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Dysgraphia

 
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Question

Is dysgraphia common in children with CdLS who do not have limb anomalies?

Answer of our experts

Dysgraphia is the inability to produce the written word. The inability is not due to intelligence or a simple learning disability but a type of cognitive or cerebral visual impairment that makes it difficult (or impossible) to remember how to form the letters that make up the written word or remember the letters that constitute a word in order to write the word. Dysgraphia may occur with a child who has the inability to read the written word - even those they might write themselves (Òword blindnessÓ). The individual sees the lines and curves but cannot interpret them. Sometimes, a person can read but not write (dysgraphia). Occasionally, a person might be able to write but not read what they wrote (alexia). These significant communication disabilities are due to damage in specific parts of the brain which is different than a learning disability which is less specific in its origin. Frequently, the term ÒdysgraphiaÓ is mixed up with the term ÒdyspraxiaÓ. Dyspraxia means the individual has the motor ability to write or play tennis or do whatever, but their movements are clumsy and not coordinated. It is difficult for them to implement the necessary motor actions in a smooth, rhythmical manner. A person who is dyspraxic can write but it may be difficult for them to do so (laborious) and difficult for others to decipher. A person with dysgraphia may be able to draw beautiful pictures but cannot produce letters on a page because they cannot re-visualize the letters or the words. They have the motor ability but not the re-visualization ability.

Dysgraphia is not common Ð at least in the usual sense. It is not uncommon among patients who have suffered a stroke (for example). Although I have seen a few children who are dysgraphic, I have never seen it in association with CdLS as being the cause of the child not being able to write. The term typically is not used with global developmental difficulties. However, either speech and/or occupational therapies might have had such an opportunity and I suggest this family seek assistance from speech and OT at a major communication center. Once an accurate diagnosis is made, then a special education teacher and the rest of the childÕs education team will need to work with the communication center in alternative means of writing. For example, given todayÕs technology, if the child can read, then voice activated computer software might be a compensatory technique. (Note: This is only an example Ð not a recommendation).

MM /TK 7-13-10

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Recommendation(s)

The eyes and the visual system

R36
Surgical correction of ptosis should be considered if vision is significantly affected or if the individual is lifting their chin in attempt to see more clearly and it is affecting the individual’s ability to move around.
R37
Blepharitis in individuals with CdLS should be treated conservatively with lid hygiene. Nasolacrimal duct obstruction (blocked tear ducts) should be suspected if symptoms are not improved with lid hygiene.
R38
Vision should be regularly evaluated in all individuals with CdLS, especially in infancy and childhood. Problems with vision should be corrected early to prevent amblyopia (lazy eye), although children may have difficulty tolerating glasses or contact lenses.

Recommendation(s)

Intellectual Disability

R36
Surgical correction of ptosis should be considered if vision is significantly affected or if the individual is lifting their chin in attempt to see more clearly and it is affecting the individual’s ability to move around.
R37
Blepharitis in individuals with CdLS should be treated conservatively with lid hygiene. Nasolacrimal duct obstruction (blocked tear ducts) should be suspected if symptoms are not improved with lid hygiene.
R38
Vision should be regularly evaluated in all individuals with CdLS, especially in infancy and childhood. Problems with vision should be corrected early to prevent amblyopia (lazy eye), although children may have difficulty tolerating glasses or contact lenses.

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