A person with dyspraxia has problems with movement, coordination, judgment, processing, memory and some other cognitive skills. Dyspraxia also affects the body’s immune and nervous systems.
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 Disabilities1, individuals with dyspraxia have difficulties in planning and completing fine motor tasks. This can range from simple motor movements, such as waving goodbye, to more complex ones like brushing one’s teeth.
What is dyspraxia?
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 Stroke2 (NINDS) describes people with dyspraxia as being “out of sync” with their environment.
Experts say that about 10% of people have some degree of dyspraxia, while approximately 2% have it severely. Four out of every 5 children with evident dyspraxia are boys. If the average classroom has 30 children, there is probably one child with dyspraxia in almost each classroom.
According to the National Health Service3, UK, many children with dyspraxia also have attention-deficit hyperactivity disorder (ADHD).
In an interview with the Daily Mail4, Harry Potter star Daniel Radcliffe explained that he has dyspraxia and what it is like to live with it. He said he went into acting partly because his dyspraxia meant he was not successful at school.
Radcliffe said, regarding tying shoelaces “Why, oh why, has Velcro not taken off?”.
Radcliffe said he wanted to become an actor from the age of five, but his mother was against it. When he was nine, she finally allowed him to audition to play in a BBC version of the Dickens classic David Copperfield. He believes his mother ceded because she felt he needed a confidence boost. “I was having a hard time at school in terms of being c**p at everything, with no discernible talent.” He won the part and David Copperfield became his first hit.
The English medical word dyspraxia comes from:
- The Greek word duspraxia, which means “dyspraxia”.
- The Greek word duspraxia comes from the Greek word Praxis, meaning “to practice; (concretely) an act; by extension, a function”.
- The Greek word Praxis comes from an older Greek word Prassein (prattein), meaning “”to pass through, experience, practice”.
Signs and symptoms
Very early childhood
The child may take longer than other children to:
- Crawl – the Dyspraxia Foundation5 says that many never go through the crawling stage.
- Speak – according to the Children’s Hospital at Westmead6, Australia, the child may be slower in answering questions, finds it hard to make sounds or repeat sequences of sounds or words, has difficulty in sustaining normal intonation patterns, has a very limited automatic vocabulary, speaks more slowly than other kids, and uses fewer words and more pauses.
- Become potty trained (get out of diapers/nappies).
- Build up vocabulary.
Later on the following difficulties may become apparent:
- Problems performing subtle movements, such as tying shoelaces, doing up buttons and zips, using cutlery, 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 jig-saw 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 do so very slightly
- Tries to avoid sports and PE
- Learns well on a one-on-one basis, but nowhere near as well in class with other kids 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.
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 Bolton7 in England say that there is often a tendency to take things literally “(the child) may listen but not understand.”
What causes dyspraxia?
Scientists do not know what causes it. 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 reasons, the brain will take much longer to process data.
Experts at the Disability and Dyslexia Service8 at the Queen Mary University of London 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 Hull9 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.”
Tests and diagnosis
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 GP (general practitioner, primary care physician), or a special needs coordinator first.
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 – this refers to how well the child uses his/her large muscles that coordinate body movement. This includes jumping, throwing, walking, running, and maintaining balance.
- Fine motor skills – this refers to how well the child can use his/her smaller muscles. Activities which require fine motor skills include tying shoelaces, doing up buttons, cutting out shapes with a pair of scissors, and writing.
The assessor will need to know when and how developmental milestones, such as walking, crawling, speaking were reached. The child will be screened for balance, touch sensitivity, and variations on walking activities.
If the assessor, or GP, does not have the necessary training, dyspraxia could be missed altogether and the child will not be referred to a specialist. Training on identifying dyspraxia can be patchy, depending on which part of the world you live in, and also which part of specific countries. The same applies to teachers – in some places they are well trained at identifying potential dyspraxia among their pupils, but not everywhere.
In an article in the British Journal of Special Education10, a team looked into how much teachers and general practitioners (primary care physicians) knew about six specific learning difficulties, including dyspraxia.
Before their study began, they had expected both groups – 105 doctors and 105 teachers – to have similar levels of knowledge. They asked the teachers and physicians to define the six learning difficulties in a questionnaire.
They found that:
- Teachers gave significantly more correct definitions than the doctors did.
- Knowledge overall in both professional groups was “limited”.
The authors concluded that general practitioners will find it difficult to detect and appropriately refer children with learning difficulties.
Although dyspraxia is not curable, with time the child can improve. However, the earlier a child is diagnosed, the better and faster his/her improvement will be. The following specialists most commonly help people with dyspraxia:
- Occupational therapyAn occupational therapist will first observe how the child manages with everyday functions both at home and at school. He/she will then help the child develop skills specific to activities which may be troublesome.
- Speech and language therapyThe speech and language therapist will first carry out an assessment of the child’s speech, and then help him/her communicate more effectively.
- Perceptual motor trainingThis involves improving the child’s language, visual, movement, and auditory skills. A series of tasks, which gradually becoming more advanced, are set – the aim is to challenge the child so that he/she improves, but not so much that it becomes frustrating or stressful.
In a study published in the Journal of Alternative and Complementary Medicine11, 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 to 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 “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, gets the motor activity going in children. Play is a way children learn about the environment and about themselves, and particularly for children aged 3 to 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.
Parents, uncles and aunts, and other adults can also become involved with a child’s active play – however, sometimes they should take a step back and let the children really explore so they can try out their own understanding of the world. The risk of negative things happening to children if they play outside are far smaller than the risks of negative things happening to them if they don’t, such as obesity, poor socialization with other children, and having less fun. It is only by taking risks that children learn the importance of, say, holding on tight, and correcting themselves.
Parents who have a child with dyspraxia need to balance the risks of negative things happening outside, with the enormous benefits that active play has to offer. Deciding what this balance is depends on many factors, such as the severity of the child’s dyspraxia, the outside environment, etc.