Handwriting Change : Causes, Symptoms, Diagnosis & Treatment

• Physiology Of Handwriting
• Reasons For Changing Handwriting
• Causes Of Macrography
• Reasons For Micrography

Handwriting changes are a deterioration in the manner of writing due to various pathological processes. It can be expressed by a violation of the slope, the size and shape of the letters, the pressure on the pen, the distance between words, line spacing. Handwriting changes are observed in a number of neurological, psychiatric syndromes, visual and musculoskeletal disorders, as well as in the process of natural aging. To diagnose the causes of this phenomenon, an examination of the central nervous system (MRI, EFI, ultrasound), neuropsychological testing, and determination of visual function are carried out. Treatment may include pharmacotherapy, psychotherapy, vision correction.

Physiology of handwriting

Handwriting is an individual graphic technique that is realized as a result of writing. The written skill is based on visual-motor coordination - the coordinated work of visual and motor analyzers. Handwriting is formed as a result of learning to write and regular practice.

The way a person writes changes over the years. During schooling, a gradual improvement in the student's handwriting takes place, and by about the 6th-7th grade, automatic writing is developed. These changes reflect the graphic maturity of motor skills. However, the final formation of handwriting ends only by 25-3 years. The handwriting of an adult has its own individual features, which are due to:

• physiological features (structure and functioning of the hand, visual analyzer);
• neuropsychological processes (formation of attention, memory, visual gnosis);
• the conditions in which writing was taught (methodology, lighting, writing materials).

The individual characteristics of handwriting include the shape and size of graphic elements, the slope of the letters, the pressure on the pen, the direction and continuity of lines, the spacing between words and lines. An analysis of the features of an individual's handwriting is the subject of study of graphology and underlies handwriting expertise.

Reasons for changing handwriting

For some people, handwriting remains stable throughout life, for others it undergoes changes under the influence of various conditions. Handwriting changes can occur as a result of:

• Psychophysiological events : fatigue, hypothermia, psychological trauma, aging, alcohol intoxication, writing in a moving vehicle.
• Pathological processes : neurological diseases, mental disorders, visual, hearing, musculoskeletal disorders.

Diagnostic signs indicating pathological changes in handwriting are:

• macrography;
• micrography;
• pretentiousness of the letter;
• letter-by-letter;
• violation of coordination of movements (tortuosity of lines, non-retention of the line), etc.

handwriting changes

Causes of macrography

Changes in handwriting by the type of megalography are characterized by the height of lowercase letters, significantly exceeding the normal size (0.5 cm). In this case, the letters go beyond the line, while only a few words fit on a sheet of paper. This symptom is typical for the following conditions:

• the initial period of learning to write;
• optical dysgraphia;
• high functioning autism;
• CNS diseases accompanied by cerebellar ataxia (strokes, cerebral tumors, hydrocephalus, multiple sclerosis, genetic syndromes);
• micropsia;
• bipolar disorder (manic stage);
• hypermetropia.

Reasons for micrography

Reducing the size of letters less than 3 mm makes a person's handwriting difficult to read, illegible. Such changes in handwriting are found in a number of neuropsychiatric and eye diseases:

• Parkinson's disease;
• symptomatic parkinsonism;
• Alice in Wonderland syndrome (macropsia);
• manic-depressive psychosis (depressive stage);
• myopia;
• obsessive-compulsive disorder;
• schizophrenia.