Dyspraxia also known as Developmental Coordination Difficulties (DCD)
This is a condition that affects the coordination of action and thought. It may also affect the body’s ability to control temperature.
The World Health Organisation (ICD 10) describes it as a Specific Developmental Disorder of motor function:
‘The main feature being a serious impairment in the development of motor coordination that is not solely explicable in terms of general intellectual retardation or of any specific congenital or acquired neurological disorder. It is usual for the motor clumsiness to be associated with some degree of impaired performance on visuo-spatial cognitive tasks’.
Causes
As yet no single cause is known and it is possible that no single cause will be found, it is probable that there are a number of reasons individuals are dyspraxic.
Impact of having dyspraxia
The impact of dyspraxia depends upon the severity. Dyspraxia may affect just one set of an individual’s muscle groups or it may affect several or all the muscle groups. For example the fine motor skills may be affected and an individual will experience difficulties with things like doing up buttons and writing.
Let us consider an example where muscles that control the jaw and tongue are affected. The impact that this could have for a child is difficulties controlling their lips, jaws, tongue and / or larynx. As babies these children will often have had difficulties feeding. It also of course means that the muscles used for controlling speech will be affected and a child with this difficulty will be late learning to speak and will need speech therapy. When they do learn to speak the quality of the speech sounds will take some time to refine into speech that is easily understood. This is because they will experience great difficulty controlling their breathing, how they make speech sounds, sequence sounds and think about sequencing sounds for words. They are also likely to dribble until they are quite old. In the early stages of learning to speak there may be problems with managing what is known as prosodic features of speech such as: control, intonation, volume and/or rate of speech.
Another difficulty for children where this muscle group is affected is that they may find it hard to control the muscles used for facial expression. This will mean that they may find it hard to show how they are feeling through facial expression.
It is often said of dyspraxic children that they will ‘fall over their own feet’ or that they are ‘clumsy’ because they are always bumping into things. Dyspraxia often causes problems with knowing where we are in relation to other things. In our inner ears we have something called vestibular receptors. These sit in an upright position. The vestibular sense helps with the co-ordination of eye movements, as well as our head and body movements. It also helps us to control both sides of our bodies. These often do not work so well when dyspraxia is present. Also within our muscles we have things that help us to be aware of the position of our bodies in relation to things around us. For example, we can do up our buttons without looking at them, we can close our eyes and touch our noses. It is the proprioceptors that enable us to do this. With dyspraxia the proprioceptive system does not work very well. This condition affects four times more boys than girls and there are estimates that up to 10% of the population may be affected to some extent. The two key areas that are affected when these systems in the body do not work or develop as they should include:
- Being able to think or plan in an organised way. Individuals with dyspraxia often find extreme difficulties in thinking in a sequential way.
- Making the muscles do what the individual wants them to do. This may affect all muscle groups or just some.
Below is a list of some of the problems that children with Developmental Coordination Difficulties (Dyspraxia) are likely to have, they usually have at least a combination of several difficulties:
In the preschool years
- Poor feeding and poor sleeping
- As babies they may constantly wave their arms and legs
- Be slow to achieve motor milestones e.g. crawling, walking, hopping, jumping, walking up and down stairs
- Their language acquisition is often delayed
- They often trip and fall
- Their concentration is usually limited and they are easily distracted from tasks
- Parents often say their child is unaware of dangers such as crossing the road
- Children are often frightened of physical activities such as PE
- Can have extreme difficulties with learning to dress themselves
- Eating and drinking can be problematic especially with learning to use cutlery. They are often very messy eaters.
Primary School Years
It is often not until children go to school that the dyspraxia is noted. Around 50% of children with dyspraxia are not identified until after the age of 5. At school they may have the following difficulties:
- Associated learning difficulties such as difficulties with learning to read (see my page on Dyslexia).
- It is likely that they will have difficulties with learning to write or are late to learn to write (see my page on Dyslexia). When they do learn to write the handwriting is almost always poorly formed.
- Dyspraxic children are often unwilling to draw because drawing skills are so poor
- They have problems following a structured school routine
- PE because of their poorly coordinated movements. This will also have an impact on their abilities to play games such as football and rounders.
- They will be slow at dressing. They may put things on in the wrong order because of their sequencing difficulties they may not be able to manage buttons, tie shoe laces etc
- Class work is often unfinished because they are slower than their peers
- Teachers will often note that the dyspraxic child is clumsy and knocks into furniture
- These children are messy workers and messy eaters. Other children object to sitting next to them.
- They are late to learn to ride a bike.
- They have difficulties with knowing left from right and following instructions.
- There may be difficulties with forming relationships.
- Peers do not always find them rewarding playmates.
Secondary school
Life in the secondary school is likely to be far more difficult for the dyspraxic child. The amount of organisation is immediately increased. They have to plan what kit and equipment to take in. They have to know their timetables and what classes they should be in and where those classes are in the building. They have to move around the building several times a day. At the end of each lesson they may have difficulties getting home work written down so it is legible and packing up quickly enough so they are not late to the next one.
These children are often poorly organised, they quite often look messy with shirts hanging out and their desks or drawer will almost always be untidy. They are usually poor timekeepers and always the last. Often they are not sure where they should be or what they should be doing. It is not deliberate; it is as frustrating and bewildering to them as it is to those around them. Everyone needs to be patient.
I hope that this has given you some useful information about the complexities surrounding dyspraxia. Dyspraxia does not affect intelligence but it does impact on academic skills and life in school. There are lots of things that teachers and parents can do to help.
Diagnosing dyspraxia is a medical assessment that is usually carried out by an occupational therapist. However I can advise on what to do if your child is dyspraxic and assess educational difficulties associated with dyspraxia. You can email me at teresa.bliss@btinternet.com You can contact me by phone on 01531 822065 or 07890909911.
Some Ideas for Parents
- Always buy shoes with Velcro fasteners
- Buy clothes that are a fairly loose fit and for KS1 boys no buttons on trousers
- Make sure your child can manage the lunchbox contents e.g. ensure your child can actually open wrappers and take lids off yoghurt pots
- Send in a small towel for swimming because it is more manageable.
- Give them the confidence to explain to adults about their condition