The purpose of this paper is to give an overview of the current research involving composition writing with respect to students experiencing difficulties. It responds to the fact that composition writing is a largely neglected area in education and research. This paper will review the following: (a) the reasons why writing competence is so vitally important in many life situations, (b) outline the ordinary development of proficient writing skills, and (c) address the causes and characteristics of what constitutes severe writing problems. The main piece of this paper centers on describing "best practice approaches" by assisting students to become proficient writers. It concludes with an outlook on pressing research questions that need to be tackled in the near future to provide even better support for students who struggle with the concepts of written expression.