Dysgraphia: More Than Just Messy Handwriting

We’re joined by Kelli Fetter, founder of Handwriting Solutions, to talk all things dysgraphia! Kelli talks with us about how dysgraphia is so much more than just ‘messy handwriting,’ how to balance building handwriting skills with accommodations, pervasive dysgraphia myths, and more. 

Learn more about Handwriting Solutions at handwritingsolutions.org.  

Transcript

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Lauren Clouser: 

Welcome to the LDA Podcast, a series by the Learning Disabilities Association of America. Our podcast is dedicated to exploring topics of interest to educators, individuals with learning disabilities, parents and professionals to work towards our goal of creating a more equitable world.

Hi everyone, welcome to The LDA Podcast. I'm here today with Kelli Fetter, who is a certified handwriting specialist and has practiced occupational therapy for over 10 years. Kelli is also the founder of Handwriting Solutions. I'm going to turn it over to her to tell us a little bit more about herself, and also Handwriting Solutions.

Kelli Fetter:

Wonderful. Yeah, thanks for having me. I am a big fan of LDA, both as a parent, consumer and a professional. So, yeah, as you mentioned, I am formerly an occupational therapist. I practiced in pediatrics for many years in a variety of settings, outpatient, early intervention and school systems. And then I also taught adjunct as a professor, teaching, of course, pediatrics and a kinesiology course. And it wasn't until my own child was diagnosed with dyslexia and dysgraphia that I really got involved in this learning disability world, as that so often happens. But I think a lot of people are surprised when I tell them that as an OT, I had never heard of dysgraphia until my child was diagnosed.

And that's pretty shocking, I believe. So really when she received her diagnosis, it was very easy to find supports and information on the dyslexia side. There's programs and curricula, just a lot more information. But at that time seven years ago, not a lot of chat about dysgraphia, not a lot of professionals in this area, and definitely not curriculum or programming or very little research at that point too. And so I kind of took my OT-neurology background and coupled it with this educational model, and really focused on trying to help her. And we had great success. And so then of course I had some friends and family asking, what did you do? She doesn't, quote, look like she has dysgraphia.

Her teachers were wondering as well, because even her teachers were not familiar with dysgraphia. And so I just realized nobody else is doing this. I can do this. And so thus Handwriting Solutions was born. And what that looks like now is we are fully virtual, providing handwriting support one-on-one in a tutoring model, as well as supporting teachers and therapists, which I'll talk about later how we're supporting them. But it's really cool because it's virtual and it's global. We have tutors and students internationally. So we are really reaching kids that just need this support that they aren’t getting in their area. 

Lauren Clouser:

Yeah, that's really awesome. And one of the reasons I was so excited to talk to you is because you have such an interesting background and seeing those things combine. Can you tell us a little bit more about dysgraphia and how it's more than just bad handwriting, just to get that out of the way?

Kelli Fetter:

Oh, yes. This is a very common myth. I see it all the time in some Facebook groups that I'm on where, you know, you don't know what you don't know. And so you post on there about your child's handwriting and it's: “do you think that my kid has dysgraphia?” And I am always the first one to go on and say, well, we need a lot more information than just a picture of the output because it is so much more than just messy handwriting. 

And in fact, some students can have dysgraphia and actually not have messy handwriting, because it can also just be that translation of thoughts to paper. It is a neurological condition. Our brains, you know, in dysgraphic students are…Their brains are just wired a bit differently when they're learning to write, to encode, if you will. So taking the information in, processing it, and then getting it out by hand to paper. So it's kind of a deficit somewhere along that continuum or that orthographic loop is the fancy way of saying that. So really it's figuring out where that breakdown is happening, but also knowing that the signs can be much more vast than just messy handwriting. 

And also, what does messy handwriting even mean? Because it is going to look very different. You know, one dysgraphic child is going to look very different than another dysgraphic child. And we can't really put blanket interventions or accommodations on a child just because they have that diagnosis. It's really important to kind of zoom in, figure out their learning profile, and figure out exactly where those barriers exist. So what that might look like. Again, yes, legibility could certainly be a factor.

But also I look at those mechanical skills of handwriting as far as line placement and sizing and spacing of letters and words and pacing. So are they able to keep up with the writing demands in a classroom? Spelling is a big factor in students with dysgraphia, so really exploring that, because they may be able to spell verbally, but then they go to write it on paper, and it's a bit jumbled up. 

Written expressions. So again, getting the thoughts out onto paper, that can sometimes exist in addition to the quote, messy handwriting, but that can also exist separately and it can also evolve. You know, with my own child, it was more of the kind of messy handwriting at the beginning. And what's interesting, and I think a lot of people will find this really interesting too, is her fine motor skills were on target. So I think sometimes we come at this from a motor deficit, and that's not always the case.

Oftentimes our dysgraphic students can have average to above average motor skills. So again, it's that neurological piece of that written output. So then we work to improve those mechanical skills of handwriting. And then as children get older, then it becomes a written expression piece of: now how do we get those thoughts out in an organized manner, in a concise manner, in a manner with effective grammar and syntax ,and kind of more of those educational related skills. But you can see it's a very broad spectrum of what we might see when a child is diagnosed with dysgraphia.

Lauren Clouser:

I really appreciate that answer. That was a fantastic look because a lot of people do think it's just handwriting. There's so many different signs that you can look out for.

Kelli Fetter:

Yeah, I mean, I think you're, you're spot on too. It can be the language piece of it as well. So certainly motor skills can be impacted or they cannot, or it could be language skills or, I think with our students with dysgraphia we have to just be aware of this comorbidity too. So yes, dysgraphia can exist on its own, but chances are they will have another diagnosis, whether that be dyslexia, ADHD, autism. You know, there's a plethora of other diagnoses, mental health concerns and anxiety, which, it's kind of the cart before the horse, like which one caused which we don't really know that. But it is important to look at the holistic child when we are serving them.

Lauren Clouser:

Absolutely. And I'm so glad that you brought up comorbidities because one of the most common comorbidities is another learning disability, or like you said, ADHD, mental health. So I think it's really important for parents and educators and practitioners to be aware that it doesn't always occur on its own. And in fact, it's likely that it doesn't occur on its own. And I'm curious, you had your background as an occupational therapist and you had mentioned you had never heard of dysgraphia, never had practiced it. So I'm curious, how has your background as an occupational therapist impacted the way you approach your dysgraphia tutoring?

Kelli Fetter:

Yeah. So, you know, when I was practicing occupational therapy, we definitely had the background of motor skills, of neurology, and really understanding how the brain worked. And so we would work on handwriting, but it was never necessarily through that specific learning disability, that dysgraphia lens. And so I think that's where this shift happened. I was able to bring that background knowledge of understanding how our neurological and musculoskeletal systems work, which is very helpful in understanding how the brain works and how that is going to impact all of these other skills. But what was missing was that educational piece. And so that's really, you know, when my daughter was diagnosed, I spent literal years reading and taking any kind of training course or studying up, even on LDA's website. And Dysgraphia Life is another wonderful resource. And so taking in all of this information that I could, looking at it from a variety of different lenses, because I think it's also tricky when we just come at dysgraphia from that educational lens too, because again, there could be other factors going on.

So what we try to do at Handwriting Solutions, and even just myself as a parent is again, zoom out, look at the holistic learning profile, and bring in both  a medical model and an educational model. And we're fortunate to have a wonderful education team at Handwriting Solutions as well. And so they can kind of take a deeper dive into more of that academic piece. And then we kind of beautifully marry it together and come at it from a variety of different angles so that we can really get to the root of the challenge that the student might be having so that we can best support them.

Lauren Clouser:

Yeah, I love that. Again, just a whole child approach really sounds like what you're talking about. And that's so key.

Kelli Fetter:

It really is. And I think sometimes, speaking as a parent, it’s confusing. Your child gets this diagnosis and then you're like, now what? My experience was, you need to do 10 different things to support your child when they get the diagnosis and you need to do OTN, PT, OTN speech, and dyslexia remediation and a mental health evaluation. I left with a whole host of like, well, now what do I do? And how in the world are we going to have time to do all of this? And really, again, we don't need to do all of those things necessarily.

We need to pick out what that underlying barrier is and build that up so that our child can access education but also be a child.

Lauren Clouser:

Yeah, that's huge. You had mentioned as well, when your daughter was diagnosed, that the schools weren't really sure what dysgraphia was, that there were resources on dyslexia, but not so much as dysgraphia. So I'm curious, have you seen any sort of shift in education where dysgraphia is becoming a little more well-known, just based on the work that you do? What do you find?

Kelli Fetter:

Yeah, I would say I am optimistic about where we're headed. So I think there is still a lot of room to grow, a lot of education and training that needs to happen on a systemic level. It is certainly no fault of the educator. I was just reading a research article this morning, actually, for a project I'm working on, and teachers know that handwriting is important. I forget what the percentage was. An overwhelmingly significant amount of teachers were like, yes, we know that handwriting is important and yet no, our pre-service college education did not teach us about dysgraphia, did not teach us about handwriting instruction. I had one teacher say: I graduated, got my classroom, and had never been taught how to teach a child how to hold a pencil.

So it's things like that where the teachers are eager to learn, so we have to empower them and educate them, ideally before they are in the workforce. But if we're not catching it that early, then certainly in those school systems, whether it's a public school system or private school system, having that education on the forefront will hopefully prevent a lot of the struggles that our dysgraphic students unfortunately have to undergo. Because when we have a solid instructional model, then that means that every student is getting what they need to get, and then only our dysgraphic students with significant needs will end up really needing that intensive intervention and remediation model, which I think in the ideal world is what we're trying to do in the school systems. But you know, again, you're struggling with the systemic issue. And so it's really cool that people, I mean just in passing, I've had, I think over the past two weeks I've had like three people just come up to me, just acquaintances, and mention: Oh yeah, didn't you say that you work with students with dysgraphia? Because my friend's daughter has dysgraphia. And it's so funny. I had never heard of that before until you.

And now I'm like, we're getting there. I am very optimistic that we are getting there with awareness, which I think is the first step is we just have to be aware of the diagnosis and what it is and what it isn't, and dispelling any myths. But then also that next step is empowering the people who serve the students, the people who are working with the students from day in and day out, and that can be teachers and also OT. You know, I think that's certainly a role for OT as well. And then of course the parents, I want to empower the parents too, because I have been there when you get the diagnosis and you're lost and confused and you have no idea where to start.

Lauren Clouser:

Absolutely. LDA definitely agrees with the supporting educators and the professionals who work with people with LD and the parents as well. They're all such key team players to create success for these students. So I'm really glad that you brought that up and I just wanted to switch gears a little bit into the research side. You have been doing a lot of dysgraphia research. If I can talk about it...You're working on a manuscript right now for a book on dysgraphia, which is very exciting.

So I just wanted to talk to you a little bit more about that research. Is there anything that really stood out to you or that surprised you?

Kelli Fetter:

Oh, yes, I have been deep diving into research. If you could see my desk, I think there's probably about 50 or 60 articles behind me that have something to do with learning disabilities or handwriting or dysgraphia, all of the above. So the first manuscript that I will be putting out is actually going to be for OT practitioners, because I just thought, well, I've got to start there because that's literally where my background exists, and I really want to empower them. But of course I have parents who are like, well, when is ours going to be released? So I'm coming at all of this from a very evidence-based mission of…you know, again, there's not a ton of dysgraphia research out there, but there's enough to where we can draw some conclusions, as well as pull from dyslexia research, and pull from handwriting research, because there's a lot more handwriting research out there, and use our experience and put together both the evidence and that experience into tangible tools that can be implemented right away. 

But yeah, what I'm seeing research and evidence wise, again I mentioned the whole lack of understanding and awareness and even support for teachers. That was pretty surprising to me, especially when you consider general education teachers, they get all the students at some point, and the fact that we're just not equipping them is not great. And I feel like that it's just doing them a disservice. So we certainly want to empower them.

I think a few other interesting pieces that I have really found more recently would be this whole AI. And you know, it's almost to the point where we just can't not talk about it. So what is this going to look like for our dysgraphic students, and how can they leverage AI in a way that's ethical? And I think it's going to be a powerful tool both for the parents or for the students, but also for the people working with them. I've seen, nothing that's out publicly, but just some papers that are researching different screening tools for handwriting deficits, which is really cool. If we can get that eventually into the hands of educators, that would be amazing. But also just, how can we bridge the gap for students? Maybe it's AI or just other high tech ways that we can bridge the gap for students so they can access their learning and show what they know while we're building up their skills and their remediation.

So those few articles that I found have been really intriguing. And then I think the bulk of what I have found and kind of the synthesis I would say, is just that we have to have that explicit and systematic instruction of handwriting for neurotypical students. For students with learning disabilities, they just might need more of it, or a slightly different approach. But you know, I think over the years it’s been put on the back burner because of a plethora of reasons. You know, I think teachers are often overworked and then there's the whole push towards standards and testing and all of this. And so handwriting just got pushed to the side a little bit. But I see so much research coming out now that's pulling it back in. That's saying, you know what, this is actually really important.

Handwriting in and of itself is important. It stimulates the brain, it increases retention, but also it's a key piece to literacy overall. Handwriting improves reading outcomes, improves spelling outcomes. The research is very, very clear. So I think,, if anything, that would be probably be the message that I would send. Even if your child has dysgraphia and writing is hard, I'm a big proponent in coming at it from building up those skills so that they will have that tool in their toolbox and also accommodating so they can access the education right now. So I think it's great to have both.

Lauren Clouser:

Yeah, I love that. And I want to elaborate on that a little bit too. I know we talked about how every intervention needs to be individualized. Some areas of dysgraphia can be more prominent in others, depending on the individual. But just based on that, building skills and accommodations balance, how are we able to keep that balance? And how can, maybe parents who are at home feeling overwhelmed, how are they able to support their children who have dysgraphia?

Kelli Fetter:

This is great. Yeah. So a couple of the research articles that I recently was reviewing talks exactly about that balance of when and how do I support my student with their handwriting. But then also I need to know what they know kind of thing. And so the simple way to kind of say it is when you're working, when the task is just handwriting, we're just going to focus on handwriting. But if the assignment or the goal of the task is sharing their knowledge on the Civil War and handwriting is a barrier, we're going to remove that barrier. And so they might use a scribe, they might use speech to text, they might type on a keyboard. You know, they can use a variety of different modalities to get those thoughts out.

And so that takes off a layer of cognitive load. I talk a lot about cognitive load in all of our education sessions and on our blog. And so if we can remove that layer of cognitive load, which at that point would be the transcription or the writing by hand, and so they get their thoughts out, then we can add that back in if we would want to. And I would suggest, if that's possible, and you have the time and bandwidth to add that back in, so maybe they're writing their thoughts out, whether that's on a computer, or a parent or a teacher has written it for them. Then they can go back and edit.

And I think this is where the magic happens with really any student, but especially students with dysgraphia, is teaching those editing skills, those self checking skills. That's what makes a good writer. And it doesn't matter if you're neurotypical or neurodivergent, being able to self check and edit and make your writing stronger, and then perhaps putting that pencil to paper, maybe through copying, because maybe that is where they are at right now. They need that visual model. So again it's taking off that cognitive load of having to think because they already have the visual model and then they can just transcribe it there. So that's just one example of many ways that we can make that task fit what they need at that moment. And so what I always tell teachers and parents is just think about the cognitive load and how you can lighten that cognitive load in that moment for the student to bridge the gap for them and then really work on those underlying skills maybe separately from that task.

Lauren Clouser:

Yeah, I think that's a great answer and I really appreciate you bringing up that balance of when do we accommodate versus when do we build skills? I think that's so key.

Kelli Fetter:

Yeah. I think there's a common misconception that I hear a lot of, by the time they're in third grade…I don't know why it's third grade, but by the time they're in third grade we really can't improve their handwriting, or by the time they're this age, we're going straight to tech. And it's really not. I would accommodate a kindergartner if I needed to. You know, I would accommodate a high schooler and anywhere in between. So I think it speaks to that individualized piece that you mentioned of what does that child need in this exact moment for this task. And then kind of scaffolding too. Maybe they don't always need that support for different tasks.

So then you can scaffold the support to where it gives them that just right challenge that, we don't want it to be too easy. We want it to be a little bit challenging, but not so challenging that they throw the paper at you. Because that's happened before with my own child.

Lauren Clouser:

No, that seems like a good balance to keep. And I wanted to give you a chance just to clear up any myths surrounding dysgraphia that maybe we haven't talked about, or something that you wish people knew more about dysgraphia.

Kelli Fetter:

Oh, yeah, well, that was certainly one. So let's just not say that we have to give accommodations by ‘x’ age, or that a child can't improve their handwriting if they're over a certain age. That's just simply not true. We know the brain is plastic and we're constantly learning. And this is a very extreme example, but one that I like to give because it is kind of a bit jarring. So I think about when an adult might suffer from a stroke, well, they're clearly going to go through rehabilitation and they're going to learn how to write again because their brains are plastic, and they can relearn skills and build skills. 

So it's similar in that our dysgraphic students can still be able to build the skills. We're not looking for perfection. We're just looking for progress and for being able to equip them with this life skill, really. So that's definitely a myth that I would bust. Another one is often dysgraphic students are average to high IQ. And so I think a common myth is just that they, ‘aren't smart’ or ‘they aren't trying hard enough.’ They're the ‘lazy students, the behavior students,’ when in reality, the majority of students that we work with are gifted even.

And so they often have this spiky profile where they are extremely above average in certain areas, and then lower in writing related tasks. And so their learning profile is kind of up and down and up and down. It’s really tricky for some of our students to even get a diagnosis and get services. Because if we zoom out and just see their composite scores, then they're going to appear average. But when we zoom in, we see these highs and lows, this up and down. And so sometimes we can miss diagnosing, we can miss giving them the right supports to where they could actually even achieve their ability because of that performance and ability mismatch. And then I think another one would just be this.

I get really frustrated with blanket accommodations. So you have dysgraphia, you get a keyboard. For a lot of our dysgraphic students, even typing is hard for them, particularly if there's some motor skills that are tricky for them too. So we want to make sure that even just those accommodations are very individualized to the child, rather than just say, you're dysgraphic. Here you go.

Lauren Clouser:

Yeah, that's absolutely true. Well, Kelli, before I let you go, I just wanted to ask what's going on with Handwriting Solutions here in the future? You have a lot of exciting projects coming up and so I just wanted to give you a chance to talk about them.

Kelli Fetter:

Yeah, we definitely have a lot going on. So besides our tutoring program, which runs continuously year round, I mentioned that I really am passionate about supporting even more students and reaching more students by supporting their educators and their therapists. And so we have a course that is specifically made for educators, for teachers, so that is going to be launched in January. So I'll be sure to include the wait list for any listeners to the podcast. And then again, I'm working on the book that is going to be for occupational therapists. And we always are having free workshops and webinars for parents as well. We have a very thorough blog that is always free on handwritingsolutions.org, so I would highly recommend listeners just kind of do a deep dive over there. We've got tons of information and resources on anything and everything, handwriting and dysgraphia.

And then, you know, we have a few freebies as well. So I can definitely send over a few links for that so that your listeners can get a couple of resources just to get them started right away. I know, again, especially if you're newer to this diagnosis, it can be really overwhelming. So we just try to lighten the load a little bit.

Lauren Clouser:

Absolutely. We will include those links in the show notes and make sure that folks get connected. So, Kelli, I wanted to thank you so much, not just for being on the podcast today, for taking time out of your schedule for this great conversation, but also for your work at Handwriting Solutions, for helping to bridge that gap with parents and educators and other professionals. I think it's really important work.

Kelli Fetter:

Thank you. Thanks so much. We're happy to do it. It's a labor of love for sure, but it's one that I am very passionate about and one that I have literally lived the journey as a parent. So I think that always helps being able to relate to parents and, and I've seen kind of all sides of the spectrum with the schools and with therapy teams as well. So happy to share. And yeah, thanks for everything that LDA does as well.

Lauren Clouser:

Thank you for listening to the LDA podcast to learn more about LDA and to get valuable resources and support, visit LDAAmerica.org.