Disorders of Written Expression
In other cases, some children have problems with the ability to produce written text fluently and continuously in response to prompts; in this case, the child may be able to produce good writing sometimes, while at other times be unable to respond effectively at all.
Sometimes both the quality and production of writing may be impaired. Handwriting may also be a problem area. However, problems in only one area, such as spelling or handwriting, excludes this diagnosis.
Disorders of written expression may have a significant impact on an individual’s school or job functioning and may have a particularly severe impact on success in high school and college.
As with other learning disorders, the assessment of a writing disorder is based on problems that are not related to intelligence, age, education, or other disorders. Disorders of written expression are generally diagnosed together with reading and mathematics disabilities, and they are more often discussed and studied under the general category of LEARNING DISABILITY than in isolation.
Significant problems with written fluency and production may also be linked to a more general learning disability but are often associated with a diagnosis of ATTENTION DEFICIT HYPERACTIVITY DISORDER. Written-output difficulties linked to deficits in attention and executive function are often diagnosed as dysgraphia.
Because “disorders of written expression” is a general diagnostic term, determining effective educational practices depends on a closer analysis of the individual’s pattern of deficits and strengths.
For those whose disorder of written expression appears along with a general expressive-language disorder or a reading disability, the development of effective writing skills begins with developing more basic language abilities. These may include intensive study and practice of oral language syntax and vocabulary in order to provide a foundation for the development of written-language skills.
In those individuals who also have a reading disorder, the development of decoding skills through practice in awareness of word sounds, discrimination, and phonics may be an essential starting point. Reading and language enrichment activities on a whole language model may boost comprehension and critical reasoning skills.
Until these skills are developed, direct remediation of written-language deficits will not be effective and may in fact lead to frustration and resistance. At the same time, it is important that some work in the area of writing development begin simultaneously with instruction in oral communication and reading development, in order to reinforce and extend the skills acquired in those areas. Such work should focus primarily on the generation of expressive writing, drawing linkages between oral language abilities and their manifestation in writing.
The concept of writing as a process, and the gradual introduction of various strategies for generating, planning, and organizing text, should all play a central role in instruction. In addition, simple elements such as sentence and paragraph concepts should be introduced. Examples of the mechanics of language, such as punctuation or sentence structure, also may be introduced.
As much as possible, work in spelling should be linked to work in the area of reading development, and spelling should generally be de-emphasized within the context of writing instruction, except as reinforcement and a reminder to apply newly learned skills.
For individuals whose written expression disorder may be associated with a reading and/or spelling disability, but not with an expressive language disorder, instruction should focus first on the introduction of the concept of writing as a recursive process, and on continuing practice with various strategies for planning, generating, and organizing writing. In most cases, engaging generating strategies that draw on oral-communication strengths, such as talking out ideas before writing, will play an effective part in writing development. Students with this pattern of abilities will also benefit from direct instruction in written language structures, rules, and conventions, and from continual reinforcement and practice of this knowledge in writing assignments. Instruction in written-language structures and rules, if embedded appropriately into a process-based classroom, may actually have a facilitative and generating power, rather than serving as a constraint on imagination and the free flow of ideas.
Individuals whose disorder of written expression is linked primarily to problems with written output are often also diagnosed with ADHD and may often possess very strong oral communication and reading skills, as well as the ability to demonstrate excellent basic writing abilities in some contexts. The difficulties such individuals experience with writing may primarily stem from deficits in attention, executive function, and active working memory that severely constrain the process of writing and result in impaired writing production, particularly on complex and unfamiliar tasks. While some direct instruction in written-language structures may be appropriate for such individuals, writing instruction in general should use a coaching model.