Re: Developmental Dyspraxia

[Guest guest]

While this is great information, I find that it is not current. We have learned

so much more then in 1975 or even 1997 that we are now implementing with our

kids. Having a child who is 98% recovered from dyspraxia (just some extremely

minor visual motor issues left), I wholeheartedly disagree with the notion that

it is not a disease that you 'recover' from but that you actually 'get' around.

I find this to be 'old' thinking and rather dated in its scope. That is the old

idea of 'coping strategies' rather then attacking the basis of what is really

going awry in the senses and the neurological connections thereto.

I used to believe this 'incurable' nonsense and so did nothing truly proactive

to really help my child. When I tossed those old, dated notions aside and

researched new information, my son got better.

So..... please take 'old' literature with a grain of salt. We now know that the

brain has tremendous plasticity and is capable of wonderous change. We also

know that there is a physical component behind many of these childhood delays

which are responsive to nutritional interventions such as vitamin E and fish oil

being just a couple.

Thank you for the research but careful how much of it you take to heart. Look

at the date of the article and the date of the information within to truly

analyze whether this is old news or breaking news. I read this article on the

UK website website when my son was six.... surely we've learned something new

since then! A lot of these websites never update their resources..... (perhaps

they are run by people who never have experienced recovery?)

Janice

Mother of Mark, 13

[sPAM][ ] Developmental Dyspraxia

http://www.dyspraxia.org.nz/what_is.htm

DEVELOPMENTAL DYSPRAXIA

HISTORY

Developmental Dyspraxia has been recognised by doctors and therapists

since very early this century, when Collier first described it

as 'congenital maladroitness'. In 1937 Dr Orton declared it to

be 'one of the six most common developmental disorders, showing

distinctive impairment of praxis'. Since then it has been described

and labelled by many, such as A. Ayres, who in 1972 called it a

disorder of Sensory Integration, or Dr Sasson Gubbay who in 1975

called it the 'Clumsy Child Syndrome'. Other labels have included

developmental awkwardness, sensorimotor dysfunction, minimal brain

dysfunction, motor sequencing disorder, and most recently

Developmental Coordination Disorder. The World Health Organisation

currently lists it as Specific Developmental Disorder of Motor

Function. Gradually over the years professionals have become

increasingly able to sift out the symptoms and more closely identify

the disorder.

Here in New Zealand it is felt that the term 'Dyspraxia' indicates

more the large range of processing difficulties experienced by our

children. We see them affected in most areas of development, with

pervasive motor planning difficulties at the heart of them. So, for

now, for us, 'Dyspraxia' stays. What it is called matters far less to

the child than does the understanding and help from those around

him/her. Whatever it is called, Developmental Dyspraxia causes

disruptions of major proportions in the lives of those whom it

afflicts and of the families and world around them.

DEFINITION

Developmental Dyspraxia (also known as Developmental Co-ordination

Disorder, and the Clumsy Child Syndrome) is a neurologically based

disorder of the processes involved in praxis or the planning of

movement to achieve a predetermined idea or purpose, which may affect

the acquisition of new skills and the execution of those already

learned. More specifically, it is a disorder of praxis, or the

process of ideation (forming an idea of using a known movement to

achieve a planned purpose), motor planning (planning the action

needed to achieve the idea), and execution (carrying out the planned

movement).

Dyspraxia may affect any or all areas of development - physical,

intellectual, emotional, social, language, and sensory - and may

impair the normal process of learning, thus is a learning difficulty.

It is not a unitary disorder (like measles or chicken pox, where all

those affected share a common set of symptoms), and affects each

person in different ways at different ages and stages of development,

and to different degrees. It is inconsistent, in that it may affect

the child one day but not the next - as if sometimes information

is 'put away in the wrong drawer' - and it may affect children in

different ways at different ages and developmental stages.

It is a hidden handicap as, under normal circumstances, children with

Dyspraxia may appear no different from their peers, until new skills

are tried or known ones taken out of context, when difficulties may

become apparent. In many affected children, Dyspraxia occurs with or

as part of other neurological conditions so that defining common

symptoms may be confusing. Therefore a diagnosis, naming the

disorder, is often very difficult, and sometimes the closest may

be 'shows some Dyspraxic tendencies'. In New Zealand, following a

major international, multi-disciplinary conference on Dyspraxia held

here in 1997, it has become easier for parents to find a professional

who is confident in making a diagnosis.

INCIDENCE

The World Health Organisation states in their 'Diagnostic and

Statistics Manual-IV', that it affects 6% of all children to varying

degrees, while other estimates vary between 10-20%. It is commonly

believed by those in New Zealand who treat Dyspraxia that this number

could be as high as 10%, but as yet insufficient studies have been

done to confirm this number. Whatever the incidence, it is only those

children whose disorder markedly impairs their learning and

development who stand a chance of having their difficulties

recognised, diagnosed, and treated.

AETIOLOGY - DEVELOPMENT

The pre-birth growth and development of the baby follows a set

pattern and time-frame. At conception the fertilised egg begins to

multiply; very soon some separate from the rest and, taking a unique

form, continue to multiply at their own increased rate, as the nerve

cells (neurons) of the brain. By about six months gestation (3 months

before birth) the full complement of neurons, with their axons, has

been produced; after that time no further new neurons are grown. They

do not regenerate, so a neuron which is damaged or dies, or does not

complete its growth (and reach its destination) in time, will not be

replaced or renewed, as are cells in other parts of the body. Thus,

if a cell or group of cells, fails to complete its growth and reach

its destination within the time-frame, future sensory information

from that area will be impaired.

Development which does continue to occur (and does so until old age)

is that of the individual cells, as they grow dendrites and

connections within the brain. There are billions of neurons in every

brain, each with very many connections with other cells. For correct

functioning, neurons have to have developed in sufficient numbers in

the right areas of the brain, extending to the correct destination,

by the appropriate time or they never will. There are two kinds of

neurons - those carrying messages to the brain (sensory) and those

carrying messages from the brain (motor).

At about 3 months before birth the axons begin to develop an

insulating fatty sheath called myelin; this allows messages to be

efficiently carried along them - a bit like insulating an electric

wire, without it the messages or impulses may scatter everywhere,

with it they are concentrated, focussed and aimed at the right

destination. This sheath is in place by around 3 months of age;

babies younger than that can be observed to make random reactive

movements, without purposeful intent. After myelination movements may

achieve a purpose, eyes may become more focussed, and the baby may

recognise or touch a face and smile.

The connections between nerve cells (dendrites and synapses) continue

to increase throughout one's lifetime, their growth stimulated by the

demands of the environment, and as learning takes place.

The brain consists of neurons, connected (by nerve fibres or axons)

to their various destinations in the body, and arranged in convoluted

lobes in two halves or hemispheres. Each hemisphere is also divided

into lobes - the Frontal, Parietal, Temporal, and Occipital lobes.

The Limbic System is among other things the emotional centre of the

brain. Different functions of the body are controlled by different

parts of the brain. " Messages " and information travel along nerve

fibres by way of the Spinal Cord, Cortex, Cerebellum and the Corpus

Callosum. Incoming information from the senses - touch, taste, sight,

smell, hearing, movement, balance, warmth, word, life, self - is

organised and stored in the brain, to be retrieved for use as it is

needed.

PRAXIS

(from the Greek, praxis = movement process, e.g. 'practice') Praxis

is the skill or process that makes us human, the link between brain

and behaviour; it allows us to make choices, to plan our lives and

our actions. With it we can function in our physical world, dress

ourselves, eat with utensils, play, write, build, change our..

environment to meet a purposeful goal. To do these things, one first

needs the idea of doing them (ideation), then to know how to do them

(motor planning), and then be able to perform the actions

(execution). That is Praxis - the ability to organise our activities

in new and creative ways, not automatically.

IDEATION

When we meet a new activity, like a set of blocks, for the first

time, we must first explore them, gathering sensory information about

them - how they feel, taste, look and smell, what shape they are and

how that feels and looks, how much space that shape takes up, what

the weight feels like, are they hard or soft, strong enough to

support each other, do they stay put or roll, balance, what we can

make them do, etc. When all that information and experience has been

explored, and sorted and stored in our brains, then (if the frontal

lobe of the brain is sufficiently well developed) we may retrieve and

use the knowledge of that experience to form the idea of using the

blocks to achieve a purpose - like a road or a bridge. To be able to

achieve this a plan of action is needed.

MOTOR PLANNING

The motor planning area in the parietal lobe of the brain, having

received the idea, must work out and plan the positions of the body,

which arm and leg muscles must contract or relax, in what sequence

and how much, how delicately the finger muscles must move and in

which direction. To work this out it needs to recall sensory

information about our past experience with the blocks - feel, weight,

size, balance, length, space, about the floor, the blocks, and about

ourselves. It also has to plan the sequence in which the muscles are

to work, how still the rest of the body must stay, etc. When this

plan is made, messages are sent out for action.

EXECUTION

Muscles can only contract or relax, and for each muscle there are

nerve fibres bringing messages from the brain telling it which to do,

for how long, and in what sequence, (and sending messages to the

brain from the muscle with sensory information to monitor the

action). When the motor plan has been made, messages are sent first

to each part of the brain, and then to all the muscles to tell them

what to do to carry out (or execute) the actions.

Everything is interdependent. Ideation, motor planning, and execution

are each dependant on accurately recalling the neurological knowledge

(or 'gnosis') gained from experience and sensory information. (In

other words, we can't get the idea, plan the movements, or execute

them unless we know from past experiences that we can.) And all are

dependant on messages travelling the right pathways and making the

right connections.

Praxis develops, just as other skills develop. It does not build or

add up like blocks. Praxis at 2 years is not a miniature version of

Praxis at 5 years; it is rather a new version (because more

connections have been made and used in the brain), enabling more

actions of increasingly better quality, and allowing for more

complicated and refined plans of action to be made.

Animals do not have Praxis. An infant developing normally begins by

making random, uncontrolled movements, arms and legs waving without

intent or purpose. Gradually he learns to lift his head, roll over,

reach for a toy; when these actions are controlled by his will and

done with a premeditated purpose - to see mother or to hold the toy -

some motor planning, and early Praxis, has been involved. The action

is not reflexive, random, accidental, or automatic. When a child

learns to talk, he has to organise a specific set of muscles (the oro-

facial and breathing muscles) to produce the right controlled set of

sounds in the right sequence at the appropriate time, to match a word

pattern he knows, and to achieve a planned purpose. To use language,

he has to have the ability to organise his thoughts, has to have the

retrievable memory of the sequence of movement of those muscles, and

the meaning of the sound-pattern it produces, so that he can repeat

it. This is Praxis.

DYSPRAXIA

Dyspraxia is a disorder of Praxis, where somewhere between sensory

information gathering and storing, ideation, motor planning, and

execution, the messages are not getting through, are not producing

the right result. Maybe the information from the senses was not

collected, transmitted, or sorted and stored properly, or stored in

the wrong place, or not found, or even used but then returned to the

wrong storage area; or maybe the motor plan was incomplete or unable

to be made, or did not connect with the right nerve fibres or muscles

for execution. Whatever it is, Praxis is inconsistently failing.

Inconsistently, because yesterday or this morning the messages may

have been getting through, the needed information retrieved, and the

child may have been able to perform the task, but now he can't, now

the plan has been lost somewhere. It may turn up again at another

time or the child may have to relearn the plan, skill, or task.

Because of the multiple nature of Praxis, there are a vast number of

possible sites of malfunction. It is not known at which point along

the 'practic chain' the malfunction(s) occur - it could be anywhere

from sensory information collection and storage to execution of

actions.

Developmental Dyspraxia is not an illness or disease from which one

can recover, but a neurologically based disorder which one

gets 'around', not 'over'.

It is not a 'unitary' disorder. (Unitary means a disorder where there

is a specific set of symptoms common to each case, like measles or

chicken pox.) Each child is affected in different ways, and to

different degrees. It is possible for a child who is affected in one

developmental area to show symptoms in another area later, according

to developmental demands. Or several different sets of symptoms may

be present from the start. It may occur in isolation or (as is

frequently, the case) as part of another disorder. Skills learned in

one context may not be able to be transferred to a new context, and

need to be learnt anew, a point which shows clearly as the child

moves to a new developmental stage.

Developmental Dyspraxia (D.D.) is different from Acquired Dyspraxia

(A.D.) in that there is no memory of Praxis for the system to recall.

as treatment is given and Praxis learnt, it builds developmentally,

increasing the amount and quality of actions, the brain affected in

D.D. is immature, where that in A.D. has already matured, so children

with Developmental Dyspraxia have no neurological memory of Praxis to

work towards.

CAUSES

Dyspraxia is not the result of poor physical strength, impaired

primary sensation, delayed development, body deformity, or anything

that would show up on normal neurological examination. It can be

acquired through damage to the brain from a stroke, an accident, or

medical disaster to the brain. These people are often older, and have

a neurological memory of praxis to work towards. However, damage

acquired at an early age may also impair the normal course of

development, and thus be developmental. Developmental Dyspraxia

occurs from birth or an early age, thus affecting the normal

development of the child, and its causes are not obvious. There may

be an inherited tendency towards similar neurological disorders.

There may have been a glitch of some kind (illness, slight trauma,

momentary lack of oxygen, etc.) at the crucial developmental time or

at birth which caused damage to some cells. It may be that the growth

of the dendrites or the connections - synapses and neurotransmitters -

which connect the cells is at fault. It may be a matter of which

cells, and how many, failed to grow and develop enough to reach their

destination at the right time before birth. It often co-exists with

other disorders (e.g. mild Cerebral Palsy, Dyslexia, Attention

Deficit Disorder, etc.) This fact also makes diagnosis difficult, as

symptoms intermingle or are shared by more than one disorder. The

gathering, sorting, and storing of sensory information may be faulty.

Or the cause may remain completely unknown. In other words, very

little is known of the causes, despite considerable research over the

years.

ASSESSMENT AND DIAGNOSIS

" Diagnosis depends not on the severity of the motor disorder, but

also on the demands of the environment, social acceptability,

tolerance of errors, and on the child's ability to cope emotionally.

So it may not become apparent until the impaired planning and

execution systems are overtaxed. " (Gubbay) Actions which are learnt

sufficiently well to become 'automatic' no longer involve praxis.

Thus, a Dyspraxic child among his peers doing familiar, learned

things does not stand out as different, seems just the same as the

others. It is only when new or unfamiliar tasks are involved that

differences may become apparent, although, as a Dyspraxic child

quickly learns techniques for covering his inabilities, even then it

is not obvious unless the observer knows what to look for. Different

tests may be given by occupational therapists, speech therapists,

teachers, psychologists, and paediatricians. As praxis affects many

different functions of the body, complete assessment and evaluation

is complicated. Basically it must - exclude other disorders, identify

Dyspraxic signs and symptoms, according to age and stage of

development, professionals examining the child should share findings

to gain a whole, and more accurate, picture, on a team approach.

Because Dyspraxia may occur in isolation (with no other obvious

abnormality), or as part (or a symptom of) another disorder,

diagnosis can be complicated and difficult. Additional problems can

include hyperactivity, learning difficulties, dyslexia, etc. Parents

play a major role in assessment by highlighting the ways in which the

disorder affects the child, themselves, and the family.

TREATMENT

The multiple nature of Developmental Dyspraxia means that therapy

covers many areas, and may include perceptual motor training (sensory

integration therapy), speech and language therapy, maths and

numeracy, reading and literacy, spelling, environmental.

manipulation, behaviour modification, and medication and treatment

for any other disorders.

The aim of treatment is to teach the child Praxis - to be able to

form ideas of trying new things and familiar things in new ways - to

plan the actions, and to execute them. It also focuses on the

different stages of Praxis, and helps it to develop following the

developmental plan. Treatment should if possible be given with a team

approach, each aspect tying in with the others holistically. Each

child's program of treatment is individual to that child, and

regularly reviewed.

Occupational Therapists may use the Southern California Sensory

Integration Tests to test and assess the child, and in treatment use

Sensory Integrative based techniques, which reinforce and help to

integrate information gathered by the senses, so that it can be

stored and accurately retrieved as it is needed. It also helps the

child to use action to gain and organise sensory information, and to

use this information to plan and to achieve the intended action.

Speech and Language Therapists help the child to gain control over

the speech muscles, so that controlled sounds can be produced at

will, to learn to plan language, to learn concepts with which to form

strategies, and to use these strategies to make connections and to

help form judgements.

Psychologists assess cognitive development and learning ability and

potential, and cognitive therapy aims to help the child to use the

gathered and stored information to form concepts, which in turn help

him to make sense of the world. Therapists also encourage fine motor

skills with toys such as puzzles, etc.

Remedial Teachers (Specific Learning Disorder, or SPELD teachers)can

help a child, on a one- to-one basis, with specific problems -

reading, spelling, maths, etc. This is often given in conjunction

with specifically designed sensory integrative-based exercises, and

using teaching methods suited to the individual child. Lessons help

the child to retrieve learned information for use. Teacher-aides in

the classroom, if obtainable, can help the child to achieve and to

learn, working on a one-to-one basis. Brain Gym exercises with their

cross-lateral element, can help the child integrate messages between

the hemispheres of the brain.

A Developmental Optometrist will identify problems with control over

eye muscles and eye tracking difficulties, and give exercises to

help. A child with eye-tracking difficulties will have problems e.g.

in copying from the blackboard or a book.

A Social Worker or Counsellor may be involved if behavioural,

emotional or family difficulties are present.

Classroom teachers need to understand Dyspraxia and the accompanying

learning difficulties children with Dyspraxia may experience. Both

their expectations and their individual teaching method for that

child may have to be adjusted. The Specialist Education Service may

arrange a needs analysis, and if it is deemed necessary, may arrange

any extra help the child may be seen to need.

Parents play the major role in continuing daily treatment routines

and exercises, as well as teaching self-care and life skills -

dressing, cleaning teeth, washing, making the bed, etc. Regular re-

assessment during ongoing treatment, to check on progress and adjust

the program as needed, should be given. Regular contact and

discussion between teachers, therapists, and family, to coordinate

treatment and teaching, is highly desirable. Above all others, the

progress of the child who has Dyspraxia will reverse if he is pulled

in too many different ways at once.

IMPLICATIONS FOR THE CHILD, FAMILY AND SCHOOL

Each child shows a different set of symptoms, possibly in different

areas - constructional, organisational, facial, ocular, verbal, etc.

As perceptual-motor abilities are central to all areas of

development, its malfunction may affect a wide range of areas at home

and at school, from life functions such as dressing or feeding

oneself, to playing, reading, writing, or maths, etc.

Dyspraxia is a hidden handicap. If a person wears glasses, or a

hearing aid, or a brace, it is immediately obvious that he or she has

a disability, and allowances are made. The Dyspraxic child appears

just like any other until learned skills are taken out of context or

new skills tried, when difficulties become apparent. It affects all

areas of development thus:-

PHYSICAL

The child may well be able to perform a task or skill, but unable to

plan the sequence of actions in order to do it. He is quite capable

of doing everything appropriate to his stage of development, but e.g.

pulling a chair to the right place at the table in order to sit and

do a drawing, requires planning which for the child, although he

could do it yesterday, may today be too difficult, 'lost in his

system'. And so with all planned, deliberate actions, from eating

with utensils and dressing himself, to talking, drawing, or

manipulating a puzzle. He may be accident prone, clumsy, lacking in

co-ordination. He may look awkward when walking, running, climbing,

slow to learn to ride a trike, walk, manage steps, put on his

clothes, or clean his teeth. He may have difficulty with eating and

swallowing, be a messy eater, be very fussy about food textures. He

may have difficulty gaining control over bladder and bowels. He may

find it hard to organise his body parts, e.g. when sitting at a desk,

or have a poor body image and be unable to identify the parts of his

body with his eyes closed. He may seemed threatened by new or

unfamiliar physical tasks, and be reluctant to try them, thus at

school Physical Education may be a problem. He may avoid trying new

things or activities which are too hard. Poor fine motor skills may

mean poor handwriting or drawing, or a dislike of puzzles.

INTELLECTUAL

The child usually has 'normal' intellect - is as intelligent as he

would have been without dyspraxia - but may have difficulty in

showing what he knows or integrating faultily stored sensory

information to form concepts. Many children with D.D. are of above

average intelligence, but have a low achievement rate. Without

accurately stored sensory information, he may not be able to form

good concepts to help him make sense of the world. He may not easily

be able to make choices (and may need to learn to do so), unable to

follow a single (or set of) instructions, or to do so in the right

sequence. He may seem easily distractable, seem to prefer activities

suited to a younger age-group, may be slow learning new games and

their rules. His memory may be excellent for some things, but

unreliable; he may have a poor memory for either things heard or

things seen. He may seem unable to plan an activity independently,

may sometimes be heard saying " I'm bored! " He may avoid or be unable

to play with things like Lego, blocks, playdough, etc., which all

require much motor planning. He may be unable to play by himself, and

have to learn to 'play'. Poor planning skills may mean that he needs

constantly to know what is going to happen today, tonight, tomorrow,

to plan ahead and repeat the plan often.

EMOTIONAL

An inability to cope with demands can lead to emotional difficulties,

stress, frustration, anxiety, tension, and failure, with resulting

low self-esteem, and possible behaviour problems. Without the

reliable use of information from experience and his senses, judgement

and awareness of others feelings, of his own feelings, and of

situations may be impaired. He may have difficulty in balancing and

centring himself emotionally. He is normal looking, so there may be

unrealistically high expectations of him. Because he is less in

control, he may become more demanding. He may show inappropriate

emotions, or too much emotion, may be unable to understand or express

his feelings or to moderate his interactions with others. Thus, a

relatively small setback can be a tragedy of the first order, or an

exciting event like a birthday or Christmas can make him physically

ill with excitement. He may have difficulty adjusting to new

situations - holidays, or a new class or teacher. Frustration and

anxiety levels can be high, affecting all members of the family. His

self-esteem is constantly at risk. Frustration, anxiety and tension

may all too frequently be a problem.

SOCIAL

Without the consistent ability to 'read' people, situations, or the

accepted behaviour in situations, friendships may be difficult, as

his ability to moderate his behaviour, modulate his actions, or

anticipate the results of his actions or behaviour (all highly

developed cognitive skills) may be impaired. All development takes

far more effort and work, so he may sometimes seem rather immature if

compared with his peers. It can be a challenge for those teaching him

to keep him motivated to learn for the extra time it takes him, but

on the other hand he has a very great need to keep up with his peers,

and to achieve. He may not be able to judge appropriate behaviour for

a situation. He may be the last one picked or the first one picked

on, open to bullying and teasing. He may tend to play with either

younger or older children rather than his peers, or sometimes prefer

to play alone.

LANGUAGE

Speech is the first consciously planned, voluntary motor skill, the

most obvious of learned voluntary skills, and often the first

disability to be noticed. The need to communicate is basic to our

lives, and the inability to do so sometimes leads to an assumption

that the intellect is also affected. It is not. The child may,

however, have a very strong body-language. Dyspraxia may be a

language problem because it impairs motor planning, which affects

language production by affecting those muscles which control speech

and the organisation of language in the brain. Poor sequencing skills

may affect the order of letters in words or words in a sentence, and

unreliable word-finding skills make telling a story or relating an

event difficult, laborious, and lengthy - or avoided! Many seem to

present initially as a speech problem, with good comprehensive and

poor expressive language. When the words do come, his speech may seem

unclear, he may have trouble getting sounds in words or words in

sentences in the right order. He may find imitating sounds,

whistling, or blowing balloons difficult. When relating a story he

may seem to have trouble organising his thoughts and relating events

in order. He may have had trouble learning to feed or suck. He may

read fluently to himself but not aloud. He may find it difficult to

relate the letter symbol with the sound, and with the sound in the

word and he may have great difficulty with spelling.

SENSORY

He may have a poorly developed (or over-developed) sense of touch, or

a poor auditory memory causing him to need things to be repeated

frequently. His sense of balance may be affected, so he may avoid

situations where it is challenged. He may have trouble with buttons

or shoelaces, because of an inability to judge the positions of his

body parts. He may have trouble blocking out extraneous sounds to

hear particular ones, or finding one item in a pile. Incoming

information may also not be moderated - the child may receive a vast

flood of information instead of a steady flow, thus may be super-

sensitive to touch; a supersensitive vestibular system may cause

motion-sickness; crowds may distress him (though his distress may

show in unexpected ways), etc.

School work may have its problems, even if not initially. Reading,

writing, maths, all require a great deal of planning and

organisation. Difficulties may not appear until the demands of later

stages of development show them up. Teachers may, find the child's

ability to retain learning inconsistent, may find sequence in all

areas, word-finding skills, communication, handwriting, reading

(especially aloud), and following instructions all affected, making

it difficult to gauge either what the child's intellectual potential

might be, or how much information the child has retained or can

recall. He or she will certainly need to discover the child's

strengths and encourage these in order to maintain self- esteem.

Inconsistency means that a skill or ability today may be a disability

tomorrow. This is not laziness - he simply can't. A perceived 'lack

of concentration' may simply mean that his planning (or praxis)

deserted him mid-task. He is an expert in covering his inabilities.

Pressure makes it worse, not better. These children need to learn,

would if they could, but - sometimes - can't.

They may become less articulate when they are upset or excited, and

need to tell you what's wrong. They may be inarticulate when telling

long stories, e.g. about what happened yesterday. Verbal sequence may

be affected; the right word may be known but unable to be retrieved.

They may have difficulty in adjusting to new situations, things out

of routine or out of context, new people, places, classes. They may

be unable to spend a night away from home (e.g. school camps). They

may need to plan for birthdays or Christmas for a whole year - and

still not cope well. Having visitors, expected or not, may cause

confusion and difficulties for him.

Because difficulties may show in one area and not others, it is

sometimes hard for professionals who treat one area to see it as

a 'global' thing, and not specific to their own field of expertise.

It has been noted that there are different types of Dyspraxia

(verbal, motor, cognitive, etc.); a child may be affected in any or

all areas at various stages of development, and to different degrees.

At home, life can be a challenge, both for the Dyspraxic child and

for those around him. He may be incapable of being anything but noisy

at times! The constant need for repetition of his own statements and

questions, our answers and questions, and for overt planning can be

trying. He needs extra attention, which may cause contention among

other family members. Dyspraxia affects judgement in all sorts of

issues, and may affect the ability to pick up on subtleties.

Relationships between all family members carry extra strain. At some

stage the child will need to understand the disorder, as will all

family members.

Dyspraxic children are normal, bright, lovable, intelligent children

who have difficulty planning and organising appropriate actions or

behaviour. The understanding and help of all who deal with them is an

essential part of their learning process. He or she is not dumb, not

stupid, not lazy, and not often un-cooperative.

PROGNOSIS

As has been indicated, the main aim of treatment is to help the child

circumnavigate his difficulties, to learn and to achieve his

potential. Without the appropriate help at the right time, the

possibility exists of him growing into an extremely frustrated, and

probably unemployable adult. However, given early therapy and help he

can learn, achieve, and eventually become a happy, satisfied, useful

adult. There are those in many highly responsible positions

throughout our society who have achieved their ambitions and work

successfully within their particular fields of interest, in spite of

their dyspraxia; equally, there are those who, without early help,

are a constant drain on our welfare and prison systems, and live

constantly with frustration.

REFERENCES AND BIBLIOGRAPHY

'The Clumsy Child', by Dr. Sasson Gubbay.

'Sensory Integration and the Child', by A. Ayres.

Conference proceedings of the conference, 'Getting it Together',

Christchurch, September 1997.

'Planning to Move, Moving to Plan - Living with Developmental

Dyspraxia in New Zealand', by Judy Davies.

'Praxis makes perfect', by the Dyspraxia Foundation of the U.K.

'Dyspraxia, a Guide for Teachers and Parents', by Kate Ripley, Bob

Daines, and Barrett.

'Sensory Integration Theory and Practice', by Fisher, Price, and

Bundy.

'Dyspraxia', by Niklas .

'The Cognitive Neurosciences', edited by Gazzangia.

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[Guest guest]

Hey Janice:

There is no date as to when the article was put together (not that I

found)...dates mentioned yes, but the info came from The Dyspraxia

Support Group of New Zealand web page. The article was compiled

using other resources-some outdated yes. The same can be said about

many subjects that come up here like for instance Special Diet for

Special Kids and Is this Your Child both written in the 90's might be

outdated to some. Or some of the books on Sensory Integration

Dysfunction might be outdated to some. The information one finds in

the books might be helpful to one and not another depending on the

situation that is going on with the child or what the parent is

interested in learning at that time.

I always find it interesting how two people reading the same article

comes out thinking differently about the same article. I saw the

statement below different--to me it reads that it isn't an illness or

disease such as Diabetes or heart disease, etc. but something a child

can overcome with the appropriate therapies-including all therapies

needed whether it be diets, supplements, speech and/or OT therapies,

etc. A while ago there was debate about using the

term " cured " , " overcome " , etc. I am not trying to debate that here,

just stating that the beauty of a message board is there is no one

size fits all and people will get different information that might

help based on whatever the situations are for their child.

" Developmental Dyspraxia is not an illness or disease from which one

can recover, but a neurologically based disorder which one

gets 'around', not 'over'. "

I actually found the information on neurons and sensory integration

interesting....

Tina

>

> While this is great information, I find that it is not current. We

have learned so much more then in 1975 or even 1997 that we are now

implementing with our kids. Having a child who is 98% recovered from

dyspraxia (just some extremely minor visual motor issues left), I

wholeheartedly disagree with the notion that it is not a disease that

you 'recover' from but that you actually 'get' around. I find this

to be 'old' thinking and rather dated in its scope. That is the old

idea of 'coping strategies' rather then attacking the basis of what

is really going awry in the senses and the neurological connections

thereto.

>

> I used to believe this 'incurable' nonsense and so did nothing

truly proactive to really help my child. When I tossed those old,

dated notions aside and researched new information, my son got better.

>

> So..... please take 'old' literature with a grain of salt. We now

know that the brain has tremendous plasticity and is capable of

wonderous change. We also know that there is a physical component

behind many of these childhood delays which are responsive to

nutritional interventions such as vitamin E and fish oil being just a

couple.

>

> Thank you for the research but careful how much of it you take to

heart. Look at the date of the article and the date of the

information within to truly analyze whether this is old news or

breaking news. I read this article on the UK website website when my

son was six.... surely we've learned something new since then! A lot

of these websites never update their resources..... (perhaps they

are run by people who never have experienced recovery?)

>

> Janice

> Mother of Mark, 13

>

>

>