Developmental Coordination Disorder / Dyspraxia

Developmental Coordination Disorder (DCD) / Dyspraxia is an immaturity of the organisation of movement. The brain does not process information in a way that allows for a full transmission of neural messages. A person with Dyspraxia finds it hard to plan what to do, and how to do it. 

Dyspraxia often comes with language problems, and sometimes a degree of difficulty with perception and thought. Dyspraxia does not affect a person’s intelligence, but it can cause learning difficulties, especially for children. 

Experts say that about 10% of people have some degree of Dyspraxia, while approximately 2% have it severely. Four out of every five children with evident Dyspraxia are boys. If the average classroom has 30 children, there is probably one child with Dyspraxia in almost each classroom. 

The English medical word Dyspraxia comes from: 

The Greek word Dyspraxia comes from the Greek word Praxis, meaning “to practice; (concretely) an act; by extension, a function”. The Greek word Praxis comes from an older Greek word Prassein (prattein), meaning “to pass through, experience, practice”. 

Scientists do not know what causes Dyspraxia. Experts believe the person’s nerve cells that control muscles (motor neurons) are not developing correctly. If motor neurons cannot form proper connections, for whatever reasons, the brain will take much longer to process data. Unfortunately, for many sufferers, there is no obvious cause. 

In very early childhood, the child may take longer than other children to: 

• Sit 
• Crawl (some never go through crawling stage) 
• Walk 
• Speak 
• Stand 
• Become toilet trained (get out of diapers/nappies) 
• Build up vocabulary 
• Speak in a clear and articulate way. Many parents of very young children with Dyspraxia say they cannot understand what they are trying to say a lot of the time 

Later on, the following difficulties may become apparent: 

• Problems performing subtle movements, such as tying shoelaces, doing up buttons and zips, using cutlery, handwriting
• Many will have difficulties getting dressed
• Problems carrying out playground movements, such as jumping, playing hopscotch, catching a ball, kicking a ball, hopping, and skipping
• Problems with classroom movements, such as using scissors, colouring, drawing, playing jig-saw games
• Problems processing thoughts
• Difficulties with concentration. Children with Dyspraxia commonly find it hard to focus on one thing for long
• The child finds it harder than other children to join in playground games
• The child will fidget more than other children
• Some find it hard to go up and downstairs
• A higher tendency to bump into things, to fall over, and to drop things
• Difficulty in learning new skills – while other children may do this automatically, a child with Dyspraxia takes longer. Encouragement and practice help enormously
• Writing stories can be much more challenging for a child with Dyspraxia, as can copying from a whiteboard

The following are also common at pre-school age: 

• Finds it hard to keep friends 
• Behaviour when in the company of others may seem unusual 
• Hesitates in most actions, seems slow 
• Does not hold a pencil with a good grip 
• Such concepts as in, out, in front of are hard to handle automatically 

Later on, in childhood 

• Many of the challenges listed above do not improve, or do so very slightly 
• Tries to avoid sports and physical education 
• Learns well on a one-on-one basis, but nowhere near as well in class with other children around 
• Reacts to all stimuli equally (not filtering out irrelevant stimuli automatically) 
• Mathematics and writing are difficult 
• Spends a long time getting writing done 
• Does not follow instructions 
• Does not remember instructions 
• Is badly organised 

A diagnosis of Dyspraxia can be made by a clinical psychologist, an educational psychologist, a paediatrician, or an occupational therapist. Any parent who suspects their child may have Dyspraxia should see their GP (general practitioner, primary care physician), or a special needs coordinator first. 

When carrying out an assessment, details will be required regarding the child’s developmental history, intellectual ability, and gross and fine motor skills: 

• Gross motor skills: refers to how well the child uses his/her large muscles that coordinate body movement. This includes jumping, throwing, walking, running, and maintaining balance
• Fine motor skills: this refers to how well the child can use his/her smaller muscles. Activities which require fine motor skills include tying shoelaces, doing up buttons, cutting out shapes with a pair of scissors, and writing

The assessor will need to know when and how developmental milestones, such as walking, crawling, speaking were reached. The child will be screened for balance, touch sensitivity, and variations on walking activities. 

Although Dyspraxia is not curable, with time the child can improve. However, the earlier a child is diagnosed, the better and faster their improvement will be. The following specialists most commonly help people with dyspraxia. 

An occupational therapist will first observe how the child manages with everyday functions both at home and at school. He/she will then help the child develop skills specific to activities which may be troublesome. 

A speech and language therapist will first carry out an assessment of the child’s speech, and then help him/her communicate more effectively. 

This involves improving the child’s language, visual, movement, and auditory skills. A series of tasks, which gradually become more advanced, are set. The aim is to challenge the child so that he/she improves, but not so much that it becomes frustrating or stressful.