ABSTRACT
Background
Developmental dysgraphia affects 5% to 20% of school-age children and reaches 59% among children with ADHD or autism. The condition produces task avoidance, eroded self-esteem, and behavioral presentations that frequently result in psychiatric referral for anxiety, depression, school refusal, and behavioral disturbance. More than 37% of children with learning disabilities reach clinical thresholds for affective and ADHD problems. Despite this clinical footprint, dysgraphia remains nosologically contested and rarely identified within psychiatric evaluation.
Objectives
This integrative review synthesizes the multidisciplinary evidence on developmental dysgraphia and examines its implications for child and adolescent psychiatric-mental health nursing.
Data Sources
Eight databases (PubMed/MEDLINE, CINAHL, PsycINFO, Scopus, ERIC, Cochrane, OTseeker, Web of Science) yielded 8290 records published between January 2000 and March 2026. After deduplication, 6308 records were screened, 1476 were assessed for eligibility, and 56 contributed to synthesis. Synthesis followed Whittemore and Knafl (2005) under PRISMA 2020 reporting conventions.
Conclusions
Findings document definitional disagreement, fragmented assessment, underpowered intervention evidence, and substantial psychosocial burden. Three nursing publications addressed dysgraphia, and none reported original research on the condition.
Implications for Practice
Dysgraphia screening may be integrated into psychiatric evaluations of children referred for ADHD, anxiety, depression, school refusal, or behavioral disturbance. Handwriting may be monitored as a stimulant medication outcome. On inpatient units, writing-based therapeutic activities require adaptation when dysgraphia is suspected. Pediatric primary care and school health represent upstream identification opportunities.