We see a lot of kids struggling with one or the other types of handwriting issue despite the fact that their IQ and memory are above average. Sometimes it becomes overwhelming if the grades drop down all of a sudden just because of difficulty in writing. Dysgraphia is a type of learning disability manifested in the form of problems with writing. It’s a neurological syndrome due to series of neuromuscular imbalances that can affect children and young adults. In those individuals chronically suffering from dysgraphia tend to use the wrong word for a specific expression. Many people have trouble in speaking and if dysgraphia is superimposed with troubles in speech, the magnitude of the problem is further amplified. What is more unfortunate is that many parents think their child is incapable hence the problem can continue for years with no proper diagnosis, however, every issue related to writing cannot be correlated into a proper dysgraphia.

Nature of problem
Students with writing challenges become laggards because they often end up struggling to coordinate the visual processing difficulties, memory, thinking and other motor executive functioning skills. However, the problem seems to vary between individuals as few kids can be trained over a period of time but for many, it’s a nightmare. Dysgraphia is spectrum of issues including issues with formation of letters, joining the letters to form a word, line spacing, aligning the words uniformly inside the margins, neatness, capitalization, misspelling, punctuation etc. Nevertheless, the diagnosis can be made if there are no neurological abnormalities in the children. Some of the overlapping conditions such as attention difficulties like ADHD, motor disorders, expressive and receptive processing disorders, and dyslexia might mislead the diagnosis as these kids also struggle to write properly. Dysgraphia is manifested with 3 major variations; namely, dyslexia, motor dysgraphia and Spatial dysgraphia. Individuals with dyslexic dysgraphia may demonstrate illegible spontaneously written work due to poor tapping speed of their fingers. This might require further evaluation of their brain because cerebellar damage is directly related to poor body balance and fine motor skills such as holding a pen. On the other hand, motor dysgraphia is linked to poor fine motor skills, spasticity of muscles of the palm and arms, poor muscle tone. These kids often struggle to accomplish a reasonable legibility despite the fact that their receptive memory and attention are normal. Spatial dysgraphia is manifested by the defect in the understanding of space. They have normal spelling and normal finger tapping speed, but they often end up writing in clumsy manner due to their inability to uniformly space the words.

Causes
It is idiopathic( unknown cause) in most of the cases, however, it is a neurobiological issue coinciding with genetic tendency. Many children are observed with an issue in their working memory linked with their failure to develop normal connections among different regions of the cerebellum that help in writing. It may also be due to their underlying problems in orthographic coding, the orthographic loop, and graph motor output (the movements that result in writing) by one's hands, fingers and executive functions involved in letter writing. It is also correlated with vision problems, motor neuron disorders, weakness in the muscles and past history of serious injury to hands.

Identifying dysgraphia
Having said that the problem sustains even till the middle adulthood as many people understand this as a natural ailment in their body. Some of the common symptoms are enlisted below.
1. Children often position their hand in an unnatural way such as odd wrist, arm, body or sitting at a 45 degree angle from the paper or bending an arm like L- shape.
2. Multiple attempts to erase and write the content can be one of the significant alarming sign of bad writing. s
3. Rarely, parents express concern about their children as they tend to mix the upper case and lower case letters.
4. Partially written words, inconsistent form and size of letters, or unfinished letters
5. Poor usage of spacing such as line spacing and word spacing and for these kids, writing on a plain paper is a worry however, pre-lined paper is a good choice.
6. Unevenly balances pace of copying and rewriting.
7. Distraction while writing is common as they often feel pain in the shoulders, fingers and arms which can result in inattentiveness over details.
8. Some children keep their vision( eye gauge) too close to the paper ( hardly 1-3 inches away from their eyes)
9. A huge difference in the legibility of the first line and the last line, however ADHD can sometimes cause this such issue.
10. One of the major signs are the poor legibility, poor spatial planning on paper, improper spellings
11. More often than not, dysgraphia kids face a hard time translating ideas into words and sentences and they are comfortable to read rather than to write.
12. Some kids show poor pincer grasp (gripping a pen ) because they tend to use their entire palm to hold the pen instead of 3 fingers( as in the normal kids).

Strategies to manage dysgraphia
It is very important to assess the specific deficit in the child such as legibility, neatness, and comfort level of the child while writing, pressure (pressing too hard while writing), issues with speed and lack of self-motivation. Parents and teachers must rule out what works best for an individual child. There are many skills and therapies that improves hand writing and the therapist can decide on to what is good for a child. Stop comparing with peers as this can ruin the child`s ego.

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