In our practice, unrecognized dysgraphia is a common cause of 'underachievement' and 'oppositionally-defiant disorder' in school age children, particularly boys. For some reason, dysgraphia has not garnered the attention of 'attention deficit disorder' or or other learning disabilities, and therefore children who are struggling with undiagnosed disabilities are mistaken for being lazy or defiant.

A child who is lame, rarely will be scolded or told to run extra laps at home, but a child with fine motor or other causes of dysgraphia is may be publicly disgraced about 'sloppy work', told to finish work at home (though it could take hours or be practically impossible), or denied recess on a regular basis to 'finish work.'

There are several types of dysgraphia, but in this post, we will discuss motor dysgraphia, or difficulty writing due to impaired fine motor or sensory-motor coordination.

A variety of dysfunctional hand grips that occur in a variety of clinical settings - but most often mild birth injury or prematurity. Though motor / sensory-motor dysgraphia is remarkably common in today's classroom (perhaps because of rising prematurity or greater survival of high risk pregnancies), teachers receive little instruction in its occurrence, and accommodations are woefully underutilized. Dysfunctional grips often have the pencil tipped forward or out of the webspace. The first three fingers are not brought together in a pinch, but rather fisted or awkwardly positioned with the sides of fingers. When children are forced to writing with very dysfunctional grasps, then pain or even repetitive stress injuries can result. Often children develop behavioral problems like task or school avoidance. Occupational therapy may help many children, but sometimes time and accommodation are essential to allow handwriting to develop to a functional level.

The first link below is to a paper describes how brain-based injury to sensory-motor systems causes individuals to press harder than normal to compensate for their loss of control. The paper concludes, "When sensory information is degraded, an increase of grip force is interpreted as a compensatory strategic increase of the safety margin to protect against unexpected load perturbations that cannot be rapidly and accurately sense ands responded by a reactive grip force increase." Children with mild neurological injury may use a very tight grasp on the pen or pencil that results in heavy pencil pressure, poor writing endurance, and hand cramping. Some teachers or administrators fear that providing a student with appropriate dysgraphia-related accommodations will result in a child "never learning to write"; however, this is not true. In fact, by denying children appropriate accommodations, these students may never be given adequate practice with higher order writing tasks like paragraph organization or redrafting, because they can't get much down on the page by hand.

Tighter grip compensates for lack of control

The Cerebellar Child    We wanted to talk specifically about cerebellar kids, because they are common sources of "mild" or soft neurological signs, but their impact on learning, activities of daily living (self-care, mood control, appetite), sensory-motor and sensory-sensory coordination, and social interaction can be tremendous. It turns out the cerebellum is particularly vulnerable to prenatal or perinatal stress, and cerebellar differences are found in groups of kids diagnosed with premature birth, mild birth injury, dyslexia, ADD / ADHD, and autism spectrum disorders. The cerebellum is sometimes referred to as the "primitive brain" because it's more along the lines of reflexive or automatic action rather than conscious thought. It used to be taught that large amounts of cerebellum could be removed (for instance because of tumor) without any significant functional deficits, but now we know that the cerebellum is involved in a lot more important cognitive functions than we were previously aware. Looking at the complex pattern of connections that pass through the cerebellum (sensory-sensory, sensory-motor, motor-motor coordination), it may come as no surprise to you that even mild cerebellar problems can produce major practical life disruptions in a child's automatic pilot (moving, balancing, speaking, or performing other skilled activities without thinking, bodily appetites and arousal, and response to danger, pain, or environmental change). Sensory processing disorder kids are often really cerebellar kids - at least from the standpoint of a neurological exam.

It's not necessarily that a child has problems all over his or her nervous system; it may be that problems have arisen in brain location that is a great relay center for sensory inputs and motor plans.

Because the cerebellum is important for triggering escape reactions in response to threat, children with even seemingly mild cerebellar problems may have trouble with quick changes in routine, and have especially volatile emotions when young and before the frontal cognitive controls have really matured.

Cerebellar cognitive affective