Occupational Therapists and Dysgraphia: How We Help

Pediatric occupational therapists (OTs) are widely known to help children with their fine motor skills. We are experts with kids needing sensory regulation interventions or self-help skills. But where do we fit in on a team when a child has a learning difference, such as Dyslexia or Dysgraphia? What is our role with this population? And how do we serve these children and support them academically and in their occupational role of literacy? Let’s find out!

Let's start by quickly defining Dyslexia and Dysgraphia...

According to the DSM 5TR, specific learning disabilities (SLD) is the umbrella diagnosis under which impairment in reading, writing, or math is delineated.

The impairment in reading (aka Dyslexia) involves difficulty reading due to problems identifying speech sounds (phonological) and how sounds relate to letters and words (decoding). This can impact their ability to access, understand and process information as they go through life.

An impairment in reading can also impact a child’s writing for several reasons. One struggle may be that the cognitive demand to figure out what letter to write when spelling out a word can be significant and therefore actual letter formation and overall legibility suffers. Another reason is the associated executive function and working memory difficulties that can coexist with Dyslexia can create difficulties when learning to write (and throughout the writing process). Though a child might not have a Dysgraphia diagnosis, children with Dyslexia can have handwriting challenges both physically and cognitively.

The impairment in writing (aka Dysgraphia) is also known as a disorder of written expression that can have both physical and/or cognitive components. Physically, a child can experience weakness or pain in their hands during writing tasks, as well as struggle to achieve a functional pencil grasp pattern. Cognitively, a disorder of written expression can impact a child’s grammar, punctuation, spelling and organization of thoughts into written form. Children with Dysgraphia often struggle with legibility of handwriting, line placement, spacing, sentence skills and more.

Now that you understand a bit about these two learning disorders, let’s look at how we can help! First, let’s clarify that 'literacy' is both the act of reading and writing! Often one forgets the output part of literacy, but it is equally important.

As Occupational Therapists, our services can be utilized with children with either Dyslexia or Dysgraphia, through remediation, modification, and/or accommodation.

OTs can use explicit, systematic and individualized programs to improve a child's ability to write, whether that child has Dyslexia or Dysgraphia. We are highly skilled in analyzing barriers to a child’s performance - and addressing these barriers, by building upon foundational skills. We can address the physical aspects of writing that are interfering with a child’s performance, as well as the cognitive barriers.

We can introduce accommodations, low tech modifications and assistive technologies if needed. We can partner with the team member who is addressing reading, whether that is a teacher, educational tutor, or speech and language pathologist (SLP), in order to better serve the child. We have the knowledge and background to problem solve strategies, to improve a child’s independence and performance in accessing their education. OTs are a vital part of the team serving these children and we must advocate for our role with this population.

Kelli Fetter, MS, OTR/L

Handwriting Solutions, LLC

www.handwritingsolutions.org