Dyspraxia or DCD means difficulty with co-ordination. This can be with large movements of arms and feet making people appear ‘clumsy’. With small (fine motor control) movements difficulties can be experienced with pen handling skills including writing and drawing. It can often be labelled as ‘dysgraphia’, which is difficulty in drawing and writing.
There are varying degrees of clumsiness and some children have problems with fine motor skill, some with balance and others with the larger movements of the limbs (e.g. awkward catching or throwing or running). Some can have all these problems.
The World Health Organisation states in their ‘Diagnostic and Statistical Manual-IV’, that it affects 6% of all children to varying degrees, while other estimates vary between 10-20%.
The cerebellum is involved in using sensory information to allow the learning of movement skills to take place. In other words the cerebellum is responsible for controlling the body’s output control to the muscles, by utilising all the incoming sensory information. These sensors include external senses like vision and hearing as well a body detectors like touch (tactile) sensation and internal movement sensors such as movement detectors in the joints and muscles.
This allows trial and error learning from birth which allows us to become more and more able to perform complex skills, many to the point of automaticity.
With Dyspraxia there is often a difficulty in co-ordinating the left and right sides of the body and also between the upper and lower body. This can lead to those who have Dyspraxia often avoiding sporting activities, especially if ball-handling skills are required. Sometimes there is also heightened sensitivity to noise and touch.
Some individuals with Dyspraxia have speech difficulties, such as stuttering or slurring words when young. This can be referred to as oral dyspraxia or verbal apraxia. Many speech symptoms are managed through early speech therapy training but this does not deal with the underlying cerebellar disorder.
Dyspraxia can often occur in children born prematurely and results in an immaturity of brain and cerebellar development. This means that nerve messages are often not being transmitted properly. Many people find ways of masking the symptoms or circumventing it as they get older, using avoidance techniques.
Children with Dyspraxia often do not crawl as a babies. However many seem to have normal early milestones such as walking. This is because many early skills are inborn but take time to show because the brain of a newborn child is very under developed. Consider an animal which is born with a more mature brain and can walk and run almost immediately without learning the skill. It is only when more skilled movements are needed (e.g. running or using buttons or cutlery that one often notices dyspraxia for the first time.
It is also the time when the cerebellum has developed and can start to aid the learning process.
Key features of Dyspraxia
Children with dyspraxia can exhibit the following characteristics:
- Small objects can be difficult to pick up in younger children;
- Unable to properly complete jigsaws / sorting games;
- Difficulty in holding a pencil / handwriting;
- Cannot sort shapes or sort toys effectively;
- Throwing / catching games are difficult;
- Low muscle tone (can lead to lax joints)
- Difficulty in dressing or tying shoelaces;
- Using a knife and fork is uncoordinated;
- There is confusion in laterality – child changes between right and left hand and may not develop a fully dominant side
- Inability to recognise danger;
- They may tire easily;
- They may demonstrate general irritability or limited social skills;
- There is often poor posture or body awareness;
- Often poor spatial awareness;
- They may give inappropriate verbal responses or seem immature.
- Limited ability to concentrate;
- Late development in language;
- Difficulty in understanding prepositions e.g. (in/on/behind /underneath)
- Unable to follow sequential instructions;
These are the commonest symptoms described in dyspraxics. Some are rarer than others, some are elements of other problems like dyslexia or ADHD.