Dysgraphia and Dyslexia Indicators: Analyzing Children’s Writing

Abstract

Even though the most prevalent category of disability served in the U.S. school system is specific learning disabilities (SLD), practitioners are often unfamiliar with the indicators associated with a specific LD such as dysgraphia and dyslexia. Misconceptions or an absence of understanding of the behavioral indicators related to dysgraphia and dyslexia puts children at risk for poor academic or social success due to a lack of intervention or late or missed diagnosis. Practitioners can utilize the Dysgraphia and Dyslexia Behavioral Indicator Checklist to identify these indicators in students’ writing samples, design appropriate instructional intervention(s), and refer them for proper assessment.

Keywords

informal assessment special education curriculum reading disabilities writing

In the United States, 37.1% of children receiving services under Part B of the Individuals with Disabilities Education Improvement Act (IDEA, 2004) qualify under the category of specific learning disabilities (SLD), making it the most prevalent eligibility category (U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs, 2022). Even though SLD represents the most predominant category, many children are not diagnosed until later in their academic journey (Chung et al., 2020). A learning disability is a disorder that impacts the psychological processes needed to understand spoken or written language and may result in difficulty listening, speaking, reading, writing, or completing mathematical calculations (IDEA, 2004). Although researchers have reported that practitioners in various parts of the world have a moderate level of awareness about LD in reading (dyslexia) and writing (dysgraphia), they often lack pre-professional training to have sufficient knowledge of assessment and interventions (Alahmadi & El Keshky, 2019; Bridges & Kelley, 2023).

In order to effectively facilitate the early identification of children with reading and writing deficits, practitioners must understand dysgraphia and dyslexia and the related risk factors using behavioral indicators that are associated with them. However, without experience or explicit training, it may be difficult for practitioners and related service providers to determine if young children’s observed weaknesses in the areas of reading and writing are atypical, as some indicators may be developmental and are often produced by their typically developing peers until certain ages (Barton, 2017; Berninger et al., 2008; Chung et al., 2020; Shankweiler & Liberman, 1978). For example, efficient writing grip, reversals, atypical margin usage, and inconsistent spacing of letters should all be resolved and minimally present by the end of school (Chung et al., 2020). Additionally, the automaticity of writing letters is typically developed by Grade 3 (Feder & Majnemer, 2007). By 5 years old, children’s oral language should include sentences with five words (Shipley & McAfee, 2021). Thus, identifying delays in writing and reading as early as possible is essential because a child’s ability to efficiently and effectively decode, comprehend, and produce written products establishes the foundation for all future academic learning (Chung et al., 2020; McCloskey & Rapp, 2017; Zaner-Bloser, 2009). This article aims to define dysgraphia and dyslexia, describe behavioral indicators in children’s writing samples, and provide a step-by-step guide for practitioners to use in the classroom. Additionally, this information will be applied in a vignette following the step-by-step guide.

Dysgraphia and Dyslexia Definitions

Practitioners may have a limited understanding of how dysgraphia and dyslexia manifest in children’s reading and writing in the classroom. Therefore, it is imperative to differentiate between dysgraphia and dyslexia. Understanding these terms is essential because it provides insight into each deficit’s source.

Dysgraphia

Within the clinical and educational communities, there is a lack of consensus regarding the definition of dysgraphia (Chung et al., 2020). In this article, dysgraphia is recognized as a neurodevelopmental disorder in which an individual has illegible or inefficient handwriting due to difficulty with hand movements used for writing and/or the ability to store and retrieve letter formations (Cortiella & Horowitz, 2014; Döhla & Heim, 2016). These difficulties are not solely due to the lack of appropriate educational instruction (Berninger & Wolf, 2016; Chung et al., 2020). However, if children have received instruction for 6 months and little to no improvement is observed, additional support should be considered (Chung et al., 2020). Children with these characteristics in a school setting may be eligible to receive services under the category of SLD due to difficulty in written expression (Chung et al., 2020; IDEA, 2004).

Dysgraphia directly impacts educational outcomes as children must produce written work to demonstrate their academic performance (Chung et al., 2020). It has been documented that 10% of children in Grades 3 and 4 had difficulty with writing speed and legibility, affecting their ability to complete their schoolwork (Phelps et al., 2015). Writing has been recognized as an essential skill to convey thoughts, learn, and express feelings (Graham et al., 2012). Therefore, if children cannot participate effectively and efficiently in written learning activities, their academic performance and future employment opportunities will be impacted (Chung et al., 2020; Graham et al., 2012).

Dyslexia

In a school setting, dyslexia is recognized as a SLD in reading (Berninger et al., 2015; IDEA, 2004). Dyslexia is a neurodevelopmental disorder defined as difficulty

with accurate and/or fluent word recognition and by poor word spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. (International Dyslexia Association [IDA], 2020, Definition section)

Dyslexia may adversely affect academic outcomes in reading, writing, and spelling but often does not impact a child’s academic performance until later grades when higher-level reading passages and decoding abilities are required (Chung et al., 2020; Nelson, 2010). Although difficulties in reading are often first noticed in higher-level grades, indicators can be observed as early as preschool (Berninger et al., 2015).

Differentiating between dysgraphia and dyslexia can be challenging because many observable behaviors during classroom writing activities may overlap. For example, children with dysgraphia and dyslexia often make a variety of errors in their writing, including spelling errors, poor grammar, letter reversals, and slow or effortful writing (Barton, 2017; Brooks et al., 2011; Collette, 1979; Kandel et al., 2017; Sumner et al., 2012). Therefore, early childhood, special education, and general education practitioners must examine children’s writing samples through activities required during the school day.

Dysgraphia and Dyslexia Behavioral Indicators

To provide practitioners with the confidence to identify areas in which children need additional instruction, the Dysgraphia and Dyslexia Behavioral Indicator Checklist (DDBIC) was developed by an interdisciplinary team of researchers (i.e., a speech-language pathologist [SLP], an occupational therapist [OT], a special educator, and a general educator; see Figures 1 and 2). The terms and descriptions for the DDBIC were synthesized from the literature and through feedback from practicing professionals. The content of the DDBIC was implemented in a pilot study to determine the impact of teaching SLP student clinicians to identify behavioral indicators in children’s writing samples after receiving training on how to identify the behavioral indicators included in the DDBIC (Baggett, 2022). The results of this study indicated that SLP student clinicians demonstrated increased confidence in identifying behavioral indicators in writing samples and making accurate referrals for an SLP or OT assessment after training.

Figure 1.

Antonio’s completed Dysgraphia and Dyslexia Behavioral Indicator Checklist during writing sample, Steps 1 to 5.

Figure 2.

Antonio’s completed Dysgraphia and Dyslexia Behavioral Indicator Checklist after writing sample, Steps 4 and 5.

The DDBIC comprises behavioral indicators that are associated with LDs in reading and writing that can be observed during and after a writing task (Barton, 2017; Berninger et al., 2008; Cortiella & Horowitz, 2014; Hebert et al., 2018; Kandel et al., 2017; Kushki et al., 2011; Sumner et al., 2012). Using the DDBIC, practitioners can observe four behavioral indicators during writing activities and 13 behavioral indicators at the end of the writing activities. All of these behavioral indicators can be analyzed using a completed writing sample.

Behavioral Indicators During Writing

Behavioral indicators observed during the writing process may include pencil grip, pressure, speed of handwriting, and other behaviors (see Figure 1; Barton, 2017; Cortiella & Horowitz, 2014; Kushki et al., 2011; Marsh, 2012; Sumner et al., 2012). These four observable behaviors can be monitored over time as a developmental skill to determine the impact on the child’s writing.

Pencil grip

A child’s pencil grip is observed by watching how a child attempts or achieves the hold of the writing tool (Marsh, 2012). Behaviorally, an efficient grip consists of distal control and wrist movement, which leads to the development of visual and perceptual control and awareness (Barton, 2017; Cortiella & Horowitz, 2014). An atypical grip is demonstrated by movement originating from the elbow and shoulder, which could potentially restrict the range of motion (Marsh, 1998). However, if a child’s writing is functional and not impacted by their grip, there is no need to correct the grip.

Pressure

In addition to how a child holds a writing tool, pressure can be observed by analyzing the type and amount of force applied between the child’s hand, the writing tool, and the paper during the writing process. Although increased writing pressure during the writing process is often observed among children with dysgraphia (Kushki et al., 2011), children may also use light pressure. For example, a child may apply hard pressure, causing writing indents on the paper and, in some cases, ripping the paper or breaking the writing tool. Children who apply hard pressure or force when writing have the potential to develop calluses on their palms and fingers (Barton, 2017). Also, the child’s hand may fatigue during writing and decrease legibility. When using a writing tool, a child may also use light pressure resulting in a writing product that is so light you can barely read or decipher the content.

Speed of handwriting

When completing a writing task, a child must be able to produce content and legible writing (Francis et al., 2017). While observing the child during a writing activity, it is important to note the speed of their handwriting. Slow handwriting may impact a child’s ability to complete writing tasks within the allotted time for a particular activity. Conversely, a child who writes too fast may have difficulty producing legible products. Thus, the ability to complete a task in the appropriate amount of time will ensure that a child can keep up with classroom tasks. If pauses are noted, observations of whether a student pauses between words (motoric/visual processing difficulties) or within words (phonological processing difficulties) can aid in determining the cause of the difficulty or delay (Kandel et al., 2017; Sumner et al., 2012).

Other observable behaviors

Children may also exhibit other behaviors during or immediately after writing tasks. These behaviors may include how they attend to a task, time to complete a task, frustration, and avoidance behaviors (Chung et al., 2020; Cortiella & Horowitz, 2014), as well as self-esteem and awareness of difficulty (Kushki et al., 2011). Difficulty attending to a variety of writing tasks or the demonstration of avoidance behaviors may be due to an increased cognitive load on a child’s cognitive processes (e.g., memory, attention, and executive functioning) that primarily support the creation of a writing product (Kushki et al., 2011). This cognitive overload may lead to an increased level of frustration. Ultimately, difficulty in reading and writing can impact a child’s psychosocial development, which may lead to poor self-esteem and negative peer relationships (Kushki et al., 2011).

Behavioral Indicators After Writing

In addition to behaviors that may occur during the writing process, practitioners can analyze the actual writing sample produced using the behavioral indicators on the DDBIC. These indicators are divided into three categories: (a) dysgraphia only, (b) dysgraphia and dyslexia, and (c) dyslexia only (see Figure 2). Figures 3 to 5 provide visual examples of each behavioral indicator that can be observed after the writing sample is collected. These writing samples were collected during a separate research study approved by the University of Nevada, Reno Internal Review Board (#661156-10). The prior study was conducted to determine the relationship between oral language ability and storytelling language abilities of children in Grade 3 with and without language impairments who told and wrote fictional narratives and expository stories.

Figure 3.

Examples of behavioral indicators 1 to 5 (dysgraphia) observed after a writing activity.

Figure 4.

Examples of behavioral indicators 6 to 11 (dysgraphia and dyslexia) observed after a writing activity.

Figure 5.

Examples of behavioral indicators 12 and 13 [dyslexia] observed after a writing activity.

Dysgraphia

There are six indicators of dysgraphia, which are denoted by a W on the DDBIC (see Figure 3). Atypical writing in relation to the vertical axis refers to inconsistent or abnormal positioning of a letter above or below the horizontal writing line (vertical access; Barton, 2017; Cortiella & Horowitz, 2014), which can often be seen as a grapheme not placed correctly on the horizontal line of writing paper. Atypical use of margins/space planning refers to inconsistent or abnormal writing spacing in relation to the writing guide’s left and/or right margins (Cortiella & Horowitz, 2014). Inversions refer to graphemes formed to look like a mirror (flipped) of the target letter in relation to the horizontal line (Cortiella & Horowitz, 2014; IDA, 2020). For example, a “b” would be written as a “p.” Transpositions refer to the incorrect order of letters in a word (Barton, 2017; IDA, 2020), which are often letters that neighbor one another in their placement. For example, instead of writing “it,” the writer transposes or changes the order and writes “ti.” Inconsistent sizing of letters refers to letters written in different sizes (Barton, 2017; Kushki et al., 2011). For example, a child may write a large lowercase grapheme “a” and then write the same grapheme much larger later in the sample. Another way to identify inconsistent letter sizing is to compare the sizing of neighboring letters in the same word (e.g., if “d” in “dog” was huge and the “o” in “from” was small, as seen in Figure 3).

Dysgraphia and dyslexia

Six indicators could be indicative of dysgraphia and/or dyslexia, which are denoted by a B on the DDBIC and presented in Figure 4. Reversals refer to a letter written in a mirrored position in relation to the vertical axis as if the mirror was held to the right of the letter (Barton, 2017; Brooks et al., 2011; Hebert et al., 2018; Shankweiler & Liberman, 1978). Specifically, a “d” is a reversal of a “b.” Reversals of letters are typical for children through the first 2 years of writing instruction (e.g., kindergarten and Grade 1; Sandman-Hurley, 2019). However, reversals observed in Grade 2 after 2 years of instruction would be considered atypical. Spelling errors refer to incorrect spelling of a word (Barton, 2017; Sumner et al., 2012). For example, if a child wrote “sters” instead of the word “stairs.” Letter crowding/atypical spacing refers to the irregular or inconsistent spacing between letters within a word and spacing between words (Barton, 2017; Cortiella & Horowitz, 2014). Poor legibility refers to letters that are not formed properly and are indistinguishable. It is difficult to determine the writer’s intended letter (Cortiella & Horowitz, 2014). Inconsistent/lack of grammatical conventions refers to a lack of or incorrect punctuation, such as a period, question mark, or capital letters in the middle of a sentence (Barton, 2017; Kandel et al., 2017). Abandoned words refer to incomplete word writing (Barton, 2017). For example, a child might write “yester” for “yesterday.”

Dyslexia

There are two indicators of dyslexia, which are denoted by an R on the DDBIC and depicted in Figure 5. Lack of diverse vocabulary refers to limited diversity of word usage (Hebert et al., 2018). For example, a child may use the same word over and over, such as “and,” “will,” or “because.” Poor idea development/organization of ideas refers to children having trouble forming their thoughts in an organized way in writing. Children with dyslexia may have an overtaxed working memory, which impacts their phonological skills needed for writing. As a result, their executive functioning skills, such as organization, may be impacted due to cognitive resources being used to spell words correctly, which leaves less cognitive resources for organization (Hebert et al., 2018). After developing a better understanding of dysgraphia and dyslexia, practitioners can be better prepared to observe and intervene with children who struggle with reading and writing tasks.

Employing the Dysgraphia and Dyslexia Indicator Checklist

Through a step-by-step process, practitioners, OTs, and SLPs can conduct ongoing authentic assessments using the DDBIC. As an ongoing authentic assessment, the DDBIC should be used at the beginning of the school year as a universal screening tool and as appropriate for each child, depending on their needs throughout the school year. However, before using the DDBIC, practitioners should review the entire checklist and the description of each behavioral indicator to ensure they are familiar with what is expected for each indicator during and after a writing activity. Suppose one of the behavioral indicators is unclear to the practitioner when reviewing the DDBIC. In that case, the practitioner can improve their understanding by reviewing the description and pictured examples again to confirm comprehension and consult with a collaborating service provider (e.g., SLP and OT) as necessary.

It may be helpful to have the behavioral indicator written descriptions and examples alongside the checklist during live observations and analysis of the writing sample. Once the practitioner is comfortable with each behavioral indicator description, they can utilize the DDBIC. The following five steps should be used to implement the DDBIC in practice.

Step 1: Design

The practitioner must first design an age-appropriate writing task to implement in the classroom with all students or a specific student. Writing tasks can range from writing a list of words, sentences, or paragraphs based on the age of the children. When selecting a writing task, practitioners should remember that a more complex writing task (paragraph) will likely produce a sample with more behavioral indicators than a simple task (word list). This is because complex writing tasks require additional cognitive load on working memory, executive functioning, and attention (Berninger & Winn, 2006; Chung et al., 2020). Similarly, an expository writing task would be more complex than a narrative writing task due to differences in structure and vocabulary (Norris, 1995).

Step 2: Implementation

Once the writing task has been designed, the practitioner must determine an appropriate day and time to implement the activity in which a live observation can occur. The writing activity may be implemented during instruction in English language arts (ELA), science, or social studies. For example, during ELA instruction, a sample may be collected after reading a story in a small group. In addition to noting the type of writing activity, it is important to record the day, start time, and stop time. Documenting the total time each child took to complete the writing activity provides an opportunity to judge the child’s writing speed compared with other children. Moreover, noting the time of day is important as mitigating factors such as hunger, motivation, and attention to task could impact the child’s performance. This information can be noted on the DDBIC.

Step 3: Live Observation

During the writing activity, the practitioner should be present to conduct live observations of each child completing the writing task. At this time, the practitioner should focus on the four behavioral indicators of the DDBIC that can only be observed during the writing task. After each child completes the writing task, the product should be collected for further analysis.

Step 4: Analyzing the Writing Sample

After the targeted writing sample is collected, the practitioner will review the behavioral indicators and mark on the DDBIC whether the behavioral indicators were present. First, the practitioner will review the four behavioral indicators during the writing process. Second, the practitioner will review the writing sample for the 13 indicators of dysgraphia and dyslexia. Using the DDBIC, the practitioner will record if the indicator was present by circling Y(yes) or N(no) in the column labeled “Step 4: Presence of Behavioral Indicator.” Children with dysgraphia and/or dyslexia will likely present with different behavioral indicators, as no two children are the same.

Step 5: Determining Plan and Collaborating Provider

After analyzing the writing sample for behavioral indicators, the practitioner will determine a plan to improve child outcomes. Using the DDBIC, the practitioner will record the plan by circling 0, 1, 2, or 3 in the column labeled “Step 5: Determining Plan and Collaborating Provider.” The practitioner may circle a 0 and a 1, 2, or 3 if they need to consult with the collaborating service provider regarding specific instruction, instructional intervention, or referral for assessment.

Select 0

A practitioner would select a 0 for a few reasons: first, if the practitioner is unsure if the behavioral indicator was present and needs to consult with the collaborating service provider to make this determination. To do this, the practitioner would look to the right of the plan column on the DDBIC to note the collaborating service provider to consult with, either an OT or an SLP. Second, the practitioner can consult with the collaborating service provider if they are unsure how to provide instruction (Tier 1) or instructional intervention (Tier 2) for the specific behavioral indicator. Third, suppose the practitioner has provided instructional intervention and has collected data. In that case, consulting with the collaborating service provider might be appropriate to determine if an evaluation is warranted.

Select 1

A practitioner would select a 1 if they recognized that the children in the classroom (Tier 1) would benefit from explicit instruction for that specific behavioral indicator. The practitioner may create a lesson plan with specific instructions and activities for the children in the classroom. These lessons should support improving the children’s skills concerning identified behavioral indicators.

Select 2

A practitioner would select a 2 if they already provided instruction to the classroom but felt that the child needed additional explicit instructional intervention (Tier 2). The practitioner would design a plan for instructional intervention that included a small group setting in the classroom, explicit instruction, a data collection plan, and the duration of the data collection interval. This will help determine if the instructional intervention was helping the child or if the child may need a referral to the collaborating service provider for an assessment. The intervention plan should be realistic regarding the child acquiring or improving their skill for the behavioral indicator. An implementation outline should be decided upon to ensure that accurate time is provided to learn the skill.

After the instructional intervention period is completed, the practitioner should implement progress monitoring. To do this, the practitioner will return to Step 1 and complete all the steps on the DDBIC to determine the acquisition of the behavioral indicator(s) of focus. If some growth has been made, but the child still needs instructional intervention to continue to make progress, the instructional intervention should be continued. If limited progress was made, the practitioner should determine if additional instructional intervention is needed or if a consultation with the collaborating service provider is necessary. If it is determined that the behavioral indicator has improved and the child no longer needs instructional intervention, targeted instructional intervention can be stopped. However, if no improvement has been made, the practitioner should select 3.

Select 3

A practitioner would select a 3 if they provided instructional intervention (Tier 2) and felt that the behavioral indicator of concern had not improved. The practitioner should now determine the appropriate collaborating service provider to consult regarding the behavioral indicator by reviewing the collaborating service provider (OT or SLP) on the DDBIC. After meeting with the appropriate collaborating service provider and reviewing progress monitoring data, the next steps should be determined. The collaborating service provider may provide additional instructional intervention ideas to the practitioner. After reviewing the data and the instructional interventions provided, the child may need an assessment and possible services by a collaborating service provider (Tier 3). If so, the practitioner would follow the steps outlined in IDEA to make a referral and obtain parental permission before the collaborating service professional could administer an assessment.

Vignette

Antonio is a Grade 1 English-speaking 6-year-old who attends an urban elementary school (see Note). He has a history of ear infections and received pressure equalizing tubes between 3 months and 3 years old with a documented hearing loss. However, a recent hearing test indicated that his hearing has returned. Antonio walked independently at 14 months, was toilet trained at 2 years 6 months, and rode a bicycle without training wheels at 5 years of age. He drew shapes and letters and cut with scissors in preschool. He communicates in sentences but has speech sound errors, such as “f” for “th.” His parents reported that Antonio struggles to learn to read and is progressing slowly. Antonio has been receiving sound-letter correspondence instruction and letter formation instruction for 1 year 6 months, which began in kindergarten and continued through the middle of Grade 1. Due to persistent difficulties in reading in the middle of Grade 1, the school team is currently providing reading instruction at the kindergarten level. In order to gain more specific information about Antonio’s writing abilities, the teacher decided to implement the DDBIC in her classroom.

To begin implementing the DDBIC, the teacher completed Step 1: Determine a Writing Task, which was to write a story about a fictional class pet. For Step 2: Implementation, the writing task was completed during the established ELA morning instruction block. The teacher noted the start and stop time for the writing sample on the DDBIC, which indicated that Antonio took longer than his classmates to complete the writing task. During Step 3: Live Observation, the teacher observed Antonio’s writing behaviors, made mental notes of the four behaviors observed during writing on the DDBIC, and collected the sample once the writing task was completed (see Figure 6).

Figure 6.

Antonio’s writing sample.

Next, for Step 4: Analyzing the Writing Sample, the teacher analyzed the writing sample to determine the presence of behavioral indicators during and after the writing task. For example, on Antonio’s DDBIC checklist, the teacher circled Y for the behavioral indicators noted during (see Figure 1) and after the writing task (see Figure 2). Specifically, during the writing task, the teacher noted the presence of the behaviors he demonstrated, such as atypical speed of handwriting (slow handwriting) and other atypical behaviors (audible sighing, pulling his hair, and looking off into the distance). When analyzing the completed writing sample, the teacher noted the presence of behavioral indicators across writing, both reading and writing, and reading on the DDBIC. In the writing section (W1–W5), three of the five behavioral indicators were observed (i.e., atypical writing in relation to the vertical axis, atypical use of margins/space planning, and inconsistent sizing of letters). Five out of the six behavioral indicators were noted in the reading and writing section (B1–B6) of the DDBIC. The only behavioral indicator he did not display was abandoned words. In the reading section (R1–R2), Antonio presented both behavioral indicators.

After analyzing the writing sample, the teacher completed Step 5: Determining Plan and Collaborating Provider. For example, when reviewing the behavioral indicators marked “Y” on the DDBIC, the teacher selected “0” and “1” for W2 (Atypical use of margins/space planning) as she has not provided this instruction to her class (Tier 1). The teacher will meet with the OT to discuss strategies to use in the classroom. Next, the teacher selected “0” and “2” for B1 (Reversals) because she previously provided instruction for reversals and needed additional strategies for small group instruction (Tier 2). For this indicator, the teacher will consult with the OT to determine motor development supports and with the SLP for guidance in instructing sound-letter correspondence. The teacher will implement these instructional strategies for 1 month while monitoring progress. Following the month of instruction (Tier 1) and instructional interventions (Tier 2), the teacher will collect another writing sample to evaluate Antonio’s writing using the DDBIC. This will allow the teacher to determine the next level of instructional support.

Conclusion

Learning disabilities in reading and writing are often not identified in children until Grade 3, although behavioral indicators of dysgraphia and dyslexia can be observed earlier in a child’s academic career (Berninger et al., 2015). However, practitioners, OTs, and SLPs are often unaware of the behavioral indicators associated with dysgraphia and dyslexia due to a lack of pre-professional training and/or experience (Alahmadi & El Keshky, 2019; Bridges & Kelley, 2023). Recent research indicates that practitioners can observe these behavioral indicators during established learning activities. However, writing samples are often underutilized to determine if children have behavioral indicators of dysgraphia and dyslexia in the early elementary grades (Baggett, 2022).

Using an assessment such as the DDBIC, practitioners can implement a step-by-step process to collect and analyze children’s writing samples to identify early behavioral indicators of dysgraphia and dyslexia in collaboration with an OT and SLP as needed. The DDBIC may also be used to monitor the progress of these behavioral indicators and to support decision-making for appropriate levels of support to improve children’s outcomes. The DDBIC also encourages interdisciplinary collaboration among practitioners and related collaborating service providers (OT and SLP), which supports improved identification accuracy and implementation of evidence-based instruction.

Even though most of the behavioral indicators identified using the DDBIC may be corrected after effective explicit instruction in the first 2 years of school, children who continue to produce these behavioral indicators in their writing may need additional targeted support or, in some cases, a referral for special education assessment (Berninger et al., 2008). Therefore, it is in the best interest of the child to work on these skills while they are learning to read and write rather than waiting to later in their academic career in Grade 3 or 4 when they are transitioning from learning to read and write, to reading and writing to learn.

Note. The vignette portrays an example of analyzing a writing sample using the DDBIC. The child’s writing samples were collected during a routine diagnostic evaluation in a clinical setting. Names are pseudonyms. Parent permission was provided for the teacher and authors to analyze the sample using the DDBIC.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The contents of this article were developed and researched under a grant from the U.S. Department of Education, #H325K190034. However, this content does not necessarily represent the policy of the U.S. Department of Education, and you should not assume endorsement by the Federal Government.

ORCID iD

Lindsay L. Diamond

References

Alahmadi

N. A.

El Keshky

M. E.

(2019). Assessing primary school teachers’ knowledge of specific learning disabilities in the Kingdom of Saudi Arabia. Journal of Educational and Developmental Psychology, 9(1), 9–22. https://doi.org/10.5539/jedp.v9n1p9

Baggett

M. D.

(2022). Training future educators and speech-language pathologists to identify indicators of specific learning disabilities in reading (dyslexia) and writing (dysgraphia) within handwriting samples. Proquest Dissertations Publishing.

Barton

(2017). How to spot dyslexia in a writing sample. Bright Solutions for Dyslexia; Vimeo. https://vimeo.com/203740803

Berninger

(2007). Process Assessment of the Learner (PAL) (2nd ed.) (Diagnostic for Reading and Writing (PAL-II RW) and Berninger, 2007. User’s guide [CD format ISBN 0158661818] with writing lessons from UW research program that can be downloaded). The Psychological Corporation.

Berninger

V. W.

Nielsen

K. H.

Abbott

R. D.

Wijsman

Raskind

(2008). Writing problems in developmental dyslexia: Under-recognized and under-treated. Journal of School Psychology, 46(1), 1–21. https://doi.org/10.1016/j.jsp.2006.11.008

Berninger

V. W.

Richards

T. L.

Abbott

R. D.

(2015). Differential diagnosis of dysgraphia, dyslexia, and OWL LD: Behavioral and neuroimaging evidence. Reading and Writing, 28, 1119–1153. https://doi.org/10.1007/s11145-015-95650

Berninger

V. W.

Winn

W. D.

(2006). Implications of advancements in brain research and technology for writing development, writing instruction, and educational evolution. In MacArthur

C. A.

Graham

Fitzgerald

(Eds.) Handbook of writing research (pp. 96–114). Guilford Press.

Berninger

V. W.

Wolf

B. J.

(2016). Dyslexia, OWL, LD, and dyscalculia: Lessons from science and teaching. Paul H. Brookes.

Bridges

M. S.

Kelley

(2023). Experiences and perceptions of school-based speech-language pathologists related to literacy: Results from a national survey. Language, Speech, and Hearing Services in Schools, 54(1), 189–197. https://doi.org/10.1044/2022_LSHSS-22-00010

10.

Brooks

A. D.

Berninger

V. W.

Abbott

R. D.

(2011). Letter naming and letter writing reversals in children with dyslexia: Momentary inefficiency in the phonological and orthographic loops of working memory. Developmental Neuropsychology, 36(7), 847–868. https://doi.org/10.1080/87565641.2011.606401

11.

Chung

P. J.

Patel

D. R.

Nizami

(2020). Disorder of written expression and dysgraphia: Definition, diagnosis, and management. Translational Pediatrics, 9(S1), S46–S54. https://doi.org/10.21037/tp.2019.11.01

12.

Collette

M. A.

(1979). Dyslexia and classic pathognomic signs. Perceptual and Motor Skills, 48, 1055–1062. https://doi.org/10.2466/pms.1979.48.3c.1055

13.

Cortiella

Horowitz

S. H.

(2014). The state of learning disabilities: Facts, trends and emerging issues. National Center for Learning Disabilities.

14.

Döhla

Heim

(2016). Developmental dyslexia and dysgraphia: What we can learn from the one about the other? Frontiers in Psychology, 6, Article 2045. https://doi.org/10.3389/fpsyg.2015.02045

15.

Feder

Majnemer

(2007). Handwriting development, competency, and intervention. Developmental Medicine and Child Neurology, 49(4), 312–317. https://doi.org/10.1111/j.1469-8749.2007.00312.x

16.

Francis

Wallen

Bundy

(2017). Comparison of the properties of the handwriting speed test (HST) and detailed assessment of speed of handwriting (DASH): An exploratory study. Physical & Occupational Therapy in Pediatrics, 37(2), 155–169. https://doi.org/10.1080/01942638.2016.1185499

17.

Graham

Bollinger

Booth Olson

D’Aoust

MacArthur

McCutchen

Olinghouse

(2012). Teaching elementary school students to be effective writers: A practice guide (NCEE 2012-4058). National Center for Education Evaluation Regional Assistance, Institute of Education Sciences, & U.S. Department of Education. https://ies.ed.gov/ncee/wwc/Docs/practiceguide/writing_pg_062612.pdf

18.

Hebert

Kearns

D. M.

Hayes

J. B.

Bazis

Cooper

(2018). Why children with dyslexia struggle with writing and how to help them. Language, Speech, and Hearing Services in Schools, 49(4), 843–863. https://doi.org/10.1044/2018_lshss-dyslc-18-0024

19.

Individuals with Disabilities Education Improvement Act of 2004, 20 U.S.C. § 1400 et seq. (2004) (reauthorization of the Individuals with Disabilities Education Act of 1990).

20.

International Dyslexia Association. (2020). Understanding dysgraphia. https://dyslexiaida.org/understanding-dysgraphia-/2

21.

Kandel

Lassus-Sangosse

Grosjacques

Perret

(2017). The impact of developmental dyslexia and dysgraphia on movement production during word writing. Cognitive Neuropsychology, 34(3–4), 219–251. https://doi.org/10.1080/02643294.2017.1389706

22.

Kushki

Schwellnus

Ilyas

Chau

(2011). Changes in kinetics and kinematics of handwriting during a prolonged writing task in children with and without dysgraphia. Research in Developmental Disabilities, 32(3), 1058–1064. https://doi.org/10.1016/j.ridd.2011.01.026

23.

Marsh

(1998). Start to finish: Developmentally sequenced fine motor activities for preschool children. Pro-Ed.

24.

Marsh

(2012). Development of a mature pencil grasp. In Handwriting research: Impact on the brain and literacy development (pp. 85–88). Zaner-Bloser.

25.

McCloskey

Rapp

(2017). Developmental dysgraphia: An overview and framework for Research. Cognitive Neuropsychology, 34(3–4), 65–82. https://doi.org/10.1080/02643294.2017.1369016

26.

Nelson

N. W.

(2010). Language and literacy disorders: Infancy through adolescence (1st ed.). Allyn & Bacon.

27.

Norris

J. A.

(1995). Expanding language norms for school-age children and adolescents: Is it pragmatic? Language, Speech, and Hearing Services in Schools, 26, 342–352. https://doi.org/10.1044/0161-1461.2604.342

28.

Phelps

Stempel

Speck

(2015). The children’s handwriting scale: A new diagnostic tool. The Journal of Educational Research, 79(1), 46–50. https://doi.org/10.1080/00220671.1985.10885646

29.

Sandman-Hurley

(2019). Dyslexia & spelling making sense of it all. Jessica Kingsley.

30.

Shankweiler

Liberman

I. Y.

(1978). Reading behavior in dyslexia: Is there a distinctive pattern? Bulletin of the Orton Society, 28(1), 114–123. https://doi.org/10.1007/bf02653429

31.

Shipley

McAfee

(2021). Assessment in speech-language pathology: A resource manual (6th ed.). Delmar Cengage Learning.

32.

Sumner

Connelly

Barnett

A. L.

(2012). Children with dyslexia are slow writers because they pause more often and not because they are slow at handwriting execution. Reading and Writing, 26(6), 991–1008. https://doi.org/10.1007/s11145-012-9403-6

33.

U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs. (2022). 43rd annual report to congress on the implementation of the Individuals with Disabilities Education Act, 2021.

34.

Zaner-Bloser. (2009). Handwriting research: Impact on the brain and literacy development.