What is dysgraphia?

Dysgraphia is a term, used mostly in the United States, for a learning disability that affects writing, especially producing legible and automatic handwriting.^[1] Some definitions also include spelling and getting ideas onto the page.^[2] It is not a diagnostic label in DSM-5, and UK handwriting specialists prefer terms such as "handwriting difficulties" or "an impairment in written expression".^[3]

Dysgraphia, dyslexia and dyspraxia

These terms overlap but are not the same. Dyslexia mainly concerns word reading and spelling, and the IDA notes that difficulties with spelling and handwriting can persist after reading improves.^[5][6] Dyspraxia, or developmental coordination disorder (the NHS term), affects coordination, and the NHS says it can make daily activities like writing difficult.^[7]

The BDA guide cautions against assuming that everyone with dyspraxia has dysgraphia: some children with dyspraxia produce tidy, legible handwriting, though usually less of it, and poor handwriting can occur without dyspraxia. It also notes that poor handwriting is frequently reported in children who meet criteria for ADHD, dyslexia or autism.^[3]

A 2019 peer-reviewed review by Biotteau and colleagues describes dysgraphia as a disturbance in the mechanics of producing written language, and reports that about half of children with developmental coordination disorder have difficulty learning to write.^[8] It also cites studies finding that coordination difficulties persist into adulthood for 30 to 70% of people identified in childhood, which can include handwriting.^[8]

How writing difficulties are assessed in adults

In the UK, the BDA guide says handwriting difficulties should be identified by an educational or clinical psychologist or an SpLD assessor.^[3] The UK list of suitable tests includes the Detailed Assessment of Speed of Handwriting for ages 17 to 25, which uses alphabet writing, copying at best and fast speeds, and ten minutes of free writing, and a second edition normed for ages 8 to 25.^[9] For coordination, the NHS says a GP may refer an adult to a specialist such as an occupational therapist.^[7]

Handwriting tests usually score legibility and speed, for example by counting how many letters someone writes in a set time, and the same review notes that no single gold-standard test for dysgraphia exists.^[8]

In the United States, a learning disability in written expression is assessed by the same kinds of licensed professionals who assess other learning disabilities, such as clinical psychologists and neuropsychologists.^[10] See who can diagnose dyslexia in adults for how this differs by country.