DYSPRAXIA (DIFFICULTY WITH MOVEMENT)

Dyspraxia is the generic term used to cover a range of disorders affecting the initiation, organization and performance of action. It has been described as having trouble getting the body to do what we want, when we want. It is an immaturity of the way the brain processes information, resulting in messages not being fully transmitted to the body and is a learning difficulty that can be present from birth (developmental dyspraxia) or as a result of brain damage suffered from a stroke or other trauma (acquired dyspraxia).

Dyspraxia is also known as a developmental co-ordination disorder, and may also be present in people with Autism Spectrum Disorder, dyslexia and dyscalculia, among others. Dyspraxia is described as having two main elements
• Ideational dyspraxia – difficulty with planning a sequence of coordinated movements
• Ideo-Motor dyspraxia – difficulty with executing a plan, even though it is known.

Diagnosis of Dyspraxia

Assessments for dyspraxia typically require a developmental history, detailing ages at which significant developmental milestones, such as crawling and walking, occurred. Motor skills screening includes activities designed to indicate dyspraxia, including balancing, physical sequencing, touch sensitivity, and variations on walking activities. There are six main areas of difficulty which can be profiled within dyspraxia; the four main areas are listed below:

Speech and language

• Difficulties controlling the speech organs.
• Difficulties making speech sounds
• Difficulty sequencing sounds
• Difficulty controlling breathing and phonation
• Slow language development
• Difficulty with feeding.

Fine motor control

• Problems with handwriting, which may be due to either ideational or ideo-motor difficulties
• Learning basic movement patterns in writing
• Establishing the correct pencil grip
• Hand aching while writing.

Whole body movement, coordination, and body image

• Issues with walking, running, climbing and jumping
• Poor timing
• Poor balance
• Difficulty combining movements into a controlled sequence.
• Difficulty remembering the next movement in a sequence.

Physical play

• Physical play
• Mistiming when catching
• Difficulty in using scissors
• Problems with dressing and feeding.

Characteristics of Dyspraxia

Due to poor muscle control, many people with dyspraxia have trouble picking up and holding onto simple objects – quite often, objects literally slip through a dyspraxic’s fingers. This disorder causes an individual to be clumsy to the point of knocking things over and bumping into people accidentally. Tripping over one’s own feet is also not uncommon, as is a poor sense of balance in general.
Dyspraxics often have difficulty in determining left from right, and this may cause problems that persist through life. Cross-laterality, ambidexterity, and a shift in the preferred hand are also common in people with dyspraxia.

Some people with this condition have poor spatial awareness in that it may be difficult to determine the speed and position of a particular object, such as potentially a baseball. Dyspraxics may also have trouble determining the distance between them and other objects.
Dyspraxic people may have Sensory Integration Dysfunction, a condition that creates abnormal over sensitivity or under sensitivity to physical stimuli, such as touch, light, and sound. This may manifest itself as an inability to tolerate certain textures such as sandpaper or certain fabrics, or even being touched by another individual (in the case of touch over sensitivity) or may require the consistent use of sunglasses outdoors since sunlight may be intense enough to cause discomfort to a a dyspraxic (in the case of light over sensitivity).

An aversion to loud music and naturally loud environments (such as clubs and bars) is typical behavior of a dyspraxic individual who suffers from auditory over sensitivity, while only being comfortable in unusually warm or cold environments is typical of a dyspraxic with temperature over sensitivity This typically occurs if the dyspraxia is comorbid to an Autism Spectrum Disorder (PDD) such as autism or Asperger syndrome. Otherwise, these symptoms tend not to be present in the individual who has dyspraxia.
Dyspraxic people sometimes have difficulty moderating the amount of sensory information that their body is constantly sending them, so as a result these people are prone to panic attacks. Having other autistic traits (which is common with dyspraxia and related conditions may also contribute to sensory-induced panic attacks.

Dyspraxics (along with people who have similar conditions on the Autism spectrum) may have difficulty sleeping since there is an inability to force the brain to stop thinking and “shut down”. A dyspraxic is nearly always thinking about several unrelated things at once, (the inverse is also possible, with only one dominant thought occupying the dyspraxic’s entire attention span at any given time) so this may cause easy distractability and daydreaming. It is quite easy for someone with dyspraxia to concentrate entirely on a particular thought instead of on the situation at hand. For this reason, dyspraxia may be misdiagnosed as ADHD since on the surface both conditions have similar symptoms in some areas. Many people with dyspraxia have short-term memory issues and may forget instructions they received only seconds before, tend to forget important deadlines, and are constantly misplacing items.

People with dyspraxia can have generally poor social skills due to emotional problems and/or a limited ability to ‘read’ situations and people’s body language. They may have a literal use of language and so find it hard to understand phrases, idioms and/or sarcastic conversation. People with dyspraxia are not purely autistic in the sense that they normally desire to interact with others but merely lack the ability to do so to some extent. Due to this inability to understand other people, most dyspraxics find themselves alone because it may be more comfortable for them. This inability to be around and relate to other people may cause severe frustration in a dyspraxic that may manifest as unusual emotional immaturity in childhood.

Moderate to extreme difficulty doing physical tasks is experienced by dyspraxics, and fatigue is common because so much extra energy is expended while trying to execute physical movements correctly. Some (but not all) dyspraxics suffer from hypotonia, which in this case is chronically low muscle tone caused by dyspraxia. People with this condition have very low muscle strength and endurance (even in comparison with other dyspraxics) and even the simplest physical activities may quickly cause soreness and fatigue, depending on the severity of the hypotonia. Hypotonia may worsen a dyspraxic’s already poor balance to the point where it is necessary to constantly lean on sturdy objects for support.

Treatment of Dyspraxia

The following people may be involved in supporting a dyspraxic child:
Pediatric occupational therapist
The Pediatric occupational therapist provides information, advice and guidance on supporting dyspraxic children. They provide equipment for improving children’s access to activities and may implement programs to support perceptual difficulties and develop fine motor co-ordination.

Speech-Language Pathologist
The Speech-Language Pathologist supports children whose dyspraxia has manifested in speech, and may provide a speech intervention program to be delivered in school.
Educational psychologist
The educational psychologist assesses children in relation to developmental profiles.

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