Dysgraphia Life hosted a fantastic live webinar with Dr. Steven Feifer on Wednesday, March 3rd, 2021. For those who were unable to attend live, the full recording of the webinar and the slide handouts can be found on our website HERE.
Dr. Feifer spoke about how dysgraphia is defined, the areas of the brain that are responsible for writing tasks, different subtypes of dysgraphia, and some strategies that can help. We conducted a quick poll and notably, parents reported that their children struggled with handwriting, spelling, AND written composition -- almost in equal numbers with handwriting edging out the other two for the most problematic area.
There were a lot of questions a and unfortunately we couldn't get to them all. A huge thank you to Dr. Feifer who has tried to answer many of the others that came in through the chat. Please see the responses below:
Q. Please give advice on having dysgraphic children develop traditional touch-typing skills vs. adapted typing where keyboard is divided in half, and child only uses index fingers and thumb.
A. If the student has graphomotor dysgraphia (Subtype 1) due to a particular apraxia which renders them incapable of using multiple fingers, then perhaps adaptive typing would be a good alternative approach than regular typing. I have personally seen kids who just use one finger…and kind of hunt and peck around the keys….and can still type 40 wpm!! However, I would start with traditional typing first.
Q. What is the most appropriate assistive technology for a 9-10 year old boy whose handwriting is illegible. Speech-to-text is undesirable because it records classmates as well unless the child goes out in the hall, which feels punitive.
A. How about an iPad or interactive whiteboard. Good point about the speech-to-text software.
Q. Do you recommended Co:Writer?
A. Sure do. I really like the word predictive software. Very good for kids with Executive Dysgraphia.
Q. Is "writing" defined here as handwritten? Or, typed too? I have seen typing pushed as a "solution" for dysgraphic students, but I still see these students struggle.
A. My talk today refers to handwriting. However, typing is a very good intervention for students with a variety of writing problems because it speeds up output and minimizes working memory demands.
Q. How do you differentiate between dyslexia and dysgraphia?
A. Dyslexia is a reading disorder and dysgraphia is a writing disorder. I have diagnostic tests (FAR & FAW) used to tease out specific subtypes in both of these domains.
Q. As a 6th grade English teacher, how would you recommend stretching kids into that divergent linguistic skill side of the brain (right hemisphere) when their brain struggles in that area because of autism, ADHD, or another diagnoses? I encounter a lot of resistance from my students with neurodiversity when I ask them to write poetry or even examine poetry, and I understand that their brain may make the task at hand more challenging.
A. Terrific question and I wish I had a quick answer for you. For starters, I would practice reading poetry and becoming familiar with the genre as much as possible before writing it. Second, I would use my graphic organizers a little differently, and make separate lists of rhyming words. Third, you may try some shared writing activity, where the teacher writes the first line using a word from your rhyming list, then the student writes the next line using a word from the list, then the teacher the next line, etc…Fourth, take advantage of rap lyrics and other music forms kids enjoy to use as examples.
Q. Besides the Executive Functioning component on the FAW and ADHD rating scales, are there other formal ways/instruments that can measure EF?
A. Yes. We use the BRIEF 2 (Behavior Rating Inventory of Executive Functioning), the D-KEFS (Delis Kaplan Executive Functioning Scale), the RIT (Reynolds Interference Test), and numerous other measures to look at executive functioning.
Q. How can teachers and parents help strengthen task initiation, sustaining attention, impulsivity, working memory, and processing speed?
A. I think you basically want an intervention for Executive Dysgraphia, which encompasses all of these processing areas. I am consultant with the Odyssey School in Baltimore, MD and they have been using Dr. Bonnie Singer’s EmPOWER program. It is fantastic and has made a huge difference for kids with language-based learning difficulties and Executive Dysgraphia.
Q. What are your best accommodations and interventions to increase written output in 3rd - 6th grade ?
A. Freedom from anxiety in the classroom. Anxiety…which is often caused by timed tests impacts working memory and leads to poor production. Also, using iPads and other technology will speed up output. Lastly, teaching kids that writing is a process… and you do not have to put everything down on paper in perfect form on the first try. In other words, we will clean up the spelling errors and grammar errors later…just put down a rough draft or what I refer to as a “brain dump” of all of your thoughts and ideas. Sometimes, have a brief classroom discussion first helps kids formulate their thoughts, then turn them loose but emphasize this is a rough draft only and sloppiness and poor grammar and incomplete sentences are fine….just get those ideas out…we’ll clean it up later.
Q. How do you help a student (middle school age) with executive functioning?
A. Very broad question because you need to specify what areas of executive functioning the student is struggling with. Timers, behavior plans, organizational notebooks, picture-schedules, reminder apps on phone, treating underlying attention concerns, etc….are all possibilities. Remember, the frontal lobes are the last area of the brain to fully myelinate, so time is on your side!
Q. Is there any evidence that handwriting practice will truly improve a student with true graphomotor dysgraphia?
A. Yes… Handwriting without Tears has strong research to support its effectiveness. We reviewed a number of handwriting programs in our book, and most just had publisher evidence and not peer reviewed research, so we kind of discounted those programs. However, the Handwriting without Tears program is very well done!
Q. I am a parent and education advocate to children with dyslexia, dysgraphia, and speech and language disorders! I was wondering what psychological educational test to show dysgraphia? OT test? Many parents come to me as they with Dysgraphic concerns!
Q. What is your opinion of Self-Regulated Strategy Development?
A. Love SRSD. Good research support and I talk about this approach for Executive Dysgraphia in my full workshops.
Q. Is there going to be a dyscalculia webinar in the future? Thank you!
A. I do many talks for school systems on dyscalculia. My latest webinar is posted on the school neuropsychology training website.
Q. How can we have the FAW test done?
A. Call our office (Monocacy Neurodevelopmental Center at 301-662-3808) to schedule an evaluation if your school system does not yet have the measure.
Q. Do you accept insurance for your evaluations?
A. Monocacy Neurodevelopmental Center is a fee for service practice. We do not accept insurance for assessments, so you would pay out of pocket. However, we work with you and help you prepare the necessary paperwork to apply to insurance for reimbursement if eligible.
Q. Is it necessary to differentiate between characteristics of dysgraphia and dyslexia? I can see lots of overlap between characteristics of both.
A. Yes it is. These are two different, but overlapping disorders, and require different types of interventions.
Q. Is there a list of books/workbooks to help a 3rd grader that has been officially diagnosed by a professional. Need tools!
A. Check out our book: “The Neuropsychology of Written Language Disorders: A Framework for Effective Interventions.” It can be found at School Neuropsych Press.
Note from Dysgraphia Life: There are also additional book suggestions in the Bookstore section of our Resources page.
Q. I’m interested in hearing strategies or suggestions for taking notes in high school. Should students write everything or should teachers provide notes?
A. I think taking notes is very challenging. Many teachers are posting lecture notes on Google classroom to assist students. I think a good way to learn the skill is to have teachers give students the notes with missing words…kind of a fill in the blank….to help them learn the basic skill. Also, check out the Live Scribe pen…it will record the lecture and synch up with your notes as well.
Q. Where can we find the screener (FAW-S)?
Q. My child has both graphomotor (<1 percentile on pegboard test) and executive dysgraphia. He's been doing occupational therapy for 8 months, and his hand strength may have improved a little, but his handwriting hasn't. Should he continue OT?
A. I would continue with OT until the therapist feels you are no longer making progress. In addition, I would also be working with a SPED teacher for assistance with Executive Dysgraphia.
Q. What strategies or therapies or evaluations do you recommend if you suspect executive dysgraphia? My child is an identified gifted child but has not had any other "testing" or labels. I suspect he could have adhd by behaviors I see at home but at school so far he has been fine, although his "giftedness" may mask this at school. He won his school spelling bee so your discussion was helpful since spelling itself has never been the issue.
A. Check out the EmPOWER program by Dr. Bonnie Singer. his is excellent for executive dysgraphia, as well as the SRSD program. Lastly, I outlined 5 steps to follow for Executive Dysgraphia on slide #16 of our talk as well.
Q. What do you rec. for math in school? Do you like Efofex?
A. Math interventions are for another webinar. However, you can check out my book for math strategies and interventions at School Neuropsych Press.
Q. What strategies are there for children with ADHD who have a combination of all three types of dysgraphia?
A. First, I really think you need to treat the attention or it will just wreak havoc with writing. Many of the other suggestions discussed in previous questions, such as the EmPOWER program by Dr. Bonnie Singer, as well as the SRSD program, would be very appropriate. Lastly, I outlined 5 steps to follow for Executive Dysgraphia on slide #16 of our talk. For a further review of spelling and handwriting strategies, check out our writing book at School Neuropsych Press.
Q. second part of above question: Should he see a psychologist or psychiatrist for the executive functioning part? His verbal comprehension score is in the 150s with FSIQ of 149.
A. Yes, I would seek a comprehensive evaluation first, then we can discuss interventions.
Q. Can you develop out of or train through therapy ‘out of’ certain traits? For example, I feel in elementary and junior high, my son would’ve been mixed dysgraphia. I feel like he can now easily recognize sounds in words (therapy) but still struggles with surface dysgraphia. Is it possible that he would no longer be considered a dysphonetic dysgraphic?
A. Yes you can…and a very good observation. As you start receiving interventions for one issue, the brain may overcompensate and thus create another. Most schools have interventions for poor decoding and dysphonetic dysgraphia (unable to represent every sound with a letter), but not many interventions for surface dysgraphia (orthographic interventions allowing us to visualize the word). Therefore, you may take an overly phonological approach to spelling, and this will not work in English considering 25% of our words cannot be sounded out….next thing you know….you are spelling laugh as “laf”!
Q. At what point is it appropriate to have a child with graphomotor dysgraphia give up on handwriting?
A. When the student no longer responds to the intervention and intense frustration has set in.
Q. How do you balance between accommodations and interventions? I feel like too many accommodations can stunt the ability to develop skills.
A. Great question! A good special education case manager knows how to write an effective IEP. The key is not to have as many accommodations as possible because as you indicated, this creates a dependent learner, but instead to have just appropriate accommodations. Also, an IEP at the elementary level tries to remediate the weak academic skill, but unfortunately, at the secondary level IEP’s tend to be “accommodations-only” in order to get kids through the classes they need to graduate.
Q. Is it important to get a dysgraphia diagnosis vs the SLD of written expression designation given by school? Is there any benefit to pursuing it?
A. No, the label does not matter as much as the service and appropriate interventions. Note from Dysgraphia Life: schools generally only recognize "specific learning disability of written expression" and not the term dysgraphia.
Q. What age/grade would you consider to be appropriate to stop practicing handwriting and switch to tech?
A. I am not sure if this is age dependent. If your child has not responded to a specific handwriting intervention and is developing intense frustration….yes, I would switch. However, learning to write is an important life-skill and unless there are significant motor deficits, I would still stay with it.
Q. Any Graphic organizer examples or types that can be recommended? (where do i find examples of helpful graphic organizers?)
Q. Would love to learn more about strategies to help a middle school child who feel stupid due to this.
A. Many strategies in our writing book found at School Neuropsych Press.
Q. What professionals can officially diagnose dysgraphia?
A. Licensed psychologist….but OT can also diagnose graphomotor dysgraphia
Q. This was exceptional. Thank you and I hope to see more opportunities.
A. Thank you…..I hope so as well. Note from Dysgraphia Life: You are welcome and there will be more to come. Please join our mailing list to stay informed.
A huge thank you to Dr. Feifer from all of us at Dysgraphia Life!