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Differential diagnosis of dysgraphia, dyslexia, and OWL LD: behavioral and neuroimaging evidence

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Abstract

In Study 1, children in grades 4–9 (N = 88, 29 females and 59 males) with persisting reading and/or writing disabilities, despite considerable prior specialized instruction in and out of school, were given an evidence-based comprehensive assessment battery at the university while parents completed questionnaires regarding past and current history of language learning and other difficulties. Profiles (patterns) of normed measures for different levels of oral and written language used to categorize participants into diagnostic groups for dysgraphia (impaired subword handwriting) (n = 26), dyslexia (impaired word spelling and reading) (n = 38), or oral and written language learning disability OWL LD (impaired oral and written syntax comprehension and expression) (n = 13) or control oral and written language learners (OWLs) without specific learning disabilities (SLDs) (n = 11) were consistent with reported history. Impairments in working memory components supporting language learning were also examined. In Study 2, right handed children from Study 1 who did not wear braces (controls, n = 9, dysgraphia, n = 14; dyslexia, n = 17, OWL LD, n = 5) completed an fMRI functional connectivity brain imaging study in which they performed a word-specific spelling judgment task, which is related to both word reading and spelling, and may be impaired in dysgraphia, dyslexia, and OWL LD for different reasons. fMRI functional connectivity from 4 seed points in brain locations involved in written word processing to other brain regions also differentiated dysgraphia, dyslexia, and OWL LD; both specific regions to which connected and overall number of functional connections differed. Thus, results provide converging neurological and behavioral evidence, for dysgraphia, dyslexia, and OWL LD being different, diagnosable SLDs for persisting written language problems during middle childhood and early adolescence. Translation of the research findings into practice at policy and administrative levels and at local school levels is discussed.

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Acknowledgments

The current study, supported by grant P50HD071764 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) to the University of Washington Learning Disabilities Research Center, has been a team effort: The first two authors contributed equally to this study. The first author recruited the sample and supervised the assessments. The second author supervised the imaging team that collected and analyzed the fMRI functional connectivity data. The last author conducted the data analyses for Study 1 and contributed to the design of cross-center Projects 1 and 3. The co-authors acknowledge the contributions of Jasmine Niedo, Roxana DelCampo, and Whitney Griffin who administered the comprehensive assessment battery, Terry Mickail who provided data base management, the imaging team involved in the larger brain imaging project, Tom Grabowski, Katie Askren, Zoe Mestre, Kevin Yagle, and Peter Boord, and Wendy Raskind who has collaborated for two decades on identifying phenotypic markers of genetic bases of written language learning disabilities. The team also gratefully acknowledges the participating children and parents’ contributions to the study.

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  1. Learning Sciences and Human Development, University of Washington, 322 Miller, Box 353600, Seattle, WA, 98195-3600, USA

    Virginia W. Berninger

  2. Radiology, University of Washington, Seattle, WA, USA

    Todd L. Richards

  3. Quantitative Studies and Measurement, University of Washington, Seattle, WA, USA

    Robert D. Abbott

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Correspondence to Virginia W. Berninger.

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Berninger, V.W., Richards, T.L. & Abbott, R.D. Differential diagnosis of dysgraphia, dyslexia, and OWL LD: behavioral and neuroimaging evidence. Read Writ 28, 1119–1153 (2015). https://doi.org/10.1007/s11145-015-9565-0

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