Childhood dysgraphia. Part 2. A study of hand function.

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Sixty-six children were studied who had presented to the paediatric neurology service over a 2-year period, because they were failing to make the expected progress in mainstream school. Their parents were interviewed with a structured questionnaire and the children had a full neurodevelopmental examination which included a detailed assessment of hand function. Thirty-nine per cent of the children had a specific dysgraphia and there was a male predominance. The different populations of affected children had distinguishing characteristics. A family history of written language skill difficulties was elicited for most of the children with a developmental spelling dysgraphia, but it was uncommon in the children with an acquired spelling dysgraphia or motor dysgraphia. Slow speech development occurred frequently in developmental and acquired spelling dysgraphic children. Mixed handedness was significantly commoner in dysgraphic children who had acquired problems (P less than 0.05), whereas handedness in the developmental groups was within the expected normal distribution. Aspects of hand function such as power of hand grip did not distinguish the dysgraphic children. However, children with a spelling or motor dysgraphia had speeds of motor performance on successive finger movements and rapid hand pats outwith the normal range. These simple tests are a useful way of examining pertinent handskill difficulties in dysgraphic children.