Dysgraphia & Tourette
A person with this specific learning disability may have problems that include illegible handwriting, inconsistent spacing, poor spatial planning on paper, poor spelling, and difficulty composing writing, as well as thinking and writing at the same time known as Dysgraphia.
Signs and Symptoms
- Illegible printing and cursive writing (despite appropriate time and attention given the task)
- Inconsistencies like mixtures of print and cursive, upper and lower case, or irregular sizes, shapes or slant of letters
- Unfinished words or letters, omitted words
- Inconsistent spacing between words and letters
- Strange wrist, body or paper position
- Difficulty visualizing letter formation
- Slow or labored copying or writing
- Poor spatial planning on paper
- Cramped or unusual grip/may complain of sore hand
- Great difficulty thinking and writing at the same time (taking notes, creative writing.)
- Suggest using assistive technology
- Avoid chastising student for sloppy, careless work
- Use oral exams
- Allow the use of a recorder for lectures
- Allow the use of a note taker
- Provide notes or outlines to reduce the amount of writing required
- Reduce copying aspects of work (pre-printed math problems)
- Allow the use of wide rule paper and graph paper
- Suggest use of pencil grips and /or specially designed writing aids
- Provide alternatives to written assignments (video-taped reports, audio-taped reports)
Reading and Writing Problems
If a student has difficulty reading, many possible reasons should be considered, including a learning disability involving reading. Any form of dyslexia (difficulty reading) needs to be considered. Even mild tics can make reading difficult. In addition, some students with TS and OCD have an obsession that compels them to count every word in a sentence and every sentence in the paragraph. This makes reading not only very arduous, but next to impossible. Professional help may be needed to discover the specific causes for the reading problem, and then to choose appropriate supports.
What You May See
Difficulties with writing can include sloppiness, frequent erasing, time-consuming efforts at perfectionism, reduced output, slow writing, refusal to write, and writing that’s difficult to read.
The vast majority of students with TS, or TS and ADHD, have written language deficits causing difficulty in getting thoughts from brain to the paper consistently, for a wide variety of reasons. The child may write very little or refuse to write altogether; margins and spacing may be uneven. Causes may include hand, finger, wrist, arm, neck, shoulder, head and eye tics or hand cramping. Or, there may be a lack of coordination or fine motor skills.
Sometimes there’s an unexplained disconnection between ideas and the ability to express these ideas in writing. Handwriting can become laborious, and a struggle for the child. Some students, due to obsessive-compulsive behaviors, become ‘stuck’ on writing perfectly, and it can take them an inordinate time to accomplish a task, leaving them frustrated, exhausted and unsatisfied with the results.
The resulting failure and subsequent refusal to write are all part of the complex and confusing symptoms of TS.
Occupational therapy support for very young students is sometimes helpful. For the most part, though, practice, or specialized pens/pencils will not have a positive outcome. Extra practice or rewriting typically won’t result in better penmanship. Teaching the child keyboard skills is frequently a better use of time and energy.
Also note that a student’s handwriting can be fine sometimes and messy at other times. Remember that all aspects of TS are inconsistent; symptoms wax and wane and are affected by stress and other environmental factors. Short assignments may be written neatly, but longer assignments may result in disintegration of writing and readability. Occupational therapists should evaluate a student while tics are more interfering, and get a lengthy writing sample.
Tools that Help
Recognizing the prevalence of handwriting difficulties for students with TS is extremely important. Teaching typing skills as early as possible is recommended. Frequently, printing is easier for the child than is cursive, and the student’s teachers may need to accept printed work.
Many students with TS are excellent auditory learners. For them, the concentration required to take notes can actually interfere with their learning. Providing notes for them to study can be beneficial.
A trial period to see if a specific support strategy improves grades, attitude, and performance is highly recommended. A child’s frustration and embarrassment over sloppy, immature handwriting frequently leads to more than academic difficulties. Support in this area can be critical to the overall success of the child.