OTS 31: Unpacking Dysgraphia Featuring Cheri Dotterer, MS, OTR/L
- Jayson Davies
- May 27, 2019
- 40 min read
Updated: May 13
Press play below to listen to the podcast
Or click on your preferred podcast player link!
Welcome to the show notes for Episode 31 of the OT Schoolhouse Podcast.
Just when Dyslexia seemed to be the new buzzword in IEP meetings, Dysgraphia and Dyscalculia joined in on the fun. Dysgraphia, especially, has cemented itself into the confines of the Occupational Therapy world. If there is an IEP team using the word Dysgraphia, there is sure to be an OT evaluation to follow.
In this episode of the OT Schoolhouse Podcast, Jayson interviews the author of the Handwriting Brain-Body DisConnect, Cheri Dotterer, MS, OTR/L.
Cheri has been an Occupational Therapist for over 20 years. Much of that time has been serving students who have been referred to her for handwriting concerns. With that said, it was her own children's struggles that really got her into studying Dyslexia, Dysgraphia, and Dyscalculia.
Listen in on this episode to learn how Cheri defines Dysgraphia and explains what the six types of Dysgraphia are. She also shares how we as OTs can help students to overcome some of the problems they face by using the Motor Learning Model and The Sensory Integration Model.
Links to Show References:
Quick reminder: Links to Amazon.com and other websites on this page may be affiliate links. Affiliate links benefit the OT Schoolhouse at no additional cost to you. I appreciate your support by using these links.
The below references were mentioned throughout Episode 31
Handwriting Brain-Body DisConnect:
Adaptive teaching techniques to unlock a child’s dysgraphia for the classroom and at home
By Cheri Dotterer, MS, OTR/L
Email Cheri at info@Dysgraphiaconsultant.com
Body Sentence Alphabet at DysgraphiaConsultant.com
Beth Pfeiffer, Beverly Moskowitz, Andrew Paoletti, Eugene Brusilovskiy, Sheryl Eckberg Zylstra, Tammy Murray; Developmental Test of Visual–Motor Integration (VMI): An Effective Outcome Measure for Handwriting Interventions for Kindergarten, First-Grade, and Second-Grade Students?. Am J Occup Ther 2015;69(4):6904350010p1-6904350010p7. DOI: 10.5014/ajot.2015.015826.
This is the article in the AJOT referenced by Cheri regarding the Test of Visual-Motor Integration
Size Matters Handwriting Program Paper
Cheri's recommended paper for teaching Handwriting
Our featured listener question was from Laura @TheOTButterfly on Instagram
Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs.
Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com
Well,
Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts
Episode Transcript
Expand to view the full episode transcript
Amazing Narrator
Hello and welcome to the OT school house podcast. Your source for school based occupational therapy tips, interviews and professional development now to get the conversation started, here is your host, Jayson Davies, class is officially in session.
Jayson Davies
Hey everyone, and welcome to the OT school house podcast. My name is Jayson Davies, and this is episode 31 where we're going to talk about dysgraphia, and we're going to unpack a little bit about what dysgraphia is with Cheri, daughter of the dysgraphia consultant.com she also has a new book that we're going to talk a little bit about. You guessed it, it's about dysgraphia, and can't wait to get to that. But first, just a few things. I'm super excited for two reasons. One is that you are here listening to this podcast. And two, because it's the end of May, I just want to congratulate everyone, myself included, honestly, that we got through another school year and now we get to celebrate a little bit. Yeah, maybe, maybe you got to work a little extended school year, es, y, but yeah, it's a little bit more chill, and we get to get have some fun, get out and have a vacation. So I'm excited for that. I'm excited for you to all have a great vacation. I'm also excited for summer because I'm gonna get to do what I haven't done in a long time, and that is to produce some solo episodes for you. We're gonna take out the guests. We're going to just strip it down a little bit and talk about the nitty gritty ot in the schools. I have a few episodes that I want to get together that's just going to be me talking to you, and I can't wait for that. So, yeah, it's going to be fun. Can't wait. The only other thing I have to say before we jump into this episode is that we actually do something a little bit different, and that we are doing a giveaway at the end of this episode. So last 10 minutes or so, we're actually going to give away two copies of Cheri's book, handwriting, brain, body, disconnect, adaptive teaching techniques to unlock a child's dysgraphia for the classroom and at home. So stay tuned. Like I said, last 10 minutes or so, we're going to give those two books away, and that's going to be in a week from now, actually. So you have to do something between now and a week from now in order to earn those books. So stay tuned. Sit back. Enjoy some wonderful communication dialog about dysgraphia. You're going to learn a lot. I did. I already took my notes. Oh, you may want to grab a pencil and paper right now. There's some good stuff coming up. So here is Cheri Dotterer. Hi Cheri. Welcome to the OT school health podcast. How are you doing this evening?
Cheri Dotterer
Oh, I am doing wonderful. I am so excited to be here. It's amazing. This technology talking to you here in Pennsylvania, all the way over in California, that blows my mind, yeah,
Jayson Davies
even though we did just have some technical difficulties, we've got it all going now. It is awesome. You can't get enough of zoom, Skype, whatever platform you're using. It's all authentic, amazing.
Cheri Dotterer
It's amazing. And there are so many teachers and OTs that I've been talking with via phone. They're like, I don't know about that zoom thing. And so we need to get them out, get used to the fact that this new technology is out there, and it's not that scary, no.
Jayson Davies
And I mean, we already had one episode on telehealth, and that's exactly what they're doing. They're using zoom or Skype or some other platform, and it's just the way that the world is going now, whether you're in business, whether you're an OT a teacher, you're going to have to be using this type of platform.
Cheri Dotterer
Yep, and, and I might be answering a question ahead of time, but I work in cyber schools, so that's how the kids are going to school. They're sitting at home, they're going on to zoom, and they're seeing their teacher and their other students, and they're getting educated from the chair in their office or their bedroom or their living room on the sofa. Who knows where they're sitting, oftentimes, but their kids are learning from the from this platform. It's amazing, yeah,
Jayson Davies
and, well, I mean, let's just keep going then, I mean, we're here to talk about dysgraphia, but I do want to talk a little bit about you and how you got to where you are now. And so you said you work with cyber schools, but you yourself actually go house to house, correct.
Cheri Dotterer
That is correct. So the students are going to cyber. So there's different platforms. They are that is of actually a public school in Pennsylvania, there is different than homeschooling. Homeschooling, they for fit their special education rights under IDEA. When they're cyber, they it's a public school, so it's fully funded under IDEA, and it has all the rules that special education carries, except they're going to school at home. So you get an IEP, you have a 504 plan. You have all those pieces that we talk about when we're working in school based therapy. Then there are charter school. Schools in Pennsylvania, those are in person schools, but they are special. So they could be a dyslexia school, it could be a autism school, it could be a school for ADHD. Then there are some other platforms, and then you have private schools in Pennsylvania, which didn't also forfeit their FAPE and their special education pieces, some of the charters do that all depends on the platform that they've chosen to be on.
Jayson Davies
Gotcha. So in California, we have what's called MPAs, or non public agencies, and then or NPS is sorry, we have MPAs, but we also have NPS, which is non public school, and that's typically where we have some of our more higher needs populations, that it could be like a very specific autism program or something like that, and it is actually a, typically, it's an IEP team decision to send that kid the district is saying we don't have the resources for that student. This is a placement that weekends we can offer your students.
Cheri Dotterer
We call them APs. Is in Pennsylvania, approved private schools. Okay? Same thing, different terms. The difference between an approved private school and a charter school as well. So it's very it gets very complex when you get down to the nitty gritty and really start to understand what all the laws are about. Incidentally, sidebar, cyber schools originated in Pennsylvania, which is very unusual, because usually Pennsylvania is one of the last thing people to implement, but they implemented them in 1988 because there was a school in western Pennsylvania, a middle school, that basically burnt down, and they had a find a way to educate these students. They were sending them over the border into Ohio. But the Ohio laws and the Pennsylvania laws were not meshing too great, and they needed to get them back. So cyber schools started out of necessity, wow. And then they expanded across the nation.
Jayson Davies
Yeah, that's crazy. And yeah, like we already talked about everything's just going digital nowadays. So yeah, so
Cheri Dotterer
I know that wasn't even anything that we were going to talk about. But, you know, we need to educate the OTs as to how the cyber world got started, because not everybody has been working in that platform. It is a new emerging field.
Jayson Davies
Yeah, well, that's just like extra Indians in baseball. You know, once it goes past nine innings, you get free, free baseball. Well, here we're giving free content, free extra stuff, not just describe, yeah. All right, well, so we got into a little bit, but little bit about what you're doing now, but tell us a little bit about the history. How did you get into how did I get here?
Cheri Dotterer
Well, I started college thinking I wanted to work at Fox Chase in the cancer unit, doing medical technology. Didn't happen. I what I grew to not particularly care for test tubes and wanted to work with people, but still wanted to work in the science field. I found out about ot in January, and by June, I was in OT school. Wow. I had already had a bachelor's degree in biochemistry, okay? And ended up, three years later, going back to school, and then I went back a second time and got my master's degree, because when I got it many, many moons ago, anyway, I went and got my master's degree. And about two years into my master's program where I was taking one class at a time. Mind you, I couldn't do it any other way. They started the OTD programs, and I didn't feel that I should switch, but I still feel that my education was just as intense as getting an OTD program. Okay, because I got an advanced masters. So that what led me into where I am now, when I was in my master's program, I took some business courses because I really wanted to be in private practice. Really wanted to start working with kids. I had been working in adults for years, and I really wanted to work with kids. I actually started in schools without any knowledge of school at all. I started my own private practice. Had no support except for who I was calling on the phone. It was bizarre. It was a crazy first year, but I worked with two CODAs that were absolutely amazing, and had an OT that I called on the phone almost every night, crying. Why did I do this to myself?
Jayson Davies
So were you working in, you said schools, but you said you started your own private practice. Were you in a clinic that was contracting or how did you do it?
Cheri Dotterer
I worked with a school based brick and mortar ot practice. Yes, and had this the cyber schools privately on the side. So I was working with another company as well to get some get some assistance, to get some help, get some idea what I was doing. But I'll tell you what the first when you walk into a classroom and you're going, what am I doing? I'm supposed to be helping handwriting. What does that mean? I was helping somebody's hand that wasn't working before. What do you mean I their hand is working? So it really was an eye opening experience walking in and really understanding what it meant for an OT to be doing handwriting? Yeah, definitely.
Jayson Davies
And I mean, that kind of leads right into dysgraphia.
Cheri Dotterer
Obviously, it does lead into dysgraphia, which is kind of what why I began to really specialize in that. Because one of the questions I was getting was, but my kid can read. Why can't he write? Then people were not making that connection. Teachers didn't understand it. I didn't understand it. I couldn't find anything online. And thank God for the world of the internet, because it has made life so much better that we can find information. I don't know where I'd be if the internet didn't exist, because that is definitely the resource that I use to answer that question. In answering that question, I found a lot of things that just didn't make sense, and one of the questions that you had sent over to me was, why are why is my why are my definitions a little bit different than everybody else's? Well, it's because I didn't understand anybody else's one of the definitions by the dyslexia community was you can be have dyslexic dysgraphia, but not have dyslexia. And I went, huh, it didn't make any sense. I had to figure out what that really meant. So I reworked what they were saying. Found other material to really support where I was going with it, and I came up with six developmental levels, which are in the book, which I fully explain in the book. The basic level is visual, spatial. So really use the sensory, motor foundation and that understanding and that knowledge to create the types so using motor learning theory and the sensory processing foundation, I created the types. The bottom is the visual spatial. Alongside of that is motor. You need the visual spatial and the motor, along with memory, to really have the basic pieces of writing and reading, but then you have to start using them so visual, spatial, motor and memory are mechanical. They are like that. Fizzle, by go, mechanical pieces of of handwriting, word formation and sentence formation really get into the language structure and language of of reading and writing, where, when you get to paragraph formation, you're really starting to use a lot more of your cognitive features, so I consider that the cognitive level. So you do incorporate all of the everything all together along the way, but you still are, are developmentally creating the almost like an inverse triangle. Yeah, you're just kind of building on on each other to to work through the levels of dysgraphia. Now what happens is, if you got something that's not working, you got a brain break, yeah, there's a glitch, and that glitch is what causes the dysgraphia.
Jayson Davies
Okay, so I want to ask you real quick, when you say memory, are you talking like working memory? You know, having seven things in your mind at once. Are you talking about muscle memory? What kind of memory are you talking?
Cheri Dotterer
Okay, that's a very good question, because I'm talking about all of the above plus some. Okay, your limbic system is really where the foundation of how your memory and how your sensory motor is going to be affected by what is going on in your emotions. So part of what I did in my research when I was. Looking at positive psychology research was the impact of emotional memory as well as muscle memory, as well as working memory, as well as processing speed, all working together, that impact, that whole memory level.
Jayson Davies
That's important, because I feel like I often have to sit in an IEP and someone parents teach or whatever, they don't understand how important memory is, because if a kid can't remember the word that they're trying to start writing, you know, they're trying to write the word the and by time they get write down T they don't remember what they're writing, right? And so that does have a big effect, right?
Cheri Dotterer
And one of the things I also learned from a speech therapist friend of mine when we're looking at IQ testing, one of the things that I didn't realize and I didn't understand the delineation of them when I was looking at psychology reports is processing speed is what you're actually see visually. Working memory is actually auditory. I didn't realize that until more recently, which I found out after the book was written. So it's not in the book, sorry, little tidbit of extra information. But yeah, I didn't realize that when you're real, when the actual test, when they're testing IQ processing speed. They're just testing their visual. When they're looking at working memory, it's auditory.
Jayson Davies
Okay.
Cheri Dotterer
So it's good to know, yeah, I I would really had to work through that thought process, because I thought working memory was visual.
Jayson Davies
Yeah, and you know what that that leads directly into what I want to talk about. Because all of us, OTs who work in school based, we sit in those initials, we sit in those triennials, and we listen to the psychologist report. I mean, that's one of the key things, man, I just dial in whenever the psychologist is talking, because there's just so much information in there. But with that, the psychologist very rarely, if ever, uses the term dysgraphia, dyslexia, any of those diagnostic type of words. And I know many out there know why, but I want you to explain why is that?
Cheri Dotterer
Yes, there is a big reason. When you are looking for the words dyslexia and dysgraphia, you will find them in the DSM five. They are medical mental health diagnoses. When you are in the school, you can't be practicing medicine, and that's the big, simple fact of the matter is, if you were to use the word diet, dyslexia or dysgraphia or dyscalculia, it's a medical diagnosis. It doesn't work in the school because you cannot provide a medical diagnosis. There are 13 educational classifications. The educational classification that dysgraphia, dyslexia and dyscalculia fall under is specific learning disability, which really is a specific oral expression, written expression, math expression, disability.
Jayson Davies
Okay, so in that case, say I get a report from my psychologist at the school, and then I get a report from potentially an outside neurologist or something that says, dysgraphia. Should I carry the same weight whether it comes from either or or are there things that I may get from one report that I won't get from the other.
Cheri Dotterer
You may get different information from the two reports I would I would consider both of them equal in weight. The neurologist has the permission to make the official mental health diagnoses. The school psychologist does not. A neuropsychologist will also make that because they are also a doctor, unlike us as OTs, even though we have a big trend of people getting an OTD, it's not the same as a medical background the medical doctor. It's not the same level of doctorate, so we have to really watch where we're treading. And one of the things that I was concerned about when I was thinking about how to classify myself was, are people going to want me to be testing and I had to really make sure that I was clear. I am a consultant. I am explaining the symptoms. I am explaining how those symptoms can be used in a school setting. I'm a consultant for the school setting. I am not a clinical um. Person that's going to be diagnosing the dysgraphia for you. However, I will say that if they can find a neuropsychologist that specializes as dyslexia and dysgraphia, they should run and take whatever money they can put together to get that diagnosis, because they are the ones that have the most understanding of the medical piece and the educational piece interesting.
Jayson Davies
That's good to know. And I'm sure a lot of parents, I'm sure it's not cheap, like you said. They probably do have to in
Cheri Dotterer
the East Coast, that evaluation runs around $5,000 Wow. And so I don't know what it is on the west coast.
Jayson Davies
Yeah, who knows. But as far as Have you had the chance to, like, observe what they do when they diagnose or do you know what types of testing they do, or what they're looking at compared to what the school psychologist would?
Cheri Dotterer
They are doing some of the taint same tests, but they're taking a deeper dive and adding specialized testing that in addition to the IQ, so they have better and more advanced education, shouldn't say better, more advanced education into understanding the whisk and the Wyatt and the Woodcock Johnson, and they can go, that's bot. Doesn't make any sense. Compared to all the other scores, let's just zero in on want that one little piece, and that's where they are different than the typical school psychologist is they have a different understanding of some of the levels. That's not to say that the school psychologist may not the school psychologist may have that same education if they've gone to get some advanced training. There is a book out that has over 300 assessments that can be used by a psychologist and neuropsychologist. So to say, what's the the assessments would be? I'm not there. However, I also went for a course in within the last 10 years from the National Special Education Advocacy Institute. So I am an educational advocate as well as the occupational therapist. Part of that education was sitting and being able to decipher and understand what it meant to have that neuro that school psychologist evaluation in front of you. It was definitely an education understanding what the real meaning behind a lot of those tests were was very, very enlightening, and I think that was part of the drive to really understand how can my child read and not be able to write? Because the I was seeing a lot of those, not those scores that were not making sense with the school psychologist and going, well, there's a problem here. There's a problem here. We need to figure out what it is. So I'm there to support the school psychologist and give a little bit of extra to the report, but we can't make that final diagnosis.
Jayson Davies
Yeah, okay, before we get too far. I mean, we've already we got a lot going on. I'm really digging this conversation, but I know some people out there are really going to kind of want to hear, what do you consider to be like, the core symptomology, or core symptoms of dyslexia, or what does it look like?
Cheri Dotterer
Well, I made it easy for everybody in my book, okay, which is handwriting, brain, body, disconnect. You can find it on Amazon if you hit to page four of that book. It has 18 SIP symptoms. Excuse me, I'm going to read them to you. You can have an idea, because they are very subtle in their differences. Because you're going to look at listen to some of them and going, that's the same thing as what she said before, but if you really dig into it, if they really are not the same. So All right, go for it, writing slower than the typical students of the same age, odd positions of the wrist or the paper, mixing upper and lower case letter forms, inconsistency in forming letters, cramping fingers or hands, irregular letter formation, size, sequencing and line placement, poor letter organization, organization thought process when writing paragraphs also repeat that one, that one didn't make sense. Unorganized. Thought Process when writing paragraphs difficult, managing margins inefficient, pencil pressure, poor. Spelling, intentionally watching their hand while they write, awkward pencil grasp, poor fine motor skills, avoiding writing tasks, letter and number reversals, difficulty with written expression. Need extended time to complete tasks. It's a big, big list, isn't it?
Jayson Davies
Yeah. And, I mean, I feel like it's very encompassing, like, so just about every kid that I work with kind of falls into that.
Cheri Dotterer
And so falls into some piece of it, yes, and, and I don't believe that the research isn't done enough to really say this area, these three symptoms go with this form of dysgraphia. These three symptoms go with this form of dysgraphia. That is one of my long term projects that I'm working on is to really delve into the symptoms and the questions that parents have and that teachers have, and that OTs have to really be able to say that this is happening, try This. So this was a the beginning project of the project. I must say this is the beginning of the project. The research really needs a lot more in depth, specific details, and that is my long term dream is to have a research institute, okay, that's specifically dealing with dysgraphia.
Jayson Davies
That's cool. So we're on that we just kind of identified what dysgraphia is. But you can't really, we've already talked a little bit about dyslexia. How is dyslexia distinctively different from dysgraphia?
Cheri Dotterer
Well, that is one of those questions that has really confused a lot of people, and it did for me for a long time as well. So what I really went and delved into was what is happening when you're reading. When you're reading, you start out by having oral conversation. You apply a symbol to it, then we apply words, then we apply spell sentences, then we apply paragraphs. However, there's a piece of it that is all oral, there's a piece of it that is red, and then there's that piece that is written. So my delineation between dyslexia and dysgraphia is a little different than the dyslexia world, where I'm really saying that anything that's going into the system, anything that's sensory, anything that's red, is the reading part. That's the dyslexia. If it's got to turn around and come back out and it's actually on paper, that's the dysgraphia. Okay, so I had tried to make it easy to really delineate the two pieces because it was very confusing the way the rest of the community and the world was trying to explain it. So I tried to break it down a little bit further.
Jayson Davies
And I'm sure that there's also that difficulty of, if a student has dyslexia, the in, the in, I guess the inward portion of that, you know, the bringing information. In, then you can only, I guess it's not natural, but you would assume that maybe the output would likely be difficult as well. So then, if they have dyslexia, they're probably more likely to have dysgraphia. Is that?
Cheri Dotterer
That is correct? That is correct. The statistics are now saying that 33% of the population has some form of dysgraphia. The research is also saying that nine out of 10 of those students fall on that bell curve that they do not qualify for, like, visual perceptual assessments. And that was one of the other things that bugged me on that bell curve, is so you get an 85 that means you can't get ot Hello. What else is going on that is making it that of a much of a borderline. So I really wanted to look at that person, that kiddo that got the 8485 8687 on all of our standard visual perceptual tests. And one of the things I also learned in the educational advocacy program is there is a clause. In the idea that says that we really shouldn't do one test. We should do a second test to support and make sure that the first test was not a false or.
Jayson Davies
Some sort of outlier or whatever, and be an outlier.
Cheri Dotterer
Yeah. So really, if we want to do best practices. We really should be supporting ourselves and having that second test. The other thing that I found out, and this is one that's going to blow everybody's mind, but there is a research report in a OT, and I do not remember where it is, if I can find it in my journals that I have in my computer, I will send you the article name. But there is an article that says that any child that understands a symbol as a letter and number should never be given a VMI. And that like blows everybody away. Yeah, yes, everybody wants to do it. And this article really blatantly says that the VMI really is null and void for every child that has any kind of knowledge of a symbol or a number interesting.
Jayson Davies
I'm gonna have to look that up, and we'll put in the show notes at ot schoolhouse.com, forward slash episode 31
Cheri Dotterer
If I will find it for you. Because I know I have it in my journal articles, in my computer. I know I have it because it was one that really blew me away.
Jayson Davies
All right. Well, I look, I'm looking forward to that. I'm sure many people out there listening, probably.
Cheri Dotterer
They will, and they're gonna, like, think I'm crazy until they read it. But, and I hate to tell the person who, the person who invented the VMI of that piece, because I know they account on a lot of OTs to use it, but I have to, I stopped using it, and I use other assessments to work on the the visual perceptual and the visual motor. I actually try to do one that gives me a global and one that gives me a more specific area so I can really look, say, okay, globally, they're right here on the border. Specifically, we only are really looking at maybe figure ground as an issue, or we're looking at visual closure as an issue. So it can really say to the parent, look, overall, he's doing pretty well, but this one area really skews the results.
Jayson Davies
So what I'm hearing you say is maybe you'll do like the test of handwriting skills, as you're kind of over Archer, maybe overarching one, maybe. But then do the DV, or the developmental test of visual perceptual skills, that's kind of your breakdown.
Cheri Dotterer
I actually use the wide range assessment of visual motor abilities, and then I do a DVD.
Jayson Davies
Okay, that makes sense, because the rabma gives you a very broad.
Cheri Dotterer
Gives you a broad. It looks also a lot closer at the three dimensional. And getting that whole, the whole matching piece of that is is three dimensional, where the other tests don't all really hit that three dimensional piece as well. And then I, I do prefer the ths, the test of handwriting skills, over anything else, because it's the only one that has normed values. The print tool is a percentage. It's really doesn't have normed values. The etch I happen to have a little in with somebody who has knowledge of the etch. And there was something, and I don't know all the specifics, but something happened with the scoring of that that it didn't come out as well as they had hoped. So that gave me that uneasy feeling. So I tend to to not use that because it's also very difficult. I don't know how we found the etch, but I found it difficult. However, there's one page in the etch that I use ever, almost every time I'm doing an eval, and that's that back page where it has all the scores on words per minute. Yep, that back page was absolutely gold. Yeah. And to be fair, it's probably a little dated at this point, but it is the only thing. It's the only table that I've found that can give you at least like a starting point for where starting point. And there are other there are other things that you can find that have been done under the educational platform, but there's nothing that has been done under the OT platform other than on that page.
Jayson Davies
Gotcha, Good to know. Alrighty. So one of the. Questions. Sorry, go ahead. So
Cheri Dotterer
another, another thing that I will really look at when I'm doing a an assessment, as I really do look at the sensory processing pieces to it. And Lucy Miller has a new test out that only came out maybe in 15, called The Goal. I don't know if you've heard of that one. I've heard of it. Yes. The goal is really amazing. It takes from where the sensory processing, the sipped ends, as far as norms go, and it starts there to continue through the high school. Okay, so one, that's one of the reasons I never got sick trained, is because they were like done till I actually got to see them. So this because they only go to, like, age six or something silly, like that.
Jayson Davies
Eight, 811 Yeah, but it's like, weird, cut off point.
Cheri Dotterer
Yeah, yeah. It's just not what I didn't see it as cost to benefit to take that, but I did get goal certified.
Jayson Davies
Okay, cool. So I had this question on here that I wanted to ask, but I'm not sure if it's really the right question, because I was going to ask, How does dysgraphia present differently from a fine motor delay? But it kind of sounds like a fine motor delay could be a potential reason or cause of dysgraphia.
Cheri Dotterer
I believe that you answered that correctly.
Jayson Davies
I don't want to elaborate at all.
Cheri Dotterer
So I believe, I believe, one of the things that we have done as occupational therapists is we've looked at all those symptoms and just never pulled them all together and put them in a nice, neat package and says, Look, parent, this is where we're at. One of the things that I really delved in when I was doing my research for the book was spelling. Because if you look, there's even less information and support on how to remediate spelling than there was about what dysgraphia is, and that's saying a lot, because there wasn't a whole lot on dysgraphia either. And I developed a an alphabet that helps students, so I did some testing with them, so if you were a student who was having trouble with spelling and you spelled like a phonetic speller, how would you spell the word enough, e, n, u, F, exactly. So we got a lot of kids that are out there spelling things like that a lot of times. So you got kids that are spelling, please, pl, Z. I kept looking at it going, how do we get these kids to really understand it? What can we do? And I went back to motor learning theory, back to the basics, back to that whole sensory processing piece. And I came up with a body, sentence, alphabet, and I don't know if you caught the email I sent you, but I am offering it for free to everybody, if they sign up for that link that I sent to you. Okay, so basically, it's taking movement and it's incorporating a movement associated with your body to go along with each letter in the word. So e is your I, N, nose. O, open your mouth. U, under your chin, like the shape of the U, G, give me your hand. H, high five. And what I do with the kids is I start on Monday, when they were looking at their spelling list, and we do these big motions. By the time we get to Friday, I'm looking at and I'm saying, Look, you need to have that in your mind, in your mind's eye, and that's where that whole emotional memory piece really becomes important, because they need to be positive when they're taking those big motions and making them little and putting them into their mind and being able to follow them. Another thing that the Orton Gillingham, the dyslexia community Wilson program, if you've heard those terms mentioned, they use some things called tapping. So to tap out the zip code with each you make that really loud. You hear the sound I'm making. I'm not really at the microphone, but every time you say one of the numbers for the zip code, you tap it out. It really works well for five and 10, but sometimes kids aren't quite sure of the number of taps when there's not five letters or numbers or or 10 letters or numbers. Sometimes they get confused, but the tapping is also something that really helps the students get through there. I noticed one of the other questions you were going to ask me, and I'm going to go right on to this one, is some treatment ideas. That's one of them. The other one that I really is one of my go tos, and I'm working on a project with with this right now, and it's much more cumbersome than I envisioned it to be when I was had the idea. But I'm using mazes, and I'm actually grading mazes and upgrading them and downgrading them, and changing the border width and changing the path width, and really using mazes as a visual spatial pencil control piece. And it's really does help the students really refine the those little fine motor movements that they need to write out words.
Jayson Davies
That's actually one of my the the maze, or it's not a maze. It's a labyrinth, if you want to call it on the bot, as well as the mazes on the M fun or two of my most informative, like just observations that I get from seeing those two parts done, I just get so much because you get to see their planning take out, or you get to see how they're holding the pencil. You get to see if they're making the fine motor movements with the with their fingers, or are they using their wrist? There's just so much that you that you do get to see with one maze.
Cheri Dotterer
So yeah, is it amazing how that that works? The other thing I use a lot is word searches. But I don't use them as word searches. I use them as letter searches. So I have a lot of kids that have so much trouble with the visual scanning, and that is part of the part of the pieces that are going together is their ocular motor and being able to visually scan really impacts the reading piece. So really working with the kiddos that are struggling with reading as well, I really try to use the word searches, and I'll pick out letters that we've been working on that week. I said, find them. Find all the B's. And did you know that A S, T, O, N, E, A stone, are the most used letters in our English alphabet?
Jayson Davies
I did not, but you're just making me think of wheel of fortune at the bottom of the screen.
Cheri Dotterer
There you go. So, so, and r is a stoner, but you know, weird when you say that the R on the end but a stone are the most used letters in the alphabet. But sometimes I don't want to say use the same letters all the time, but when you're looking at a word search, think of a stone as the letters that you're going to be able to find the most because they're the most used letters.
Jayson Davies
Gotcha. Yeah, that makes sense.
Cheri Dotterer
And really, if you watch how the child is circling those letters, it tells you a lot about what they're doing with their visual scanning. Wait, say that again. Watch how they're circling them. Are they going left to right? Are they going, oh, there's an a, oh, there's an eight, oh, there's an eight, oh, there's an A, and they're called scattered all over the board, um, are they missing the middle? Are they missing the outside? Do we have a tunnel vision or a peripheral vision issue going on. It was, and that stems from my years in working with adults were working with strokes and hemiparesis and pieces that I would do that same activity. I would take the word search, cut it into four, and really count the number of yeses and the number of misses and give a ratio and, and you really can tell with the kiddos that just are all scattered. What happened? You just look at the paper, and you go, wow. And, and then you talk to mom or dad a little bit, and they'll go, Yeah, well, they've always had trouble with reading. There you go, visual scanning, where it brings us to one of those controversies, and that's vision therapy. Where, if it really is truly an ocular motor issue, that is the problem, vision therapy will help. If it's not the ocular motor vision therapy is probably not going to help.
Jayson Davies
All right, that's good to know.
Cheri Dotterer
Yeah, that was, I could see by your face that that one took you off guard a little bit.
Jayson Davies
I was like, wait, because and I do work on ocular motor skills, as I'm sure many people do, and that scanning and stuff like. That, you know, putting stuff up on the wall and using the laser pointer and stuff like that, you know. But I don't know enough about vision therapy and vision services, and in the school, it's not very common that we see that no.
Cheri Dotterer
And they don't like to pay for it a lot of times, even though it is covered under IDEA, they don't like to pay for it a lot of times, because you can't get a vision therapist to come into the school. They got to send them out, which takes away time for for their education. And today's education is very difficult to get everything done in the day's time. These teachers have a lot of pressure on them. They do. I don't envy them today.
Jayson Davies
No, not at all. Today, it gets to the point where you almost feel bad about taking out of a student, out of the classroom, because it's like, you pull them out, they're missing something. I have so many kids that get so anxious about missing something in the classroom, and I'm like, I need to talk about this.
Cheri Dotterer
Here's my question to you is, how often do you do inclusion and pushing therapy?
Jayson Davies
I do. I mean, it's not quite 5050, but it's I do both.
Cheri Dotterer
Another thing that I learned when I was doing the educational advocacy class is and this kind of goes against everything that I was learning as an OT is that OTs really shouldn't have their own goal on an idea, on an IBP. We should really be a an SDI and a supportive service related to the written expression goal, yes, so whatever that written expression goal is that the teacher is writing we should be providing objectives underneath it, rather than our own separate goal.
Jayson Davies
Oh, that's a good way. I never heard about the adding objectives underneath it, but that makes sense.
Cheri Dotterer
So it's it, but it kind of goes against the everything that we've learned, doesn't it? Yeah, it's kind of counterintuitive.
Jayson Davies
It is because we, especially if coming from the medical side, you know, we have to have our goal. But I have been, there are some teachers that I have talked my way into those types of goals and explaining, you know, this is why it should be this way, because they're here to get an education, and you are the educator, and I'm here to support them so that they can get that education. And, yeah, in my opinion, that's how the goal should be written in that case.
Cheri Dotterer
So I'm glad we agree on that one. But it really kind of it throws us a lot of therapists for a loop when they hear me say that, they're like, no, no, that can't be. That can't be. But really, if you look into the IEP, and you look at what it really says, I mean, the idea, not the IEP, about the IEP, that's what it's trying to tell you, is that we really should be short term objectives underneath there, and then be really working with the teacher towards that written expression goal, yeah. All right, or the math goal, depending if it has something to do with the writing.
Jayson Davies
Yeah, yeah. All right. I have a few more questions I want to ask, and I want to let you talk a little bit more about your book, because I'm excited for that, and I know everyone needs to at least know about it. Remediation versus accommodations. Okay, what are your thoughts on that? Is there a certain time you know, everyone wants to know, oh, What grade do I stop working on handwriting? Or what are your thoughts on that?
Cheri Dotterer
The research says that you can work on handwriting up and through high school, your brain will solidify the neural pathway when the frontal lobe starts to really get to the end of its developmental stage, which is now they're saying is around 30. Oh, wow, every time I turn around, it's later and later and later. But really the if you're really looking at the neurodevelopmental and the neuro science behind it, you're looking at puberty, their brain, yes, it's growing, but they also have all those hormones going on in there. Their brain doesn't have enough time to shift between education and hormones and everything else that's going on, right? It's really a bad time to stop. It's really a bad time to stop. And motor learning theory says practice, practice, practice, continue to practice, even if you are converting over to keyboard, still having that practice and really, truly the whole Common Core and taking cursive out of the system, yeah, was not a good idea, nope. And there are states that are putting it back in. Mm, hmm. Yeah, and I sigh, because it's, it's really bothers me. But one of my goals will always be that the child will be able to write, make their signature. I mean, we're granted if it's feasible. Now I'm looking more at learning support students who have some writing skill, yeah, they will be able to write their name. The other thing that I really see with a lot of these kids with memory issues is they can't remember their basic demographics. I've been working with one student this year who is in fifth grade. It has taken us till now from September that he can remember his name, address, phone number, date of birth, and know how to spell the words he still doesn't have the month, right? Yeah, but he doesn't even know how to spell his middle name correctly. It wasn't one of those things that was forced. We haven't even started working on writing his name in cursive, but that's one of the things that mom agrees with me before I discharge, that he needs to be able to write his name. Yeah, and it's sad. It's so sad and frustrating. These kids are not going to be able to read the Declaration of Independence. They need to have some kind of ability to recognize those letters, whether they can still write them or not. They need to be able to recognize it so they can try to decipher them. Yeah, because a lot of them are a lot different looking, they've also made some major changes because of the US mail system. The Q that used to look like the letter two is no longer valid. You need to make your Q like an O with a like a printed o with kind of like a blend between a printed O and a cursive O, because the new computer systems were mistaking the two for the queue for a two, and really having problems. So you have to be aware of those things. And then you look at some of the writing systems that are out there, they haven't caught up.
Jayson Davies
Yeah? Well, I mean, even when you're trying to make a worksheet for your kids, and you're trying to use your computer, you have to figure out what font to use, because, man, you get you get the century Gothic.
Cheri Dotterer
Use century Gothic. So I'm going to say on that one, there we go. I did a webinar about two years ago and how to make your own paper, and I went through all the major handwriting programs, because they're all slightly different. I went through Excel and I went if you're using this handwriting paper, you use this size spacing pixels to create that size of a letter for your child. It was, it was absolutely crazy. I still have that the video, which I need to put up on my your website, on my website again, because I don't know that I could live through doing it, repeating it again, because it was just very intense, and it takes so much work to create worksheets, and also it takes a lot of work to change worksheets that are already produced so that students who have issues can manage them. One of the issues I keep running into with figure ground is too much color, too much on the page, so separating the worksheets down to having one problem on a page, mom looks at me and goes, You're kidding me, and goes, No, right, too much paper. It's child's Look at me, going, that's the only way I can answer it.
Jayson Davies
Yeah. Okay, so that leads me to, I'm going to combine these two adapted paper and adapted pencils.
Cheri Dotterer
Okay, can I tell you my go to paper? Can I be honest? Can I can I tell you the world?
Jayson Davies
Most people know that we have our own paper, but go for it. Whatever paper you use.
Cheri Dotterer
My go to paper is the size matters. Handwriting program, okay, there's a research based program. It has all the varieties of different papers that you can come up with. I've even used the paper and came up with my own. Whatever works for the student is what you got to use. Well, yeah, whatever works for that student is what you got to use. Adaptive. Um pencils, adaptive grips and all that stuff. Same thing, the same thing. It's whatever's going to work for the student. Some students really, absolutely do not have the strength in their fingers to hold that pencil. That's a standard pencil. They just don't have the strength um doing I call it the the jellyfish that that one where you're going in and out with your hands. Kids can't do it. Yeah, and they, they their hands cramp. They don't know how to deal with it. They don't know that inverting the prayer pose really changes the strength or the stretch on the flexor muscles, and really will stop a cramp.
Jayson Davies
No idea.
Cheri Dotterer
Pressure, pressure points in your phenar eminence, squeeze it as hard as it can, and it's going to hurt. You got to tell the kids, make your make your hand hurt, because when you leave go, it's going to feel fine. So teaching them the trigger point and the the inner eminence, and teaching them the little tricks like that that they can do that aren't going to take up time in the classroom, and they kind of don't even have to realize if they doing those things a lot of times they're doing them naturally. They don't even realize it.
Jayson Davies
Gotcha. All right. Well, I have one more, and this was from someone on Instagram. Her name's Laura, her hashtag or not, her hashtag. Her name on Instagram is the OT butterfly, and she wanted to ask if you have any tips for setting expectations when talking to parents who have been told their kid has dysgraphia or what your thoughts are are on that.
Cheri Dotterer
Incidentally, sidebar, I love the OT butterflies. Ot challenge for the month of April, and I know I never got to put a post every day it was blow blew me away. But I just want to say the OT butterfly that she had a great ot challenge, and I would like, I'm I have it all listed out, and I'm going to continue it. It's just not going to be every day. But as to answer her question, which was, gosh.
Jayson Davies
That's all right. That's all right. It's a Monday night. We're getting through this. Do you have tips for basically, parents and setting expect, okay, parents found out, like my kid has dysgraphia. What? What? Okay, what are we telling them?
Cheri Dotterer
I would explain to them that what I told you earlier are on in the conversation where dysgraphia, dyslexia, dyscalculia, are medical diagnoses. In the school setting, we need to use educational classifications. They are there's only 13 of them, whereas if you look at the DSM five, there's how many plus there's how many ICD 10 codes. So trying to explain where we're getting the numbers from and why we can't use the medical numbers in the classroom might help a parent look at the symptoms. One of the phrases that we used in the educational advocacy program was, what does it look like? Explain what it looks like, because then you're going to be looking at the symptoms and you're not going to be making that diagnosis piece. So the diagnosis piece can't enter into the world of the education, it can only stay in the medical model. Worry about the symptoms and look at the symptoms and for yourself, figure out, are they visual, spatial? Are they motor? Are they memory? Are they those foundational pieces that are impacting word, sentence and paragraph formation, and find ways to be able to work across the spectrum and help out. Incidentally, one of the things I haven't really said was we can work on paragraph formation with students we, as OTs, can work with all levels of dysgraphia. We need to create accommodations and modifications and educate the parents and the teachers on those educational pieces. That's where we that's where our expertise is. Task analysis.
Jayson Davies
Yes, yes, I completely agree with you. In fact, I just got an email from one of my case carriers and showing me a, you know, five paragraph essay that this kid had written out, and he just can't put a paragraph together. Yeah. I mean, he has a page and a half, two pages of written something, but there is no organized. Organization to his paragraphs. And this is a high schooler.
Cheri Dotterer
And one thing that, yeah, one thing that you can work with them on, is just identification. So think about it. When they were younger, when we were first teaching them the letters, they need to identify the letter before they could write it. They don't know how to identify parts of speech. They're not there's no time to teach grammar. They don't understand the parts of speech. I'm working with a kiddo right now where all we're doing is, okay, here's a sentence, and we're color coding the different parts of speech. I'm not teaching language. I'm helping him identify and using color coding and working with those pieces to help him go, oh, he he will. And he was also having trouble with text to speech and speech to text, getting kids to slow down is another piece of the puzzle that they're not being taught how to do, because education is so we've got to get all this done, and it's boom, boom, boom, boom, Boom, boom. We, as OTs, need to teach those kids how to relax. Yeah, absolutely. We need to teach mindfulness those pieces, those augmented pieces that we don't necessarily think of right away, that are going to really affect dysgraphia. Well, they are, because they're affecting that whole emotional memory. Yeah, yeah. Alrighty.
Jayson Davies
Well, that's fantastic. Thank you so much for all that I want to give you now the opportunity you've got this book, it just came out. It will have been out for like, a few months, maybe two or three months by time this podcast gets out there. But it's the handwriting, brain, body disconnect, adaptive teaching techniques to unlock a child's dysgraphia for the classroom and at home.
Cheri Dotterer
Yes, thank you. Yeah, it's in there. What is in there? The book starts off telling you what dysgraphia is, then it talks a little bit about reading, then it talks about writing, then I go into the whole neuroscience behind reading and behind writing, and I talk a little bit about where the glitches are that create problems. We didn't really get to talk about this a whole lot. But why do you think a child could might have trouble reading versus writing? The short answer is they're coming from different parts of the brain, but teachers don't know that. We learn it, but maybe don't retain it. Yes, then I talk about the strategies at the end of the book, and we really go into where, since the visual, spatial, what's motor, what's memory, and I go and I break them down, and I talk about each one of the levels, and give provide strategies that you can use in the classroom. It's been amazing. The feedback I've gotten, knock on wood. I haven't gotten any negatives yet, but I'm waiting for that to come. But everybody has said that it has been an easy read. I have one person OT, mind you, so she has some background. It wasn't a parent, but an OT told me that she read 70 pages in one night. Wow. I was like, wow. That blows my mind. So that proves to me that it is an easy enough read for the person who doesn't understand the details. That was my goal was to break it down so that a parent could understand it. It is not a textbook. It is not a neuroscience book. It's a book to educate parents and teachers who haven't been able or haven't been educated in this area, so that that's where we would and then the very, very end of the book, I do go into some the IEP, some accommodations and some goals that we as ot standalone goals that we could use that incorporate all ADLs, instrumental ADLs that reflect that are also reflective of dysgraphia as well.
Jayson Davies
Gotcha. Well, that's great. You know what? I had no intentions of doing this, but I'm gonna go on Amazon right now. I'm going to purchase your book. Whoa.
Cheri Dotterer
Thank you.
Jayson Davies
Yeah. Course, I'm also going to purchase a second copy of the book, and I'm gonna give that out to someone who actually who screenshots a picture of them listening to this, this episode of the podcast, Episode 31 and tags us in a social media post. So ot school house in a social media post. Again, all you got to do is screenshot your phone or take a picture of yourself listening to this episode and then put together a little clever caption, whatever you want to do and tag us on Twitter, Instagram, Facebook, you know, using the at ot school house. And I will choose one winner a week from now, and I will send the book to them. So I'm going to be reading it, and I hope someone else will be reading it right alongside me and listening to the podcast. So I'm excited to do this. Wow, that's amazing.
Cheri Dotterer
And I will, and I will send them. Will send a second person a copy, and both people will also get a copy of my bookmark. Hold on, Jayson, I have a bookmark that on one side has the symptoms and on the other side just has the types of dysgraphia. So I'll get a couple of those sent out to you. Sounds good. All right, thank you. I appreciate you doing that like I said, Man, we just make things happen here. So yeah, some and some things I have coming up with a couple, a webinar that I have on my website that you can take for a low cost. That's one hour, just a quick overview of the entire beginning of the book, overview of the types of dysgraphia. And then there's an in depth eight hour eight hours worth of video, plus some really intense educational pieces that it all ultimately is a 90 hour course, wow, you do everything that's in the course, it takes about 90 hours to get through it. So there's a continuing ed course on the on the website that you can take as well.
Jayson Davies
Awesome. Well, we spent one hour with you this evening, and I'm sure we could have gone three. So at least that's awesome. I love it. But yeah, again, one last time. Where Can everyone get a hold of you?
Cheri Dotterer
Sure, dysgraphiaconsultant.com.
Jayson Davies
Awesome. And I know you're also on Facebook, Instagram, Twitter, everywhere.
Cheri Dotterer
I'm on, yeah, I'm on Facebook and Instagram as dysgraphia consultant, I have a Facebook group, handwriting, brain, body, disconnect, the name of the book, and I am on LinkedIn under my name because they don't. They make you do a company. My company is on there, and I am putting up articles and under the company name up in LinkedIn.
Jayson Davies
Great. And like always, we will be sure to have all the information on the show notes. You'll get that that link in just a second here, as well as everything right below. If you're listening on iTunes, you can just scroll down and you'll see a bunch of links. Go ahead.
Cheri Dotterer
I do have another favorite to ask of your audience, though. Yes, go for it. I have been nominated for the author Academy Awards, so I will if everybody, anybody who is listening to this, can after they're done with their looking at whatever it is they need to do to find me, go on to author Academy awards.com click the red button that says vote, and then page down a little bit, you're gonna see a thingy. We can scroll left and right. Scroll to page six, look for my book and click on my book.
Jayson Davies
All right, that's simple, yeah, that's simple.
Cheri Dotterer
And go find out. I'll try to I'll put the directions. I'll send you the directions, and so you have the actual link and such.
Jayson Davies
Sounds good, Alrighty, well, Sherry, thank you so much for coming on. Really appreciate that I learned so much tonight, so.
Cheri Dotterer
I hope you can absorb it. It it might take you a few times listening to this episode, won't it?
Jayson Davies
Maybe we'll see. But I'm going to try and use some stuff this week that you talked about, so it's going to be wonderful.
Cheri Dotterer
Wonderful. If you need to get a hold of me and ask questions, you can give me a buzz my my email is info at dysgraphia consultant at.com but you can always look at look it up on the website. Sounds good? Consultant.
Jayson Davies
Easy enough. Alrighty. Well, thank you, Sherry. So much for for coming on and it's a great episode. Take care and have a great rest of your evening.
Cheri Dotterer
Thank you. You as well. Bye, bye. Now, all right. Well,
Jayson Davies
that was Cheri Dotterer, aka the dysgraphia consultant of dysgraphia consultant.com and as she mentioned, she does have her new book. It is called the handwriting brain, body disconnect, adaptive take gene techniques to unlock a child's dysgraphia for the classroom and at home. Also, real quick, we kind of touched on it in the end of the podcast there, but I. Uh, as for the giveaway, there will be a total of two books as well as two bookmarks, along with those books that are going to be going out to two lucky winners that do take a picture of how they listen to this podcast, basically screenshot you listening to it or whatever, post that on social media, tag at ot school house, and we'll be sure to pick a winner in a week from now, which will be June 4, is when we will select our winner. So thank you everybody, and we'll see you next time on the OT school house podcast. Take care.
Amazing Narrator
Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed.
Click on the file below to download the transcript to your device.
