The co-ordination problems of children with dyspraxia
The term “dyspraxia” is commonly used to cover an extensive range of co-ordination disorders. Technically, developmental co-ordination disorder (DCD) is the overarching description, with dyspraxia as one profile in this range of conditions. Nevertheless, dyspraxia is still used more generally and is recognized by the majority of people as the generic term.
In her book Hands on Dyspraxia, Jill Christmas has identified some of the key indicators of dyspraxia as:
- seeming clumsy and bumping into others
- standing too close to others or knocking over objects
- being easily confused about finding ones way
- struggling with handling toys or balls
- eating messily and spilling things
- poor concentration and struggling to recall instructions, which may come across as laziness
- unclear or muddled speech
- squinting, rubbing eyes, and having running eyes
- prolonged behaviour problems, such as extreme frustration, low self-esteem, social avoidance, fidgeting and distractibility
- poorly developed social skills due to a lack of confidence and ability to “read” non-verbal signs of communication.
A child who seems to be delayed, according to developmental milestones, often catches up in their own time, as each child moves forward at their own pace with development more advanced in some areas than others. However, when a child seems to have a cluster of on-going challenges which are affecting their day to day living, it becomes increasingly important to identify why this is so in order to provide targeted support and strategies to build firm foundations for learning and living.
If a child can be prevented from experiencing repeated failure, s/he is more likely to develop resilience and the self-confidence to try new activities. We know that the Early Years are a very important time for physical, emotional, intellectual and social development and positive and negative experiences can have a profound influence on later learning and development. As Macintyre (2009) has pointed out, “Movement difficulties can be identified early; indeed they may be one of the first signs that extra support is required. And if identification is early, help, intervention, remediation, call it what you will, can be early too.”
Unfortunately, many children with motor difficulties remain undetected until they show signs of significant delay. The Dyspraxia Foundation claim that only one quarter of dyspraxic children are recognized as such when they begin school.
What do we know about dyspraxia?
While figures vary greatly, up to ten per cent of the population may have dyspraxia. Risk factors for dyspraxia include prematurity or post-maturity problems around the birth process or a family history of dyspraxia.
Boys are four times more likely than girls to be referred for assessment for dyspraxia (Christmas, 2009). There is a suggestion that girls tend to be more precise in their fine motor activities while boys are faster and less accurate. This is often observed in pre-school children where boys often prefer gross motor play (Addy, 2004).
Children with dyspraxia usually look physically normal and dyspraxia is not acquired through accident or illness. It cannot be cured, but children can learn to cope better with some of the things they find hard to do. While some children are only mildly affected by the condition, for others dyspraxia can have a significant effect on their lives and learning. Up to 50 per cent of the most severely affected children will continue to have problems as adults.
Dyspraxia is one of a group of specific learning difficulties, including dyslexia, dyscalculia and dysgraphia, and there is often an overlap between these neuro-developmental disorders. There are also often links between dyspraxia and other disorders such as attention deficit hyperactivity disorder and autistic spectrum disorders.
Types of dyspraxia
There are three main types of dyspraxia:
Oral dyspraxia relates to difficulties with planning and carrying out non-speech sounds, such as blowing and sucking, as well as tongue or lip movements. This may have an effect on speech and/or swallowing skills. There may also be dribbling and difficulties eating.
This is a speech disorder that affects the planning, sequencing and execution of movements for making speech sounds. The cause of verbal dyspraxia is not known but there is some evidence of a family tendency towards speech and language problems and, with skilled professional intervention, most children should end up with clear intelligible speech. Children with verbal dyspraxia may have speech which is hard to understand because they are having difficulties in making and co-ordinating the precise movements of the muscles necessary for clear speech. They may simplify words. For example, they may say “bur” instead of “burger” or they may muddle up the order of sounds in a word. They may also pronounce the same word inconsistently.
You may observe them moving their tongue and lips around as they try to work out how to make a sound and they may use gestures to help them express what they want to convey. The child knows what s/he wants to say but persistently makes speech errors which are not usually made at his/her age. As a result, they may come to avoid speaking or limit their vocabulary to words they can articulate.
This term relates to difficulty in planning, sequencing and carrying out sequences of movements in a smooth and co-ordinated way under good control. It is related to voluntary control of age appropriate skills.
When a child explores a new toy, s/he initially gains sensory information about how it feels, looks and smells. In order to do this, the motor planning area of the brain must work out and plan which arm and leg muscles to move and how to maintain balance whilst the sequence is carried out. Although the child may be of average intelligence, s/he may behave immaturely and it will take him/her longer than some other children to manipulate the toy effectively. The child’s performance may also vary from day to day and at different times of the day and this can be a source of great frustration for the child and for those who are living or working with them.
While it is not possible to cure dyspraxia, children can be taught strategies to help them achieve their full potential. This involves a team approach which utilises the skills of many different specialists, such as occupational therapists, speech and language therapists, psychologists and specialist teachers. The programme will depend on the child’s strengths and weaknesses, and advice and exercises will generally be given to help the child and their family come to terms with the challenges dyspraxia can engender.
Mary Mountstephen is a specialist teacher and regularly holds workshops and training for teachers and parents. She is the author of many books, including A Practical Guide to Support Children with Dyspraxia and Neurodevelopmental Delay (Meeting Special Needs):
For further information about dyspraxia, visit:
This article was first published in issue 48 (September/October 2010) of SEN Magazine.