What is dyspraxia

Dyspraxia is also known as developmental co-ordination disorder or developmental dyspraxia, is a motor skill disorder which impacts upon an individual’s ability to perform either, or both, fine and gross motor skills that affects your movement and coordination and is often identified in early childhood and causes continued problems into adulthood. Fine motor skills include tasks like handwriting, tying shoelaces and buttoning a shirt. Gross motor skills include tasks like walking, running and climbing. Individuals with the disorder will have trouble with a mix of these skills compared to others of the same age, intelligence and level of experience and this trouble will have an impact on their ability to function at home, school and/or in the community. Developmental dyspraxia can also affect verbal, oral and motor skills. Developmental dyspraxia is a lifelong condition.

Developmental dyspraxia (developmental coordination disorder) is characterized by an impairment in your ability to plan and carry out sensory and motor tasks. Dyspraxia is a condition affecting physical co-ordination that causes a child to perform less well than expected in daily activities for his or her age, and appear to move clumsily.

Dyspraxia can also come on later in life after an illness or an injury.

Developmental dyspraxia (developmental coordination disorder) is distinct from other motor disorders such as cerebral palsy and stroke, and occurs across the range of intellectual abilities. Individuals may vary in how their difficulties present: these may change over time depending on environmental demands and life experiences.

The term ‘dyspraxia’ typically refers to developmental, or motor, dyspraxia, rather than verbal or oral dyspraxia. Unfortunately, there is no clear definition of dyspraxia that enables it to be applied consistently, meaning it is often applied in different ways by different groups. It is also used interchangeably with a number of different terms, the most common of which is developmental co-ordination disorder or developmental dyspraxia.

Developmental co-ordination disorder is listed under the Neurodevelopmental Disorders category in the 5th version of Diagnostic and Statistical Manual of the American Psychiatric Association (DSM 5) ¹. It was endorsed as the preferred term at an international, multi-disciplinary consensus meeting in Canada in 1994 and more recently, by the European Academy of Childhood Disability ². The latter stated that there was no evidence for any difference between developmental co-ordination disorder and dyspraxia.

Developmental dyspraxia (developmental coordination disorder) is thought to be around three or four times more common in boys than girls, and the condition sometimes runs in families. A recent review by the European Academy of Childhood Disability ² determined that approximately 5-6% of school-age children are affected. Boys are more commonly affected than girls, though the ration varies considerably from study to study – some suggest twice as many boys are affected while others say the ratio is closer to 7 boys for every girl. Though historically, some professionals dismissed developmental dyspraxia (developmental coordination disorder) as simply clumsiness that will be outgrown, the review by the European Academy of Childhood Disability determined that between 50-70% of children fail to outgrow the disorder ².

Early developmental milestones of crawling, walking, self-feeding and dressing may be delayed in young children with dyspraxia, and drawing, writing and performance in sports are usually behind what is expected for their age.

Although signs of dyspraxia are present from an early age, children vary widely in their rate of development, and dyspraxia isn’t usually definitely diagnosed until a child with dyspraxia is around five years old or more.

Generally, individuals with developmental dyspraxia (developmental coordination disorder) appear “out of sync” with their environment. Symptoms vary and may include poor balance and coordination, clumsiness, vision problems, perception difficulties, emotional and behavioral problems, difficulty with reading, writing, and speaking, poor social skills, poor posture, and poor short-term memory. Children may present with difficulties with self-care, writing, typing, riding a bike and play as well as other educational and recreational activities. In adulthood many of these difficulties will continue, as well as learning new skills at home, in education and work, such as driving a car and DIY.

There may be a range of co-occurring difficulties which can also have serious negative impacts on daily life. These include social and emotional difficulties as well as problems with time management, planning and personal organization, and these may also affect an adult’s education or employment experiences.

Although individuals with developmental dyspraxia (developmental coordination disorder) may be of average or above average intelligence, they may behave immaturely.

While developmental dyspraxia cannot be cured, regular therapy can help improve the dyspraxia. Developmental dyspraxia (developmental coordination disorder) is a lifelong disorder. Many individuals are able to compensate for their disabilities through occupational and speech therapy.

Treatment is symptomatic and supportive and may include occupational and speech therapy, and “cueing” or other forms of communication such as using pictures and hand gestures. Many children with dyspraxia require special education.

A number of therapies can make it easier for children to manage their problems.

These include:

• being taught ways of carrying out activities they find difficult – such as breaking down difficult movements into much smaller parts and practising them regularly
• adapting tasks to make them easier – such as using special grips on pens and pencils so they are easier to hold

Although dyspraxia doesn’t affect how intelligent a child is, it can make it more difficult for them to learn and they may need extra help to keep up at school.

Treatment for dyspraxia will be tailored to your child and usually involves a number of different healthcare professionals working together.

Although the physical co-ordination of a child with dyspraxia will remain below average, this often becomes less of a problem as they get older.

However, difficulties in school – particularly producing written work – can become much more prominent and require extra help from parents and teachers.

How would I recognize a child with dyspraxia?

The pre-school child

• Is late in reaching milestones e.g. rolling over, sitting, standing, walking, and speaking
• May not be able to run, hop, jump, or catch or kick a ball although their peers can do so
• Has difficulty in keeping friends; or judging how to behave in company
• Has little understanding of concepts such as ‘in’, ‘on’, ‘in front of’ etc
• Has difficulty in walking up and down stairs
• Poor at dressing
• Slow and hesitant in most actions
• Appears not to be able to learn anything instinctively but must be taught skills
• Falls over frequently
• Poor pencil grip
• Cannot do jigsaws or shape sorting games
• Artwork is very immature
• Often anxious and easily distracted

The school age child

• Probably has all the difficulties experienced by the pre-school child with dyspraxia, with little or no improvement
• Avoids physical activity and games
• Does badly in class but significantly better on a one-to -one basis
• Reacts to all stimuli without discrimination and attention span is poor
• May have trouble with maths and writing structured stories
• Experiences great difficulty in copying from the blackboard
• Writes laboriously and immaturely
• Unable to remember and /or follow instructions
• Is generally poorly organized

Can my child have both autism and dyspraxia?

Although Dyspraxia may occur in isolation, it frequently coexists with other conditions such as Aspergers Syndrome, Attention Deficit Hyperactive Disorder (ADHD), Dyslexia, language disorders and social, emotional and behavioral impairments.

The term autism is used to describe individuals who have a marked difficulty with social relationships, social communication/language skills and imagination. These difficulties are often accompanied by repetitive patterns of behaviour and interests. Children with Asperger’s syndrome are at the more able end of the autism spectrum and have difficulty with the non-verbal aspects of social communication such as gesture and facial expression. They also have difficulty adjusting their language to and behavior to different social situations. Motor coordination difficulties are often observed in children with Asperger’s syndrome. In theory a formal diagnosis of dyspraxia should not be made if a child has a “pervasive developmental disorder” (including autism). However in reality children are sometimes given both diagnoses, especially if their motor coordination is significantly affected. Where the autism is severe this should be given as the main diagnosis.

Does dyspraxia run in families?

No “dyspraxic gene” has been identified. However many parents of children who have dyspraxia can identify another member of the family with similar difficulties: as dyspraxia is more often found in boys than girls this may be a father, grandfather, uncle or cousin. Sometimes, during the course of an assessment fathers realise that they experienced similar difficulties as a child. They then have to rethink their own life experiences while also supporting their child and partner. Ragu Lingham ³ concluded in his research that there is a hereditary risk factor with coordination difficulties and Michele Lee and Sue Yoxall found in their study ⁴ that 32% reported a family history of dyspraxia or co-ordination difficulties.

How does dyspraxia effect movement and co-ordination?

Recognised developmental milestones may be affected with a pattern of late achievement in skills such as rolling, sitting, standing and walking. Later more complex movements such as running hopping, jumping or kicking and catching a ball may not be at peer level. Movements can be slow and hesitant and are not picked up instinctively, and there may be lack of confidence to tackle new skills. Physical activity and games may be avoided. Balance and stability are often affected and the child may fall or trip over nothing. The control of fine motor skills such as writing and art work are usually more difficult. Conceptual problems can occur such as mastering jigsaws and sorting games when young, and producing graphs, maps and analyzing in science and mathematics later on.

What is the overlap between dyspraxia and dyslexia?

There is a lot of overlap between the signs and symptoms of dyspraxia and dyslexia: research suggests that 52% of children with dyslexia have features of dyspraxia (Kaplan 1998). The term dyslexia is used to describe a difficulty learning to read, write and spell. People with dyslexia often have poor organisational skills and may have difficulty with language (spoken and heard) and with maths. Like dyspraxia, the term dyslexia is used to describe a set of symptoms. It is usually identified by educational experts, and help focuses on specialist teaching of reading, writing and spelling.

I have a daughter with dyspraxia who has just left school and is finding it difficult to find a job. Is there anywhere she could go for help and advice?

Before going anywhere for advice it is important that your daughter organises her thinking. So many people just haven’t a clue what dyspraxia is. It would be useful for your daughter to jot down all her strengths and lists what her goals and objectives are. Then it is important to acknowledge the difficulties the dyspraxia creates. For example, these may be: communication difficulties and motor control organization. Your daughter could then create a written statement about dyspraxia and the way it affects her. (It is so useful as it can be handed to those she meets rather than her having to continually explain things.) The statement should say what she has achieved, what she is good at and what strategies are useful to accommodate her learning difference. This document should not be longer than 2 sides of A4 paper. There is plenty of information on the Dyspraxia Foundation and Key 4 Learning websites to help. Armed with this document, there are then several places for her to go for help. Jobcentre Plus. Your daughter could go and see the advisors and give them her disclosure document. They will discuss with her a variety of options and government schemes that are available for individuals with learning differences to help them gain jobs. The local careers advisory team and/or Connexions. They will also give support and should have a specialist advisor who will be able to help. Employers. She could to directly to employers by replying to adverts and send her disclosure document with the application form. Once your daughter has a job, there is a government scheme called Access to Work. Both she and her employer can benefit from their help and support ensuring that the appropriate adjustments are put in place to help. Finally, going for a first job is hard for everyone. It is especially hard if you have a learning difference. It is important that your daughter has lots of support. Sometimes a buddy, friend or mentor can help and take the pressure off the family by going with your daughter to the Jobcentre or Careers Advisor.

I have dyspraxia and I am having problems coping at work. What can I do?

If you are in a large company there will probably be a diversity representative. If there is, this a good place to start. Go and explain the difficulties you are having. Other individuals you could speak to could be; your line manager, a union representative or a member of the Human Resource team. The Government also runs a scheme called Access to Work. You can visit or phone your local Jobcentre Plus and ask for the Disability Employment Advisor who will discuss with you ways in which they can help. Sometimes individuals find it hard to discuss difficulties. It is important to try and identify someone in the organization that you work in to act as mentor, advocate or buddy. It is also important to identify whether you are recognized as having a disability in the context of the Disability Discrimination Act, as this changes your legal rights. However remember that most good employers will be keen to help and understand your disability as a duty of care.

What is DAMP?

The term DAMP (Deficits in Attention, Motor Control and Perception) is sometimes used to describe people who have signs of both developmental co-ordination disorder and Attention Deficit Hyperactivity Disorder (ADHD). It is most commonly used in Scandinavia. The term ADHD is used to describe people whose difficulties with attention, impulsiveness and hyperactivity affect all areas of the life, in particular their social relationships and educational performance. People with DAMP seem to have a particular difficulty with social relationships.

Dyspraxia in adults

Dyspraxia does not affect your intelligence, but it may make daily life more difficult for you. It can affect your co-ordination skills – such as tasks requiring balance, playing sports or learning to drive a car – and your fine motor skills, such as writing or using small objects.

Causes of dyspraxia in adults

Dyspraxia in adults is more common in men and often runs in families.

It is not known what causes dyspraxia, but you may be at a higher risk of developing it if you were born prematurely.

Dyspraxia in adults symptoms

Symptoms of dyspraxia in adults can vary between individuals and may change over time. You may find routine tasks difficult, and coping at work may be hard.

If you have dyspraxia you may have problems with:

• co-ordination, balance and movement
• learning new skills, thinking, and remembering information at work and in leisure activities
• daily living skills, such as dressing or preparing meals to time
• writing, typing, drawing and grasping small objects
• social situations
• dealing with your emotions
• time management, planning and personal organization

Dyspraxia in adults should not be confused with other disorders affecting movement, such as cerebral palsy and stroke. Dyspraxia can affect people of all intellectual abilities.

Treatment for dyspraxia in adults

Although there is no cure for dyspraxia, there are therapies that can help you cope with your condition and be successful in your studies, work and home life, such as:

• occupational therapy – to help you find practical ways to remain independent and manage everyday tasks such as writing or preparing food.
• cognitive behavioral therapy (CBT) – a talking therapy that can help you manage your problems by changing the way you think and behave.

It may also help if you to:

• keep fit – you may find regular exercise helps with co-ordination, reduces feelings of fatigue and prevents you gaining weight
• learn how to use a computer or laptop if writing by hand is difficult
• use a calendar or diary to improve your organisation – you may be able to synchronise this with your phone and computer
• learn how to talk positively about your challenges and how you have overcome them
• seek out support through programmes such as Access to Work from Jobcentre Plus

Support for people living with dyspraxia

Dyspraxia can have a big effect on your life, but support is available to help you manage your condition and have the best possible quality of living.

It might help to speak to others who have the same condition or to connect with a charity.

Dyspraxia causes

Carrying out co-ordinated movements is a complex process that involves many different nerves and parts of the brain. Any problem in this process could potentially lead to difficulties with movement and co-ordination.

There has been no single cause for developmental dyspraxia (developmental coordination disorder) identified. There is a lot of variability in developmental dyspraxia (developmental coordination disorder) – variability in severity, in the type of skills affected, in the area of control that is impacted (e.g. some children may have difficulty with planning movement while others may have difficulty sending the right messages within the brain and to the limbs to get them to move in the desired fashion), and in the presence or absence of associated disorders. This variability makes it hard for researchers because within any group that they study, it is rare that two children will present with the same make-up of these factors. Scientists do know that there are risk factors that place a child at increased risk of developing developmental dyspraxia (developmental coordination disorder) and these are discussed below. There has also been a recent increase in the study of the brain and how it functions in developmental dyspraxia (developmental coordination disorder) and some of this is explained below.

Brain function in developmental dyspraxia

Technology to study the structure and function of the brain is always improving. Scientists are beginning to use research looking at the brain in developmental dyspraxia, but at this stage, the studies are typically very small and they still have a long way to go.

About the brain

To better understand dyspraxia, it helps to understand a little bit about the brain itself. The brain is made up of billions of cell, or neurons. Each cell has a body, which can receive messages from other cells through little branches that extend from the body. It also has an axon, which looks like the other branches, but is much longer. This axon is used to send messages to other cells. This allows different parts of the brain to talk to each other. Why would they need to talk to each other?

The brain is divided into four lobes (frontal, parietal, occipital and temporal). The cerebellum is attached via an area of the brain stem, which runs from the brain down into the spinal cord. Scientists know that some areas of the brain are move involved in some functions than others. For example, the frontal lobe plays a big part in the way you think. Toward the rear of the frontal lobe, there is an area called the motor cortex – this receives information from lots of areas of the brain and converts them into messages, sent via the spinal cord, to move your body. The parietal lobe interprets information received from your senses. The occipital lobe helps you understand what you see and the temporal lobe helps you understand what you hear.

These different areas of the brain need to communicate with each other to help you understand and navigate your live. For example, to pour a glass of water, you need visual information to help us understand how far away the glass is, which will help us determine the muscles we need to move to reach for a glass. You need sensory information from the parietal lobe to tell you how heavy the glass is so that you can use the right amount of force to grasp the glass. And so on.

The structure of the brain in developmental dyspraxia

All areas of the brain and spinal cord contain two types of matter – grey and white. Grey matter contains the cell bodies and the message receiving branches of the cell. One recent study examined children with combined motor and attention deficits and found that the grey matter was thinner in some regions (frontal, parietal and temporal lobes) in children with deficits compared to those without ⁵. This might mean that the cell bodies are smaller or there are less of them.

White matter contains the axons, or message sending branches of the cells. A new technology allows research to measure these pathways. Two small studies have indicated that there may be differences in the maturity or integrity of these pathways in developmental dyspraxia ⁶.

The function of the brain in developmental dyspraxia

Brain function can be explored by asking individuals with developmental dyspraxia to complete set tasks within a brain scanner. Researchers can then analyse which areas of the brain are active and compare this pattern to that in individuals without impairment. Overall, the studies that have done this so far indicate that there are differences in brain activity in developmental dyspraxia, most often observed in areas of the brain known to contribute to motor function, such as the frontal and parietal lobes and the cerebellum ⁷.

When this is all pulled together, it appears that the brain of individuals with developmental dyspraxia is not functioning in the same way as individuals without developmental dyspraxia. Whether this is because there are fewer or smaller cells, or the pathways that send messages between the cells are less mature, or some other reason, is not certain and requires more research. The differences may result from any of the risk factors we discussed earlier, from another, not yet identified risk, or a combination.

Risk factors for developmental dyspraxia

1. Premature birth (before the 37th week of pregnancy). The most recognised risk factor for developmental dyspraxia is being born premature (less than 37 weeks gestation). A review study reported that an estimated 40.5% of children born preterm scored in the mild-moderate motor impairment range on standardised batteries, and 19% fell in the moderate-severe range ⁸. This represents 2.5-4 times more children in these ranges than we would expect in an average sample of children. We also know that the percentage of children falling within the motor impaired range increases as gestational age decreases – i.e. there is a greater risk of developing developmental dyspraxia when born at 28 weeks compared with being born at 34 weeks ⁹. Some disagreement remains about whether a child born premature should be given the same developmental dyspraxia diagnosis as a child born at term. The motor impairment we see in both is similar on the surface, but a child born premature is often exposed to a much higher number of pre- and post-birth complications – for example, their mother may have had an infection, they may have been in intensive care due to low oxygen, they may have been given steroids after birth. Exposure to such complications may result in later motor impairment that is different in origin to that seen in children who were born at term.
2. Male gender. It is unclear why, but males are more likely to be diagnosed with developmental dyspraxia than females. The ratio of males to females varies, with a recent review reporting ratios of between 2 to 7 males to each female ¹⁰.
3. Small for gestational age (being born with a low birth weight). Children born at a weight considerably lower than that expected for their gestational age are considered small for gestational age. This has found to be a risk factor for developmental dyspraxia in children born at term, as well as those born premature ⁹. Being born with a low birth weight (small for gestational age) can be the result of smoking in pregnancy (this is not the only cause though) – maternal smoking has also been noted as a risk factor for developmental dyspraxia ⁹.
4. Having a family history of dyspraxia. A family history of clumsiness has long been considered a potential risk factor for developmental dyspraxia ¹¹, but it has only been more recently that geneticists have begun to quantify the genetic component of the disorder. Current estimates suggest that up to 70% of the variability we see in developmental dyspraxia is linked to an individual’s genetic make-up ¹², but much more work is needed in this area.
5. Other factors – the mother drinking alcohol or taking illegal drugs while pregnant. There are lots of other factors that could potentially impact on a child’s risk of developing developmental dyspraxia. These include, but are not limited to, environment, the socioeconomic status of the child’s family, nutrition, movement exposure and complications in pregnancy or early life.

Dyspraxia symptoms

Dyspraxia (developmental co-ordination disorder) can cause a wide range of problems. Some of these may be noticeable at an early age, while others may only become more obvious as your child gets older.

Problems in infants

Delays in reaching normal developmental milestones can be an early sign of dyspraxia in young children. For example, your child may take slightly longer than expected to roll over, sit, crawl or walk.

You may also notice that your child shows unusual body positions (postures) during their first year.

Although these may come and go, they also:

• have difficulty playing with toys that involve good co-ordination – such as stacking bricks
• may have some difficulties learning to eat with cutlery

Problems in older children

As your child gets older, they may develop more noticeable physical difficulties in addition to a number of other problems.
Movement and co-ordination problems

Problems with movement and co-ordination are the main symptoms of dyspraxia.

Children may have difficulties:

• with playground activities such as hopping, jumping, running, and catching or kicking a ball – they often avoid joining in because of their lack of co-ordination and may find physical education difficult
• walking up and down stairs
• writing, drawing and using scissors – their handwriting and drawings may appear scribbled and more childish than other children their age
• getting dressed, doing up buttons and tying shoelaces
• keeping still – they may swing or move their arms and legs a lot

A child with dyspraxia may appear awkward and clumsy as they may bump into objects, drop things and fall over a lot.

But this in itself isn’t necessarily a sign of dyspraxia, as many children who appear clumsy actually have all the normal movement (motor) skills for their age.

Some children with dyspraxia may also become less fit than other children as their poor performance in sport may result in them being reluctant to exercise.

Additional problems

As well as difficulties related to movement and co-ordination, children with dyspraxia can also have a range of other problems, such as:

• difficulty concentrating – they may have a poor attention span and find it difficult to focus on one thing for more than a few minutes
• difficulty following instructions and copying down information – they may do better at school in a one-to-one situation than in a group, as they’re able to be guided through work
• being poor at organizing themselves and getting things done
• not automatically picking up new skills – they need encouragement and repetition to help them learn
• difficulties making friends – they may avoid taking part in team games and may be bullied for being “different” or clumsy
• behavior problems – often stemming from a child’s frustration with their symptoms
• low self-esteem

But although children with dyspraxia may have poor co-ordination and some of these additional problems, other aspects of development – for example, thinking and talking – are usually unaffected.

Related conditions

Children with dyspraxia may also have other conditions, such as:

• attention deficit hyperactivity disorder (ADHD) – a group of behavioral symptoms that include inattentiveness, hyperactivity and impulsiveness
• dyslexia – a common learning difficulty that mainly affects the way people read and spell words
• autism spectrum disorder (ASD) – a condition that affects social interaction, communication, interests and behavior

Some children with dyspraxia have difficulty co-ordinating the movements required to produce clear speech.

Dyspraxia diagnosis

Talk to your doctor, health visitor or special educational needs co-ordinator if you think your child has dyspraxia.

They may refer your child to another professional who can help arrange an assessment.

This could be:

• a pediatrician – a doctor specializing in the care of children and babies, who will usually be based in your local community (community paediatrician)
• a pediatric occupational therapist – a healthcare professional who can assess a child’s functional abilities in daily living activities, such as handling cutlery and getting dressed
• a pediatric physiotherapist – a healthcare professional who can assess a child’s movement (motor) skills
• a clinical psychologist or Child and Adolescent Mental Health Services clinician – a healthcare professional who specialises in the assessment and treatment of mental health conditions to deal with emotional problems
• an educational psychologist – a professional who assists children who are having difficulty progressing with their education as a result of emotional, psychological or behavioral factors

Other doctors who may be involved in this process include a neurodevelopmental pediatrician or a pediatric neurologist.

These are pediatricians who also specialize in the development of the central nervous system, which includes the brain, nerves and spinal cord.

A neurodevelopmental pediatrician may work at a child development center or local health clinics.

Occasionally, a neurologist is needed to help rule out other conditions that affect the brain and nervous system (neurological conditions), which may be causing your child’s symptoms.

It’s important to get a correct diagnosis so you can develop a better understanding of your child’s problems and appropriate support can be offered.

Getting a diagnosis can also help reduce the stress experienced by both parents and children with dyspraxia.

Assessment

The diagnosis of dyspraxia is usually made by a pediatrician, often in collaboration with an occupational therapist.

Generally, the pediatrician is more involved in the diagnosis and the occupational therapist is involved in both diagnosis and treatment.

For a diagnosis to be made, it’s essential for the child to have what is called a norm-referenced assessment of his or her motor ability, which may be carried out by an occupational therapist, physiotherapist or pediatrician.

Children with suspected dyspraxia are usually assessed using a method called the Motor ABC, which involves tests of:

• Gross motor skills – their ability to use large muscles that co-ordinate significant body movements, such as moving around, jumping and balancing
• Fine motor skills – their ability to use small muscles for accurate co-ordinated movements, such as drawing and placing small pegs in holes

Your child’s performance on the assessment is scored and compared with what is the normal range of scores for a child of their age.

There also needs to be evidence that the child’s mental ability is within the normal range for his or her age.

This may be clear based on reports from the child’s school obtained by a pediatrician, although sometimes the child may also have a standard assessment of mental ability done by a psychologist or, in the case of young children, a pediatrician.

As part of an assessment, your child’s medical history, which includes things like any problems that occurred during their birth and whether there have been any delays reaching developmental milestones, will be taken into account.

Your family medical history, such as whether any family members have been diagnosed with dyspraxia, may also be taken into account.

Once the assessment process is complete, the pediatrician will produce a report on the child’s condition in collaboration with other professionals involved.

Dyspraxia in children diagnostic criteria

The specific criteria defined by the American Psychiatric Association’s Diagnostic and Statistical Manual, 5th Edition (DSM 5) ¹.

For a diagnosis of dyspraxia to be made, your child usually needs to meet all of the following criteria: 

1. Acquisition and execution of coordinated motor skills are below what would be expected at a given chronologic age and opportunity for skill learning and use; difficulties are manifested as clumsiness (e.g. dropping or bumping into objects) and as slowness and inaccuracy of performance of motor skills (e.g. catching an object, using scissors, handwriting, riding a bike, or participating in sports).
2. The motor skills deficit significantly or persistently interferes with activities of daily living appropriate to the chronologic age (e.g. self-care and self-maintenance) and impacts academic/school productivity, prevocational and vocational activities, leisure and play.
3. The onset of symptoms is early in the developmental period.
4. The motor skills deficit cannot be better explained by intellectual disability or visual impairment and are not attributable to a neurologic condition affecting movement (e.g. cerebral palsy, muscular dystrophy, or a degenerative disorder).
   

Dyspraxia should only be diagnosed in children with a general learning disability if their physical co-ordination is significantly more impaired than their mental abilities.

Although dyspraxia may be suspected in the pre-school years, it’s not usually possible to establish a definite diagnosis before the age of four or five as it can be difficult to be certain whether a child has dyspraxia if they’re still very young.

Dyspraxia treatment

Dyspraxia in children can’t be cured, but there are ways your child can be helped to manage their problems.

A small group of children, usually those with mild symptoms of clumsiness, may eventually “grow out” of their symptoms.

But the vast majority of children need long-term help, and will continue to be affected as teenagers and adults.

Once dyspraxia has been diagnosed, a treatment plan tailored to your child’s particular difficulties can be drawn up, which may involve input from a variety of specialists.

This, combined with extra help at school, can help your child manage many of their physical difficulties, improve their general confidence and self-esteem, and enable them to become a well-adjusted adult.

Healthcare professionals

A number of healthcare professionals may be involved in your child’s care.

For example, your child may need help from a pediatric occupational therapist, who can assess their abilities in daily activities, such as:

• handling cutlery
• dressing
• using the toilet
• playing
• school skills involving fine movement activities – such as writing

The therapist can then work with the child and their parents and teachers to help find ways to manage any problems.

Your child may also receive help from a pediatric physiotherapist. They can help assess the child’s abilities and create an individualized therapy plan, which may include activities to help improve walking, running, balance and co-ordination, among others.

Other health professionals that may be involved in your child’s care may include:

• a pediatrician – a doctor who specializes in the care of babies and children
• a clinical psychologist – a healthcare professional who specializes in the assessment and treatment of mental health conditions
• an educational psychologist – a professional who assists children who are having trouble progressing with their education as the result of emotional, psychological or behavioral factors

Some of the interventions these health professionals may provide are outlined below.

Task-oriented approach

One of the main types of intervention used to help children with dyspraxia manage their condition is known as a task-oriented approach.

This involves working with you and your child to identify specific activities that cause difficulties, and finding ways to overcome them.

For example, a therapist can help improve difficulties with specific movements by breaking the action down into small steps, and teaching your child to plan these individual movements carefully and practise them regularly.

Your child may also benefit from adapting tasks to make them easier to perform, such as adding special grips to pens to make them easier to hold, or wearing loose-fitting clothes and Velcro fasteners rather than shoelaces to make dressing easier.

Your child may be encouraged to exercise regularly as well, as this is generally considered to be beneficial for children with dyspraxia.

Process-oriented approach

An alternative method to the task-oriented approach is the process-oriented approach. This approach is based on the theory that problems with your child’s senses or perception of their body may be contributing to their movement difficulties.

A process-oriented approach may involve regular activities aimed at improving these potential problems, with the aim of trying to improve your child’s more general movement (motor) skills, rather than helping them with a particular task or activity.

However, this isn’t thought to be as effective as the task-oriented approach outlined above.

Treating other conditions

Children with dyspraxia often have other conditions as well, which may need to be treated separately. The treatments for some of these related conditions are described below.

Attention deficit hyperactivity disorder (ADHD)

If your child also has attention deficit hyperactivity disorder (ADHD), they may benefit from taking medication to help them concentrate better, be less impulsive, feel calmer, and learn and practise new skills.

Dyslexia

If your child also has dyslexia, they may benefit from special educational interventions designed to improve their reading and writing.

Autism spectrum disorder

If your child also has autism spectrum disorder (ASD), they may benefit from special programmes designed to help improve their communication, social interaction, and cognitive and academic skills.

Speech and language problems

Speech and language therapy may be useful if your child also has problems with their speech.

A speech and language therapist can assess your child’s speech, identify what problems they have, and help them find ways to communicate to the best of their ability.

This may involve exercises to move the lips or tongue in a certain way, practising producing certain sounds, and learning to control their breathing.

Treatment as your child gets older

Although the physical co-ordination of a child with dyspraxia will remain below average, this often becomes less of a problem as they get older.

By adolescence this usually improves as they get older, although difficulties in school – particularly producing written work – can become much more prominent.

A further treatment period by an occupational therapist for handwriting problems may be helpful when your child is a little older.

Teachers may request older children be allowed more time in exams. Having access to a computer can make homework easier, and some schools will provide a laptop.

A young person with dyspraxia may also have one or more of the associated problems mentioned above, which may adversely affect their behaviour, socialisation and school achievement.

These young people often require a significant degree of parental support in addition to the treatment they receive.

Alternative therapies

Because of the potential limitations of available treatments for dyspraxia and the fact it can’t be cured, some parents may be tempted to look into alternative therapies that claim to cure or greatly improve the condition.

But there’s usually no scientific evidence to support the use of alternative therapies, and they can be expensive and time consuming.

It’s also important to bear in mind that in many cases the physical co-ordination problems associated with dyspraxia will naturally improve over time.

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