Dysgraphia Assessment — Examiner Form

Writing Screener · Checklist · Graphomotor Notes · Rubrics
Adapted from L. Dowdy · Barber Sped Hub · Hutto ISD Special Education
Student & Examiner Information
Grade Band — Select to filter dictation sentences and spelling lists throughout this form

Step 1 — Writing Checklist (Prior to Screener)

Gather 2–3 authentic writing samples. Rate student's performance relative to same-age peers.

Area Assessed ImpairedBelow AvgAverageAbove AvgSuperior
Handwriting
Spelling
Written Expression
Oral Language
Self-Management Skills

Check concerns observed (relative to same-age peers). Write N/O if not observed.


Step 2 — Writing Screener Tasks
Before beginning: Open Student Response Pages and print them. Give student the printed packet. Do not begin tasks until pages are ready.

Writing Speed Reference (WPM by grade)

Grade12345678
WPM 4–56–77–108–1310–1512–1714–2016–23
1
Name and Date (K–12)
E: "Please write your first and last name on the line." (Prompt for last name if student only writes first.)
2
Alphabet Sequence (K–12) · 1 minute
E: "Please write the letters of the alphabet in order when I say go. If you finish before I tell you to stop, start over. Please write in lowercase. If you don't know how to form a letter in lowercase, write it in uppercase. Write in print. If you don't know a letter, you can skip it. You will have one minute." (Say go & start timer. If student pauses 5+ seconds on a letter, ask to go to the next.)
Letters per min (LPM): ÷ 5 = WPM:
3
Best Sentence Copy (K–12) · 1 minute
E: "Please look at this sentence." (Point to sentence on student page.) "Copy the sentence in your best handwriting when I say go. If you finish before I tell you to stop, start over and write the sentence again." (Say go & start timer.)
The quick brown fox jumps over the lazy dog.
LPM: ÷ 5 = WPM:
4
Sentence Dictation (1st–12th)
E: "Listen to the following sentence. I will say it two times. Now repeat the sentence." (If student can't repeat, repeat sentence or dictate in two phrases.) "Write the sentence using your best handwriting. You may write in print or cursive."
Showing sentences for: Click a sentence to select it
K–2nd Grade Sentences
Little dogs sniff the wet grass.
The cats drink milk in the morning.
My best friend likes to eat pancakes.
We swing and slide at the park.
3rd–6th Grade Sentences
The hikers found a sparkling pond and decided to take a quick swim.
The pioneer family loaded the wagon with supplies and prepared to head west.
7th–12th Grade Sentences
The paramedic persisted as he scaled the extremely steep incline in treacherous weather to locate the missing hiker.
The inexperienced mechanic attempted to repair the massive engine at the automotive shop without success.
My drama teacher insists on additional practices before Saturday's matinee performance in the high school auditorium.
The catastrophic hurricane approached the Florida coastline, ravaged the delicate ecosystems, and flooded thousands of structures.
5
Writing Prompt (K–12) · 5 minutes
Student provides information orally then writes a narrative. Scaffold orally if needed (what, who, why, where, when). Note where student is at exactly 1 minute. Do NOT provide spelling for any words.
E: "Tell me about ______. Now write what you just shared down. You may write in print or cursive. You will have five minutes."

Select a prompt (click to highlight):

A time you baked/cooked something
Something funny that happened in class
A sport you play
A hobby or talent you have
A time something unexpected happened
A recent vacation or family outing
Your favorite video / movie / board game
What you did for your last birthday
Your pet
LPM: ÷ 5 = WPM:
6
Spelling
Showing list for:
1. Tub
6. Flipped
2. Blast
7. Born
3. Ramp
8. Shapes
4. Sting
9. Chick
5. Looking
10. Bottle
1. Rainy
6. Lightening
2. Points
7. Shaking
3. Happening
8. Persisted
4. Carefully
9. Weekday
5. Judged
10. Vision
1. Domesticated
6. Clarification
2. Contagious
7. Justified
3. Recommended
8. Dangerously
4. Psychology
9. Suspension
5. Solidified
10. Effectiveness
7
Number Sequence (optional)
E: "Write the numbers from 1 to 20 on the line."

Step 3 — Graphomotor Observational Notes
Handedness
Pencil Grip
Pencil Pressure
Paper Placement & Posture
Helper Hand & Motor Patterns
Letter Characteristics

Step 4 — Writing Rubrics

Writing Screener Rubric

Area Assessed ImpairedBelow AvgAverageAbove AvgSuperior
Name Writing
Alphabet Sequence
Sentence Copy
Sentence Dictation
Written Expression
Spelling

Writing Rubric 1 — Holistic

Area Assessed ImpairedBelow AvgAverageAbove AvgSuperior
Handwriting
Spelling
Written Expression
Oral Language
Reading Comprehension
Self-Management

Writing Rubric 2 — Detailed Holistic

Area Assessed ImpairedBelow AvgAverageAbove AvgSuperior
Letter Formation
Letter Size
Spacing (b/t words and w/in)
Pencil Grip
Alphabet Fluency
Sentence Copy
Sentence Dictation
Punctuation / Capitalization
Written Expression
Spelling
Verbal Abilities
Decoding
Reading Fluency
Reading Comprehension
Self-perception of writing skills