Tools and Methods for Diagnosing Developmental Dysgraphia in the Digital Age: A State of the Art

Abstract

Handwriting is a complex perceptual motor task that requires years of training and practice before complete mastery. Its acquisition is crucial, since handwriting is the basis, together with reading, of the acquisition of higher-level skills such as spelling, grammar, syntax, and text composition. Despite the correct learning and practice of handwriting, some children never master this skill to a sufficient level. These handwriting deficits, referred to as developmental dysgraphia, can seriously impact the acquisition of other skills and thus the academic success of the child if they are not diagnosed and handled early. In this review, we present a non-exhaustive listing of the tools that are the most reported in the literature for the analysis of handwriting and the diagnosis of dysgraphia. A variety of tools focusing on either the final handwriting product or the handwriting process are described here. On one hand, paper-and-pen tools are widely used throughout the world to assess handwriting quality and/or speed, but no universal gold-standard diagnostic test exists. On the other hand, several very promising computerized tools for the diagnosis of dysgraphia have been developed in the last decade, but some improvements are required before they can be available to clinicians. Based on these observations, we will discuss the pros and cons of the existing tools and the perspectives related to the development of a universal, standardized test of dysgraphia combining both paper-and-pen and computerized approaches and including different graphomotor and writing tasks.

Keywords: developmental dysgraphia; diagnosis; handwriting; process; product.

Figure 1

Examples of the complementary use of paper-and-pen tests and computerized tools for the diagnosis and rehabilitation of handwriting deficits. In addition to handwriting traces collected by clinicians using standard paper-and-pen tools, written samples could also be collected using tablets and/or smart pens, both by clinicians (top panel) and by teachers in their classrooms (bottom panel). Kinematic features reflecting the handwriting process could then be extracted from these computerized traces and transmitted by the teachers to the clinicians. The practitioner could combine all these static, dynamic, and kinematic parameters with the evaluation of other skills to eventually propose a complete diagnosis and an adapted rehabilitation program for the children.