University of Edinburgh

The Role of Vision in Learning

Presented on Friday 7 November 2008

Writing difficulties and confusion

Nadia Northway


  • Important part of school curriculum
  • Difficulties can impede learning

What does writing require?

  • Handwriting is a complex skill involving a wide range of cognitive, linguistic, perceptual and motor abilities.
  • It is a skill that children rarely acquire spontaneously.
  • Even with expert tuition, it usually takes some time to perfect.
  • As the child progresses through school the requirement to write legibly and fluently, at speed, increases considerably and the cost of being unable to do so also increases.
  • At secondary school, children are obliged to write almost constantly, taking notes to dictation, writing essays, and copying down the homework required for the next day.
  • For the child who has learned to form letters without apparent deliberation or effort, such tasks are straightforward. In contrast, for the child who is still struggling with the basic elements of the skill then even copying down homework may present a problem.
  • Cognitive skills
  • Language skills
  • Motor skills
  • Perceptual skills

Handwriting difficulties

  • Cognitive - development of skills required to copy for example are key such a visual and spatial memory
  • Linguistic - assume language skills adequate to allow translation from speech to writing
  • Motor - has the physical skills to write, fine motor skills
  • Perceptual - visual and auditory

How does hand writing go wrong?

  • Formation of letters stage- left handedness v righthandedness, letter and number confusions,
  • Spacing issues- perceptual problems
  • Transfer from single letter to cursive writingmotor or perceptual problem
  • Fatigue, pain – may be due to poor grasp, poor muscular control
  • Creative writing - cognitive difficulty, sequential difficulties

Who has difficulty with writing?

  • Dyslexia
  • DCD/ dyspraxia
  • Autistic spectrum disorders
  • Muscular disorders - myasthenia etc
  • Meares-Irlen syndrome
  • Speech and language disorders


Dysgraphia (or agraphia) is a deficiency in the ability to write, regardless of the ability to read, not due to intellectual impairment.

People with dysgraphia often can write on some level, but often lack co-ordination, and may find other fine motor tasks such as tying shoes difficult.

It often does not affect all fine motor skills. They can also lack basic spelling skills (having
difficulties with p,q,b,d), and often will write the wrong word when trying to formulate thoughts (on paper).

Types of Dysgraphia

Dyslexic dysgraphia spontaneously written work is illegible, copied work is fairly good, and spelling is bad. No fine motor difficulties. A dyslexic dysgraphic does not necessarily have
dyslexia. (Dyslexia and dysgraphia appear to be unrelated but often occur together)

Motor dysgraphia: due to deficient fine motor skills, poor dexterity, low muscle tone, and/or unspecified motor clumsiness. Generally, written work is poor to illegible, even if copied by sight from another document. Letter formation may be acceptable in very short samples of writing, but this requires extreme effort and an unreasonable amount of time to accomplish. Writing is often slanted due to holding a pen or pencil incorrectly. Spelling skills are not impaired.

Spatial dysgraphia: Dysgraphia due to a defect in the understanding of space has illegible spontaneously written work, illegible copied work, but normal spelling and normal tapping


  • Generally illegible writing (despite appropriate time and attention given the task).
  • Inconsistencies : mixtures of print and cursive, upper and lower case, or irregular sizes, shapes, or slant of letters.
  • Unfinished words or letters, omitted words.
  • Inconsistent position on page with respect to lines and margins and inconsistent spaces between words and letters.
  • Cramped or unusual grip, especially holding the writing instrument very close to the paper, or holding thumb over two fingers and writing from the wrist.
  • Talking to self while writing, or carefully watching the hand that is writing.
  • Slow or labored copying or writing - even if it is neat and legible.
  • Pain and discomfort
  • Fatigue
  • Students may exhibit strong verbal but particularly poor writing skills
  • Random (or non-existent) punctuation.
  • Spelling errors (sometimes same word spelled differently);
  • Reversals;
  • phonic approximations;
  • syllable omissions;
  • errors in common suffixes.
  • Clumsiness and disordering of syntax; an impression of illiteracy.
  • Misinterpretation of questions and questionnaire items.
  • Disordered numbering and written number reversals.
  • A mixture of upper/lower case letters,
  • Irregular letter sizes and shapes,
  • Unfinished letters,
  • Struggle to use writing as a communications tool,
  • Odd writing grip
  • Decreased or increased speed of writing and copying,
  • Muscle spasms in the arm and shoulder (sometimes in the rest of the body),
  • Inability to flex (sometimes move) the arm (creating an L like shape), and general illegibility.
  • Reluctance or refusal to complete writing tasks