Dyspraxia
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Dyspraxia is a life long developmental co-ordination disorder that is more common in males than in females, and has been believed to affect 8-10% of all children (Dyspraxia Trust, 1991). Ripley, Daines and Barrett state that 'Developmental dyspraxia is difficulty getting our bodies to do what we want when we want them to do it', and that this difficulty can be considered significant when it interferes with the normal range of activities expected for a child of their age. Madeline Portwood makes the distinction that dyspraxia is not due to a general medical condition, but that it may be due to immature neuron development. Part of a continuum of related disorders, dyspraxia is also known as Developmental Co-ordination Disorder, and may also be present in people with Asperger syndrome, dyslexia and dyscalculia, among others. Dyspraxia is described as having two main elements
- Ideational Dyspraxia
- Difficulty with planning a sequence of co-ordinated movements.
- Ideo-Motor Dyspraxia
- Difficulty with executing a plan, even though it is known.
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2.1 Speech and language |
Assessment and diagnosis
Assessments for dyspraxia normally 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. A baseline motor assessment establishes the starting point for developmental intervention programs. Comparing children to normal rates of development may help to establish areas of significant difficulty.
Developmental Profiles
There are six main areas of difficulty which can be profiled within dyspraxia, the four main areas are listed below:
Speech and language
Developmental verbal dyspraxia is a type of ideational dyspraxia, causing linguistic or phonological impairment. Key problems include
- Difficulties controlling the speech organs.
- Difficulties making speech sounds
- Difficulty sequencing sounds
- Within a word
- Forming words into sentences
- Difficulty controlling breathing and phonation.
- Slow language development.
- Difficulty with feeding.
Handwriting and drawing
Difficulties with fine motor co-ordination lead to problems with handwriting, which may be due to either ideational or ideo-motor difficulties. Problems associated with this area may include:
- Learning basic movement patterns.
- Developing a desired writing speed.
- The amount of graphemes to be learned – e.g. the letters of the Latin alphabet, as well as 10 numbers.
- Establishing the correct pencil grip.
Whole body movement, co-ordination and body image
Issues with fine motor co-ordination mean that major developmental targets include walking, running, climbing and jumping. One area of difficulty involves associative movement, where a passive part of the body moves or twitches in response to a movement in an active part. For example, the support arm and hand twitching as the dominant arm and hand move, or hands turning inwards or outwards to correspond with movements of the feet. Problems associated with this area may include:
- Poor timing
- Poor balance
- Difficulty combining movements into a controlled sequence.
- Difficulty remembering the next movement in a sequence.
Physical Play
Difficulties in areas relating to physical play may lead to dyspraxic children standing out from their peers. Major developmental targets include ball skills, use of wheeled toys and manipulative skills, including pouring, threading and using scissors.
- Problems with spatial awareness, or Proprioception
- Mistiming when catching
- Complex combination of skills involved in using scissors
The other two developmental profiles concern dressing and feeding.
General difficulties
Poor hand eye co-ordination can create problems in many areas, including using scissors and glue. Difficulty with positional language leads to left-right confusion. Organisational difficulties include poor listening skills and memory retention, and weak sequencing skills. Dyspraxia may lead to immature behaviour due to frustration or developmental levels.
Role of Support Agencies
Within the United Kingdom there are several agencies that are able to support children with dyspraxia. They may provide reports on the child’s progress, including:
- A developmental history with motor milestones
- Patterns of social interaction, communication and behaviour,
- Educational history and analysis of learning styles
- Views of the child, including their response to the current learning environment.
- The child’s level of overall special educational needs
- resources, equipment and facilities required to support the child.
The following people may be involved in supporting a dyspraxic child:
Paediatric Occupational Therapist
The Paediatric Occupational Therapist provides information, advice and guidance on supporting dyspraxic children. They provide equipment for improving children’s access to activities and may implement programmes to support perceptual difficulties and develop fine motor co-ordination.
Speech and Language Therapist
The Speech Therapist 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.
Health Visitor
The health visitor may assist in a diagnosis of dyspraxia for pre-school age children.
Further Information
- Dyspraxia foundation (http://www.dyspraxiafoundation.org.uk/)
- Madeleine Portwood (http://web.ukonline.co.uk/members/madeleine.portwood/dysprax.htm)
- SpectrumHaven (http://www.spectrumhaven.com) Website, chat room and forums for people with dyspraxia