School Neuropsychology: A Practitioner's Handbook

By James B. Hale; Catherine A. Fiorello | Go to book overview

CHAPTER 7
The Neuropsychology
of Written Language Disorders

CHARACTERISTICS OF CHILDREN WITH WRITTEN LANGUAGE DISORDERS

Complexity of Written Language Disorders

From a neuropsychological perspective, written language is by far the most difficult academic skill (Lerner, 2000); yet it has probably received less empirical examination than any other domain (Hooper et al., 1994). Why has written language received so little attention? The old belief that writing is a natural extension of language may have something to do with it. This belief, long held by the educational establishment, is that if you provide children with handwriting instruction, they will be able to convey their thoughts on paper as easily as they do when speaking. If a child can speak, and can use a pencil, then he or she will have no difficulty with written language. As empirical evidence emerges that oral and written language are dissociable, the basis of this belief is slowly being eroded. We now know that there are many cognitive processes associated with written language achievement, and that dysfunction in one or more of those areas can lead to a written language disorder (WLD).

Unlike the other academic domains discussed so far, written language is the only academic skill that is primarily an output task. Written language depends on the input system for memory and feedback to the output system, but it is more of a “frontal” skill than the others, because it requires formulating ideas, organizing the ideas into paragraphs and sentences, using words to convey meaning and link ideas, using graphomotor skills to write and spell words, evaluating the accuracy of the product, and editing as necessary. In fact, the executive or critical analysis of the written language product may be the single most important determinant of success (Harris & Graham, 1997), but the executive skills of planning and revising written language products are seldom used by children with WLDs (Graham, Harris, MacArthur, & Schwartz, 1991).

Written language is by no means solely a frontal task, however, because the posterior regions are required at every step. Writing requires some comprehension of the writing problem prior to ideation, prior knowledge and experiences to develop the written material, visualization of word

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