About Dyspraxia FAQs
The following is a list of frequently asked questions, please select the category you think your question may apply to or use the search feature.
Developmental coordination difficulties are thought to affect between 5-10% of school-aged children, with 2% being severely affected. In the UK these difficulties are often referred to as dyspraxia, although in other countries the term developmental coordination disorder (DCD) is more commonly used. The term DCD describes a more generalised motor co-ordination difficulty which shows a marked difference between the levels of skills that would be expected for age or level of intelligence and significantly interferes with academic or activities of daily living. This is not caused by another medical condition (for example cerebral palsy) and is not part of a pattern of general learning difficulties. The term dyspraxia describes an immaturity in the development of the organisation and sequencing of movements. It can also affect speech, perception and thought. Not all people with DCD have dyspraxia, but often the words are used interchangeably. Difficulties associated with both DCD and dyspraxia have an impact on living and learning in all areas of a child’s life, at home, school and at play.
The term autism is used to describe individuals who have a marked difficulty with social relationships, social communication/language skills and imagination. These difficulties are often accompanied by repetitive patterns of behaviour and interests. Children with Asperger’s syndrome are at the more able end of the autism spectrum and have difficulty with the non-verbal aspects of social communication such as gesture and facial expression. They also have difficulty adjusting their language to and behaviour to different social situations. Motor coordination difficulties are often observed in children with Asperger’s syndrome. In theory a formal diagnosis of dyspraxia should not be made if a child has a “pervasive developmental disorder” (including autism). However in reality children are sometimes given both diagnoses, especially if their motor coordination is significantly affected. Where the autism is severe this should be given as the main diagnosis.
No “dyspraxic gene” has been identified. However many parents of children who have dyspraxia can identify another member of the family with similar difficulties: as dyspraxia is more often found in boys than girls this may be a father, grandfather, uncle or cousin. Sometimes, during the course of an assessment fathers realise that they experienced similar difficulties as a child. They then have to rethink their own life experiences while also supporting their child and partner.
Dyspraxia is generally recognised to be an impairment or immaturity of the organisation of movement. Neural systems that are developing more slowly will have insufficient sensory and motor integration foundation on which to build more complex movements. Recognised developmental milestones may be affected with a pattern of late achievement in skills such as rolling, sitting, standing and walking. Later more complex movements such as running hopping, jumping or kicking and catching a ball may not be at peer level. Movements can be slow and hesitant and are not picked up instinctively, and there may be lack of confidence to tackle new skills. PE and games may be avoided. Balance and stability are often affected and the child may fall or trip over nothing. The control of fine motor skills such as writing and art work are usually more difficult. Conceptual problems can occur such as mastering jigsaws and sorting games when young, and producing graphs, maps and analysing in science and mathematics later on.
If a child is causing concern in any areas showing immaturity in planning and organising movement or problems or delays in speech and language, the further investigation and recognition of the child’s needs will allow the child to receive appropriate intervention and support to help achieve their potential. Recognition and intervention at an early stage enables peer acceptance and coping strategies which support the Dyspraxic child throughout education and beyond. If the child is at pre-school level then a consultation with a GP or Health Visitor can result in a referral to a Paediatrician or a multi-disciplinary team in a child development unit. Child development teams make assessments to determine the child’s needs and provide appropriate advice and /or therapy. Detection of problems often occurs in the school age child. Parents can discuss their concerns with their child’s teacher or the school special needs co-ordinator, the school nurse, school doctor or GP. These people can make referrals to appropriate services within the area for assessment, for example to a Paediatrician, hospital or community based therapy team, educational psychologists or child and family support teams. In adulthood if further diagnosis or intervention support is required, then a GP may refer to appropriate services such as therapists, consultant psychologists or neurologists.
Many GPs are unfamiliar with dyspraxia. Therefore it is important to take in information with you. Take in a completed checklist with examples of how the indicators of dyspraxia apply to you. The doctor will probably discuss with you an appropriate referral. Dyspraxia affects people differently, therefore it will be appropriate for some to go to a physiotherapist, for others a speech and language therapist, an optometrist or an occupational therapist. However the GP will also discuss why an assessment is appropriate. Usually it is only necessary if you have hit a “glass ceiling” and your dyspraxia is disabling you from living your life in a way that you want to.
Before going anywhere for advice it is important that your daughter organises her thinking. So many people just haven’t a clue what dyspraxia is. It would be useful for your daughter to jot down all her strengths and lists what her goals and objectives are. Then it is important to acknowledge the difficulties the dyspraxia creates. For example, these may be: Communication difficulties Motor control Organisation Your daughter could then create a written statement about dyspraxia and the way it affects her. (It is so useful as it can be handed to those she meets rather than her having to continually explain things.) The statement should say what she has achieved, what she is good at and what strategies are useful to accommodate her learning difference. This document should not be longer than 2 sides of A4 paper. There is plenty of information on the Dyspraxia Foundation and Key 4 Learning websites to help. Armed with this document, there are then several places for her to go for help. Jobcentre Plus. Your daughter could go and see the advisors and give them her disclosure document. They will discuss with her a variety of options and government schemes that are available for individuals with learning differences to help them gain jobs. The local careers advisory team and/or Connexions. They will also give support and should have a specialist advisor who will be able to help. Employers. She could to directly to employers by replying to adverts and send her disclosure document with the application form. Once your daughter has a job, there is a government scheme called Access to Work. Both she and her employer can benefit from their help and support ensuring that the appropriate adjustments are put in place to help. Finally, going for a first job is hard for everyone. It is especially hard if you have a learning difference. It is important that your daughter has lots of support. Sometimes a buddy, friend or mentor can help and take the pressure off the family by going with your daughter to the Jobcentre or Careers Advisor.
If you are in a large company there will probably be a diversity representative. If there is, this a good place to start. Go and explain the difficulties you are having. Other individuals you could speak to could be; your line manager, a union representative or a member of the Human Resource team. The Government also runs a scheme called Access to Work. You can visit or phone your local Jobcentre Plus and ask for the Disability Employment Advisor who will discuss with you ways in which they can help. Sometimes individuals find it hard to discuss difficulties. It is important to try and identify someone in the organisation that you work in to act as mentor, advocate or buddy. It is also important to identify whether you are recognised as having a disability in the context of the Disability Discrimination Act, as this changes your legal rights. However remember that most good employers will be keen to help and understand your disability as a duty of care.
The Dyspraxia Foundation is unable to endorse or discredit any individual complementary therapy treatment. If one particular therapy has been considered, then gather as much independent information as possible and request the professional or recognised body of the therapist and check their credentials. Parents/those affected should also ask for research to prove the effectiveness of the treatment. The Dyspraxia Foundation issue a fact sheet which can be obtained with regards to treatment approaches, therapies and contact numbers of Professional Bodies.
For most with the diagnosis of Dyspraxia there is no known cause, no clinical neurological abnormality is present to explain the condition. Research suggests that it is due to an immaturity of neurone development in the central nervous system. MRI scanning techniques have identified immaturities in some individuals in the development of neural pathways. Impulses are received through a network of nerve pathways and are received in the cortex, the largest part of the brain. These impulses give information about our physical condition and the surrounding environment. Constant repetition of movement allows more refinement and control of movement in response to a stimulus. Immaturities in the development of these pathways show as difficulties in producing a purposeful, co-ordinated and refined movement. Other areas of the brain known as the limbic system act in synergy with the cortex to respond to instinctive responses in the body. If immaturities occur within the system, over or under reaction to sensory stimuli will affect the emotional and physical control of activity levels. These reactions are usually seen as impulsiveness, hyperactivity and lack of attention.
The term DAMP (Deficits in Attention, Motor Control and Perception) is sometimes used to describe people who have signs of both DCD and Attention Deficit Hyperactivity Disorder (ADHD). It is most commonly used in Scandinavia. The term ADHD is used to describe people whose difficulties with attention, impulsiveness and hyperactivity affect all areas of the life, in particular their social relationships and educational performance. People with DAMP seem to have a particular difficulty with social relationships.
There is a lot of overlap between the signs and symptoms of dyspraxia and dyslexia: research suggests that 52% of children with dyslexia have features of dyspraxia (Kaplan 1998). The term dyslexia is used to describe a difficulty learning to read, write and spell. People with dyslexia often have poor organisational skills and may have difficulty with language (spoken and heard) and with maths. Like dyspraxia, the term dyslexia is used to describe a set of symptoms. It is usually identified by educational experts, and help focuses on specialist teaching of reading, writing and spelling.
Speech & Language
Developmental verbal dyspraxia (dvd) is used in UK to describe the same condition referred to in the USA as developmental apraxia of speech (DAS) or childhood apraxia of speech (CAS).
Verbal dyspraxia refers to difficulty in making and co-ordinating the precise articulatory movements required in the production of clear speech, whereas oral dyspraxia refers to difficulties in making and co-ordinating movements of the vocal tract (larynx, lips, tongue, palate) in the absence of speech. Oral dyspraxia might affect a child’s ability to protrude his tongue on request or to round his lips when copying an adult model. It may affect individual movements or sequences of movements eg moving your tongue quickly from side to side. Although it may seem logical that a child with verbal dyspraxia will also have oral dyspraxia, research and clinical experience suggest otherwise. Some children with verbal dyspraxia do also have oral dyspraxia, but others do not and may in some cases have surprisingly well-controlled oral movements when speech is not involved. Most professionals now distinguish between oral and verbal dyspraxia, but occasionally they are used interchangeably which can be confusing.
In any individual child it is possible for these conditions to occur in isolation or in combinations. However, when they do co-occur, they do not necessarily do so to equal severity. In addition, although there may be co-occurring motor and/or speech features, they may not necessarily be dypraxia. For example, some children with generalised dyspraxia have immature or delayed speech development. However, their motor co-ordination difficulties stand out as their main area of difficulty and their speech difficulties would not match the profile expected in verbal dyspraxia. For other children, their main area of difficulty is with speech production, rendering their speech unintelligible, but they may also have some minor motor co-ordination difficulties.
The Royal College of Speech and Language Therapists holds a register of private practitioners. Independent practitioners list their specialisms. You can visit their website at : www.rcslt.org.uk The Nuffield Speech Clinics held at the Nuffield Hearing and Speech Centre at RNTNE Hospital offer a 2nd opinion NHS service for children with severe speech disorders/verbal dyspraxia , who meet the relevant referral criteria. For further information, see the details at the end of the downloadable fact sheet on developmental verbal dyspraxia on this site.
Speech and language therapists are the appropriate professionals to assess a child’s speech and language skills and to diagnose verbal dyspraxia, where appropriate. If a child has a complex profile involving a range of difficulties (eg affecting learning, behaviour, motor skills and speech and language), a speech and language therapist will be one of a team of professionals involved in the assessment process.