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Dysgraphia Differs between Children with Developmental Coordination Disorder and/or Reading Disorder

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Title: Dysgraphia Differs between Children with Developmental Coordination Disorder and/or Reading Disorder
Language: English
Authors: Caroline Jolly (ORCID 0000-0002-5726-4184), Marianne Jover, Jérémy Danna
Source: Journal of Learning Disabilities. 2024 57(6):397-410.
Availability: SAGE Publications and Hammill Institute on Disabilities. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 14
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Education Level: Elementary Education
Descriptors: Learning Disabilities, Neurodevelopmental Disorders, Handwriting, Students with Disabilities, Differences, Foreign Countries, Reading Difficulties, Comorbidity, Handheld Devices, Developmental Disabilities, Perceptual Motor Coordination, Intelligence Tests, Disability Identification, Rehabilitation, French, Native Speakers, Handedness, Reading Skills, Psychomotor Skills, Elementary School Students
Geographic Terms: France
Assessment and Survey Identifiers: Wechsler Intelligence Scale for Children
DOI: 10.1177/00222194231223528
ISSN: 0022-2194
1538-4780
Abstract: Handwriting deficits, or dysgraphia, are present in several neurodevelopmental disorders. To investigate whether dysgraphia differs according to the associated disorder, we performed a detailed analysis of handwriting in a group of French children with developmental coordination disorders (DCD), reading disorder (RD), or comorbid RD and DCD. Handwriting deficits were investigated at the product (quality of the trace) and the process (movement that generates the trace) levels. Nineteen children with singular RD (among which eight with dysgraphia), 13 children with singular DCD (among which seven with dysgraphia), 16 children with comorbid RD+DCD (among which 11 with dysgraphia), and 20 typically developing children, age 7 to 12, performed the BHK (Brave Handwriting Kinder) test, a standardized assessment of handwriting, on a graphic tablet. Developmental coordination disorders primarily affected handwriting quality, while RD affected slowness and, to a lesser extent, quality. Children with RD, solely or comorbid with DCD, wasted time by lifting and stopping the pen when writing. The comorbidity added to but did not worsen, handwriting difficulties. These results reflect distinct motor impairments and/or strategies in children with DCD or RD. We identified subtypes of dysgraphia and advocated for a fine-grained analysis of the writing process and the assessment of motor and reading skills when studying dysgraphia.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1447346
Database: ERIC
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  Value: <anid>AN0180675690;led01nov.24;2024Nov07.04:23;v2.2.500</anid> <title id="AN0180675690-1">Dysgraphia Differs Between Children With Developmental Coordination Disorder and/or Reading Disorder </title> <p>Handwriting deficits, or dysgraphia, are present in several neurodevelopmental disorders. To investigate whether dysgraphia differs according to the associated disorder, we performed a detailed analysis of handwriting in a group of French children with developmental coordination disorders (DCD), reading disorder (RD), or comorbid RD and DCD. Handwriting deficits were investigated at the product (quality of the trace) and the process (movement that generates the trace) levels. Nineteen children with singular RD (among which eight with dysgraphia), 13 children with singular DCD (among which seven with dysgraphia), 16 children with comorbid RD+DCD (among which 11 with dysgraphia), and 20 typically developing children, age 7 to 12, performed the BHK (Brave Handwriting Kinder) test, a standardized assessment of handwriting, on a graphic tablet. Developmental coordination disorders primarily affected handwriting quality, while RD affected slowness and, to a lesser extent, quality. Children with RD, solely or comorbid with DCD, wasted time by lifting and stopping the pen when writing. The comorbidity added to but did not worsen, handwriting difficulties. These results reflect distinct motor impairments and/or strategies in children with DCD or RD. We identified subtypes of dysgraphia and advocated for a fine-grained analysis of the writing process and the assessment of motor and reading skills when studying dysgraphia.</p> <p>Keywords: DCD; dyslexia; dysgraphia; handwriting deficits; fine-grained analysis; reading disorder</p> <p>Handwriting deficits, characterized by poor quality and/or speed that cannot be explained by a neurological or intelligence deficit, or a lack of writing practice, are referred to as dysgraphia. If not identified and handled early, these deficits can have a serious impact on children's academic performance. Dysgraphia does not constitute a discrete disorder according to international classifications (see the <emph>Diagnostic and Statistical Manual of Mental Disorders</emph> [5th ed.; <emph>DSM-5</emph>]; [<reflink idref="bib4" id="ref1">4</reflink>]) but is reported in several neurodevelopmental disorders. The first question addressed in this study is whether the nature of dysgraphia differs between developmental coordination disorders (DCD) and reading disorder (RD), both of which are neurodevelopmental disorders involving distinct, if not independent, impairments.</p> <p>The comorbidity between neurodevelopmental disorders such as RD, attention deficit hyperactivity disorder (ADHD), or DCD is often observed ([<reflink idref="bib48" id="ref2">48</reflink>]; [<reflink idref="bib66" id="ref3">66</reflink>]; [<reflink idref="bib67" id="ref4">67</reflink>]). While DCD and RD concern distinct domains (reading vs motor coordination), they often appear in a comorbid manner ([<reflink idref="bib61" id="ref5">61</reflink>]; [<reflink idref="bib75" id="ref6">75</reflink>]). The processes underlying this heterotopic comorbidity are still poorly documented and understood ([<reflink idref="bib25" id="ref7">25</reflink>]). Furthermore, the impact of this comorbid condition on the children's potential handwriting deficits is unknown and constitutes the second question addressed in this study.</p> <hd id="AN0180675690-2">Dysgraphia in Children With DCD</hd> <p>The association between dysgraphia and DCD has long been observed (for a recent review, see [<reflink idref="bib8" id="ref8">8</reflink>]). Depending on the study, handwriting deficits have been found in 50% to 88% of children with DCD ([<reflink idref="bib26" id="ref9">26</reflink>]; [<reflink idref="bib42" id="ref10">42</reflink>]; [<reflink idref="bib53" id="ref11">53</reflink>]; [<reflink idref="bib58" id="ref12">58</reflink>]; [<reflink idref="bib80" id="ref13">80</reflink>]). Handwriting difficulties also constitute the second reason for medical consultation ([<reflink idref="bib36" id="ref14">36</reflink>]; [<reflink idref="bib56" id="ref15">56</reflink>]). Many studies have documented handwriting deficits in children with DCD, both at the product level, that is, the quality of the written trace, and at the process level, that is, the movement that generates the trace. At the product level, a decreased legibility, an increased number of corrections, and a random spatial arrangement of the letters demonstrate a lower handwriting quality in children with DCD compared with control (CTL) children ([<reflink idref="bib26" id="ref16">26</reflink>]; [<reflink idref="bib68" id="ref17">68</reflink>]). The letters are of irregular shape, often too large, and less consistent than those of CTL children ([<reflink idref="bib15" id="ref18">15</reflink>]; [<reflink idref="bib26" id="ref19">26</reflink>]; [<reflink idref="bib42" id="ref20">42</reflink>]; [<reflink idref="bib44" id="ref21">44</reflink>]; [<reflink idref="bib62" id="ref22">62</reflink>]). At the process level, children with DCD make more pauses during writing, both "on paper" (more stops) and "in-air" (more lifts; [<reflink idref="bib63" id="ref23">63</reflink>], [<reflink idref="bib64" id="ref24">64</reflink>]; [<reflink idref="bib69" id="ref25">69</reflink>]; [<reflink idref="bib74" id="ref26">74</reflink>]). Likewise, on-paper and lift durations were longer in children with DCD in a copy task ([<reflink idref="bib68" id="ref27">68</reflink>]; [<reflink idref="bib70" id="ref28">70</reflink>]). Finally, they also fail to adapt to size or speed constraints ([<reflink idref="bib42" id="ref29">42</reflink>]; [<reflink idref="bib74" id="ref30">74</reflink>]).</p> <p>The examination of handwriting in DCD children, however, led to some discrepancies. Pen pressure on the writing surface is either lower or higher in children with DCD compared with children without DCD ([<reflink idref="bib27" id="ref31">27</reflink>]; [<reflink idref="bib65" id="ref32">65</reflink>]; [<reflink idref="bib68" id="ref33">68</reflink>]). Furthermore, some authors found a higher writing speed in children with DCD ([<reflink idref="bib44" id="ref34">44</reflink>]) while others did not ([<reflink idref="bib63" id="ref35">63</reflink>]), or found a lower speed ([<reflink idref="bib26" id="ref36">26</reflink>]).</p> <p>Dysgraphia in DCD children has mainly been explained by a lack of movement sequence automation and motor planning in motor skills ([<reflink idref="bib8" id="ref37">8</reflink>]; [<reflink idref="bib42" id="ref38">42</reflink>]; [<reflink idref="bib62" id="ref39">62</reflink>]) and/or a neuromotor noise and a deficit in predictive motor control (for a review, see [<reflink idref="bib1" id="ref40">1</reflink>]). More precisely, the variability in handwriting performance of children with DCD suggests a lack of exploiting the noise-reducing capabilities of muscles and joints ([<reflink idref="bib81" id="ref41">81</reflink>]).</p> <hd id="AN0180675690-3">Dysgraphia in Children With RD</hd> <p>Handwriting deficits in children with RD have been less investigated, and more discrepancies remain in the literature (for reviews, see [<reflink idref="bib29" id="ref42">29</reflink>]; [<reflink idref="bib45" id="ref43">45</reflink>]). At the product level, children with RD write larger and with poorer legibility than CTL children, due to more missing and/or concatenated strokes within letters ([<reflink idref="bib3" id="ref44">3</reflink>]; [<reflink idref="bib17" id="ref45">17</reflink>]; [<reflink idref="bib50" id="ref46">50</reflink>]; [<reflink idref="bib77" id="ref47">77</reflink>]). At the process level, some studies reported lower writing speed and pen pressure ([<reflink idref="bib2" id="ref48">2</reflink>]; [<reflink idref="bib20" id="ref49">20</reflink>]; [<reflink idref="bib59" id="ref50">59</reflink>]), increased lift duration ([<reflink idref="bib16" id="ref51">16</reflink>]), increased total writing time, and a higher number of pauses ([<reflink idref="bib3" id="ref52">3</reflink>]) in children with RD compared with children without RD. Likewise, results concerning writing speed in children with RD are not unequivocal; some authors show a lower speed in children with RD while others do not ([<reflink idref="bib2" id="ref53">2</reflink>]; [<reflink idref="bib59" id="ref54">59</reflink>]; [<reflink idref="bib78" id="ref55">78</reflink>]).</p> <p>To what extent do these handwriting difficulties in children with RD result from slower language/orthographic processing ([<reflink idref="bib2" id="ref56">2</reflink>]; [<reflink idref="bib5" id="ref57">5</reflink>]; [<reflink idref="bib79" id="ref58">79</reflink>]), or from graphomotor deficits in addition to these processing difficulties at a more central level ([<reflink idref="bib33" id="ref59">33</reflink>]; [<reflink idref="bib37" id="ref60">37</reflink>]; [<reflink idref="bib46" id="ref61">46</reflink>]), is still debated. As motor skills were not always checked in children with RD, it is still unclear whether their handwriting difficulties arise from their spelling deficit or motor difficulties per se ([<reflink idref="bib38" id="ref62">38</reflink>]). For instance, atypical pausing behaviors among children with RD were associated with a lack of automaticity in spelling ([<reflink idref="bib63" id="ref63">63</reflink>]; [<reflink idref="bib78" id="ref64">78</reflink>], [<reflink idref="bib79" id="ref65">79</reflink>]) but could also arise from an associated undetected DCD.</p> <hd id="AN0180675690-4">Dysgraphia in Children With RD+DCD</hd> <p>Comorbidity between neurodevelopmental disorders is very frequent and constitutes a line of research to better understand the developmental trajectory of the deficits and their underlying mechanisms ([<reflink idref="bib25" id="ref66">25</reflink>]). Studies systematically exploring the effect of comorbidity are recent ([<reflink idref="bib10" id="ref67">10</reflink>]; [<reflink idref="bib12" id="ref68">12</reflink>]; [<reflink idref="bib13" id="ref69">13</reflink>]; [<reflink idref="bib21" id="ref70">21</reflink>]; [<reflink idref="bib32" id="ref71">32</reflink>]; [<reflink idref="bib54" id="ref72">54</reflink>]). The prevalence of comorbidity between RD and DCD is higher than the chance level but is not yet precisely known. Recent studies on different groups of children showed that for most tasks, children with comorbid DCD and RD did not differ from children presenting with isolated RD or DCD: working memory ([<reflink idref="bib54" id="ref73">54</reflink>]), oculomotor behavior ([<reflink idref="bib9" id="ref74">9</reflink>]; [<reflink idref="bib10" id="ref75">10</reflink>], [<reflink idref="bib11" id="ref76">11</reflink>]), graphomotor tasks ([<reflink idref="bib46" id="ref77">46</reflink>]). One exception should, however, be mentioned: anticipatory postural adjustments were worsened in children of the comorbid group as compared with the RD- or DCD-alone groups ([<reflink idref="bib21" id="ref78">21</reflink>]). These results highlight an additive effect, which was also detected in [<reflink idref="bib30" id="ref79">30</reflink>] study, and are in line with the multiple deficits approach to neurodevelopmental disorders ([<reflink idref="bib60" id="ref80">60</reflink>]; [<reflink idref="bib61" id="ref81">61</reflink>]).</p> <p>The effect of comorbidity between RD and DCD on children's handwriting has been barely explored. [<reflink idref="bib20" id="ref82">20</reflink>] showed that RD children with a comorbid condition (DCD or ADHD) have a reduced handwriting speed compared with children with singular RD. Downing specifically explored the effect of comorbidity on RD and/or DCD children's handwriting ([<reflink idref="bib30" id="ref83">30</reflink>]; [<reflink idref="bib31" id="ref84">31</reflink>]). The authors showed that children with RD had lower scores on some dimensions related to handwriting legibility (letter formation and word spacing). In contrast, children with DCD had lower scores on all dimensions of handwriting legibility. The handwriting of children with comorbid DCD and RD did not differ from that of children with singular disorders, suggesting that their difficulties reflect an additive profile of spelling and additional, DCD-related, deficits. Using a dimensional approach and generalized additive model analysis, [<reflink idref="bib46" id="ref85">46</reflink>] analyzed the handwriting of children with or without DCD and RD. They showed that handwriting difficulties depended on the children's scores on both motor and reading tests. Comorbidity added but not multiplicated handwriting difficulties.</p> <hd id="AN0180675690-5">Aim and Hypothesis</hd> <p>There are few studies comparing handwriting process and product deficits in children with RD or DCD children in a common protocol. The assessment of handwriting is often based on paper-and-pencil tests, which prevents a detailed analysis of the variables characterizing the process of handwriting ([<reflink idref="bib23" id="ref86">23</reflink>]). In addition, the question of the impact of comorbidity on handwriting performance has seldom been addressed. Identifying and understanding the deficits specific to each disorder are important from a clinical perspective, both to enable more efficient and well-targeted remediation and to help in the diagnosis of dysgraphia ([<reflink idref="bib6" id="ref87">6</reflink>]; [<reflink idref="bib35" id="ref88">35</reflink>]).</p> <p>This study aimed to assess whether dysgraphia differs according to the associated neurodevelopmental disorder, based on a digitalized analysis of the Brave Handwriting Kinder (BHK) test ([<reflink idref="bib41" id="ref89">41</reflink>]; French version by [<reflink idref="bib19" id="ref90">19</reflink>]). The BHK test produces two scores, namely, a quality score based on 13 spatial criteria related to the written trace and a speed score based on one single criterion measuring the number of characters (letters and punctuations) produced in 5 min. A more detailed analysis of the process of writing in the spatial, temporal, kinematic, and dynamic aspects is required to complement this evaluation mainly based on the legibility of the written trace, and to better identify differences related to the neurodevelopmental disorder. First, the quality and speed scores of the BHK test were rated to determine the handwriting performance and the proportion of dysgraphia in children with DCD and/or RD and CTL children. Then, we compared children with dysgraphia and RD, DCD, or RD+DCD to identify subtypes of dysgraphia. We hypothesized that children with DCD and children with RD would encounter different difficulties reflected by distinct handwriting features. More specifically, while the reduction in writing speed in children with RD is relatively well established in the literature, the results are more controversial with regard to DCD. More fine-grained analysis of the writing movement recorded on the tablet will enable us to determine precisely what changes in the process of forming the written trace are relative to DCD and RD. The question is to determine whether the writing difficulties related to each disorder are qualitatively different in terms of pen lifts and stops, movement fluency, and trace length. Furthermore, we expected that comorbidity would result in the addition of RD- and DCD-specific difficulties but would not worsen the difficulties associated with each disorder.</p> <hd id="AN0180675690-6">Method</hd> <p></p> <hd id="AN0180675690-7">Participants</hd> <p>Sixty-eight children were included in the study, divided into four groups: the "RD" group of 19 children with singular RD, the "DCD" group of 13 children with singular DCD, the "RD+DCD" group of 16 children with comorbid RD and DCD, and the "CTL" group of 20 children without reading or motor difficulties. Children with RD and/or DCD had received their diagnosis beforehand from an experienced clinician based on the <emph>DSM-5</emph> criteria ([<reflink idref="bib4" id="ref91">4</reflink>]) and were receiving treatment for a neurodevelopmental disorder. Demographic and clinical profiles for the groups are available in Table 1. All children were right-handed and French native speakers. There was no difference in mean age (χ<sups>2</sups> = 2.84, <emph>df</emph> = 3, <emph>p</emph> =.417), nor in gender proportion (χ<sups>2</sups> = 1.25, <emph>df</emph> = 3, <emph>p</emph> =.74) between the groups. All parents reported normal hearing and normal or corrected-to-normal vision.</p> <p>Table 1. Groups' Characteristics According to the Analysis.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th align="center">Characteristics</th><th align="center">CTL group</th><th align="center">RD group</th><th align="center">DCD group</th><th align="center">RD+DCD comorbid group</th><th align="center"><italic>p</italic></th><th align="center">DSCF</th></tr></thead><tbody><tr><td colspan="7">Gender and age</td></tr><tr><td><italic>n</italic> (% females)</td><td>20 (45)</td><td>19 (42.1)</td><td>13 (30.8)</td><td>16 (50)</td><td>.74</td><td /></tr><tr><td> Age range (years)</td><td>8.9–11.8</td><td>8.1–11.8</td><td>8.8–11.8</td><td>8.1–11.8</td><td>NA</td><td /></tr><tr><td><italic>M</italic><sub>age</sub> (<italic>SD</italic>)</td><td>9.99 (0.97)</td><td>9.98 (1.28)</td><td>10.14 (1.14)</td><td>9.44 (1.31)</td><td>.417</td><td /></tr><tr><td colspan="7">Intelligence</td></tr><tr><td> Similarities (standard score), <italic>M</italic> (<italic>SD</italic>)</td><td>16.3 (2.39)</td><td>13.32 (2.19)</td><td>14.46 (4.18)</td><td>12.44 (3.37)</td><td>.003</td><td>CTL > RD, RD+DCD</td></tr><tr><td> Picture Concepts (standard score), <italic>M</italic> (<italic>SD</italic>)</td><td>10.6 (1.85)</td><td>11.26 (2.42)</td><td>10.08 (2.56)</td><td>10.75 (2.91)</td><td>.609</td><td /></tr><tr><td>Motor: MABC percentile, <italic>M</italic> (<italic>SD</italic>)</td><td>45.72 (25.22)</td><td>34.38 (18.12)</td><td>4.3 (3.47)</td><td>4.12 (2.87)</td><td><.001</td><td>CTL > DCD, RD+DCDRD > DCD, RD+DCD</td></tr><tr><td colspan="7">Reading</td></tr><tr><td> Alouette accuracy <italic>z</italic>-score, <italic>M</italic> (<italic>SD</italic>)</td><td>0.67 (0.27)</td><td>–2.51 (2.62)</td><td>0.48 (0.33)</td><td>–3.07 (2.75)</td><td><.001</td><td>CTL > RD, RD+DCDDCD > RD, RD+DCD</td></tr><tr><td> Alouette efficiency <italic>z</italic>-score, <italic>M</italic> (<italic>SD</italic>)</td><td>1.12 (0.76)</td><td>–1.48 (0.78)</td><td>0.50 (0.77)</td><td>–1.52 (0.52)</td><td><.001</td><td>CTL > RD, RD+DCDDCD > RD, RD+DCD</td></tr><tr><td> ODEDYS log accuracy, <italic>M</italic> (<italic>SD</italic>)</td><td>0.69 (0.59)</td><td>–1.86 (1.31)</td><td>0.25 (0.57)</td><td>–1.59 (1.21)</td><td><.001</td><td>CTL > RD, RD+DCDDCD > RD, RD+DCD</td></tr><tr><td> ODEDYS log speed, <italic>M</italic> (<italic>SD</italic>)</td><td>0.46 (0.61)</td><td>–2.71 (4.8)</td><td>0.35 (0.58)</td><td>–1.89 (1.6)</td><td><.001</td><td>CTL > RD, RD+DCDDCD > RD, RD+DCD</td></tr><tr><td> ODEDYS word accuracy, <italic>M</italic> (<italic>SD</italic>)</td><td>0.98 (0.60)</td><td>–1.5 (1.05)</td><td>0.73 (0.84)</td><td>–1.65 (1.16)</td><td><.001</td><td>CTL > RD, RD+DCDDC > RD, RD+DCD</td></tr><tr><td> ODEDYS word speed, <italic>M</italic> (<italic>SD</italic>)</td><td>0.78 (0.38)</td><td>–3.36 (5.06)</td><td>0.65 (0.43)</td><td>–2.04 (1.78)</td><td><.001</td><td>CTL > RD, RD+DCDDCD > RD, RD+DCD</td></tr><tr><td> ODEDYS-2 sup, <italic>M</italic> (<italic>SD</italic>)</td><td>0.42 (0.84)</td><td>–0.36 (0.99)</td><td>0.16 (0.82)</td><td>–0.47 (0.94)</td><td><.05</td><td>CTL > RD, RD+DCD</td></tr><tr><td> ODEDYS-2 fus, <italic>M</italic> (<italic>SD</italic>)</td><td>0.61 (0.74)</td><td>0.09 (0.79)</td><td>0.11 (0.94)</td><td>–0.27 (1.11)</td><td><.05</td><td>CTL > RD, RD+DCD</td></tr><tr><td> ODEDYS-2 log, <italic>M</italic> (<italic>SD</italic>)</td><td>0.30 (0.64)</td><td>–0.90 (1.38)</td><td>0.18 (0.80)</td><td>–0.06 (0.90)</td><td><.01</td><td>CTL > RD</td></tr><tr><td colspan="7">Language</td></tr><tr><td> EVAC <italic>z</italic>-score, <italic>M</italic> (<italic>SD</italic>)</td><td>0.73 (0.59)</td><td>–0.01 (0.78)</td><td>0.51 (1.11)</td><td>–0.18 (0.72)</td><td><.01</td><td>CTL > RD, RD+DCD</td></tr><tr><td> ECOSSE <italic>z</italic>-score, <italic>M</italic> (<italic>SD</italic>)</td><td>0.84 (0.46)</td><td>0.33 (0.56)</td><td>0.21 (0.90)</td><td>0.08 (0.59)</td><td><.01</td><td>CTL > DCD, RD+DCD</td></tr></tbody></table> </ephtml> </p> <p>1 <emph>Note.</emph> CTL = control group; RD = reading disorder group; DCD = developmental coordination disorder group; RD+DCD = comorbid DCD/RD group; Alouette = Alouette Test–Revised ([<reflink idref="bib52" id="ref92">52</reflink>]); ODEDYS = <emph>Outils de Dépistage des</emph> Dyslexies [Dyslexia Screening Tools] ([<reflink idref="bib43" id="ref93">43</reflink>]); EVAC = <emph>Epreuve Verbale d'Aptitude Cognitive</emph> [Verbal Cognitive Aptitude Test] ([<reflink idref="bib34" id="ref94">34</reflink>]); ECOSSE = <emph>Epreuve de Compréhension Syntaxico-Sémantique</emph> [Syntactic-Semantic Comprehension Test] ([<reflink idref="bib51" id="ref95">51</reflink>]); DSCF = Dwass-Steel-Critchlow-Fligner pairwise comparisons. Sup = suppression; fus = fusion; log = logatom.</p> <p>All children underwent complete medical and psychological screening before their inclusion in the study (see Table 1). We used the French version of the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV; [<reflink idref="bib82" id="ref96">82</reflink>]) to establish their normal intellectual functioning levels. We referred to the full-scale intelligence quotient (IQ), when available, or the Similarities and Pictures Concepts subtests. These subtests belong to the Verbal Comprehension Index and to the Fluid Reasoning Index, respectively. In the French version, they have demonstrated good reliability (.77 and.64) and acceptable convergent validity (.58 and.50, respectively). They are considered complementary measures of general intelligence ([<reflink idref="bib39" id="ref97">39</reflink>]; [<reflink idref="bib49" id="ref98">49</reflink>]). The subtests' raw scores were converted to age-scaled standard scores (<emph>M</emph> = 10, <emph>SD</emph> = 3) and children were included if their scores were equal or above 7. Although all children reached this score, it is worth noting that there was a significant difference in the Similarities subtest score of the WISC between the CTL group and the two groups with RD. This difference is not surprising due to the nature of the Similarities task that relies strongly on lexicon knowledge ([<reflink idref="bib82" id="ref99">82</reflink>]). Preserved oral language skills were established using two tests. The subtest "missing words" of the EVAC (<emph>Epreuve Verbale d'Aptitude Cognitive</emph> [Verbal Cognitive Aptitude Test]; [<reflink idref="bib34" id="ref100">34</reflink>]) evaluates the morphosyntactic abilities on the expressive side and requires the children to write a missing word in a sentence (e.g., <emph>Il est recommandé de se brosser les dents ___ d'aller dormir</emph> / It is recommended to brush your teeth ___ going to bed). The test was standardized on 943 children between 7 and 16 years but its psychometric properties have not been further tested. On the contrary, the ECOSSE (<emph>Epreuve de Compréhension Syntaxico-Sémantique</emph> [Syntactic-Semantic Comprehension Test]; [<reflink idref="bib51" id="ref101">51</reflink>]), based on [<reflink idref="bib14" id="ref102">14</reflink>] test of Reception of Grammar evaluates the syntactic-semantic comprehension. It requires the child to point to a picture corresponding to a word or a sentence pronounced by the experimenter (e.g., <emph>L'homme poursuit le chien</emph> / The man chases the dog). The test was standardized on 2,000 children between 7 and 12 years; however, its psychometric properties have not been tested. Finally, attention deficit hyperactivity disorder (ADHD) was excluded on the basis of the parent's responses to the <emph>DSM-5</emph> checklist ([<reflink idref="bib4" id="ref103">4</reflink>]).</p> <p>The children were also evaluated regarding their reading and motor skills. The Alouette test ([<reflink idref="bib52" id="ref104">52</reflink>]) was used to evaluate reading accuracy and efficiency (accuracy/reading time). The text to read aloud in this test has no meaning and requires word decoding. The Alouette is the most commonly used standardized test for the evaluation of reading capacity in France. It was standardized on 415 children between 6 and 16 years, but its psychometric properties have not been tested.</p> <p>Reading and phonological abilities were evaluated with items of the first and second versions of the ODEDYS test ([<reflink idref="bib43" id="ref105">43</reflink>]). Reading abilities were tested with logatom reading (reading isolated pseudo words) and word reading (reading isolated irregular words). Both reading accuracy and speed were scored. Phonological abilities were tested using three items of the Version 2 of ODEDYS: phoneme suppression (remove the first phoneme of a word to repeat), phoneme fusion (build a pseudo word using the first phoneme of two words), and logatom repeating (repeat pseudo words after the experimenter). The ODEDYS test was standardized on 536 children between the second and the fifth grades, but the psychometric properties have not been tested.</p> <p>Motor skills were assessed using the Movement Assessment Battery for Children, First Edition ([<reflink idref="bib76" id="ref106">76</reflink>]). The French norms of the MABC were based on 1,233 children between 4 and 12 years. The reliability was satisfactory (89% of agreement); the convergent validity was low, although significant (<emph>r =</emph>.40).</p> <p>The following criteria were used to compose the groups. Children with RD (singular or associated with DCD) had received their diagnosis from an experienced clinician and were receiving treatment for a reading problem by a pediatric speech therapist. They scored below the normal range when reading isolated irregular words or logatoms (–1.5 <emph>SD</emph>; ODEDYS) and/or when reading a meaningless text (–1 <emph>SD</emph>; Alouette test). Children with DCD (singular or associated with RD) had received their diagnosis from an experienced clinician and were receiving treatment for a motor coordination problem that interfered with their daily living activities and scored below the 15th percentile at the MABC1, which corresponds to the cut-off value for moderate DCD (for a review, see [<reflink idref="bib73" id="ref107">73</reflink>]). To avoid any overlap between groups, additional inclusion criteria included an MABC1 score above the 20th percentile for RD and CTL children and reading scores above –0.5 <emph>SD</emph> on reading tests for DCD and CTL children.</p> <p>Children were enrolled in the cohort for a large multidimensional research project (DYSTAC-MAP cohort, ANR-13-APPR-0010). Children with RD and/or DCD were recruited via speech or psychomotor therapists with whom they were undergoing rehabilitation at local hospitals, or through public announcement. Children of the CTL group were recruited through public announcements. The parents and children gave their written informed consent to participate in the study before the start of the project, which had been approved by the French Ethics Committee Review Board (CPP, agreement 2014-A01960-47).</p> <hd id="AN0180675690-8">Task</hd> <p>Children took the test during their first visit to the laboratory, around 1 week after their inclusion visit. The children performed the BHK test ([<reflink idref="bib41" id="ref108">41</reflink>]), a standardized evaluation of handwriting quality and speed. The task requires children to copy out a text for 5 min on a blank paper, with their usual handwriting. The handwriting quality score is calculated based on 13 criteria described in the manual, resulting in a degradation score: the higher the score, the worse the quality. These criteria are as follows: (<reflink idref="bib1" id="ref109">1</reflink>) Writing is too large; (<reflink idref="bib2" id="ref110">2</reflink>) widening of left-hand margin; (<reflink idref="bib3" id="ref111">3</reflink>) bad letter or word alignment; (<reflink idref="bib4" id="ref112">4</reflink>) insufficient word spacing; (<reflink idref="bib5" id="ref113">5</reflink>) acute turns in connecting joints to letters; (<reflink idref="bib6" id="ref114">6</reflink>) irregularities or absence of joints (breaks in the trace); (<reflink idref="bib7" id="ref115">7</reflink>) collisions of letters; (<reflink idref="bib8" id="ref116">8</reflink>) inconsistent letter size; (<reflink idref="bib9" id="ref117">9</reflink>) incorrect relative height of the various kinds of letters; (<reflink idref="bib10" id="ref118">10</reflink>) letter distortions; (<reflink idref="bib11" id="ref119">11</reflink>) ambiguous letter forms; (<reflink idref="bib12" id="ref120">12</reflink>) corrections of letter forms; and (<reflink idref="bib13" id="ref121">13</reflink>) unsteady writing trace. A detailed description of each criterion can be found in the pioneer studies by Hamstra-Bletz and colleagues ([<reflink idref="bib40" id="ref122">40</reflink>]; [<reflink idref="bib41" id="ref123">41</reflink>]). Only the five first lines of the text are rated. Each criterion is scored between 0 and 5. The five lines are analyzed together for Criteria 1 and 2. Each line is analyzed separately for Criteria 3 to 13, with a score of 0 or 1 for each line depending if the criterion is absent or present in the line. The final quality score is the sum of all subscores. The handwriting speed score is estimated by counting the number of written characters. The French adaptation of the test demonstrated satisfactory concurrent validity (<emph>r =</emph>.68), intra- (percentage of agreement = 80%–92%) and inter-rater reliability (<emph>r</emph> =.68–.9) ([<reflink idref="bib19" id="ref124">19</reflink>]). The BHK test was performed under the usual conditions, except that the children wrote the text on a sheet of paper (29.7 × 21 cm) affixed to a graphic tablet (Wacom®, Intuos 4L, 200 Hz). Digital data were recorded by a Matlab® program including the Psychophysics toolbox (<ulink href="http://psychtoolbox.org/">http://psychtoolbox.org/</ulink>). The BHK tests were rated by an experienced clinician ([<reflink idref="bib19" id="ref125">19</reflink>]). Reliability was assessed with a second rating performed by C.J. on 25% of the sample. Intraclass correlation coefficient (ICC) was.85 for the quality score and 1.00 for the speed score, indicating very good reliability.</p> <hd id="AN0180675690-9">Data Analyses</hd> <p></p> <hd id="AN0180675690-10">Clinical Analysis</hd> <p>The quality and speed <emph>z-</emph>scores were compared between the groups of children (CTL, RD, DCD, and RD+DCD). Furthermore, based on these scores, we identified the children with dysgraphia in each group. Children were considered with dysgraphia if their quality <emph>z-</emph>score was greater than or equal to +1.5 <emph>SD</emph> (deterioration score) or if their speed <emph>z-</emph>score was lower than or equal to –1.5 <emph>SD</emph> (see Table 1). Note that none of the children in the CTL group reached those thresholds. We thus obtained three subgroups of children that all displayed dysgraphia: children with singular RD (DG-RD), children with singular DCD (DG-DCD), and those with comorbid RD and DCD (DG-RD+DCD).</p> <hd id="AN0180675690-11">Digital Analysis</hd> <p>As only the first five lines of the produced text are considered for the clinical evaluation, we selected this part of the text for the digital analysis of handwriting using the recorded (x, y) coordinates, time, and pen pressure. Data segmentation of the written tracks was conducted with a JAVA program to dissociate tracings and pen lifts. The six digital variables extracted from the written tracks are presented in Table 2. These variables have been extensively investigated for examining the handwriting process in children with and without learning disabilities (for a brief review, see [<reflink idref="bib23" id="ref126">23</reflink>]). They respectively describe the spatial (trace length), temporal (tracing duration, total lift time, and total stop duration), kinematic (SNvpd), and dynamic (mean pen pressure) content of handwriting performance.</p> <p>Table 2. Description of the Digital Variables Used for Analysis of Handwriting Process.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /></colgroup><thead><tr><th align="center">Variable</th><th align="center">Description</th></tr></thead><tbody><tr><td>Spatial: Trace length (mm)</td><td>Total trajectory followed by pen in contact with paper</td></tr><tr><td colspan="2">Temporal</td></tr><tr><td> Tracing duration (s)</td><td>Time pen is in contact with paper</td></tr><tr><td> Total lift duration (s)</td><td>Total duration with pen "in air" (axial pressure on tablet equals 0)</td></tr><tr><td> Total stop duration</td><td>Total duration of periods during which pen is in contact with paper but does not move for at least 35 ms</td></tr><tr><td colspan="2">Kinematic</td></tr><tr><td> SNvpd (Signal-to-Noise velocity peaks difference)</td><td>Difference between number of velocity peaks after filtering tangential velocity with frequency cutoff of 10 Hz and number of velocity peaks after filtering tangential velocity with cutoff of 5 Hz (<xref ref-type="bibr" rid="bibr23">Danna et al., 2013</xref>)</td></tr><tr><td>Dynamic: Mean men pressure (A.U.)</td><td>Mean axial pressure exerted by the pen on the tablet</td></tr></tbody></table> </ephtml> </p> <hd id="AN0180675690-12">Statistical Analyses</hd> <p>Data were analyzed using Jamovi (https://<ulink href="http://www.jamovi.org">www.jamovi.org</ulink>). First, a nonparametric Kruskal–Wallis test with the four groups of children (CTL, RD, DCD, and RD+DCD) as a between-subjects factor was conducted to compare the age and the BHK quality and speed <emph>z-</emph>scores. Dwass-Steel-Critchlow-Fligner tests were applied for post hoc pairwise comparisons. Effect sizes were calculated using epsilon squared (ε²). Chi-square tests (χ<sups>2</sups>) were used to compare the proportion of males/females and the proportion of children with dysgraphia between groups. Second, we compared the three subgroups of children with dysgraphia with a Kruskal–Wallis test because of their reduced number, and Dwass-Steel-Critchlow-Fligner for post hoc pairwise comparisons. The Benjamini–Hochberg method was used to adjust <emph>p</emph> values for multiple testing (<emph>q</emph> < 0.25). All significance levels were set at <emph>p</emph> =.031. Effect sizes were expressed using epsilon squared (ε²).</p> <hd id="AN0180675690-13">Results</hd> <p></p> <hd id="AN0180675690-14">BHK z- scores</hd> <p>This first analysis aims at comparing the children's overall writing performance between the groups. Results are presented in Figure 1. Median and interquartile range values are presented in Supplemental Table S1. A group effect was observed for both the quality and speed scores, <emph>F</emph>(<reflink idref="bib3" id="ref127">3</reflink>,<reflink idref="bib64" id="ref128">64</reflink>) = 12.1, <emph>p</emph> <.001, <ephtml> <math display="inline" xmlns="http://www.w3.org/1998/Math/MathML"><mrow><msubsup><mi>η</mi><mtext>p</mtext><mn>2</mn></msubsup></mrow></math> </ephtml> =.363; <emph>F</emph>(<reflink idref="bib3" id="ref129">3</reflink>,<reflink idref="bib64" id="ref130">64</reflink>) = 10.1, <emph>p</emph> <.001, <ephtml> <math display="inline" xmlns="http://www.w3.org/1998/Math/MathML"><mrow><msubsup><mi>η</mi><mtext>p</mtext><mn>2</mn></msubsup></mrow></math> </ephtml> =.321 respectively. Concerning the quality score, post hoc comparisons revealed significant differences between the CTL group and the RD group (<emph>p</emph> =.013), and between CTL group and both the DCD and RD+DCD groups (<emph>p</emph> <.001), the latter displaying the worst scores (see Supplemental Table S2 for complete results). Concerning the speed score, post hoc comparisons revealed differences between the CTL group and both the RD and RD+DCD groups (<emph>p</emph> <.001) (see Supplemental Table S3 for complete results). Again, the RD+DCD group displayed the worst BHK speed scores.</p> <p>Graph: Figure 1. Median and Interquartile Range for the Speed (Left) and Quality (Right) Scores of Each Group. Note. The quality z -score expresses a degradation, the higher the z -score, the worse the quality. CTL = control group; RD = reading disorder group; DCD = developmental coordination disorder group; RD+DCD = comorbid DCD/RD group.* p <.001. *** p <.05.</p> <hd id="AN0180675690-15">Dysgraphia Proportion in Neurodevelopmental Disorders</hd> <p>Fifty-four percent of the children with neurodevelopmental disorders had BHK scores reaching one of the clinical thresholds for dysgraphia. The dysgraphic children were eight of 19 in the RD group (42.1%), seven of 13 in the DCD group (53.8%), and 11 of 16 in the RD+DCD group (68.7%). Only three children did not present deficits in their BHK quality score and were included in the group with dysgraphia solely on the basis of their velocity score. These three children all presented an RD. All other children presented deficits in the BHK quality score, or in both scores. No children from the CTL group reached one of the thresholds for dysgraphia. The proportion of children with dysgraphia did not differ significantly between the three groups of children with neurodevelopmental disorders (χ<sups>2</sups> = 2.483, <emph>df</emph> = 2, <emph>p</emph> >.2).</p> <hd id="AN0180675690-16">Dysgraphia and Neurodevelopmental Disorders</hd> <p>To better understand the handwriting deficits depending on the neurodevelopmental disorder, we compared the clinical and digital variables between the subgroups of RD, DCD, and RD+DCD children with dysgraphia (DG-RD, DG-DCD, and DG-RD+DCD respectively). Results are presented in Table 3.</p> <p>Table 3. Median, Interquartile Range, and Results of the Kruskal–Wallis Comparisons for Each Clinical and Digital Variable Between Children With Dysgraphia Among the RD, DCD, and RD+DCD Groups.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th align="center">Group</th><th align="center">DG-RD (<italic>n</italic> = 8)</th><th align="center">DG-DCD (<italic>n</italic> = 7)</th><th align="center">DG-RD+DCD (<italic>n</italic> = 11)</th><th align="center">χ<sup>2</sup></th><th align="center"><italic>df</italic></th><th align="center"><italic>p</italic></th><th align="center">ε<sup>2</sup></th></tr></thead><tbody><tr><td>BHK</td><td>2.1 (1.07)</td><td>3.41 (1.62)</td><td>2.22 (2.06)</td><td>3.264</td><td>2</td><td>.196</td><td>0.131</td></tr><tr><td> Quality score</td><td>–1.2 (1.55)</td><td>0.082 (0.93)</td><td>–0.84 (1.3)</td><td>5.414</td><td>2</td><td>.061</td><td>0.217</td></tr><tr><td> Speed score</td><td>1,193 (318)</td><td>1,265 (364)</td><td>1,427 (819)</td><td>0.115</td><td>2</td><td>.944</td><td>0.005</td></tr><tr><td>Kinematic variables</td><td>65.1 (17.5)</td><td>33.8 (10.2)</td><td>64.7 (49.7)</td><td>6.931</td><td>2</td><td>.031<xref ref-type="table-fn" rid="tfn3">*</xref></td><td>0.277</td></tr><tr><td> Trace length (mm)</td><td>70.9 (55.9)</td><td>31.7 (16.7)</td><td>71.7 (97.4)</td><td>7.27</td><td>2</td><td>.026<xref ref-type="table-fn" rid="tfn3">*</xref></td><td>0.291</td></tr><tr><td> Tracing duration (s)</td><td>7.07 (3.68)</td><td>3.23 (2.62)</td><td>8.76 (28.7)</td><td>7.46</td><td>2</td><td>.024<xref ref-type="table-fn" rid="tfn3">*</xref></td><td>0.299</td></tr><tr><td> Total lift duration (s)</td><td>174 (72.5)</td><td>75 (35.5)</td><td>153 (167)</td><td>8.207</td><td>2</td><td>.017<xref ref-type="table-fn" rid="tfn3">*</xref></td><td>0.328</td></tr><tr><td> Total stop duration (s)</td><td>312 (107)</td><td>273 (104)</td><td>359 (121)</td><td>2.207</td><td>2</td><td>.332</td><td>0.088</td></tr><tr><td> SNvpd</td><td>2.1 (1.07)</td><td>3.41 (1.62)</td><td>2.22 (2.06)</td><td>3.264</td><td>2</td><td>.196</td><td>0.131</td></tr><tr><td> Mean pen pressure</td><td>–1.2 (1.55)</td><td>0.082 (0.93)</td><td>–0.84 (1.3)</td><td>5.414</td><td>2</td><td>.061</td><td>0.217</td></tr></tbody></table> </ephtml> </p> <ulist> <item>2 <emph>Note.</emph> DG = group with DCD and/or RD; RD = reading disorder group; DCD = developmental coordination disorder group; RD+DCD = comorbid DCD/RD group and dysgraphia; BHK = <emph>Beknopte beoordelingsmethode voor kinderhandschriften</emph> [Concise Evaluation Scale for Children's Handwriting] ([<reflink idref="bib41" id="ref131">41</reflink>]); SNvpd = signal-to-noise velocity peaks difference; ε<sups>2</sups> = effect size expressed by epsilon square.</item> <item>3 <emph>p</emph> <.05.</item> </ulist> <p>Concerning the BHK scores, no significant difference between groups was observed for the quality or the speed score. Concerning the digital analysis, four kinematic features were significantly different between the subgroups of children with dysgraphia: the tracing duration, the total lift duration, the total stop duration, and the SNvpd. Post hoc analyses (see Table 4) showed that these four parameters were lower in DG-DCD children than in DG-RD, and that the total lift duration, the total stop duration, and the SNvpd were lower in DG-DCD than in DG-RD+DCD children. Note that the DG-RD+DCD children differentiated themselves only from children with DG-DCD and that the former group of children showed a much higher interquartile range than the latter.</p> <p>Table 4. Results of the Post Hoc Comparisons for Each Clinical and Digital Variable Between Children With Dysgraphia and RD, Dysgraphia and DCD, and Dysgraphia and RD+DCD groups.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th align="center">Group</th><th align="center">DG-DCD vs. DG-RD</th><th align="center">DG-DCD vs. DG-RD+DCD</th><th align="center">DG-RD vs. DG-RD+DCD</th><th align="center">DSCF</th></tr></thead><tbody><tr><td>BHK</td><td /><td /><td /><td /></tr><tr><td> Quality score</td><td>0.237 (–2.293)</td><td>0.946 (–0.449)</td><td>0.298 (2.102)</td><td /></tr><tr><td> Speed score</td><td>0.071 (–3.110)</td><td>0.152 (–2.626)</td><td>0.910 (0.584)</td><td /></tr><tr><td>Kinematic variables</td><td /><td /><td /><td /></tr><tr><td> Trace length (mm)</td><td>1.000 (0.000)</td><td>0.946 (0.448)</td><td>0.967 (0.584)</td><td /></tr><tr><td> Tracing duration (s)</td><td>0.029<xref ref-type="table-fn" rid="tfn5">*</xref> (3.601)</td><td>0.084 (3.010)</td><td>0.996 (0.117)</td><td>DG-DCD < DG-RD</td></tr><tr><td> Total lift duration (s)</td><td>0.040<xref ref-type="table-fn" rid="tfn5">*</xref> (3.437)</td><td>0.055 (3.266)</td><td>0.985 (–0.234)</td><td>DG-DCD < DG-RDDG-DCD < DG-RD+DCD</td></tr><tr><td> Total stop duration (s)</td><td>0.054 (3.27)</td><td>0.055 (3.27)</td><td>0.531 (1.52)</td><td>DG-DCD < DG-RDDG-DCD < DG-RD+DCD</td></tr><tr><td> SNvpd</td><td>0.025<xref ref-type="table-fn" rid="tfn5">*</xref> (3.69)</td><td>0.038<xref ref-type="table-fn" rid="tfn5">*</xref> (3.46)</td><td>1.000 (0.000)</td><td>DG-DCD < DG-RDDG-DCD < DG-RD+DCD</td></tr><tr><td> Mean pen pressure</td><td>0.697 (1.146)</td><td>0.294 (2.113)</td><td>0.832 (0.817)</td><td /></tr></tbody></table> </ephtml> </p> <ulist> <item>4 <emph>Note.</emph> Results are expressed as <emph>p</emph> (<emph>W</emph>). DG = group with DCD and/or RD; RD = reading disorder group; DCD = developmental coordination disorder group; RD+DCD = comorbid DCD/RD group and dysgraphia; BHK = <emph>Beknopte beoordelingsmethode voor kinderhandschriften</emph> [Concise Evaluation Scale for Children's Handwriting] ([<reflink idref="bib41" id="ref132">41</reflink>]); SNvpd = signal-to-noise velocity peaks difference; DSCF: Dwass-Steel-Critchlow-Fligner pairwise comparisons.</item> <item>5 <emph>p</emph> <.05.</item> </ulist> <hd id="AN0180675690-17">Discussion</hd> <p>Identifying and understanding the underlying deficits of dysgraphia are important for both well-targeted diagnosis and more efficient rehabilitation. In this study, we performed a fine-grained analysis of handwriting in children with DCD, RD, or comorbid DCD and RD, both at the product and at the process levels, using the BHK test recorded with a graphic tablet.</p> <hd id="AN0180675690-18">Assessment of Handwriting Among Neurodevelopmental Disorders</hd> <p>We found significant differences when comparing BHK scores among the groups of children. Children with DCD obtained the worst quality scores, while children with RD, either singular or combined with DCD, had the worst speed scores. In agreement with previous observations, children with singular RD wrote more slowly and with a relatively lower quality than the control children ([<reflink idref="bib3" id="ref133">3</reflink>]; [<reflink idref="bib17" id="ref134">17</reflink>]; [<reflink idref="bib50" id="ref135">50</reflink>]; [<reflink idref="bib77" id="ref136">77</reflink>]; [<reflink idref="bib78" id="ref137">78</reflink>]). The nature of the BHK task, which involves reading, may partly explain the writing slowness of children with RD. In addition, we found that children with singular DCD presented a very poor handwriting quality as described earlier ([<reflink idref="bib15" id="ref138">15</reflink>]; [<reflink idref="bib26" id="ref139">26</reflink>]; [<reflink idref="bib42" id="ref140">42</reflink>]; [<reflink idref="bib44" id="ref141">44</reflink>]; [<reflink idref="bib62" id="ref142">62</reflink>]; [<reflink idref="bib68" id="ref143">68</reflink>]). The DCD children did not write significantly fewer characters than the control children as the difference between CTL and DCD children was not significant for the BHK speed score. As mentioned in the introduction, discrepancies regarding writing speed were found among the publications in children with DCD ([<reflink idref="bib26" id="ref144">26</reflink>]; [<reflink idref="bib44" id="ref145">44</reflink>]; [<reflink idref="bib63" id="ref146">63</reflink>]). Our results are congruent with those of [<reflink idref="bib63" id="ref147">63</reflink>]. Using the Italian adaptation of the BHK, [<reflink idref="bib26" id="ref148">26</reflink>] showed that quality and speed scores were lower in children with DCD than in children without DCD. As this team did not control for comorbidity, one possible explanation may be the presence of comorbid RD that may also impact handwriting in the Italian DCD group. Although they all presented noticeable difficulties in the handwriting assessment, our results showed that handwriting difficulties between children with DCD and children with RD differed. While children with RD presented reduced scores both on the quality and the speed scales, children with DCD only appeared to be impaired in the quality scale. This result may reflect distinct underlying neuromotor mechanisms, and/or different strategies adopted during handwriting by RD and DCD children when completing the BHK test.</p> <p>Children presenting with both RD and DCD obtained the worst scores in both BHK scales. They were the most impaired because they wrote slowly (like RD children) and with a decreased quality and legibility (like DCD children, and with lower quality than RD children). However, they did not differ from the singular RD for the velocity, and from the singular DCD for the quality. According to our hypothesis, our results revealed that the comorbidity of these disorders adds to, but does not worsen, handwriting deficits. This additive effect is comparable with the one observed by [<reflink idref="bib30" id="ref149">30</reflink>], with children adding the difficulties associated with each of the disorders when they have a DCD and an RD. However, as children of the comorbid condition probably miss resources to overcome their difficulties, we expected these children to more often reach the clinical threshold for dysgraphia. From a clinical point of view, the number of children reaching this threshold did not differ significantly between the three groups. However, dysgraphia seems to affect a larger proportion of children with comorbid DCD and RD (68.7%) than children with DCD (53.8%) or RD (42.1%) alone in our groups, suggesting that the consequences of these disorders may be additive. Children with comorbid RD and DCD deal with both motor and linguistic difficulties, and thus would surely find fewer available resources than children with a singular disorder. From this point of view, the consequence of the comorbid condition on handwriting would rely on a synergistic interaction between DCD and RD, making the children more likely to fail the BHK test ([<reflink idref="bib71" id="ref150">71</reflink>]).</p> <hd id="AN0180675690-19">Toward Subtypes of Dysgraphia: Comparison Between Children With DCD and/or RD</hd> <p>The digital analysis of the BHK produced by children with DCD or RD was considered as a mean to better understand the commonalities and differences between handwriting difficulties in these two disorders. Furthermore, the comparison between children with singular or comorbid conditions should help to better understand the developmental trajectory of the disorders and their underlying mechanisms. When focusing on children with dysgraphia, we observed that the BHK scores did not differ between the neurodevelopmental disorders. The digital analysis of handwriting helped to go beyond the paper-and-pen approach of dysgraphia and disentangle the contribution of the children's neurodevelopmental disorders. Thus, we observed that dysgraphic children with singular RD differed from dysgraphic children with singular DCD on four kinematic variables: tracing duration, total lift duration, total stop duration, and SNvpd. In other words, dysgraphic children with RD wrote over a longer time, with a slower velocity, and had a jerkier movement with more or longer stops than dysgraphic children with DCD. In sum, children with RD were not only perturbed by the reading of the text to copy but were also slower and less fluent. Their handwriting processes resemble students who are just beginning to learn to write, that is, based on a visual control that prevents them from writing faster, as suggested by [<reflink idref="bib7" id="ref151">7</reflink>]. Concerning dysgraphic children with a DCD, the paper–pen test demonstrated that they wrote as poorly and as slowly as dysgraphic children with RD, but the processes underlying their handwriting were closer to ballistic movements than dysgraphic children with RD (higher speed, smaller tracing duration, and smoother movement). According to the internal modeling deficit hypothesis in DCD ([<reflink idref="bib1" id="ref152">1</reflink>]), our results suggest that children with DCD tend to be overconfident in the predictions they make from the efference copy, which decreases sensory processing of reafferent information and prevents them from updating the existing forward model from the online control of the pen trajectory. Consequently, their movements are faster but inaccurate.</p> <p>Overall, our results confirm that handwriting difficulties of children with RD and DCD rely, at least partly, on different underlying mechanisms and are interesting regarding the existing literature. They highlight that DCD primarily affects handwriting quality ([<reflink idref="bib42" id="ref153">42</reflink>]; [<reflink idref="bib62" id="ref154">62</reflink>]; [<reflink idref="bib71" id="ref155">71</reflink>]) while RD affects both speed and, to a lesser extent, handwriting quality ([<reflink idref="bib38" id="ref156">38</reflink>]; [<reflink idref="bib78" id="ref157">78</reflink>]). However, we did not report more frequent and longer pauses from children with DCD ([<reflink idref="bib63" id="ref158">63</reflink>], [<reflink idref="bib64" id="ref159">64</reflink>]). This discrepancy may be explained by the potential presence of comorbid RD within [<reflink idref="bib63" id="ref160">63</reflink>] group of children with DCD, as suggested by the fact that almost a third of the children within this group presented spelling difficulties. In addition, our results bring clues to the understanding of handwriting difficulties in the context of DCD or RD alone and reinforce the idea that the handwriting difficulties observed in these two disorders are related to distinct handwriting impairments.</p> <p>Finally, the digital analysis showed that at the process level, dysgraphic children with RD+DCD only differed from dysgraphic children with DCD. They showed longer lift duration and a jerkier movement than dysgraphic children with DCD. As the dysgraphic children with RD, and unlike their DCD peers, their handwriting looked like a beginner's. In sum, the results of the group comparisons suggest that dysgraphic children with both DCD and RD resemble more RD children than DCD children. The digital analysis also confirmed that comorbidity did not induce a synergistic effect, that is, increased the severity of the dysgraphia. The dysgraphic children with RD+DCD never presented poorer performances than dysgraphic children with RD who presented the most impaired movement automation. Finally, it is noteworthy that dysgraphic children with comorbid RD and DCD showed a much higher within-group variability than their peers. This high variability probably contributes to the small number of significant differences between the groups with dysgraphia in the analysis of the digital variables. This variability deserves more investigation as it might hide two or more groups of children. The first hypothesis is that some children in this group would be more greatly impaired than others, confirming that the spread of deficits causing the comorbidity could also increase the severity of symptoms ([<reflink idref="bib71" id="ref161">71</reflink>]). Another hypothesis is that some children of the RD+DCD group present more "DCD-like" perturbations and others present more "RD-like" perturbations. This point of view is compatible with [<reflink idref="bib46" id="ref162">46</reflink>] observation according to which both reading and motor skills explained the children's graphomotor production and with the multiple deficit model ([<reflink idref="bib55" id="ref163">55</reflink>]; [<reflink idref="bib60" id="ref164">60</reflink>]; [<reflink idref="bib61" id="ref165">61</reflink>]). From this point of view, the coexisting risk factors would be various and of different strengths to induce comorbid RD and DCD. This would lead to different profiles of comorbid children: the "DCD-like" and the "RD-like."</p> <hd id="AN0180675690-20">Limitations</hd> <p>The main limitation of our study concerns the sample size, which prevents us from going deeper into the characterization of different profiles within each neurodevelopmental disorder, whereas different subtypes of DCD (e.g., [<reflink idref="bib80" id="ref166">80</reflink>]), different subtypes of RD (e.g., [<reflink idref="bib18" id="ref167">18</reflink>]), and probably different subtypes of comorbid children, exist. A large-scale study would reveal the extent to which different subtypes of each neurodevelopmental disorder can lead to different types of dysgraphia. For instance, it has been suggested that different types of RD may lead to different types of dysgraphia ([<reflink idref="bib83" id="ref168">83</reflink>]). To what extent one of these two types of RD leads to writing performance closer to that of DCD children constitutes a first perspective.</p> <p>Another limitation of this study is that the BHK test is a copy task that involves reading time, which needs to be taken into account to avoid the child's slowness in writing being the result of this increased reading time. Performing this task on a graphics tablet enables us to identify pen lifts that are considered key moments for looking at the model to be copied. Nevertheless, the addition of eye-tracking would allow reading times to be better taken into account. Furthermore, our finding based on a copy task must be confirmed in a free production writing task to be replicated and generalized.</p> <p>Finally, producing the writing task when placing paper over a graphic tablet may have a double constraint that needs to be considered: On one hand, the presence of the tablet may affect the performance, as the child is placed in an unusual condition. On the other hand, to our knowledge, the potential for loss of digital measurement accuracy when placing paper over a graphic tablet has never been investigated, and could be significant in some cases.</p> <hd id="AN0180675690-21">Conclusion</hd> <p>This study provides indications to help the understanding of handwriting deficits in the context of either DCD or RD and supports the hypothesis that handwriting difficulties are related to distinct neuromotor impairments. Note that this study does not allow us to determine whether the deterioration in handwriting movements in children with RD results from a motor deficit associated with possible dyslexia (in line with the cerebellar deficit hypothesis, [<reflink idref="bib57" id="ref169">57</reflink>]; see also [<reflink idref="bib3" id="ref170">3</reflink>]), or from a linguistic deficit affecting the motor control of handwriting movements, given that motor and orthographic processes interact (e.g., [<reflink idref="bib22" id="ref171">22</reflink>]; [<reflink idref="bib47" id="ref172">47</reflink>]). These observations highlight the importance of performing a complete diagnosis of children, including an assessment of both motor and reading skills. They also give clues to potential intervention strategies to remediate handwriting deficits in children with RD, DCD, or RD+DCD. For instance, our study confirms that the slowness of writing in children with DCD is not linked to their average pen speed, but probably to macrography, that is, the tendency to write bigger, or supernumerary strokes. Consequently, a rehabilitation strategy based on the addition of spatial constraints would be more relevant than one based on the addition of temporal constraints (e.g., instruction to write faster) for children with DCD, while the reverse might be more relevant with children with RD. This study is important not only from a clinical perspective for the subsequent rehabilitation of these children by occupational therapists but also for the inclusion of children in research cohorts. The identification of subtypes of dysgraphia requires a fine-grained analysis of the handwriting process and product. In clinical practice, the test scores are not sufficient to disentangle the various difficulties. It is thus important to develop automated tools to assess handwriting at both levels for the identification of dysgraphia ([<reflink idref="bib6" id="ref173">6</reflink>]; [<reflink idref="bib24" id="ref174">24</reflink>]; [<reflink idref="bib28" id="ref175">28</reflink>]; [<reflink idref="bib72" id="ref176">72</reflink>]).</p> <hd id="AN0180675690-22">Supplemental Material</hd> <p>Graph: Supplemental material, sj-docx-1-ldx-10.1177_00222194231223528 for Dysgraphia Differs Between Children With Developmental Coordination Disorder and/or Reading Disorder by Caroline Jolly, Marianne Jover and Jérémy Danna in Journal of Learning Disabilities</p> <p>We are grateful to Mathilde Verriez for the quotation of the BHK tests and to Hervé Levaillant for his help in data analysis. We would also like to thank David Wood (English at your Service, <ulink href="http://www.eays.eu">www.eays.eu</ulink>) for revising the English of the paper.</p> <ref id="AN0180675690-23"> <title> References </title> <blist> <bibl id="bib1" idref="ref40" type="bt">1</bibl> <bibtext> Adams I. L., Lust J. M., Wilson P. H., Steenbergen B. (2014). Compromised motor control in children with DCD: A deficit in the internal model? A systematic review. Neuroscience and Biobehavioral Reviews, 47, 225–244. https://doi.org/10.1016/j.neubiorev.2014.08.011</bibtext> </blist> <blist> <bibl id="bib2" idref="ref48" type="bt">2</bibl> <bibtext> Afonso O., Suárez-Coalla P., Cuetos F. (2020). Writing impairments in Spanish children with developmental dyslexia. Journal of Learning Disabilities, 53, 109–119. https://doi.org/10.1177/0022219419876255</bibtext> </blist> <blist> <bibl id="bib3" idref="ref44" type="bt">3</bibl> <bibtext> Alamargot D., Morin M.-F., Simard-Dupuis E. (2020). Handwriting delay in dyslexia: Children at the end of primary school still make numerous short pauses when producing letters. Journal of Learning Disabilities, 53, 163–175. https://doi.org/10.1177/0022219420903705</bibtext> </blist> <blist> <bibl id="bib4" idref="ref1" type="bt">4</bibl> <bibtext> American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.</bibtext> </blist> <blist> <bibl id="bib5" idref="ref57" type="bt">5</bibl> <bibtext> Arfé B., Corato F., Pizzocaro E., Merella A. (2020). The effects of script and orthographic complexity on the handwriting and spelling performance of children with dyslexia. Journal of Learning Disabilities, 53(2), 96–108. https://doi.org/10.1177/0022219419892845</bibtext> </blist> <blist> <bibl id="bib6" idref="ref87" type="bt">6</bibl> <bibtext> Asselborn T., Gargot T., Kidziński Ł., Johal W., Cohen D., Jolly C., Dillenbourg P. (2018). Automated human-level diagnosis of dysgraphia using a consumer tablet. npj Digital Medicine, 1, Article 42. https://doi.org/10.1038/s41746-018-0049-x</bibtext> </blist> <blist> <bibl id="bib7" idref="ref115" type="bt">7</bibl> <bibtext> Barnett A. L., Connelly V., Miller B. (2019). The interaction of reading, spelling, and handwriting difficulties with writing development. Journal of Learning Disabilities, 53, 92–95. https://doi.org/10.1177/0022219419894565</bibtext> </blist> <blist> <bibl id="bib8" idref="ref8" type="bt">8</bibl> <bibtext> Barnett A. L., Prunty M. (2020). Handwriting difficulties in developmental coordination disorder (DCD). Current Developmental Disorders Reports, 8, 1–9. https://doi.org/10.1007/s40474-020-00216-8</bibtext> </blist> <blist> <bibl id="bib9" idref="ref74" type="bt">9</bibl> <bibtext> Bellocchi S., Ducrot S. (2021). Same, same but different: The optimal viewing position effect in developmental dyslexia, developmental coordination disorder and comorbid disorders. Dyslexia, 27, 297–311. https://doi.org/10.1002/dys.1688</bibtext> </blist> <blist> <bibtext> Bellocchi S., Ducrot S., Tallet J., Jucla M., Jover M. (2021). Effect of comorbid reading disorder on oculomotor behavior in children with DCD: A study with the developmental eye movement test. Human Movement Science, 76, 102764. https://doi.org/10.1016/j.humov.2021.102764</bibtext> </blist> <blist> <bibtext> Bellocchi S., Muneaux M., Huau A., Lévêque Y., Jover M., Ducrot S. (2017). Exploring the link between visual perception, visual-motor integration, and reading in normal developing and impaired children using DTVP-2. Dyslexia, 23, 296–315. https://doi.org/10.1002/dys.1561</bibtext> </blist> <blist> <bibtext> Biotteau M., Albaret J. M., Lelong S., Chaix Y. (2017). Neuropsychological status of French children with developmental dyslexia and/or developmental coordination disorder: Are both necessarily worse than one? Child Neuropsychology, 23(4), 422–441. https://doi.org/10.1080/09297049.2015.1127339</bibtext> </blist> <blist> <bibtext> Biotteau M., Péran P., Vayssière N., Tallet J., Albaret J. M., Chaix Y. (2017). Neural changes associated to procedural learning and automatization process in developmental coordination disorder and/or developmental dyslexia. European Journal of Paediatric Neurology, 21(2), 286–299. https://doi.org/10.1016/j.ejpn.2016.07.025</bibtext> </blist> <blist> <bibtext> Bishop D. V. (1983). Test for reception of grammar. Age and Cognitive Performance Research Centre, University of Manchester, M13 9PL.</bibtext> </blist> <blist> <bibtext> Bo J., Colbert A., Lee C.-M., Schaffert J., Oswald K., Neill R. (2014). Examining the relationship between motor assessments and handwriting consistency in children with and without probable developmental coordination disorder. Research in Developmental Disabilities, 35, 2035–2043. https://doi.org/10.1016/j.ridd.2014.04.027</bibtext> </blist> <blist> <bibtext> Brun-Hénin F., Velay J.-L., Beecham Y., Cariou S. (2013). Troubles d'écriture et dyslexie: Revue théorique, aspects cliniques et approche expérimentale [Handwriting disorders and dyslexia: Theoretical review, clinical aspects and experimental approach]. Développements, 13(4), 4–28. https://doi.org/10.3917/devel.013.0004</bibtext> </blist> <blist> <bibtext> Capellini S. A., Coppede A. C., Valle T. R. (2010). Fine motor function of school-aged children with dyslexia, learning disability and learning difficulties. Prò-Fono Revista de Atualizacao Cientìfica, 22, 201–208. https://doi.org/10.1590/s0104-56872010000300008</bibtext> </blist> <blist> <bibtext> Castles A., Coltheart M. (1993). Varieties of developmental dyslexia. Cognition, 47, 149–180. https://doi.org/10.1016/0010-0277(93)90003-E</bibtext> </blist> <blist> <bibtext> Charles E., Soppelsa R., Albaret J.-M. (2003). BHK: échelle d'évaluation rapide de l'écriture [BHK: Rapid Evaluation Scale of Handwriting]. ECPA.</bibtext> </blist> <blist> <bibtext> Cheng-Lai A., Li-Tsang C. W. P., Chan A. H. L., Lo A. G. W. (2013). Writing to dictation and handwriting performance among Chinese children with dyslexia: Relationships with orthographic knowledge and perceptual-motor skills. Research in Developmental Disabilities, 34(10), 3372–3383. https://doi.org/10.1016/j.ridd.2013.06.039</bibtext> </blist> <blist> <bibtext> Cignetti F., Vaugoyeau M., Fontan A., Jover M., Livet M. O., Hugonenq C., Audic F., Chabrol B., Assaiante C. (2018). Feedforward motor control in developmental dyslexia and developmental coordination disorder: Does comorbidity matter? Research in Developmental Disabilities, 76, 25–34. https://doi.org/.1016/j.ridd.2018.03.001</bibtext> </blist> <blist> <bibtext> Danna J., Longcamp M., Nalborczyk L., Velay J.-L., Commengé C., Jover M. (2022). Interaction between orthographic and graphomotor constraints in learning to write. Learning and Instruction, 80, 101622. https://doi.org/10.1016/j.learninstruc.2022.101622</bibtext> </blist> <blist> <bibtext> Danna J., Paz-Villagrán V., Velay J.-L. (2013). Signal-to-noise velocity peaks difference: A new method for evaluating the handwriting movement fluency in children with dysgraphia. Research in Developmental Disabilities, 34, 4375–4384. https://doi.org/10.1016/j.ridd.2013.09.012</bibtext> </blist> <blist> <bibtext> Deschamps L., Devillaine L., Gaffet C., Lambert R., Aloui S., Boutet J., Brault V., Labyt E., Jolly C. (2021). Development of a pre-diagnosis tool based on machine learning algorithms on the BHK test to improve the diagnosis of dysgraphia. Advances in Artificial Intelligence and Machine Learning, 1(2), 109–128. https://doi.org/10.54364/AAIML/2021.1108</bibtext> </blist> <blist> <bibtext> Dewey D. (2018). What is comorbidity and why does it matter in neurodevelopmental disorders? Current Developmental Disorders Reports, 5, 235–242. https://doi.org/.1007/s404757-018-0152.3</bibtext> </blist> <blist> <bibtext> Di Brina C., Caravale B., Mirante N. (2021). Handwriting in children with developmental coordination disorder: Is legibility the only indicator of a poor performance? Occupational Therapy in Health Care, 36(4), 353–367. https://doi.org/10.1080/07380577.2021.1986873</bibtext> </blist> <blist> <bibtext> Di Brina C., Niels R., Overvelde A., Levi G., Hulstijn W. (2008). Dynamic time warping: A new method in the study of poor handwriting. Human Movement Science, 27, 242–255. https://doi.org/10.1016/j.humov.2008.02.012</bibtext> </blist> <blist> <bibtext> Dimauro G., Bevilacqua V., Colizzi L., Di Pierro D. (2020). TestGraphia, a software system for the early diagnosis of dysgraphia. IEEE Access, 8, 1–12. https://doi.org/10.1109/ACCESS.2020.2968367</bibtext> </blist> <blist> <bibtext> Döhla D., Heim S. (2016). Developmental dyslexia and dysgraphia: What can we learn from the one about the other? Frontiers in Psychology, 6, Article 2045. https://doi.org/10.3389/fpsyg.2015.02045</bibtext> </blist> <blist> <bibtext> Downing C. (2018). Understanding writing difficulties amongst children with neurodevelopmental disorders. The Cases of dyslexia and/or developmental coordination disorder (DCD) [PhD Manuscript]. Bangor University. https://research.bangor.ac.uk/portal/en/theses/understanding-writing-difficulties-amongst-children-with-neurodevelopmental-disorders(24b0633f-1586-4ac0-b758-89a7b1e0ba8a).html</bibtext> </blist> <blist> <bibtext> Downing C., Caravolas M. (2018, July). Handwriting legibility reflects spelling difficulties in dyslexia but not in developmental coordination disorder (DCD) [Paper presentation]. 25th Annual Meeting of the Society for the Scientific Study of Reading, Brighton, UK.</bibtext> </blist> <blist> <bibtext> Downing C., Caravolas M. (2020). Prevalence and cognitive profiles of children with comorbid literacy and motor disorders. Frontiers in Psychology, 11, Article 1097. https://doi.org/10.3389/fpsyg.2020.573580</bibtext> </blist> <blist> <bibtext> Downing C., Caravolas M. (2023). Handwriting legibility and fluency and their patterns of concurrent relations with spelling, graphomotor, and selective attention skills. Journal of Experimental Child Psychology, 236, 105756. https://doi.org/10.1016/j.jecp.2023.105756</bibtext> </blist> <blist> <bibtext> Flessas J., Lussier F. (2003). EVAC–Epreuve Verbale d'Aptitudes Cognitives [EVAC–Verbal Cognitive Aptitude Test]. ECPA.</bibtext> </blist> <blist> <bibtext> Gargot T., Asselborn T., Pellerin H., Zammouri I., Anzalone S. M., Casteran L., Johal W., Dillenbourg P., Cohen D., Jolly C. (2020). Acquisition of handwriting in children with and without dysgraphia: A computational approach. PLOS ONE, 15(9), Article e0237575. https://doi.org/10.1371/journal.pone.0237575</bibtext> </blist> <blist> <bibtext> Geuze R. H. (2005). Postural control in children with developmental coordination disorder. Neural Plasticity, 12(2–3), 183–196. https://doi.org/10.1155/NP.2005.183</bibtext> </blist> <blist> <bibtext> Gosse C., Dricot L., Van Reybroeck M. V. (2022). Evidence of graphomotor dysfunction in children with dyslexia: A combined behavioural and fMRI experiment. Cortex, 148, 68–88. https://doi.org/10.1016/j.cortex.2021.11.021</bibtext> </blist> <blist> <bibtext> Gosse C., Van Reybroeck M. (2020). Do children with dyslexia present a handwriting deficit? Impact of word orthographic and graphic complexity on handwriting and spelling performance. Research in Developmental Disabilities, 97, 103553. https://doi.org/10.1016/j.ridd.2019.103553</bibtext> </blist> <blist> <bibtext> Grégoire J. (2006). L'examen clinique de l'intelligence de l'enfant: Fondements et pratique du WISC IV [Clinical evaluation of child intelligence: Fundamentals and Practice]. Mardaga.</bibtext> </blist> <blist> <bibtext> Hamstra-Bletz E., Blöte A. W. (1990). Development of handwriting in primary school: A longitudinal study. Perceptual and Motor Skills, 70, 759–770. https://doi.org/10.2466/PMS.70.3.759-770</bibtext> </blist> <blist> <bibtext> Hamstra-Bletz E., de Bie J., den Brinker B. P. L. M. (1987). Beknopte beoordelingsmethode voor kinderhandschriften [Concise Evaluation Scale for Children's Handwriting]. Swets & Zeitlinger.</bibtext> </blist> <blist> <bibtext> Huau A., Velay J.-L., Jover M. (2015). Graphomotor skills in children with developmental coordination disorder (DCD): Handwriting and learning a new letter. Human Movement Science, 42, 318–332. https://doi.org/10.1016/j.humov.2015.03.008</bibtext> </blist> <blist> <bibtext> Jacquier-Roux M., Valdois S., Zorman M., Lequette C., Pouget G. (2005). Odédys-2: outils de dépistage des dyslexies [Odedys-2: Dyslexia screening tools]. Laboratoire Cogni-Sciences.</bibtext> </blist> <blist> <bibtext> Jolly C., Gentaz E. (2014). Analysis of cursive letters, syllables, and words handwriting in a French second-grade child with developmental coordination disorder and comparison with typically developing children. Frontiers in Psychology, 4, Article 1022. https://doi.org/10.3389/fpsyg.2013.01022</bibtext> </blist> <blist> <bibtext> Jover M., Ducrot S., Huau A., Bellocchi S., Brun-Hénin F., Mancini J. (2013). Les troubles moteurs chez les enfants dyslexiques: Revue de travaux et perspectives [Motor disorders in dyslexic children: Review and perspectives]. Enfance, 4, 323–347. https://doi.org/10.4074/S0013754513004023</bibtext> </blist> <blist> <bibtext> Jover M., Huau A. (2021). Approche dimensionnelle de la comorbidité entre trouble développemental de la coordination et trouble spécifique de l'apprentissage de la lecture: étude sur la graphomotricité [A dimensional approach to comorbidity between developmental coordination disorder and dyslexia: A study of graphomotor abilities]. Approche Neuropsychologique des Apprentissages chez l'Enfant, 175, 673–688.</bibtext> </blist> <blist> <bibtext> Kandel S., Perret C. (2015). How does the interaction between spelling and motor processes build up during writing acquisition? Cognition, 136, 325–336. https://doi.org/10.1016/j.cognition.2014.11.014</bibtext> </blist> <blist> <bibtext> Kaplan B. J., Dewey D. M., Crawford S. G., Wilson B. N. (2001). The term comorbidity is of questionable value in reference to developmental disorders: Data and theory. Journal of Learning Disabilities, 34(6), 555–565. https://doi.org/10.1177/002221940103400608</bibtext> </blist> <blist> <bibtext> Keith T. Z., Fine J. G., Taub G. E., Reynolds M. R., Kranzler J. H. (2006). Higher order, multisample, confirmatory factor analysis of the Wechsler Intelligence Scale for Children–Fourth Edition: What does it measure. School Psychology Review, 35(1), 108–127.</bibtext> </blist> <blist> <bibtext> Lam S. S. T., Au R. K. C., Leung H. W. H., Li-Tsang C. W. P. (2011). Chinese handwriting performance of primary school children with dyslexia. Research in Developmental Disabilities, 32(5), 1745–1756. https://doi.org/.1016/j.ridd.2011.03.001</bibtext> </blist> <blist> <bibtext> Lecocq P. (1996). E.CO.S.SE: Epreuve de Compréhension Syntaxico-Sémantique [E.CO.S.SE: Syntactic-semantic comprehension test]. Presses Universitaires du Septentrion.</bibtext> </blist> <blist> <bibtext> Lefavrais P. (2005). Test de l'Alouette, version révisée [Alouette test, revised version]. ECPA.</bibtext> </blist> <blist> <bibtext> Lopez C., Hemimou C., Golse B., Vaivre-Douret L. (2018). Developmental dysgraphia is often associated with minor neurological dysfunction in children with developmental coordination disorder (DCD). Neurophysiologie Clinique, 48, 207–217. https://doi.org/10.1016/j.neucli.2018.01.002</bibtext> </blist> <blist> <bibtext> Maziero S., Tallet J., Bellocchi S., Jover M., Chaix Y., Jucla M. (2020). Influence of comorbidity on working memory profile in dyslexia and developmental coordination disorder. Journal of Clinical and Experimental Neuropsychology, 42(7), 660–674. https://doi.org/10.1080/13803395.2020.1798880</bibtext> </blist> <blist> <bibtext> McGrath L. M., Peterson R. L., Pennington B. F. (2020). The multiple deficit model: Progress, problems, and prospects. Scientific Studies of Reading, 24, 7–13. https://doi.org/10.1080/10888438.2019.1706180</bibtext> </blist> <blist> <bibtext> Miller L. T., Missiuna C. A., Macnab J. J., Malloy-Miller T., Polatajko H. J. (2001). Clinical description of children with developmental coordination disorder. Canadian Journal of Occupational Therapy, 68(1), 5–15. https://doi.org/10.1177/000841740106800101</bibtext> </blist> <blist> <bibtext> Nicolson R. I., Fawcett A. J., Dean P. (2001). Developmental dyslexia: The cerebellar deficit hypothesis. Trends in Neuroscience, 9, 508–511. https://doi.org/10.1016/s0166-2236(00)01896-8</bibtext> </blist> <blist> <bibtext> O'Hare A., Khalid S. (2002). The association of abnormal cerebellar function in children with developmental coordination disorder and reading difficulties. Dyslexia, 8(4), 234–248. https://doi.org/10.1002/dys.230</bibtext> </blist> <blist> <bibtext> Pagliarini E., Guasti M. T., Toneatto C., Granocchio E., Riva F., Sarti D., Molteni B., Stucchi N. (2015). Dyslexic children fail to comply with the rhythmic constraints of handwriting. Human Movement Science, 42, 161–182. https://doi.org/10.1016/j.humov.2015.04.012</bibtext> </blist> <blist> <bibtext> Pennington B. F. (2006). From single to multiple deficit models of developmental disorders. Cognition, 101(2), 385–413. https://doi.org/10.1016/j.cognition.2006.04.008</bibtext> </blist> <blist> <bibtext> Pennington B. F., McGrath L. M., Peterson R. L. (2019). Diagnosing Learning disorders. From science to practice (3rd ed.). Guilford Press.</bibtext> </blist> <blist> <bibtext> Prunty M. M., Barnett A. L. (2020). Accuracy and consistency of letter formation in children with developmental coordination disorder. Journal of Learning Disabilities, 53, 120–130. https://doi.org/10.1177/0022219419892851</bibtext> </blist> <blist> <bibtext> Prunty M. M., Barnett A. L., Wilmut K., Plumb M. S. (2013). Handwriting speed in children with developmental coordination disorder: Are they really slower? Research in Developmental Disabilities, 34, 2927–2936. https://doi.org/10.106/j.ridd.2013.06.005</bibtext> </blist> <blist> <bibtext> Prunty M. M., Barnett A. L., Wilmut K., Plumb M. S. (2014). An examination of writing pauses in the handwriting of children with developmental coordination disorder. Research in Developmental Disabilities, 35, 2894–2905. https://doi.org/10.106/j.ridd.2014.07.033</bibtext> </blist> <blist> <bibtext> Prunty M. M., Pratt A., Raman E., Simmons L., Steele-Bobat F. (2020). Grip strength and pen pressure are not key contributors to handwriting difficulties in children with developmental coordination disorder. The British Journal of Occupational Therapy, 83, 387–396. https://doi.org/10.1177/0308022619885046</bibtext> </blist> <blist> <bibtext> Ramus F., Pidgeon E., Frith U. (2003). The relationship between motor control and phonology in dyslexic children. The Journal of Child Psychology and Psychiatry, 44(5), 712–722. https://doi.org/10.1111/1469-7610.00157</bibtext> </blist> <blist> <bibtext> Rochelle K. S. H., Witton A., Talcott J. B. (2009). Symptoms of hyperactivity and inattention can mediate deficits of postural stability in developmental dyslexia. Experimental Brain Research, 192, 627–633. https://doi.org/10.1007/s00221-008-1568-5</bibtext> </blist> <blist> <bibtext> Rosenblum S., Livneh-Zirinski M. (2008). Handwriting process and product characteristics of children diagnosed with developmental coordination disorder. Human Movement Science, 27, 200–214. https://doi.org/10.106/j.humov.2008.02.011</bibtext> </blist> <blist> <bibtext> Rosenblum S., Parush S., Weiss P. L. (2003). The in-air phenomenon: Temporal and spatial correlates of the handwriting process. Perceptual and Motor Skills, 96(3), 933–954. https://doi.org/10.2466/pms.2003.96.3.933</bibtext> </blist> <blist> <bibtext> Rosenblum S., Regev N. (2013). Timing abilities among children with developmental coordination disorders (DCD) in comparison to children with typical development. Research in Developmental Disabilities, 34(1), 218–227. https://doi.org/10.1016/j.ridd.2012.07.011</bibtext> </blist> <blist> <bibtext> Schoemaker M. M., Lingam R., Jongmans M. J., van Heuvelen M. J., Emond A. (2013). Is severity of motor coordination difficulties related to co-morbidity in children at risk for developmental coordination disorder? Research in Developmental Disabilities, 34, 3084–3091. https://doi.org/10.1016/j.ridd.2013.06.028</bibtext> </blist> <blist> <bibtext> Sihwi S. W., Fikri K., Aziz A. (2019). Dysgraphia identification from handwriting with support vector machine method. Journal of Physics: Conference Series, 1201, 012050. https://doi.org/10.1088/1742-6596/1201/1/012050</bibtext> </blist> <blist> <bibtext> Smits-Engelsman B., Schoemaker M., Delabastita T., Hoskens J., Geuze R. (2015). Diagnostic criteria for DCD: Past and future. Human Movement Science, 42, 293–306. https://doi.org/10.1016/j.humov.2015.03.010</bibtext> </blist> <blist> <bibtext> Smits-Engelsman B. C. M., Niemeijer A. S., van Galen G. P. (2001). Fine motor deficiencies in children diagnosed as DCD based on poor grapho-motor ability. Human Movement Science, 20(1–2), 161–182. https://doi.org/10.1016/s0167-9457(01)00033-1</bibtext> </blist> <blist> <bibtext> Smits-Engelsman B. C. M., Jover M., Green D., Ferguson G., Wilson P. (2017). DCD and comorbidity in neurodevelopmental disorder: How to deal with complexity? Human Movement Science, 53, 1–4. https://doi.org/10.1016/j.humov.2017.02.009</bibtext> </blist> <blist> <bibtext> Soppelsa R., Albaret J.-M. (2004). Manuel de la Batterie d'Evaluation du Mouvement chez l'Enfant (M-ABC) [Manual of the movement assessment battery for children]. ECPA.</bibtext> </blist> <blist> <bibtext> Sovik N., Arntzen O., Thygesen R. (1987). Relation of spelling and writing in learning disabilities. Perceptual and Motor Skills, 64(1), 219–236. https://doi.org/10.2466/pms.1987.64.1.219</bibtext> </blist> <blist> <bibtext> Sumner E., Connelly V., Barnett A. L. (2013). Children with dyslexia are slow writers because they pause more often and not because they are slow at handwriting execution. Reading and Writing, 26(6), 991–1008. https://doi.org/10.1007/s11145-012-9403-6</bibtext> </blist> <blist> <bibtext> Sumner E., Connelly V., Barnett A. L. (2014). The influence of spelling ability on handwriting production: Children with and without dyslexia. Journal of Experimental Psychology: Learning, Memory, and Cognition, 40(5), 1441–1447. https://doi.org/10.1037/a0035785</bibtext> </blist> <blist> <bibtext> Vaivre-Douret L., Lalanne C., Ingster-Moati I., Boddaert N., Cabrol D., Dufier J.-L. (2011). Subtypes of developmental coordination disorder: Research on their nature and etiology. Developmental Neurospychology, 36(5), 614–643. https://doi.org/10.1080/87565641.2011.560696</bibtext> </blist> <blist> <bibtext> Van Galen G. P., Portier S. J., Smits-Engelsman B. C. M., Schomaker L. R. B. (1993). Neuromotor noise and poor handwriting in children. Acta Psychologica, 82, 161–178. https://doi.org/10.1016/0001-6918(93)90010-o</bibtext> </blist> <blist> <bibtext> Wechsler D. (2005). WISC-IV—Echelle d'intelligence de Wechsler pour enfants et adolescents—4ème edition [Wechsler Intelligence Scale for Children and Adolescents, 4th edition]. ECPA.</bibtext> </blist> <blist> <bibtext> Zoccolotti P., Friedmann N. (2010). From dyslexia to dyslexias, from dysgraphia to dysgraphias, from a cause to causes: A look at current research on developmental dyslexia and dysgraphia. Cortex, 46, 1211–1215. https://doi.org/10.1016/j.cortex.2010.09.003</bibtext> </blist> </ref> <ref id="AN0180675690-24"> <title> Footnotes </title> <blist> <bibtext> The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.</bibtext> </blist> <blist> <bibtext> This work was supported by a grant from The French National Research Agency (ANR DYSTAC-MAP, ANR-13-APPR-0010-01) and was carried out within the "Institut Convergence ILCB" (ANR-11-LABX-0036). This work was promoted by The French National Research Agency (grant number ANR DYSTAC-MAP, ANR-13-APPR-0010-01) and was carried out within the "Institut Convergence ILCB" (ANR-11-LABX-0036).</bibtext> </blist> <blist> <bibtext> Caroline Jolly</bibtext> </blist> <blist> <bibtext>Graph https://orcid.org/0000-0002-5726-4184</bibtext> </blist> <blist> <bibtext> Supplemental material for this article is available at https://doi.org/10.1177/00222194231223528</bibtext> </blist> </ref> <aug> <p>By Caroline Jolly; Marianne Jover and Jérémy Danna</p> <p>Reported by Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib48" firstref="ref2"></nolink> <nolink nlid="nl2" bibid="bib66" firstref="ref3"></nolink> <nolink nlid="nl3" bibid="bib67" firstref="ref4"></nolink> <nolink nlid="nl4" bibid="bib61" firstref="ref5"></nolink> <nolink nlid="nl5" bibid="bib75" firstref="ref6"></nolink> <nolink nlid="nl6" bibid="bib25" firstref="ref7"></nolink> <nolink nlid="nl7" bibid="bib26" firstref="ref9"></nolink> <nolink nlid="nl8" bibid="bib42" firstref="ref10"></nolink> <nolink nlid="nl9" bibid="bib53" firstref="ref11"></nolink> <nolink nlid="nl10" bibid="bib58" firstref="ref12"></nolink> <nolink nlid="nl11" bibid="bib80" firstref="ref13"></nolink> <nolink nlid="nl12" bibid="bib36" firstref="ref14"></nolink> <nolink nlid="nl13" bibid="bib56" firstref="ref15"></nolink> <nolink nlid="nl14" bibid="bib68" firstref="ref17"></nolink> <nolink nlid="nl15" bibid="bib15" firstref="ref18"></nolink> <nolink nlid="nl16" bibid="bib44" firstref="ref21"></nolink> <nolink nlid="nl17" bibid="bib62" firstref="ref22"></nolink> <nolink nlid="nl18" bibid="bib63" firstref="ref23"></nolink> <nolink nlid="nl19" bibid="bib64" firstref="ref24"></nolink> <nolink nlid="nl20" bibid="bib69" firstref="ref25"></nolink> <nolink nlid="nl21" bibid="bib74" firstref="ref26"></nolink> <nolink nlid="nl22" bibid="bib70" firstref="ref28"></nolink> <nolink nlid="nl23" bibid="bib27" firstref="ref31"></nolink> 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bibid="bib10" firstref="ref67"></nolink> <nolink nlid="nl41" bibid="bib12" firstref="ref68"></nolink> <nolink nlid="nl42" bibid="bib13" firstref="ref69"></nolink> <nolink nlid="nl43" bibid="bib21" firstref="ref70"></nolink> <nolink nlid="nl44" bibid="bib32" firstref="ref71"></nolink> <nolink nlid="nl45" bibid="bib54" firstref="ref72"></nolink> <nolink nlid="nl46" bibid="bib11" firstref="ref76"></nolink> <nolink nlid="nl47" bibid="bib30" firstref="ref79"></nolink> <nolink nlid="nl48" bibid="bib60" firstref="ref80"></nolink> <nolink nlid="nl49" bibid="bib31" firstref="ref84"></nolink> <nolink nlid="nl50" bibid="bib23" firstref="ref86"></nolink> <nolink nlid="nl51" bibid="bib35" firstref="ref88"></nolink> <nolink nlid="nl52" bibid="bib41" firstref="ref89"></nolink> <nolink nlid="nl53" bibid="bib19" firstref="ref90"></nolink> <nolink nlid="nl54" bibid="bib52" firstref="ref92"></nolink> <nolink nlid="nl55" bibid="bib43" firstref="ref93"></nolink> <nolink nlid="nl56" bibid="bib34" firstref="ref94"></nolink> <nolink nlid="nl57" bibid="bib51" firstref="ref95"></nolink> <nolink nlid="nl58" bibid="bib82" firstref="ref96"></nolink> <nolink nlid="nl59" bibid="bib39" firstref="ref97"></nolink> <nolink nlid="nl60" bibid="bib49" firstref="ref98"></nolink> <nolink nlid="nl61" bibid="bib14" firstref="ref102"></nolink> <nolink nlid="nl62" bibid="bib76" firstref="ref106"></nolink> <nolink nlid="nl63" bibid="bib73" firstref="ref107"></nolink> <nolink nlid="nl64" bibid="bib40" firstref="ref122"></nolink> <nolink nlid="nl65" bibid="bib71" firstref="ref150"></nolink> <nolink nlid="nl66" bibid="bib55" firstref="ref163"></nolink> <nolink nlid="nl67" bibid="bib18" firstref="ref167"></nolink> <nolink nlid="nl68" bibid="bib83" firstref="ref168"></nolink> <nolink nlid="nl69" bibid="bib57" firstref="ref169"></nolink> <nolink nlid="nl70" bibid="bib22" firstref="ref171"></nolink> <nolink nlid="nl71" bibid="bib47" firstref="ref172"></nolink> <nolink nlid="nl72" bibid="bib24" firstref="ref174"></nolink> <nolink nlid="nl73" bibid="bib28" firstref="ref175"></nolink> <nolink nlid="nl74" bibid="bib72" firstref="ref176"></nolink>
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  Data: Dysgraphia Differs between Children with Developmental Coordination Disorder and/or Reading Disorder
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  Data: <searchLink fieldCode="AR" term="%22Caroline+Jolly%22">Caroline Jolly</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-5726-4184">0000-0002-5726-4184</externalLink>)<br /><searchLink fieldCode="AR" term="%22Marianne+Jover%22">Marianne Jover</searchLink><br /><searchLink fieldCode="AR" term="%22Jérémy+Danna%22">Jérémy Danna</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Learning+Disabilities%22"><i>Journal of Learning Disabilities</i></searchLink>. 2024 57(6):397-410.
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  Data: SAGE Publications and Hammill Institute on Disabilities. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
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  Data: 14
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  Data: 2024
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  Data: Journal Articles<br />Reports - Research
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  Data: <searchLink fieldCode="EL" term="%22Elementary+Education%22">Elementary Education</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Learning+Disabilities%22">Learning Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Neurodevelopmental+Disorders%22">Neurodevelopmental Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Handwriting%22">Handwriting</searchLink><br /><searchLink fieldCode="DE" term="%22Students+with+Disabilities%22">Students with Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Differences%22">Differences</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Reading+Difficulties%22">Reading Difficulties</searchLink><br /><searchLink fieldCode="DE" term="%22Comorbidity%22">Comorbidity</searchLink><br /><searchLink fieldCode="DE" term="%22Handheld+Devices%22">Handheld Devices</searchLink><br /><searchLink fieldCode="DE" term="%22Developmental+Disabilities%22">Developmental Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Perceptual+Motor+Coordination%22">Perceptual Motor Coordination</searchLink><br /><searchLink fieldCode="DE" term="%22Intelligence+Tests%22">Intelligence Tests</searchLink><br /><searchLink fieldCode="DE" term="%22Disability+Identification%22">Disability Identification</searchLink><br /><searchLink fieldCode="DE" term="%22Rehabilitation%22">Rehabilitation</searchLink><br /><searchLink fieldCode="DE" term="%22French%22">French</searchLink><br /><searchLink fieldCode="DE" term="%22Native+Speakers%22">Native Speakers</searchLink><br /><searchLink fieldCode="DE" term="%22Handedness%22">Handedness</searchLink><br /><searchLink fieldCode="DE" term="%22Reading+Skills%22">Reading Skills</searchLink><br /><searchLink fieldCode="DE" term="%22Psychomotor+Skills%22">Psychomotor Skills</searchLink><br /><searchLink fieldCode="DE" term="%22Elementary+School+Students%22">Elementary School Students</searchLink>
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  Data: 10.1177/00222194231223528
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  Data: 0022-2194<br />1538-4780
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  Data: Handwriting deficits, or dysgraphia, are present in several neurodevelopmental disorders. To investigate whether dysgraphia differs according to the associated disorder, we performed a detailed analysis of handwriting in a group of French children with developmental coordination disorders (DCD), reading disorder (RD), or comorbid RD and DCD. Handwriting deficits were investigated at the product (quality of the trace) and the process (movement that generates the trace) levels. Nineteen children with singular RD (among which eight with dysgraphia), 13 children with singular DCD (among which seven with dysgraphia), 16 children with comorbid RD+DCD (among which 11 with dysgraphia), and 20 typically developing children, age 7 to 12, performed the BHK (Brave Handwriting Kinder) test, a standardized assessment of handwriting, on a graphic tablet. Developmental coordination disorders primarily affected handwriting quality, while RD affected slowness and, to a lesser extent, quality. Children with RD, solely or comorbid with DCD, wasted time by lifting and stopping the pen when writing. The comorbidity added to but did not worsen, handwriting difficulties. These results reflect distinct motor impairments and/or strategies in children with DCD or RD. We identified subtypes of dysgraphia and advocated for a fine-grained analysis of the writing process and the assessment of motor and reading skills when studying dysgraphia.
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  Data: 2024
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        PageCount: 14
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      – SubjectFull: Learning Disabilities
        Type: general
      – SubjectFull: Neurodevelopmental Disorders
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      – SubjectFull: Handwriting
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      – SubjectFull: Students with Disabilities
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      – SubjectFull: Wechsler Intelligence Scale for Children
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      – TitleFull: Dysgraphia Differs between Children with Developmental Coordination Disorder and/or Reading Disorder
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            NameFull: Jérémy Danna
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 11
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 0022-2194
            – Type: issn-electronic
              Value: 1538-4780
          Numbering:
            – Type: volume
              Value: 57
            – Type: issue
              Value: 6
          Titles:
            – TitleFull: Journal of Learning Disabilities
              Type: main
ResultId 1