Handwriting changes are a deterioration in the manner of writing due to various pathological processes. It can be expressed by a violation of the inclination, size and shape of letters, the force of pressure on the handle, the distance between words, line spacing. Changes in handwriting 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, a CNS examination (MRI, EFI, ultrasound), neuropsychological testing, and visual function determination are performed. Treatment may include pharmacotherapy, psychotherapy, vision correction.
Physiology of handwriting
Handwriting is an individual graphic technique that is implemented as a result of writing. The basis of the written skill is visual-motor coordination – the coordinated work of visual and motor analyzers. Handwriting is formed as a result of learning to write and regular practice.
A person’s writing style changes over the years. During school education, there is a gradual improvement of the student’s handwriting, and by about 6-7 grade, the automatism of writing is developed. These changes reflect the graphic maturity of motor skills. However, the final formation of the handwriting ends only by the age of 25-30. 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 the teaching of writing took place (methodology, illumination, writing materials).
Individual characteristics of handwriting include the shape and size of graphic elements, the inclination of letters, pressure on the pen, the direction and continuity of lines, the interval between words and lines. The analysis of the features of an individual’s handwriting is the subject of graphology and is the basis of handwriting expertise.
Causes for handwriting changes
In some people, the handwriting remains stable throughout life, in 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 moving transport.
- Pathological processes: neurological diseases, mental disorders, visual, hearing, musculoskeletal disorders.
Diagnostic signs indicating pathological changes in handwriting are:
- pretentiousness of the letter;
- letter – by – letter letter;
violation of coordination of movements (tortuosity of lines, incontinence of the line), etc.
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 boundaries of the line, while only a few words fit on a piece of paper. This feature is typical for the following conditions:
- the initial period of learning to write;
- optical dysgraphy;
- high-functioning autism;
- CNS diseases accompanied by cerebellar ataxia (strokes, cerebral tumors, hydrocephalus, multiple sclerosis, genetic syndromes);
- bipolar disorder (manic stage);
Causes of micrography
Reducing the size of letters less than 3 mm makes a person’s handwriting poorly readable, illegible. Such handwriting changes occur in a number of neuropsychiatric and eye diseases:
- Parkinson’s disease;
- symptomatic parkinsonism;
- Alice in Wonderland syndrome (macropsia);
- manic-depressive psychosis (depressive stage);
- obsessive-compulsive disorder;