Disorders of written expression and dysgraphia usually co-occur with language disorders and other learning disabilities. To write effectively, the individual must develop adequate spelling skills, knowledge of grammar and handwriting, and organizational skills. For spelling, adequate phonological and orthographic awareness must be present. For more elaborate expression, knowledge of grammatical rules by which we organize the components of language are paramount. For the written word to be legible, the individual must know the symbols, symbol combinations, and possess the perceptual and motor-skills necessary to produce them. Often dysgraphia is related to difficulties with planning sequential finger movements and in some cases is correlated with a neurological condition know as apraxia.
When conducting a neuropsychological assessment, each of the components necessary for adequate writing skills are evaluated including: spelling, grammar, and quality of handwriting. We also look at phonological awareness, ability to translate thoughts into written form and fine motor skills necessary to accurately produce symbols and space words.