Specific Learning Disorder, Impairment in Written Expression is part of a cluster of diagnoses called Specific Learning Disorders. Specific Learning Disorders are a group of psychiatric conditions that include:
These disorders are categorized by a persistent difficulty learning keystone academic sills with an onset during the years of formal schooling. Key academic skills include reading of single words accurately and fluently, reading comprehension, written expression and spelling, arithmetic calculation, and mathematical reasoning. Difficulties learning to map letters with the sound of one's language- to read printed words- is one of the most common manifestations of specific learning disorder. Children and adolescents with specific learning disorder experience a persistent, or restricted progress in learning for at least six months despite intervention. The learning difficulties are usually readily apparent in the early school years in most children.
Children and adolescents with Specific Learning Disorders also perform well below average for their age, and average achievement is only attained through extraordinarily high levels of effort or support. The low academic skills cause significant interference with school skills that is usually indicated by school report or teacher's grades. These learning difficulties are considered "specific" for four reasons: (1) they are not attributable to an intellectual disability; (2) the difficulty cannot be attributed to external factors such as economic or environmental disadvantage, chronic absenteeism, or lack of education in the individual's community context; (3) it cannot be attributed to a neurological or motor disorder and (4) the difficulty must be restricted to one academic skill or domain (i.e., reading single words, retrieving or calculating number facts).
Note that Dysgraphia is a general term used to describe difficulty in written expression. If dysgraphia is used to specify this particular pattern of difficulties, it is important to specify what difficulties are present.
Approximately 5-5% of individuals in the general population have a learning disorder. The prevalence of writing impairments is not widely known. Research estimates place the prevalence of writing impairments in elementary schools ranging between 3-5%.
Writing impairments are characterized by one or more of the following domains:
Common characteristics of children with a writing impairment are:
Impairments in writing severity can range from mild to severe. In severe cases, writing disorders can impact several academic domains so that the individual is unlikely to learn those skills without ongoing intensive individualized and specialized teaching for most of the school years
It is not uncommon for children to have difficulties learning skills in one or two academic domains, such as reading and writing. Many children and adolescents with impairments with writing also have neurodevelopmental disabilities such as attention-deficit/hyperactivity disorder (ADHD), communication disorders, autism spectrum disorders, anxiety, depression, and bipolar disorder.
As with most learning disabilities, the exact cause of writing disabilities is unknown. However, research to date has shown orthographic coding in working memory is related to handwriting. Orthographic coding refers to the ability to store unfamiliar written words in working memory while the letters in the word are analyzed during word learning or the ability to create permanent memory of written words linked to their pronunciation and meaning.
Impairments in written expression are treatable using a targeted, individualized intervention. The intervention is uniquely tailored to remedy the child's weaknesses in a targeted area of writing (e.g., spelling, grammar and punctuation, clarity or organization of written expression).
Although interventions should be individualized to take into account a child's academic strengths and weaknesses, there are recommendations of what a writing intervention should include: Self-Regulated Strategy Development in Writing; Classroom Based Interventions; Strategies for Teaching Writing
First Line Treatments
Second Line Treatments
When patients do not respond adequately to the first line treatments described above, other strategies might include:
Although interventions should be individualized to take into account a child's academic strengths and weaknesses, there are recommendations of what a writing intervention should include: Self-Regulated Strategy Development in Writing; Classroom Based Interventions; Strategies for Teaching Writing
First Line Treatments
Second Line Treatments
When patients do not respond adequately to the first line treatments described above, other strategies might include: