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Disorders of Written Expression
ICD 787.2

Disorders of written expression (writing) in children often become evident in the preschool and early elementary years. These children may speak/hear language well, but have difficulty writing. Language development is a process that occurs naturally while communicating through the written mode has to be explicitly taught. Reading difficulties may accompany writing problems; the two skills are highly intertwined, developing together in a predictable manner. Children become “stuck” in a particular phase of development and cannot develop their skills beyond a certain level without the help of a speech-language pathologist. Frustration with writing tasks is often evident early in elementary school education; thus, early intervention (beginning treatment at the first signs of difficulty) is the best means of improving the child’s skills, motivation, and self-esteem. These disorders may occur in adults also, as the result of such conditions as traumatic head injury or stroke (see section on aphasia).

Difficulties in written expression (ability to write) may also be a by-product of early language development difficulties. A child may have resolved earlier, more basic language skills but have difficulty putting thoughts and ideas on paper. This also holds true with the child with persistent language problems.

The preschool and early elementary years lay the “building blocks” of writing. Children’s development in these areas is predictable. In the second or third year of life, children engage in “pretend” reading and writing (i.e. scribbling, holding a book and muttering to him/herself). Exposure to printed material and its uses (i.e. writing a grocery list) is a helpful activity for a parent to engage in with a child. By the age of 4, children may attempt to guess a written word or write words with invented spellings (basic, rudimentary writing—may not include real letters, or it may include random strings of somewhat recognizable letters). Once they are in kindergarten and elementary school, children begin to learn/recognize letters, and can begin to read and write words more accurately. Next, a “sounding out” strategy develops for reading and writing. The last primary, notable development in early elementary school children is the ability to segment words into sounds and pay attention to and learn grammatical morphemes (i.e. “-er” and “-ing” suffixes, prefixes, etc.). This ability makes writing, spelling and reading more automatic. The child can begin to read for meaning (read to comprehend a message, story, text, etc.).

In older children, writing problems are seen on a “grander” scale. They likely had early difficulties as mentioned above. Sometimes it is the more advanced curriculum of older children (i.e. middle, high school) that brings previously undetected disorders of written expression “out from underground.” For example, these teens or pre-teens may be so “bogged down” in the mechanics (i.e. spelling, punctuation, grammar) of writing that composing longer passages, as they are required to do in these years of school, is difficult or impossible. If these students did not receive any special help in their earlier school years, or if this intervention was not effective for them, frustration, lack of motivation, and poor self-esteem may become more entrenched.

Writing (as well as reading) disabilities do not disappear with age. In most cases, the continued efforts of a speech-language pathologist and/or educational therapist or resource specialist in working with a child’s family and classroom teachers are necessary. A great deal of research has been conducted with persons with these disabilities, and effective ways have been identified to help these students develop strategies that are effective in facilitating learning and independence in learning.

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