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Written Expression Learning Disorder

Practice Essentials

Writing is a complex task requiring the mastery and integration of a number of subskills. The process of writing connects cognition, language, and motor skills. Some children have difficulties in one aspect of the process, such as producing legible handwriting or spelling, whereas other children have difficulty organizing and sequencing their ideas. Difficulties in one area can delay skill development in the other areas, as practice of all writing skills may be impeded. Children often experience this disorder as thoughts that move faster than their hand can translate them into written ideas on the page. In real-world situations, children with primary impairment in handwriting often have associated spelling problems without reading problems. In addition, for some people, impairment in attention due to Attention Deficit Hyperactivity Disorder may be associated with dysgraphia.

Students with Specific Learning Disabilities that impair writing skills (handwriting, spelling, and/or composing) may not only need accommodations (e.g., allowing more time to complete written work or using a laptop) but also continuing explicit instruction in alphabet letter access, retrieval, and production and copying words in sentence context and using multiple modes of letter production in spelling and composition instruction. The use of different approaches to handwriting (writing by hand, typing) may be helpful to strengthen the orthographic loop of working memory that supports written language learning by connecting the mind’s eye with the serial movements of hands and fingers in producing the sequential component strokes of letter forms.

Recent research looked at DTI and fMRI to elucidate the brain regions involved and found that connections from the supramarginal gyrus to the anterior cingulate and from the inferior frontal gryus to the frontal gyrus may be involved and are affected in word-specific spelling impairment in children with dysgraphia.

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