Dyspraxia

Clinic

• Dyspraxia = Developmental coordination disorder (DCD) = Developmental motor coordination disorder = Developmental dyspraxia
• It is a neurodevelopmental disorder characterized by impaired coordination of physical movements as a result of brain messages not being accurately transmitted to the body.
• Deficits in fine or gross motor skills movements interfere with activities of daily living.
• It is often described as disorder in skill acquisition, where the learning and execution of coordinated motor skills is substantially below that expected given the individual's chronological age.
• Difficulties may present as clumsiness, slowness and inaccuracy of performance of motor skills (e.g., catching objects, using cutlery, handwriting, riding a bike, use of tools or participating in team sports or swimming).
• It is also often accompanied by difficulty with organization and/or problems with attention, working memory and time management.
• A diagnosis of DCD is reached only in the absence of other neurological impairments such as cerebral palsy, multiple sclerosis, or Parkinson's disease.

Types

Various areas of development can be affected by DCD and these may persist into adulthood.

• In children, DCD may exhibit as delays in early development of sitting, crawling, walking; poor ability or difficulties with childhood activities such as running, jumping, hopping, catching, sports and swimming; slowness; frequent tripping and bruising; poor handwriting skills; difficulties with self care; difficulties with skills such as using cutlery or tying shoelaces; poor spatial understanding; difficulty following instructions; poor time management; and often losing objects.
• In adulthood, in addition to a childhood history as above, the condition may manifest as a difficulty learning new motor skills or applying skills in a different or busy environment, poor organization and time management skills, missed deadlines and lateness for appointments (or earliness as a coping strategy), and awkward pauses before answering in conversation. There is often a history of underachievement in education or the workplace. Although skills can be acquired, such as neat handwriting, handwriting speed will then be much lower than expected.

DCD has no cure. Often various coping strategies are developed, and these can be enhanced through occupational therapy, psychomotor therapy, physiotherapy, speech therapy, or psychological training.

Evidence from research and clinical practice indicates that DCD is not just a physical disorder, and there may be deficits in executive functions, behavioural organisation and emotional regulation that extend beyond the motor impairments and which are independent of diagnoses of co-morbidities. In addition to the physical or motor impairments, developmental coordination disorder is associated with problems with memory, especially working memory. This typically results in difficulty remembering instructions, difficulty organizing one's time and remembering deadlines, increased propensity to lose things or problems carrying out tasks which require remembering several steps in sequence (such as cooking). Whilst most of the general population experience these problems to some extent, they have a much more significant impact on the lives of dyspraxic people. However, many dyspraxics have excellent long-term memories, despite poor short-term memory. Many dyspraxics benefit from working in a structured environment, as repeating the same routine minimises difficulty with time-management and allows them to commit procedures to long-term memory.

People with developmental coordination disorder sometimes have difficulty moderating the amount of sensory information that their body is constantly sending them, so as a result these dyspraxics may be prone to sensory overload and panic attacks.

Moderate to extreme difficulty doing physical tasks is experienced by some people with dyspraxia, and fatigue is common because so much energy is expended trying to execute physical movements correctly. Some dyspraxics have hypotonia, low muscle tone, which can also detrimentally affect balance.