks.
   4. Auditory techniques uses rhythm and cadence to stimulate cochlea-vestibular mechanisms involved in processing spatial temporal aspects of sensory information.
   5. Commercial Products- Several commercial products are available for use with ideomotor and constructional apraxias related to dysgraphia.
      For a thorough listing, see Feifer and De Fina (2002).
5. School-based modifications and accommodations
   1. Write in cursive to help the student more easily keep up with his or her thoughts while writing.
   2. Whitney and Hirsch’s (2007) four C’s of motivation: challenge, control, commitment (seeing relevance), compassion (from parents and teachers).
   3. From Thorne, G. Graphomotor Skills: Why some kids hate to write
      
      1. For problems with orthographic coding, tape an alphabet line to the desk for easy reference.
      2. Extend time to complete written assignments and/or reduced volume of written output (i.e., write just the answers to chapter questions, rather than the questions and the answers). Focus on what is being assessed; in other words, if one is assessing comprehension of a social studies chapter, provide modifications in written expression to prevent writing problems from interfering with the assessment of comprehension.
      3. Increase opportunities for oral answers to quizzes and tests.
      4. Teach the child to type.
      5. Break down writing into phases:
         • Generate an idea
         • Organize the idea
         • Attend to spelling and grammar issues
      6. Allow the student access to handouts or copies of other student’s notes from teacher lessons
      7. Give separate grades on written assignments; one for overall appearance and mechanics of writing, and one for content.
      8. Have the child self-correct his or her work based on learned strategies, and make a list of most frequently encountered errors.
   4. From Jones, S. (1998)
      1. Accommodate:
         1. Adjust rate—allow more time or allow child to work ahead at home or as a ‘library assistant.
         2. Adjust volume – provide child with a copy of the teacher’s outline or notes; allow student to use voice recognition programs to dictate note; remove neatness and spelling as grading criteria for some assignments. Allow abbreviations in writing; provide photocopies of math problems rather than having student copy the problems before working them.
         3. Change the complexity: keep a model of writing at the students desk or notebook for the student to follow; break writing into stages; allow student to use spell check.
         4. Change the tools of writing:: use cursive if preferred; use paper with raised lines; allow students to use graph paper for math; allow student to use the writing instrument of their choice; use fun grips; allow use of a word processor; use voice recognition software.
      2. Modify:
         1. Volume: Reduce copying elements of tests and assignments and stress quality of quantity.
         2. Complexity: grade different assignments of different writing process parts (some spelling, others grammar or neatness, etc.); develop cooperative writing projects where each child in a group is responsible for a different aspect of the writing project; provide extra structure for long-term writing assignments.
         3. Format: offer student alternative such as oral report or visual project
      3. Remediate:
         1. Refer to OT or special ed
         2. Teach alternative handwriting methods such as “Handwriting without Tears”
   
   Balance accommodations and modifications with continued handwriting practice or written language skills.