Developmental Dysgraphia in Chinese: A Review of Neurocognitive Mechanisms, Classification, and Assessment

Handwriting plays a crucial role in literacy development, especially in logographic systems such as Chinese. Many children experience developmental difficulties in acquiring handwriting skills, a specific learning disorder known as developmental dysgraphia. However, there is a lack of systematic review on the neurocognitive processes underlying different types of developmental dysgraphia in Chinese. To fill in this gap, we first propose a cognitive model of Chinese character handwriting based on adult research. Unlike stage-based theory that assumes distinct mechanisms for adults and children, our review supports the continual development theory, suggesting that similar cognitive stages operate across both child and adult handwriters. Based on the cognitive model of handwriting, we identify five categories of developmental dysgraphia, including surface dysgraphia, phonological dysgraphia, deep dysgraphia, graphemic buffer dysgraphia, motor-spatial dysgraphia, and then review on the relationship between dyslexia and dysgraphia. We systematically review their behavioural syndromes and associated brain regions in both alphabetic languages and Chinese, revealing neurocognitive mechanisms for each type. Finally, we examine current assessment tools for diagnosing dysgraphia, highlight their limitations, and call for development of more comprehensive assessments for developmental dysgraphia.