Management of learning related difficulties can be complicated, and for parents trying to navigate the web of services that may or may not be available to their children, it can become a daunting task. That said, one lesser known challenge that many children with learning-related difficulties face is called “Dyspraxia”. This article is a brief attempt to clarify some terminology, highlight signs and symptoms of dyspraxia, to aid parents and professionals in early identification, and an overview of some common interventions found to be effective for children experiencing dyspraxia. With this information, parents may be better equipped to make informed choices that will help their children learn and develop.
Dyspraxia is a general medical term used to describe
- the loss of ability to perform familiar, purposeful movements in the absence of paralysis or other neural sensorimotor impairment OR
- an inability to execute complex coordinated movements resulting from lesions in the motor area of the cortex but involving no sensory impairment or paralysis
Another term for “dyspraxia” is Developmental Coordination Disorder and dyspraxia is not to be confused with the term “apraxia”, although the two are often, in error, used interchangeably; “a” means without or full and “dys” means abnormal, difficult or partial loss. Additionally, apraxia is clinically known to refer specifically to speech and language functions whereas dyspraxia more often refers to the rest of the body or limbs and extremities. The two conditions may but do not always occur simultaneously and often co-occur with other diagnosable conditions, such as autism, attention deficit disorder, and dyslexia. That said, a child with dyspraxia, may or may not have any other diagnosable condition(s), but this is less often the case.
Dyspraxia impacts a child’s ability to do more than school-related tasks, although it is often at school, where children with dyspraxia, may struggle most, because of the motor and visual motor demands in school tasks such as handwriting and copying from the board. Beyond handwriting, very often children with dyspraxia struggle to learn and/or do every day activities that other children just seem to pick up easily, such as dressing themselves, brushing their teeth, tying their shoes, eating with utensils, playing games/sports with friends, playing on the playground with other kids their age. Children with dyspraxia may find it difficult to complete activities in context or at the same pace as their peers and/or to adjust their actions according to what’s going on around them, so that games like soccer, basketball, and even swimming, offer great challenge or anxiety. They may appear slow, unmotivated, and easily distracted and frustrated, and they may experience low self-esteem, anxiety, and any other number of emotional challenges, as a result of their difficulties. For these reasons, it is important to identify dyspraxia as early as possible so that children can learn to overcome their motor challenges before the negative symptoms progress and so that the interventions available are more likely to work.
Dyspraxia is a neurological and motor based problem, so frequent, repetitive intervention is likely to be more effective when children are young (early school age). That said, the brain can change at any age. The more engaged a child is and the more motivated they are to do the activities, the more likely it is that the intervention will be successful. Occupational Therapy with a sensory integration approach (link to http://www.aota.org/Practitioners-Section/Children-and-Youth/Browse/SI/Fact-Sheet.aspx?FT=.pdf) and/or school-based OT are proven interventions for helping children with motor-based challenges such as dyspraxia. Brain-based learning programs that incorporate movement and other developmentally based activities along with understanding of the whole child and the brain-body connections that contribute to learning are imperative. One significant factor to remember when selecting the type of intervention is to choose the intervention based on the skills the child needs to learn. If an OT is providing handwriting intervention at school, it may improve the child’s handwriting but it may or may not improve the underlying motor skill deficit (the dyspraxia) that caused the poor handwriting in the first place. On the flip side, if the child is struggling most at home with daily skills like tying shoes, doing up buttons, and playing with other children, then offering handwriting intervention at school, may not be the most important type of intervention to pursue. That said, it is important for all disciplines and professionals working with a child who has dyspraxia to be communicating and collaborating, so that strategies may be carried over between disciplines and between home and school. Therefore, it is important to work closely with each respective professional to customize an individualized treatment program and home program, that has set quantifiable goals and progress should be monitored closely and approximately every 6-8 weeks to ensure the child is benefitting.
Motor skills offer children a strong foundation from which they may continue their development into higher learning, cognitive and academic skills, like reading. By mastering skills like handwriting and reading, children build self-esteem because they can master their worlds.
Kelly Beins is owner and Occupational Therapist at Occupational Therapy Consulting, LLC (link to: www.otc-frederick.com), in Frederick, MD and Washington, DC. She is certified in sensory integration and integrated Listening systems and has worked with children and adolescents with learning challenges for the past 13 years. Ms. Beins has presented at the local and national levels and currently writes for her own blog and local publications about various topics related to child development.