Handwriting Brain Body DisConnect

Adaptive teaching techniques to unlock a child's dysgraphia for the classroom and at home

Cheri L Dotterer, William Houlette, Bethany Peat, William Houlette, Bethany Peat

• Publisher: Therapy Services, LLC
• Year: 2019
• eBook ISBN: 9781640853935
• Edition: 1
• Topic: Personal Development
• Subtopic: Writing & Presentation Skills

School is tough enough when you know how to write. Imagine being one of the 33% of students who struggle with writing letters and numbers. This inability or difficulty is called dysgraphia. Children who suffer from dysgraphia often earn the reputation of being lazy or dumb. However, these children, like all children, want to succeed. They do not need to live lives of frustration and anxiety and a constant feeling of failing the adults they respect.

For over a decade, Cheri Dotterer has observed children with these challenges in school systems across the world. She witnessed their struggle with not only writing but also the challenging behaviors due to their feelings of defeat from the frustration. While experiencing writing challenges as a child and becoming a professional in occupational therapy with a specialty in dysgraphia, Cheri has discovered a process toreduce the anxiety and frustration in children and build up theirconfidence and competence while writing. In this book, you will discover:

• How the brain and body work together to create neural pathways for learning
• How different environmental features interfere with learning
• How to incorporate movement strategies into teaching both spelling and vocabulary in the regular education classroom
• How to discuss goals, accommodations, and modifications for special education Individualized Education Programs (IEP) or 504 plans.

Eliminate stress today by including these adaptive techniques into your classroom and home today!

Part One
Dysgraphia~Decoding~Encoding

Chapter One
Dysgraphia

Emerging writers do not always translate what they see and hear to written expression well. Approximately 10-33% of the population have handwriting hindrances (VanHoorn, Maathuis, Peters, & Hadders-Algra, 2010). Experts indicate that a child must understand directionality, recognize similarities and differences, as well as possess a functional pencil grip, and the ability to copy to have functional handwriting skills (VanHoorn, Maathuis, Peters, & Hadders-Algra, 2010). When a child is having difficulty with handwriting, it is called dysgraphia. While Behringer and Wolf (2018) define dysgraphia based on an educational classification, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) (American Psychiatric Association (APA), 2013) does not define dysgraphia as a specific identifiable diagnosis. It is mentioned as a symptom under the criterion of a Specific Learning Disability, Neurodevelopmental Disorders section.

“Dys” means disability and “graph” means to write by hand. Dysgraphia is a genetic condition, but the cause is not understood. Possible origins include a lack of oxygen or head injury (Karnik & Karnik, 2012). The following is a general list of symptoms taken from the research of Karnik and Karnik (2012). It has been paraphrased for clarity.

• Writing slower than typical students of the same age
• Odd positions of the wrist or paper
• Mixing upper and lowercase letter forms
• Inconsistency in forming letters
• Cramping fingers or hands
• Irregular letter formation, size, sequencing, or line placement
• Poor letter organization
• Unorganized thought processes when writing paragraphs
• Difficult managing margins
• Inefficient pencil pressure
• Poor spelling
• Intentionally watching their hand write letters
• Awkward pencil grasp
• Poor fine motor skills
• Avoiding writing tasks
• Letter and number reversals
• Difficulty with written expression
• Need extended time to complete tasks

Brant (2014) and Bryce & Stephens (2014) state that there are three types of dysgraphia. Karnik and Karnik (2012) indicate five different types. None of the published material provides clear explanations along with a functional application to help students cope with dysgraphia.

After much deliberation and research, I have merged the findings of the researchers to clarify the confusion regarding dysgraphia. The Types of Dysgraphia were created to reflect the developmental levels of reading and writing and interweaves them with sensory-motor development to help explain dysgraphia. Although these types are distinctly different in their symptoms, students may have overlapping symptoms from each type. Students may never develop the proper neural pathways to progress through each type. They could also develop some, but not all the neural pathways yielding splintering skills in various areas. Depending on the day, students may also have moments in which they remain in lower developmental patterns.

The foundation of dysgraphia is the ability to process information. To begin processing information, a person must be able to interpret visual-spatial information and respond to it. In this type, early reading difficulties also impact the ability to write. Visual-spatial dysgraphia (VSD) involves the sensory input a person receives from their environment. Motor Dysgraphia (MotorD) reflects the motor development of a student. The third type is Memory Dysgraphia (MemD), which reflects the brain-body disconnection to effective working memory. Working memory is the body’s short-term memory system, which keeps a constant running record of what the body is doing. These types of dysgraphia involve primarily the mechanical portions of writing. Word and Sentence Formation Dysgraphia (SFD) are more greatly impacted by the language aspects of writing. Finally, Paragraph Formation Dysgraphia (PFD) utilizes our cognitive neural pathways to develop creating prose. However, our brain and body are one complete unit. All aspects of writing intermingle.

Some authors (Brant, 2014); (Bryce & Stephens, 2014) (Karnik & Karnik, 2012); & (HPS, 2018) have referred to this type of dysgraphia (difficulties with word, sentence, and paragraph formation) as dyslexic dysgraphia. However, they qualify their terminology stating that this type of dysgraphia does not reflect dyslexia (a disability in reading). This created some confusion.

Information processing is an individual’s ability to learn and retain new information; that is, decode, interpret, and respond with efficiently encoded written words. it in their brains. Merriam-Webster (2017) clarifies information processing as short-term memory acquisition, working memory capacity, recall, and word fluency. Merriam (2017) also states the individuals may have auditory interferences such as loud or annoying noises distracting them from focusing on their work. A second type of interference is that of one’s own thoughts distracting the individual from producing work. We’ve all experienced preoccupation with our internal thoughts that have nothing to do with the task we need to complete. More information on executive functioning is discussed in chapter five.

Information Processing Dysgraphia

Information Processing Dysgraphia encompasses all aspects of the mechanics, language, and cognitive aspects of writing at their most fundamental levels. Letter and number comprehension and use is the foundation of processing information. Placing the information on paper is also a concern with information processing dysgraphia. Typically, handwriting is illegible, motor skills are impaired, and language skills are laborious for the student. Working memory disruptions create hesitation and confusion with letter formation, sizing, sequencing, and line placement, and so impact the mechanical portion of writing. The language and cognitive portions of writing are engaged developmentally at a basic level.

On a brighter side, a student with information processing dysgraphia’s ability to copy is wonderful. They tell oral stories in explicit detail. With that visual cue in front of them, they do not need to use their working memory to create letter or number forms. This student flourishes if they have a scribe to initially record their oral feedback. The student then recopies it. As a teacher or parent, you may also digitally record the student’s information and have them write down the material if the playback contains a visual cue for letters, numbers, and any other pertinent symbols. Assistive technology has made playback much easier.

The next two forms of dysgraphia are the most understood forms. They are the types that are most common referral for occupational therapy. Developmentally, our brain-body connections take sensory feedback and create motor responses.

Visual-Spatial Dysgraphia (VSD)

Visual-Spatial Dysgraphia (VSD) is a brain-body disconnect involving a lack of visual-spatial awareness or visual perception. Without visual-spatial awareness, students cannot determine where to place the symbols on paper. These students typically have the most illegible handwriting of all the types of dysgraphia (Bryce & Stephens, 2014). Visual-spatial awareness is the foundation of visual perception. Integration of the motor output is visual-motor integration. Visual perception and visual-motor integration will be explained further in supplemental chapters.

Students with a primary concern of visual-spatial awareness most likely have age appropriate fine motor skills. They can follow rhythmic music patterns. Their oral narration and spelling are age appropriate (Brant, 2014). They also have difficulty with drawing, coloring, painting, letter formation, and accurately creating simple shapes. Their writing speed and fluency are poor. As a result, they avoid handwriting (Bryce & Stephens, 2014); (Karnik & Karnik, 2012).

Students with VSD require a visual cue for anything that they are writing, drawing, coloring, or painting. They do well with drawings that have individual steps broken down into small steps. RealOTSolutions.com has a book called I Can Draw that breaks drawings down into 3, 4, and 5-steps (Moskowitz, 2015).

Most handwriting programs come equipped with a desktop strip that can be placed on the student’s desk. These strips provide a visual cue for the program being taught.

To help a student with word and letter spacing, many sensory-motor style supports have been invented. Anything that creates a visual cue between words will help. Popsicle sticks, stickers, and fingers have been used to facilitate the cue.

Due to the gift of rhythm in these children, songs are helpful in the student’s mastery of the visual-spatial difficulties. Handwriting Without Tears has several CDs that help students. Real OT Solutions also uses songs, but they have not published a CD (Olsen & Knapton, 2008).

Motor Dysgraphia (MotorD)

If the area of concern is motor in nature, MotorD is the level in which the student will have more trouble. Delays in fine motor skills, eye-hand coordination, motor clumsiness, and hand strength plague these students. Not only do they have trouble with handwriting, but they also behave differently in the hall or at recess. These students need to “hug” the wall as they are moving through the hallway. They have difficulty climbing playground equipment. They have difficulty standing on one foot. At their desk, students lean forward and lay on the desk or slouch in their chair. They complain of hand pain or cramping when writing. They use every excuse in the book to not engage in handwriting. Many students with low muscle tone have MotorD.

Additionally, they have trouble crossing midline. For example, tasks that require their arm to reach across their body to the opposite side are difficult. They contour their body in unusual ways to compensate for the need to cross midline. Letters like X force the writer to cross midline and is one reason that diagonal lines are more difficult to write for them. Writing to the end of the paper is difficult if the paper is taped on the table near their belly button. These students tend to rotate their paper rather than writing in typical letter formation movement patterns.

Karnik and Karnik (2012) state that these students tend to write extremely slow, form letter unusually, such as from the baseline up, and have difficulty properly using handwriting paper. They size letters inconsistently, demonstrate unique methods to sequence letters, and do not understand proper baseline placement of letters. Because of being unsure about letters, they tend to mix upper and lower cases. Due to their low muscle tone, they tend to write very lightly; sometimes their handwriting is so faint, it can hardly be read. On the other hand, some children write with such pressure to create dark lines, they are frequently breaking pencil tips. However, spelling and the ability to draw shapes are intact. Bryce & Stephens (2014) and Brant (2014) concur that visual-spatial tasks such as coloring, drawing, and painting are intact. Karnik and Karnik (2012) also indicate other strengths include: good auditory and visual memory, the ability to narrate responses verbally, and age appropriate spelling.

Due to the low muscle tone, occupational therapists may offer adaptive seating or pencil grips for students with MotorD. Another adaptation could include a slant board.

The motor delays will impact other tasks that students need to accomplish. These tasks may include dressing properly. If your child dresses with clothes inside out or backwards, they may have a dyspraxia. Dyspraxia is inability to “conceptualize, plan, and execute a habitual motor act” (Parham & Mailloux, 2005, p. 382). It cannot be explained through a medical diagnosis (Parham & Mailloux, 2005).

Tying shoes and opening containers tend to disrupt the lives of these children and their caregivers. See your occupational therapist for adaptive strategies to decrease awkward movement patterns.

Another task that may be awkward is using utensils. Cutting food requires a child to cross midline and use both upper extremities simultaneously. If your child is in grade school and you have given them opportunities to try using a knife and fork with little success, ask for an occupational therapy evaluation.

Hand strengthening activities and in-hand manipulation activities help these students. An example of a hand strengthening activity is pulling coins out of silly putty or play dough. Therapy putty is used more often by therapists it is gluten-free. Moving two dice around in your hand is an in-hand manipulation activity. These tasks will help improve the child’s ability to hold a pencil for longer periods of time.

Students with MotorD benefit from extended time to complete assignments. They also benefit from direct copying rather than copying from the board. Encourage them to use a spacer between words. Examples of spacers include popsicle sticks...

Table of contents

• Praise for Handwriting Brain-Body DisConnect
• Title Page
• Copyright
• Dedication
• Table of Contents
• List of Illustrations
• List of Tables
• Foreword
• Preface Definition, Audience, and Purpose
• Acknowledgements
• October is Dyslexia Awareness Month
• Introduction
• List of Abbreviations
• Part One Dysgraphia~Decoding~Encoding
• Chapter One Dysgraphia
• Chapter Two Decoding
• Chapter Three Encoding
• Part Two Decoding Neural Pathways
• Chapter Four Neuroscience Introduction
• Chapter Five Decoding Brain Anatomy
• Chapter Six Sensory: The Decoding Pathway
• Chapter Seven Encoding: The Motor Pathway
• Chapter Eight Decoding: Vision
• Chapter Nine Decoding Memories
• Chapter Ten Decoding Visual Memory
• Part Three Mechanical Dysgraphia
• Chapter Eleven Encoding VSD
• Chapter Twelve Adaptive Strategies
• Chapter Thirteen Encoding MotorD
• Chapter Fourteen Encoding MemD
• Part Four Language~Cognitive Dysgraphia
• Chapter Fifteen Encoding WFD
• Chapter Sixteen Encoding SFD
• Chapter Seventeen Encoding PFD
• I hope that this book helped explain how dysgraphia impacts students in the classroom and provides you with inclusive strategies that can be implemented across your entire curriculum. Thank you for reading. For more information and more strategies go to www.dysgraphiaconsultant.com and take our questionnaire to determine the type of dysgraphia your student may have and strategies to maximize their learning experience.
• References
• Appendices
• Appendix A Resources for Brain Development
• Appendix B References for Sensory Processing Disorder
• Appendix C Handwriting Resources for Students
• Appendix D What Does the Law Say?
• Appendix E Occupational Therapy Goals, Accommodations, and Modifications
• A Message from Cheri
• About the Author
• This publication accompanies the course titled Handwriting Brain-Body DisConnect Workshop.