Understanding Dyspraxia

See also: Understanding Autism Spectrum Disorder

Dyspraxia, also known as developmental coordination disorder, is a condition that affects movement and coordination in both children and adults. It can affect ability to perform both fine motor skills—such as holding a pen or pencil and writing—and gross motor skills like running or riding a bike. It is categorised as a neurodevelopmental disorder, and like dyslexia, it is a lifelong condition that cannot be ‘cured’.

Dyspraxia is perhaps not particularly well-known, and is sometimes considered a ‘hidden’ disability. However, it is surprisingly common. It is estimated to affect around 5% of school-aged children, and around 2% are severely affected. This page explains the common signs of dyspraxia, and the support that may be helpful.

What is Dyspraxia?

Defining Dyspraxia

“Developmental Coordination Disorder (DCD), also known as dyspraxia, is a common disorder affecting fine and/or gross motor coordination in children and adults.”

Dyspraxia Foundation

The NHS website draws a distinction between developmental coordination disorder and dyspraxia.

It defines developmental coordination disorder specifically as the difficulties with movement and coordination that first develop in young children. It states that dyspraxia is a more general term that can also be applied to movement difficulties that happen later in life because of damage to the brain. This includes from traumatic brain injury or stroke.

However, for most purposes, the term dyspraxia is likely to be understood as movement and coordination problems affecting either adults or children, which they have had all their lives.

The basic cause of dyspraxia is disruption of messages between brain and body—but the cause of this is usually unclear. Children are more likely to have dyspraxia if they were born prematurely, or had low birthweight. There is also some evidence of a genetic component, because it runs in families.

Signs of Dyspraxia

Signs of dyspraxia are apparent from a very early age, although it is often not diagnosed until later.

In young children and babies, dyspraxia often manifests as slowness to meet developmental milestones associated with fine and gross motor skills. These include crawling and walking, dressing, and self-feeding.

As children grow older and reach school age, they may show difficulty holding a pen or pencil, problems getting dressed or changed quickly, or trouble riding a bike. They may stumble and fall more often, been seen as ‘clumsy’, dislike physical activity or running around, and avoid taking part in playground games.

Developmental disorder or just differences between children?

Every child reaches different developmental milestones at different ages and stages. However, there is a normal ‘range’ for each milestone. Children with dyspraxia will often be ‘late’ when compared with other children of a similar age, but this is not definitive. A formal diagnosis is therefore not usually made until after the age of about 5 years old—even if parents and professionals have been fairly sure of the issue for some time.

Some people have a specific form of dyspraxia called verbal dyspraxia. They have trouble coordinating the precise movements that are required for talking. This may occur by itself, or alongside the more general form of dyspraxia. People with verbal dyspraxia may show long pauses before responding to comments or questions.

Some people with dyspraxia also have trouble with organisation. They may find it difficult to pay attention, follow instructions, or remember things. Some may also struggle with time management.

In fact, many adults with dyspraxia say that these issues are more difficult to manage than the coordination problems.

Co-occurring conditions

Dyspraxia often occurs with other neurodevelopment conditions and specific learning difficulties such as dyslexia, attention deficit hyperactivity disorder (ADHD), dyscalculia and autism spectrum disorder. Many of these conditions also have similar signs and symptoms, including the organisational and memory issues.

Do you need separate diagnoses for each one?

It depends whether that is helpful. If your school or workplace (or your child’s school) is prepared to meet your or their needs based on a single diagnosis and how you or they present, then you probably don’t need to take it any further.

Young people with dyspraxia are likely to be anxious, and often have low self-esteem. It seems likely that this is related to feeling ‘different’ or ‘less’ than those around them because of their physical difficulties. People with dyspraxia may also be more likely to develop mental health problems such as depression or anxiety, and may therefore need to seek medical help.

Diagnosing Dyspraxia

To get a formal diagnosis of dyspraxia, you need an assessment carried out by a qualified professional. As a starting point, it is a good idea to talk to your family doctor. You might also already be seeing a paediatrician or, for a school-aged child, be able to talk to the school’s Special Educational Needs Coordinator (SENCo). They can all make a referral for an assessment.

The assessment is likely to be carried out by one or a combination of a paediatrician, an occupational therapist, a physiotherapist and/or an educational psychologist. These professionals all have different expertise: for example, an occupational therapist will assess functional ability to carry out particular tasks, and a physiotherapist will assess motor skills.

An assessment usually looks at both fine and gross motor skills, and then compares those with age-standardised ‘norms’. A neurological assessment may also be needed to rule out any other conditions.

A diagnosis of dyspraxia is generally only made if four conditions are satisfied:

  • Motor skills are significantly lower than would be expected for someone of that age and experience;

  • The lack of motor skills significantly affects day-to-day activities;

  • The symptoms developed from an early stage of development; and

  • There is no other cause of the lack of motor skills (such as a general developmental delay or learning disability, or a medical condition such as cerebral palsy).

Coping with Dyspraxia

Dyspraxia cannot be ‘cured’, but there are ways to help people with dyspraxia to develop coping strategies.

These include both formal therapy and things you can do for yourself. For example:

  • Occupational therapy can help to find easier ways to carry out tasks that are difficult; and

  • Cognitive behavioural therapy can help to change thinking and behaviour, enabling issues to be seen differently.

There is also evidence that keeping fit and active can be helpful in managing dyspraxia and improving coordination. However, people with dyspraxia may need some help in getting started, and may find that their progress is not as rapid as those around them. Parents can help by encouraging children to get involved in a physical activity that interests them, and then to keep going. They can also provide additional support by teaching children how to do tasks that they find difficult, or helping them to practise these tasks.

Tools like electronic calendars or reminders can be helpful for organisation. Schools may also be able to provide additional help or accommodations, such as tools to help with pen or pencil grip or, later, an accommodation to use a laptop or computer to avoid having to hand-write everything.

A Final Thought

Having dyspraxia is likely to make life more difficult, and schools are not always the most accommodating places. However, with the right help and support, you can develop good coping strategies. More, you can find things you love to do—and then do them.