The Graded Response Model (GRM; Samejima, "Estimation of ability using a response pattern of graded scores," Psychometric Monograph No. 17, Richmond, VA: The Psychometric Society, 1969) can be derived by assuming a linear regression of a continuous variable, Z, on the trait, [theta], to underlie the ordinal item scores (Takane & de Leeuw in "Psychometrika," 52:393-408, 1987). Traditionally, a normal distribution is specified for Z implying homoscedastic error variances and a normally distributed [theta]. In this paper, we present the Heteroscedastic GRM with Skewed Latent Trait, which extends the traditional GRM by incorporation of heteroscedastic error variances and a skew-normal latent trait. An appealing property of the extended GRM is that it includes the traditional GRM as a special case. This enables specific tests on the normality assumption of Z. We show how violations of normality in Z can lead to asymmetrical category response functions. The ability to test this normality assumption is beneficial from both a statistical and substantive perspective. In a simulation study, we show the viability of the model and investigate the specificity of the effects. We apply the model to a dataset on affect and a dataset on alexithymia.