Dyspraxia is also known as motor learning difficulties, perceptuo-motor dysfunction, and developmental coordination disorder (DCD). The terms "minimal brain damage" and "clumsy child syndrome" are no longer used.
According to the National Center for Learning Disabilities, individuals with dyspraxia have difficulties in planning and completing fine and gross motor tasks. This can range from simple motor movements, such as waving goodbye, to more complex ones like sequencing steps to brush one's teeth.
What is dyspraxia?
Harry Potter star, Daniel Radcliffe, has dyspraxia. Photo by Joella Marano
Dyspraxia is a neurological disorder that impacts an individual's ability to plan and process motor tasks.
Individuals with dyspraxia often have language problems, and sometimes a degree of difficulty with thought and perception. Dyspraxia, however, does not affect the person's intelligence, although it can cause learning problems in children.
Developmental dyspraxia is an immaturity of the organization of movement. The brain does not process information in a way that allows for a full transmission of neural messages.
A person with dyspraxia finds it difficult to plan what to do, and how to do it.
The National Institute of Neurological Disorders and Stroke (NINDS) describes people with dyspraxia as being "out of sync" with their environment.
Experts say that about 10 percent of people have some degree of dyspraxia, while approximately 2 percent have it severely. Four out of every 5 children with evident dyspraxia are boys, although there is some debate as to whether dyspraxia might be under-diagnosed in girls.
Symptoms of dyspraxia
Symptoms tend to vary depending on the age of the individual. Later, we will look at each age group in more detail. Some of the general symptoms of dyspraxia include:
- poor balance
- poor posture
- differences in speech
- perception problems
- poor hand-eye coordination
Diagnosis of dyspraxia
A diagnosis of dyspraxia can be made by a clinical psychologist, an educational psychologist, a pediatrician, or an occupational therapist. Any parent who suspects their child may have dyspraxia should see their doctor.
When carrying out an assessment, details will be required regarding the child's developmental history, intellectual ability, and gross and fine motor skills:
- Gross motor skills - how well the child uses large muscles that coordinate body movement, including jumping, throwing, walking, running, and maintaining balance.
- Fine motor skills - how well the child can use smaller muscles, including tying shoelaces, doing up buttons, cutting out shapes with a pair of scissors, and writing.
The evaluator will need to know when and how developmental milestones, such as walking, crawling, and speaking were reached. The child will be evaluated for balance, touch sensitivity, and variations on walking activities.
Dyspraxia in children
Dyspraxia symptoms may vary depending on age. With that in mind, we will look at each age individually. Not every individual will have all of the symptoms outlined below:
Very early childhood
The child may take longer than other children to:
- Crawl - the Dyspraxia Foundation says that many never go through the crawling stage.
- Speak - according to the Children's Hospital at Westmead, Australia, the child may be slower in answering questions, find it hard to make sounds, or repeat sequences of sounds or words; they may also have difficulty in sustaining normal intonation patterns, have a very limited automatic vocabulary, speak more slowly than other children, and use fewer words with more pauses.
- Become potty trained (get out of diapers).
- Build up vocabulary.
Tying shoelaces can be a difficult task for children suffering with dyspraxia.
Later on, the following difficulties may become apparent:
- Problems performing subtle movements, such as tying shoelaces, doing up buttons and zips, using cutlery, and handwriting.
- Many will have difficulties getting dressed.
- Problems carrying out playground movements, such as jumping, playing hopscotch, catching a ball, kicking a ball, hopping, and skipping.
- Problems with classroom movements, such as using scissors, coloring, drawing, playing jigsaw games.
- Problems processing thoughts.
- Difficulties with concentration. Children with dyspraxia commonly find it hard to focus on one thing for long.
- The child finds it harder than other kids to join in playground games.
- The child will fidget more than other children.
- Some find it hard to go up and down stairs.
- A higher tendency to bump into things, to fall over, and to drop things.
- Difficulty in learning new skills - while other children may do this automatically, a child with dyspraxia takes longer. Encouragement and practice help enormously.
- Writing stories can be much more challenging for a child with dyspraxia, as can copying from a blackboard.
The following are also common at pre-school age:
- Finds it hard to keep friends.
- Behavior when in the company of others may seem unusual.
- Hesitates in most actions, seems slow.
- Does not hold a pencil with a good grip.
- Such concepts as 'in', 'out', 'in front of' are hard to handle automatically.
Later on in childhood
- Many of the challenges listed above do not improve or only improve slightly.
- Tries to avoid sports.
- Learns well on a one-on-one basis, but nowhere near as well in class with other children around.
- Reacts to all stimuli equally (not filtering out irrelevant stimuli automatically)
- Mathematics and writing are difficult.
- Spends a long time getting writing done.
- Does not follow instructions.
- Does not remember instructions.
- Is badly organized.
Dyspraxia in adults
In adults, symptoms include:
- Poor posture and fatigue.
- Trouble completing normal chores.
- Less close control - writing and drawing are difficult.
- Difficulty coordinating both sides of the body.
- Unclear speech, often word order can be jumbled.
- Clumsy movement and tendency to trip over.
- Grooming and dressing more challenging - shaving, applying makeup, fastening clothes, tying shoelaces.
- Poor hand-eye coordination.
- Difficulty planning and organizing thoughts and tasks.
- Less sensitive to non-verbal signals.
- Easily frustrated.
- Low self-esteem.
- Difficulty sleeping.
- Difficulty distinguishing sounds from background noise.
- Notable lack of rhythm when dancing or exercising.
Social and sensory - individuals with dyspraxia may be extremely sensitive to taste, light, touch, and/or noise. There may also be a lack of awareness of potential dangers. Many experience moods swings and display erratic behavior.
Researchers at the University of Bolton in England say that there is often a tendency to take things literally "(the child) may listen but not understand."
Causes of dyspraxia
Scientists do not know what causes dyspraxia. Experts believe the person's nerve cells that control muscles (motor neurons) are not developing correctly. If motor neurons cannot form proper connections, for whatever reason, the brain will take much longer to process data.
Experts at the Disability and Dyslexia Service at the Queen Mary University of London, U.K., say that studies suggest dyspraxia may be caused by an immaturity of neuron development in the brain, rather than any specific brain damage.
A report from the University of Hull in England says that dyspraxia is "probably hereditary: several genes have been implicated. Often, there are many members within a family who are similarly affected."
Treatments for dyspraxia
Although dyspraxia is not curable, with treatment, the individual can improve. However, the earlier a child is diagnosed, the better their prognosis will be. The following specialists most commonly treat people with dyspraxia:
An occupational therapist will evaluate how the child manages with everyday functions both at home and at school. They will then help the child develop skills specific to daily activities which they find difficult.
Speech and language therapy
The speech-language pathologist will conduct an assessment of the child's speech, and then implement a treatment plan to help them to communicate more effectively.
Perceptual motor training
This involves improving the child's language, visual, movement, and auditory skills. The individual is set a series of tasks that gradually become more advanced - the aim is to challenge the child so that they improve, but not so much that it becomes frustrating or stressful.
Equine therapy for dyspraxia
In a study published in the Journal of Alternative and Complementary Medicine, a team of Irish, British, and Swedish researchers evaluated the effects of equine therapy (therapeutic horse-riding) on a group of 40 children aged 6-15 years with dyspraxia.
The children participated in six horse-riding sessions lasting 30 minutes each, as well as two 30-minute audiovisual screening sessions.
They found that riding therapy stimulated and improved the participants' cognition, mood, and gait parameters. The authors added that "the data also pointed to the potential value of an audiovisual approach to equine therapy."
Experts say that active play - any play that involves physical activity - which can be outdoors or inside the home, helps improve motor activity. Play is a way children learn about the environment and about themselves, and particularly for children aged 3-5; it is a crucial part of their learning.
Active play is where a very young child's physical and emotional learning, their development of language, their special awareness, the development of what their senses are, all come together.
The more children are involved in active play, the better they will become at interacting with other children successfully.