The majority of students with TS for whom I have advocated have dysgraphia. The difficulty that dysgraphia causes for individuals with TS is in getting thoughts from the brain to the paper for a wide variety of reasons. This is a well-documented area of disability for students with TS and ADHD and results in handwriting that is messy, sloppy and difficult to read. Oftentimes margins and spacing are uneven. The child may write very little or refuse to write altogether. The reasons are complex but can include hand cramping, or finger, wrist, arm, neck, shoulder, head and eye tics. It can also (but is not always the case) be due to coordination or fine motor skills. Sometimes it is an unexplained disconnect of some sort between ideas and the ability to express them in writing.
Handwriting can be slow and laborious and, as a result, an area of struggle for the child. Some students are obsessed with writing perfectly and it takes them an inordinate amount of time to accomplish the task.
Frequent erasing and a resistance to write are both signs that the child is experiencing symptoms of dysgraphia. Unfortunately, parents and teachers frequently assume that the child is refusing to write because they don’t like to do it. In reality, the reverse is very likely true. The child does not like to do it because he is experiencing the symptoms described above which often leads to failure and therefore he refuse to write.
Occupation therapy support for young students sometimes can be helpful. However, for the most part, practice and specialized pens/pencils will not have a positive outcome. Extra practice or rewriting typically will not result in better penmanship. Frequently the best use of time and energy is to teach the child keyboarding skills at as early an age as possible.
It is important to note that for some students, handwriting is sometimes fine and other times messy. Remember that all symptoms are inconsistent, they wax and wane and are affected by stress and other environmental factors. Some students are able to write neatly for a short time but with longer assignments the dysgraphia becomes more of an issue.
Educating the school on the prevalence of this symptom for students with TS is extremely important. As a proactive measure, advocating that keyboarding skills be taught as early as possible is wise. In most cases, printing is easier to accomplish than cursive and therefore printing also needs to be acceptable.
Advocating for a scribe (someone who writes what the student says) can be helpful if keyboard skills are weak. This allows the student to demonstrate the extent of his/her knowledge on a subject without dysgraphia preventing it. Having someone scribe as the student talks also teaches dictating skills, which have assisted students and adults, use a voice-activated computer program. Good keyboarding skills would always be a priority as there are times when speaking into a computer is not practical and keyboarding is a skill that is invaluable.
When advocating for writing support, bring samples of the student’s handwriting to the meeting. If you have a sample of a handwritten essay and another essay that was done on the computer (assuming that the computer generated one is superior), this can be helpful in validating that the child’s performance is hindered due to the symptoms of dysgraphia.
Common modifications that may be important to consider are:
Use of computer for taking notes, essays and long answers
Do not grade on appearance
Provide notes (Sometimes, teachers will handout copies of notes with blanks prior to the lesson so that the student can write in appropriate words for the blanks. If this works, it may assist the student in paying attention and of benefiting from writing key words.)
Reduce homework assignments that require writing
Provide alternative methods of assessing acquired knowledge such as oral reports, oral tests and quizzes
Extend time for tests, quizzes, projects, etc.
Allow for testing in separate locations with scribing support available, if necessary
You may also want to suggest that a trial period of specific supports be attempted to determine if support will improve grades, attitude, behaviors, etc. The frustration and embarrassment of sloppy, immature handwriting frequently leads to more than academic difficulties. Support in this area is frequently critical to the overall success
of the child.
By Kathleen Giordano, Education Specialist, TSA, Inc.