Sourced from Dyspraxia Foundation
Developmental dyspraxia is an impairment or immaturity of the organisation of movement. It is an immaturity in the way that the brain processes information, which results in messages not being properly or fully transmitted. The term dyspraxia comes from the word praxis, which means ‘doing, acting’.
Dyspraxia affects the planning of what to do and how to do it. It is associated with problems of perception, language and thought.
Dyspraxia is thought to affect up to ten per cent of the population and up to two per cent severely. Males are four times more likely to be affected than females. Dyspraxia sometimes runs in families. There may be an overlap with related conditions.
Other names for dyspraxia include Developmental Co-ordination Disorder (DCD), Perceptuo-Motor Dysfunction, and Motor Learning Difficulties. It used to be known as Minimal Brain Damage and Clumsy Child Syndrome.
Statistically, it is likely that there is one child in every class of 30 children. We need to make sure that everyone understands and knows how best to help this significant minority.
Causes of Dyspraxia
For the majority of those with the condition, there is no known cause. Current research suggests that it is due to an immaturity of neurone development in the brain rather than to brain damage. People with dyspraxia have no clinical neurological abnormality to explain their condition.
Recognising Dyspraxia in children
- Is late in reaching milestones e.g. rolling over, sitting, standing, walking, and speaking
- May not be able to run, hop, jump, or catch or kick a ball although their peers can do so
- Has difficulty in keeping friends; or judging how to behave in company
- Has little understanding of concepts such as ‘in’, ‘on’, ‘in front of’ etc
- Has difficulty in walking up and down stairs
- Poor at dressing
- Slow and hesitant in most actions
- Appears not to be able to learn anything instinctively but must be taught skills
- Falls over frequently
- Poor pencil grip
- Cannot do jigsaws or shape sorting games
- Artwork is very immature
- Often anxious and easily distracted
- Probably has all the difficulties experienced by the pre-school child with dyspraxia, with little or no improvement
- Avoids PE and games
- Does badly in class but significantly better on a one-to -one basis
- Reacts to all stimuli without discrimination and attention span is poor
- May have trouble with maths and writing structured stories
- Experiences great difficulty in copying from the blackboard
- Writes laboriously and immaturely
- Unable to remember and /or follow instructions
- Is generally poorly organized
People who have dyspraxia tend to have poor understanding of the messages that their senses convey and difficulty in relating those messages to actions.
There may be difficulty in planning and organising thoughts.
The cerebral cortex is the large uppermost area of the brain. The cerebral cortex can be divided into four distinctive areas.
These are; the motor area, the frontal lobe, the sensory area and the hind cerebral cortex. As the name suggests, the frontal lobe is situated at the front of the brain. Both the motor and sensory areas are bands radiating across the brain, immediately after the frontal lobe.
Behind the sensory cortex is the hind cerebral cortex, where the auditory and visual areas are held deep within the brain itself.
Impulses from sensory organs are relayed to the cerebral cortex by means of a network of pathways of nerve fibres. In the course of growing and learning, the connections between the nerve cells (neural pathways) become established.
They are reinforced when the desired outcomes are achieved – for example, a child learning to process the complex series of movements required to pick up a cup and drink from it. Constant repetition allows the planning of these actions to become almost reflexive.
Using external sensory input e.g. sight and sound,together with these ‘learned’ patterns of movement, the cerebral cortex is able to judge the best course of action to take. It then sends out the appropriate motor impulses.
The cerebral cortex is divided into a right and left hemisphere, which have specialist functions. They operate in an almost separate fashion.
Many functions are ‘shared’, but generally each side appears to work almost independently offering its piece of information to complete the ‘picture’ and therefore forming a whole. e.g. the left hemisphere receives the information, in a jumbled, disjointed way; it is only when the right hemisphere works in harmony with the left that images and actions are interpreted in the correct order and the information is comprehended as a complete piece or object.
Individuals with Dyspraxia do not seem to have both hemispheres responding in this simultaneous, co-ordinated fashion. It is also the development of the two hemispheres that decides whether a person is right or left handed, again this basic development seems substantially reduced and therefore the child may use both hands without preference for some time, thus reducing the development of hand-writing skills still further.
The cortex also surrounds structures known as the ‘thalamus’, ‘hypothalamus’ and ‘pituitary gland’. This area it known as the limbic system. This system is responsible for the ‘instinctive’ and automatic responses within the body: it is also closely linked with emotional behaviour.
As the cortex matures is acts to ‘dampen down’ the effects of the limbic system’s emotional output in response to stimuli. If this were not the case, the individual would be highly excitable, over emotional and be extremely sensitive to external sensory input.
Reading and spelling
Children with dyspraxia may have difficulties with reading and spelling. Limited concentration and poor listening skills, and literal use of language may have an effect on reading and spelling ability.
A child may read well, but not understand some of the concepts in the language. The child may also be reluctant to read aloud because of articulation difficulties or because they lack self-confidence.
Exercises may be beneficial for children with reading and spelling difficulties. Take Time by Mary Nash-Wortham and Jean Hunt provides a series of exercises for parents, teachers and therapists to do with children.
Computers can also help with reading and spelling: Wordshark is a widely used program, available from the Dyspraxia Foundation.
Research has shown that children with developmental verbal dyspraxia whose speech difficulties persist beyond the age of 5 & 6 years are at risk of having literacy difficulties. The risk is increased if there is a family history of speech, language or specific learning difficulties.
The child with developmental verbal dyspraxia has an impaired speech processing system, which affects their ability to make sound ñ letter links and to carry out phonological awareness tasks (e.g. segmenting, blending, rhyming etc) essential for literacy acquisition. Spelling is usually more affected than reading.
Poor handwriting is one of the most common symptoms of dyspraxia. Children who have poor handwriting don’t need their parent or teacher to tell them about it. Every time they write, they can see that they are not as good as their friends.
Handwriting expert Dr Rosemary Sassoon believes that children with dyspraxia should be judged only against their own best efforts. They should be encouraged to progress in a relaxed way. Her leaflet A Quick Look at Handwriting Problems gives practical suggestions about working with children to develop handwriting skills.
As the child progresses through the educational system, the requirement for written work increases. Take Time by Mary Nash-Wortham and Jean Hunt provides exercises that can help with handwriting. Write from the Start by Ion Teodorescu and Lois Addy are two books which contain the Teodorescu Perceptuo-Motor Programme, for developing the fine motor and perceptual skills for effectice handwriting.
Speech and Language
Speech may be immature or unintelligible in early years. Language may be impaired or late to develop.
For some children, the primary difficulty is in making and co-ordinating the precise movements, which are used in the production of spoken language, which results in severe and persisting speech production difficulties. The condition is termed developmental verbal dyspraxia: it may occur in isolation or in conjunction with general motor difficulties.
Children with speech and /or language difficulties should be referred to a Speech and Language Therapist as early as possible. A referral can be made by a GP, Health Visitor, other professional or by parents themselves. Speech and language therapists carry out assessments, can identify a child’s presenting difficulties and advise on management and support.
The Dyspraxia Foundation can help you to find sources of support in your area. It publishes a range of leaflets, booklets and books on aspects of the condition call 01462 454986.
For pre-school children
Talk to you GP and Health Visitor: they can refer your child to a paediatrician or a Child Development Centre. The appropriate psychologist, physiotherapist, speech and language therapist or occupational therapist can then assess your child for dyspraxia
For school-age children
Talk to your GP, school nurse, school doctor or Special Needs Co-ordinator who can make referrals for assessments. Hospital referral may be required for special tests or treatment.
There is useful information in the Department for Education and Employment’s booklet “Special Educational Needs: A Guide for Parents” call 020 7925 5000 or 0845 1232303 in Scotland, for a copy.
Problems experienced in childhood may continue into adulthood. Initial contact should be made with your GP who may refer you to a clinical psychologist, consultant neurologist, physiotherapist or occupational therapist.
The Foundation’s Adult Support Group may be able to help – call 020 7435 7891.
Although dyspraxia is not curable, children with the condition may improve with growing maturity. Symptoms in children and adults can lessen if they are given appropriate treatment and advice on practical actions to minimise the day- to- day difficulties that their dyspraxia can cause.