Dyspraxia, a form of developmental co-ordination disorder (DCD), is a common disorder affecting fine and/or gross motor co-ordination in children and adults. While DCD is often regarded as an umbrella term to cover motor co-ordination difficulties, dyspraxia refers to those people who have additional problems planning, organising and carrying out movements in the right order in everyday situations.
Dyspraxia can also affect articulation and speech, perception and thought (Dyspraxia Foundation, 2013). Although dyspraxia may occur in isolation, it frequently co-exists with other conditions such as attention deficit hyperactivity disorder, dyslexia, language disorders and social, emotional and behavioural impairments. DCD/dyspraxia is generally considered to be present in about 5 per cent of the population, with boys more frequently affected than girls.
It is often difficult to make a diagnosis of DCD in a young child (that is, under the age of five) as a number of difficulties noted could be related to other conditions or simply a lack of opportunity to learn a skill.
If there are concerns, a referral should be made to the GP. Typically, children will be referred to a paediatrician as well as to physiotherapy and occupational therapy for an assessment, advice and treatment.
Children may show some or all of the following signs, which will appear significantly more pronounced in children with DCD than in their peers of a similar age.
- High levels of motor activity - unable to sit still.
- May constantly bump into objects, fall or trip over.
- Awkward running gait.
- Little interest in or poor ability with throwing, catching or kicking balls.
- Difficulty walking up and down stairs.
- Difficulty pedalling a tricycle or a similar type of toy.
- Lack of an awareness of danger.
- Difficulty with fine motor skills such as using cutlery, pencils, drawing and cutting.
- Delay in hand dominance.
- Messy eater - frequently spills drinks and prefers to use fingers.
- Prone to temper tantrums and may be easily distressed.
- Lack of imaginative play and a dislike of playing with constructional toys.
- Speech and language difficulties.
- Poor ability to play with peers.
- Highly sensitive to sensory stimulation, such as noise or wearing new clothes.
- Difficulties following instructions.
- Poor concentration.
DCD/dyspraxia will have an impact on the child's ability to practise and be good at activities and sports as well as later, with their academic work. As a consequence they do not practise the key skills of co-ordination, stamina and core stability vital for the perfection of life skills.
Studies have shown that children do not grow out of their difficulties and that problems do continue into adolescence and adulthood. To ensure that these children reach their maximum potential and are as successful as possible in life, early identification is of paramount importance.
PRACTICAL IDEAS
To help a child develop key motor skills, encourage them to:
- walk on different surfaces such as thick mats, cushions, duvet covers and balance boards
- catch balloons, scarves, juggling balls and different-sized balls
- catch bubbles in the air
- have fun on obstacle courses and in soft play areas.
When working on fine motor skills, ensure the child is in a good sitting position with their feet flat on the floor and their bottom back, and provide resources such as:
- chunky pencils and crayons
- magnetic games and toys, as these provide some resistance to build hand strength
- playdough that can be rolled, pinched and squeezed
- larger equipment such as puzzles with round knobs rather than small pegs, and
- an easel for drawing.
To help the child with dressing and at mealtimes:
- use loose-fit easy on/off clothing with Velcro fastenings
- place a non-slip mat under a plate and provide cutlery with chunky handles, and
- consider the child's preferences for food textures.
Finally, to help support the child's speech and thought processes, be sure to:
- break down tasks into small sections to be mastered one by one
- give only one or two instructions at a time and ask the child to repeat them before carrying them out
- use simple language with visual prompts
- focus on teaching play skills such as turn-taking and negotiating
- use visual timetables to show daily events
- choose an environment free from distractions when focusing on new skills.
SUMMARY
Though the child will not 'grow out' of the condition, there is much that can be done to help them. In addition to the professional help, the Dyspraxia Foundation is the only national charity solely dedicated to supporting people affected by the condition. It offers support to parents, those affected with dyspraxia, and the professionals working with them.
Members have access to many useful fact sheets and information as well as local support groups for families and adults.
It is important that those working in the field are able to identify and offer support as well as encourage children to carry out physical activities and lead as active life as possible to ensure good health and well-being for their future.
CASE STUDY: OSCAR RAINBOW
Oscar Rainbow is like any other four-year-old boy who loves to play football.
However, when aged just two and half years, Oscar was diagnosed with developmental speech dyspraxia.
The initial signs were spotted at his two-year check-up as he struggled with basic speech patterns. Although this was quickly dismissed as a speech disorder, after much investigation his obvious difficulties were eventually found to be dyspraxia. However, he had to wait until he was three before he could embark on speech therapy.
With guidance from the Dyspraxia Foundation, Oscar's parents were able to talk with his playgroup (and later school) staff about his condition and how to help him.
This year, Oscar started reception and is helped by a teaching assistant during his lessons. Moreover, having speech therapy three times a week has allowed Oscar to progress greatly. Children with developmental speech dyspraxia benefit from regular appointments with a speech therapist and lots of repetition with words.
Giving clear visual instructions is also hugely advantageous when communicating with dyspraxic children. In addition to this, creative teaching methods using sports, art and music should never be underestimated as a great learning prop for children with developmental speech dyspraxia.
Thanks to a supportive family, school and the Dypraxia Foundation, Oscar has been given the right advice early on. Last year, Oscar's sister Daisy gave up sweets, chocolate, ice-cream and cake for an entire month and raised more than £1,000 to help the foundation.
Oscar's mother Karen urges other families with children with signs of developmental speech dyspraxia to fight for regular speech therapy appointments, as this is imperative in helping a child get to grips with their condition.
At times, Karen had to really push for recognition of Oscar's condition and believes more should be done to help children in this situation. To sign her petition for improvement in the level of provision of NHS paediatric speech and language therapy in England, visit http://epetitions.direct.gov.uk/petitions/45538.
MORE INFORMATION
Dyspraxia Awareness Week is 13-19 October 2013. To find out more about the campaign and the condition, contact The Dyspraxia Foundation at 8 West Alley, Hitchin, Herts SG1 1ED, on 01462 455016, or visit www.dyspraxiafoundation.org.uk
