Dysgraphia as defined in the latest edition of the Diagnostic and Statistical Manual (DSM-5) is a “specific learning disorder” with impairment in written expression. Writing problems can result from one or more of the following components:
- Fine motor difficulties
- Visual-spatial difficulties
- Handwriting issues
In addition, spelling problems, difficulty with word retrieval and verbal fluency, and language processing problems can all contribute to difficulty producing a written product.
Because dysgraphia can include various components, multiple evaluation tools should be used to determine your child’s specific problems.
Evaluating Dysgraphia
An Occupational Therapist can evaluate the fine motor problems, but for the purposes of identification for school services and accommodations, an evaluation by a licensed psychologist or a certified school psychologist is needed.
Following is a list of categories, along with possible assessments, that a psychologist may use for evaluating dysgraphia. Usually one measure is used per category. And while this list includes many commonly used measures, it does not include all options.
Intelligence Measures
- The Wechsler Intelligence Scale for Children (WISC-V)
- The Wechsler Adult Intelligence Scale (WAIS-IV)
- Differential Ability Scales (DAS)
Constructional Ability
- Beery Visual-Motor Integration Test-6th edition (VMI)
- Bender Gestalt II
- NEPSY-II (Design Copying)
Working Memory
- Working memory on intelligence tests (listed above)
- Test of Memory and Learning-2 (TOMAL-2)
- Visual working memory (Finger Windows) on Wide Range Assessment of Memory and Learning-2 (WRAML-2)
Executive Functions
- Rey Complex Figure Test
- Behavior Rating Inventory of Executive Function (BRIEF)
- NEPSY or Woodcock Johnson subtests
Writing and Spelling Skills
- Wechsler Individual Achievement Test (WIAT-III, a preferred test of organizing written language and usage for older children)
- Woodcock Johnson-III Tests of Achievement (WJ-III)
- Test of Written Language-4 (TOWL-4)
Phonological Awareness
- Comprehensive Test of Phonological Processing (C-TOPP)
- Word Decoding, Pseudoword Decoding on WIAT-III and Word Attack on the WJ-III
- NEPSYII phonological processing
Retrieval fluency
- WJ-III Written Fluency, Rapid Naming
- NEPSY Verbal Fluency, Speeded Coding
I also like the Process Assessment of the Learner-II (PAL-II), normed up to grade 4, which also looks at the ability to listen and take notes. Obviously, children with dysgraphia of all ages will have trouble taking notes; unfortunately there is not a note-taking test for older students.
Marcia Eckerd is an evaluator, consultant, and therapist who specializes in working with children with NLD and autism-spectrum disorders.