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Remediation for Written Expression

The fact that as humans we write things down is fascinating. No other living thing has a written language. Animals do communicate in other ways (e.g., leaving scent), but not as elaborate as human written language. Written language is such an important part of today's technological world. The social media is all about written language. Contracts are made through written language. Histories are recorded through writing. Good written language skills are also important for school success.

Some children develop without the abilities to achieve in written language expression. Many of the children on the autism spectrum disorders have delayed development of fine motor skills which put them at a disadvantage with their peers at school. Other children can hold a pencil well, but are unable to put their ideas on paper. Often, they can speak well and can develop a great verbal report, but have significant difficulties trying to convey the same information on paper. The way a person writes (i.e., Written Expression) can even give clues if a person is suffering from neurological disorder (e.g., Alzheimer's Disorder), brain damage, or a mental illness (e.g., Manic-Depressive Disorder).

This article will offer suggestions on remediation of problems related to written expression. The following topics will be presented: Fine Motor Control, Pencil Grip, Letter Formation, Copying information from the board, Spelling, Writing letters and numbers backward, Written Expression - putting words on paper, Evidence of Brain Damage through drawings, and Evidence of Manic Depression by Writing. Remediation will be presented from a Neuro-developmental Model. The goal of neuro-development is to help individuals overcome their deficiencies by changing brain structure through repeated exercises until mastery has been achieved. Neuro-development can be augmented by incorporating a Holistic Approach.

Fine Motor Control

Examples of gross motor movements include kicking your legs, throwing a ball and running. Examples of fine motor movements include cutting paper with scissors, using a pencil or pen, and threading a needle. Being able to use a pencil or pen is a beginning step in written expression. Before the pencil or pen can be used correctly a child must have fine motor control. Poor pencil grip in older children is often a sign of a child who compensated for poorly developed fine motor control when younger.

Assessment. There are scientific methods to assess fine motor skills. An occupational therapist and neurologists are trained on how to assess for fine motor skill deficiencies. An unscientific approach that parents can do is to gather several same age peers and the child in question. Compare this child's ability to use a pair of scissors to cut out an object with the other children's ability. Next, have them color something with Crayons. If the child in question has much poorer abilities on these tasks than the majority of the peers, then it is likely that the child in question could benefit from neuro-development to increase fine motor abilities.

Remediation: Occupational Therapists and Physical therapist are usually the best trained professionals to improve fine motor skills. Almost every major city in the United States has these professionals providing services. Much of their services is covered by insurance companies. We recommend that you start with one of these professionals for the remediation of fine motor skills.

There are many activities that you can do at home to augment or develop fine motor skills. Having participants play with clay and/or a resistive putty is a great activity that builds fine motor skills. Having them practice coloring and using scissors are other activities that naturally develop fine motor skills. There is also a Finger Movement Exercise designed to strengthen fine motor skills.

In addition there are also many resources that teach remediation of fine motor skills on the Internet. Two of our favorites include Wikihow.com and About Child Parenting. These resources provide many examples of exercises and things to do to develop fine motor skills.

Judith Bluestone wrote The Fabric of Autism (ISBN: 0972023526) and isted several neuro-developmental exercises to help Autistic children overcome fine motor deficits and strengthening muscle tone. One of our favorites is the Paper Crumbling Exercise. It is fortunate that there are many resources available to individuals, parents and teachers to help children and adults strengthen fine motor skills.

Writing Posture and Pencil Grip

Another milestone in the development of written expression skills is the correct grip to hold a pencil. Some would argue the importance of this, but it does make writing much easier if the correct pencil grip is used. Children with poor fine motor skills will compensate by developing a poor pencil grip so they can control their writing instrument better. When they finally develop good fine motor abilities, they will continue their poor pencil grip and will use this incorrect pencil grip thought out their lives. Fortunately, some of them can even write as well and as fast as everyone else even though they have an incorrect pencil grip. That may lead some to argue that the correct pencil grip might not be all that important. We do not share this view and feel it is better to use neurodevelopment to learn the correct pencil grip. You tube offers videos that demonstrate the correct method to hold a pencil. There is one for right handed indivduals and one for left handed indivduals. This one explains both the left and right handed grip and gives reasons why it is important to have the correct pencil grip. Click here for written instructions on correct pencil grip for left handed individuals.

Over time, the structure of the brain changes to accommodate the person's pencil grip. That is why it is very difficult to break someone who has a poor pencil grip and poor writing posture. That is why it takes at least 21 days of working with participants at least 10 minutes a day to get them to change their poor pencil grip for a the correct pencil grip. Some participants will take a little longer. If allowed, some will revert back to the incorrect pencil grip once they have mastered the correct pencil grip. Efforts must be used to prevent this regression into the poor pencil grip. This can easily be monitored when working with the child doing their written homework assignments. Do not be punitive because punishments can affect the child's attitude and motivation to do homework. Try to keep your interventions positive and have rewards for compliance and achievement. With consistency, patience and perseverance the participant's brain structure will change to accommodate the correct pencil grip and writing posture.

Letter formation

A symptom of dyslexia is the ability to write letters and certain numbers backwards or using incorrect writing sequences. This can be easily corrected in normal children but can be difficult to correct in children with reading and writing disorders. Again, using principles of neuro-development can help children who habitually write some letters and numbers incorrectly. As with overcoming a poor pencil grip, it will take time, patience and consistency to overcome the child's habit of writing certain letters and numbers the wrong way.

Assessment. An incorrect pencil grip is relatively easy to spot. Assessing incorrect letter formation is a little bit more difficult and it requires familiarity with correct letter formations. When a child writes a letter backward, that is easy to spot, but how they write the letter is more difficult. It is made possible by consulting a letter formation writing chart. Observe the way the participant forms his/her letters. If they sometimes or consistently print the letter or number in the wrong way according to the chart, the student is viewed as having a problem that can be remediated. Prevention is the best cure; it is best to teach children how to print letters correctly. A writing chart can guide teachers and parents to teach the correct writing sequences to make the letter correctly. These charts are available thought the Internet. Two of our favorites are at Sparklebox and Hand Writing without Tears.

Remediation. Have your child practice everyday writing letters and numbers that they consistently do wrong. Showing them a couple of times ever so often will not remediate their problem. It must be done daily. With patience and persistence, they will be more consistent in printing letters the correct way. Children with dyslexia tend to regress and revert back to their old way of writing. When this happens have them write the letter the correct way for a minute or two each day for about 21 days. It may take longer, but if you just focus on the letters that the student does wrong, eventually the student will have all the letters and the numbers written in the right way and it will be part of his muscle or neurological memory. Make sure that you watch them when they write in other settings. As much as you can, do not allow them to revert back to their old way of forming the letters incorrectly. In addition to the regular one or two minute forming the letters the correct way, they may need a punishment of stopping what they are doing, write the letter they just wrote incorrectly 10 times correctly and then have them continue their writing. Each time they write that letter wrong, give them the punishment of having to write the letter correct 10 times. As you do this, remember you are changing the structure of their brain. Once they have that structure change, they will be less likely to revert back to their old way of forming letters incorrectly. If you do not do this activity, the participant could continue forming letters incorrectly even into adulthood. It is learning cursive writing that helps most children not carry this into adulthood.

Writing Letters and Numbers Backward

When children are learning to read, many will write letters or numbers backward and sometimes words in a mirror image. This is considered relatively normal through the first grade. Many children will simply outgrow this tendency. Some of them will not. We recommend neuro-development for those children who do not outgrow this tendency.

Assessment. The child continues to write letters and or numbers backwards even when in the second grade.

Remediation. We enjoy using our Letters of Clay Exercise and the exercise explained in Letter Formation (see above) to deal with this problem. It usually takes patience and consistency over time to stimulate the brain to be able to view letters correctly and to be able to write them in the correct manner. Improvements should be seen within 30 days, continue these exercises until mastery has been achieved.

Hand Writing (Printing versus Cursive)

Most people would agree that cursive writing is faster for most individuals to write. I have seen some students print faster than they could do cursive writing. Many schools do not teach cursive writing anymore and it is becoming a lost art for those communities. The Declaration of Independence was written in cursive writing and soon many will not be able to read it if the trend continues. Fortunately there are plenty of versions of the Declaration of Independence and other old documents in printed form. The use of electronic communication also discourages the use of cursive writing.

For students struggling to learn cursive writing, we recommend the website Handwriting without Tears and our Loop Exerice or Drawing Exercise. The loop exercise prepares the neuro-pathways and muscle groups for easy cursive writing. Improvements in cursive writing should be observed within 30 days as long as the student does not have weaknesses in fine motor skills. If they do, work on fine motor skills, as explained above, first then to the loops exercise.

Writing Speed

The main reason why some children write so slow and so laborious is due to a deficiency in the development of fine motor skills. But there are other reasons as well. Another cause would be poor developmental or near point vision. This can be assessed by a developmental optometrist. A regular optometrist is not recommended because a child could have perfect 20/20 vision and still be lacking in developmental vision abilities (e.g., convergence, focus flexibility). If your child has an unusual posture when writing or takes "forever" to print something yet has good fine motor skills, then suspect developmental vision problems and have the person examined by a developmental optometrists. Developmental optometrists routinely use neuro-developmental techniques to correct the person's vision problems.

Another cause of slow writing speed is due to a general slowness in all brain processing. Some children are just slow in their ability to process information and coordinate their movements. Neuro-development can help address slow processing. If you suspect your loved one has problems with processing information quickly, refer to our section on processing for activities to improve processing speed. These activities should be utilized in conjunction with the processing speed of writing exercises listed below.

One of our favorite writing exercises is our Drawing Exercise. This is useful for children learning cursive writing. It has the current hand movements to do well in the English language of cursive writing. At first children will find it tedious and time consuming. After several trials their speed will improve. It is important that the participant be supervised because they will have a natural tendency to use the wrong movements. Over time, they will get better at it and less supervision will be required.

Another great activity that has to do with writing but also is part of reading is an activity called Letter Tracking ExerciseLetter Tracking. For this exercise a booklet called Letter Tracking (developed by a company that works with developmental optometrists). This activity combines mental processing speed, familiarity with the alphabet and hand movement speed for a race against the clock. As the child moves through the book, the pages become more and more difficult. It is the perfect neuro-development intervention for slow writers due to slow processing speed.

When remediating writing speed, it is important to stress accuracy. The goal is to be accurate as well as fast. Do not count the output if it is sloppy or illegible. However, stay within the child's ability level. If you know the child can do better, require it even if the speed is much improved. In addition all circles need to be made in a counter-clockwise movement. This is important for writing speed.

When some children write neatly on some days and other day's they write very sloppy, this is a symptom of a intolerance to a food or environmental intolerance. Unfortunately it is a common problem that does not get addressed well. Too many children are put on ADHD medicine when they should be restricted in the things they are exposed to and allergic to. If you feel your child has a food or environmental intolerance or for more information about this we refer to the following books: What's Eating Your Child?: The Hidden Connection Between Food and Childhood Ailments by Kelly Dorfman ISBN = 0761161198 and/or the classic book Is This YOur Child? by Doris M.D., ISBN=0688119077. Many children with a seemingly inability to write on some days but other days are fine, will respond to treating their intolerances and neuro-development will not be needed.

Copying Information from the Board

Some children can write with neatness and their speed is adequate, but when it comes to copying information on the board, they are very very slow. This is often a focus flexibility problems and it is usually part of a developmental vision problem. Please refer to our section on visual remediation exercises for more information. Usually the child can see well close up, and they can pass and eye exam. What the cannot do well is go from focusing far away, then focusing close up, and then refocusing far away, very well. This process is slow and tendious for the child with a problem in focus flexibility. Neuro-development can help improve writing speed of coping something from the board.

Assessment. Again, assessment is straight forward. The following conditions need to be ruled out: an Attention Deficit Disorder, problem with writing speed, regular vision problem (they can not see things far away), and the child's way of avoiding homework. A person with an attention deficit disorder will get distracted while they are coping things from the board, a person with poor writing speed will write slowly at near point work also, and a person who is near sighted will be unable to see the board well, and there are some children that avoid doing work, by not coping things off the board on purpose. If these conditions have been ruled out and there is still a great discrepancy between near point work (doing school work or homework at their desk) and board work speed, then the focus flexibility exercise should be helpful. It is possible that a child could be inattentive and have a focus flexibility problem as well. If so, work on increasing attention skills as well as focus flexibility.

Remediation. The Focus Flexibility Exercise is a great remediation tool. Make sure that other developmental vision problems do not co-exist. If they do, incorporate other vision exercises with focus flexibility. Mastery is achieved when the child can copy information from the chalk board or smart board within an average time of their same age peers.

Spelling

Several factors may contribute to whether a person is a good speller or not. One factor is memory. Short term, rote memory and long term memory are necessary to do well on a spelling test. There is a personality variable related to spelling. Individuals with the personality trait of Sensing on the Meyers Briggs Personality Type Inventory are generally better spellers than individuals who score high on Intuitive. We suspect good spelling is related to personality. With that said, here is our intervention to get children to improve their spelling on spelling tests.

Assessment. Psycho-metricians can measure a child's ability to spell. Almost every achievement test comes with a spelling subtest. A parent can obtain a non-scientific measure by comparing their child's ability to learn words with their siblings or peers at school. If there is a significant difference in learning to spell between the child and her peers, then chances are that the following may be helpful.

Some children have trouble learning spelling words. It takes them a long time to learn to spell the words and sometimes they forget what they studied when it comes to test time. There are some kids who will do well at home, get to school and fail the test, come home and then get all the words correctly. These children may have a problem with test anxiety. The anxious child who does poorly on spelling test should see a therapist to master relaxation and cognitive theory. This will allow them to overcome their anxiety that is causing them to be unable to spell during a test. Another less likely cuase for being able to spell on moment and then not be able to spell in the next is an intolerance to a food or a substance within the environment. If you feel your child has a food or environmental intolerance or for more information about this we refer to the following books: What's Eating Your Child?: The Hidden Connection Between Food and Childhood Ailments by Kelly Dorfman ISBN = 0761161198 and/or the classic book Is This YOur Child? by Doris M.D., ISBN=0688119077. Many children with a seemingly inability to write on some days but other days are fine, will respond to treating their intolerances and neuro-development will not be needed. Part of the assessment process is to rule out possible causes for the inability to spell. A plan should then be generated to overcome the problems identified.

Remediation. If test anxiety and environmental intolerances have been ruled out, then the child should be ready for remediation. The Structure of Intellect (SOI) has several neuro-developmental components that deal with being able to remediate spelling. SOI remediation involves developing attention to detail and improving memory.

If a child has poor ability to spell as well as a poor memory, then improving their memory can be helpful. See our section on Memory for neuro-development methods to improve memory.

A method we have found successful to help children learn and retain spelling words for spelling tests is through the use of a rebounder or mini trampoline. Any type of trampoline or bounce able object (e.g., bed, couch) will suffice. The child calls out a letter of the word for each bounce on the rebounder. They are to learn the word forwards until they can say the word and each letter of the word to the rhythm of their bounce. Then they are to spell the word backwards. Once they say the word, spell it backwards to the rhythm of each bounce, then they are to spell the word forward again. Usually by bouncing, children spend less time learning to spell the word than they did the regular way and they are usually able to remember the word until the day of the test.

Written Expression (Putting Words on Paper)

Some people have great verbal skills, but when it comes to putting things on paper, their mind goes blank or they are unable to organize their thoughts on paper. This can be frustrating and is usually a problem for older students (e.g., students in middle school and high school). It can even interfere with students being able to pass their required English credits to graudate from High School. It also limits their ability to participate in college.

Assessment. Some standardized achievement tests (e.g., Wechsler Individual Achievement Test-Third Edition), can measure verbal fluency and written fluency. If the student scores much higher on verbal skills and less on written fluency and wrottem skills, then it is likely that the child has a problem putting thoughts or words into written communication on paper. Parents and teachers notice that the student can do well on multiple choice tests and math tests but when they have to do an essay, they just do not do as well. They are significantly worse at putting their words onto paper.

Intervention. This problem can be compensated by allowing students to turn in their assignments orally (e.g., on a tape or digital recorder) instead of in written form. Another way is to get organized and follow a plan on what to write. There are websites on the Internet designed to help individuals with poor writing skills. Mind Tools offers such a technique to organize what needs to be said. Another site is Time4writing.com. There are also programs (e.g., Natural Speaking Dragon) that converts what you say and put it into typed form in a computer. All the student needs to do is edit the results and turn it in as their essay. Some schools will allow students to do this in the classroom as part of their Individual Education Plan (IEP).

Remediation. Remediation is also an intervention but involves giving the participant a chance to overcome the deficiency through neuro-development. Putting words on paper is very complex and involves multiple developed skills and abilities. These include processing speed, writing speed (see above), fine motor skills (see above), developmental vision skills, and letter formation skills (see above). These are all basic. If the participant has weaknesses in any of these areas, we suggest addressing these problems first and then grauduating to the remedial exercise dissuced below.

Word Fluency Exercise was developed to increase the speed of brainstorming in an oral and written form. It is natural for individuals to be much faster in saying things than writing things. To assess if this exercise can be helpful, a parent can get a group of children over and have them all participate in a one minute game. The game is to write down as many animals as they can. Participants who are much lower than everyone else can probably benefit from this exercise, providing that there is nothing wrong with their ability to write.

Being able to brainstorm and come up with ideals in a written form is just one skill of being able to put words onto paper. It is much more difficult to organize thoughts and put them into an essay. We developed a procedure called the Essay Writting Exerciseto help individuals write essays. At first it looks as a tactical plan. What makes it a neuro-developmental approach is the way that it is to be used. It should be used to develop short and easy essays at first. Even though the participant may be behind their peers in school and there is pressure to do someting quickly, we highly recommend starting off with short and easy essays until they are mastered. Then move on to more complex essays. We recommend the use of compensation techniques described above until the student has had the time and experience to overcome their deficit through neuro-development. If you use it regularly, improvements should be seen in 30 to 60 days. Over time and consistent use (used everytime a student has to do an essay), the student will get better and better at it and thus create neuro-development. They will be able to write essays in High School and College.

Written Expression as Clues for Diagnoses

This article will make a few comments about writing samples and drawing samples as evidence of problems with a person's thinking or some type of neurological deficit (e.g., brain damage).

The Bender Gestalt test is an easy to administer written test to screen for the presence of brain damage. One common problem is seen in drawing squares. If the participant leaves off or makes gaps on one side of the square, it is usually a sign of brain damage. It is usually the right or left side that is left off or not connected fully. This is called inattention to the left or inattention to the right, depending on which side of the square has the ommision.

Similarly, some children when they write will have a tendency to drift to the left or drift to the right in that they will leave increasingly more spaces at the left or the right side of the paper as they continue writing down a page. This can be a sign of neurological or visual problems within that student. Children who are older and cannot stay on a line or may drift to another line, may have neurological problems as well. These individuals should be examined by a Developmental Optometrist, Neurologist, or NeuroPsychologist. Sometimes it is helpful to see more than one professional when trying to identify the potential of some type of brian or muscle damage.

Another interesting correlation is that some teenagers and adults with Bipolar Disorder will write lengthy letters when they are in a manic state. Their writing is usually excessively long compared with normal individuals. Often the content is not much richer than normal conversation and includes some rambling and repeating of ideas. These individuals should seek treatment by Mental Health Professionals. Because of our bias towards Holistic approaches, we recommend professionals who use Holistic approaches in dealing with mental illness.

Summary

There are many reasons why a student can be lacking in written expression. For younger children, a common problem is a lack of fine motor development. There muscles are just too week to be able to hold a pencil well or write. Some individuals also have poor visual development which will impact on their ability to write neatly and precisely. Some children become anxious and can perform well in a low stressful environment (e.g., home) but may perceive testing as high stress and will not be able to write or communicate well. Some people have processing speed problems that interfere with writing and some children lack focus and the ability to concentrate. Some older children can communicate well verbally but appear unable to do so in a written form. All of these problems can be addressed through neuro-development. Some writing problems are caused by allergies or intollernences. If allergens are suspected we recommend a medical doctor who used the Provication/Nuturalizaiton technique of allergy testing or an IGG blood test. Anxiety should be addressed with a mental health provider. Neuro-development takes time and patience and consistently applied. To get neuro-development to work, the first step is to break tasks down into manageable steps. Then work the steps. Improvement should be seen within 30 days. If improvement has not been seen, then it is likely that the tasks will have to be simplified even further. If the tasks are broken down and then added upon in difficulty, improvements within 30 days should be observed. Some children need a couple of years of constant and increasingly difficult neuro-development. Other children can accomplish everything they need to do within 90 days of intervention. Any gain in written expression skills will benefit individuals for the rest of their life. The rewards of neuro-development will be worth the costs and sacrifices made.

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