Dyspraxia
An information booklet for parents and families
This book belongs to: Age:
Contents
What is Dyspraxia?
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How does dyspraxia affect the body?
2
Common symptoms of dyspraxia
3
A child’s perspective - Suzie
5
Draw your own
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What is Occupational Therapy?
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How can Occupational therapy assess my needs?
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How can occupational therapy help?
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A case study - Suzie
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A child’s perspective after occupational therapy intervention
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Draw your own after occupational therapy intervention
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References
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What is Dyspraxia? Dyspraxia is also known as Developmental co-ordination disorder (DCD). Dyspraxia is a neurodevelopmental disorder, meaning that it is difficult for the brain to communicate effectively with the body. As a result, communications may be slow or inaccurate and certain tasks may be more challenging to complete. Dyspraxia is a condition that is known to affect an individual’s physical coordination. This can impact a child’s ability to take part in daily activities they enjoy and are expected of them. This could be running, playing hopscotch, or handwriting in class. Although there is no cure for dyspraxia and it is a lifelong condition, there are a number of ways that the difficulties caused by dyspraxia can be lessened to help children overcome some of their difficulties and make activities easier for them. You may also notice that the symptoms of dyspraxia can change over time, or become less severe, this may be through practice, therapies, or naturally as the child ages. When receiving a diagnosis, it can be difficult to process all the information you are given. In this booklet, we will talk about how dyspraxia affects your body, symptoms of dyspraxia, and how Occupational Therapy can help. We will include activities for you to complete with your child to aid you through the process of receiving a diagnosis of dyspraxia.
Did you know? Dyspraxia is thought to affect around 6% of the population, with 2% being affected severely.
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How can dyspraxia affect the body? Neurological – the brain
Dyspraxia is a neurological condition, meaning it affects the brain and how the brain communicates. Some research suggests that dyspraxia is caused by neurons in the brain not maturing or developing quickly enough, which is why it is called a neurodevelopmental condition. Dyspraxia can make it difficult for the brain to send signals to the rest of the body, meaning that signals may be slow, get lost, or confused.
The brain is split into different areas, including the motor cortex. The motor cortex is responsible for controlling muscles and their movements. This is where fine and gross motor skills are produced. Fine motor skills are considered to be movements using small muscles, and usually refer to the fingers in this situation. These movements require hand-eye coordination, and are used for activities such as handwriting, picking things up, as well as doing buttons or shoelaces. Gross motor skills on the other hand are movements using larger muscles, such as in the arms, legs and core (stomach muscles). These skills are used to perform movements such as running, jumping, maintaining balance, and lifting. Anatomical – the body As dyspraxia is a neurological condition, there are not many anatomical or biological affects on the physical body. However, it has been suggested that a physical symptom of dyspraxia can be muscle weakness, due to difficulties caused by the brain communicating ineffectively with the body, causing muscles to be underused, or not used appropriately. Now we will look at how these affects can be seen in the symptoms of dyspraxia.
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Common Symptoms of Dyspraxia: You may notice symptoms of dyspraxia early on in development in a child with dyspraxia, these symptoms can look different depending on age.
Babies: •
Developmental delays such as rolling, crawling, walking and feeding.
•
Problems with sleeping.
•
Unusual and overly frequent movement in arms and legs.
•
Abnormal posture.
Although signs of dyspraxia may be noticeable are from a young age, dyspraxia is usually not formally diagnosed until a child is 5+ years of age.
Children: •
Difficulty with gross motor skills such as: o
Coordination and balance.
o
Jumping.
o
Catching and throwing balls.
•
o
Running.
o
Kicking a ball.
o
Skipping.
o
Running.
Difficulty with fine motor skills such as: o
Handwriting. 3
o
Using scissors.
o
Doing up buttons, shoelaces and zips.
o •
Using cutlery.
Difficulty focussing on tasks (short attention span).
•
Difficulty organising self and activities
•
Difficulty remembering instructions seen or told.
•
Takes longer to learn skills.
All of these can be overwhelming and difficult for a child to process, which can lead to frustration and behavioural difficulties. It is important to remember that tasks can be a lot more challenging for children with dyspraxia than for a child without, so it can be helpful to write lists as prompts and provide more time for completing activities particularly challenging.
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This is Suzie. Suzie has dyspraxia, and here she is sharing with us how her dyspraxia affects her.
I find it hard to remember what my mum and teachers have asked me to do
I find buttons really tricky to do up, they’re too fiddly! Sometimes I struggle to write neatly!
I find it hard to kick a ball and play hopscotch with my friends! I always trip over my feet!
I can never figure out how to tie my shoelaces by myself
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Your turn: Use the stick figure to draw a picture of yourself, and then write or draw all the ways you think dyspraxia affects your body and activities. You can look back at Suzie or the symptoms list if you need some help!
Don’t forget to date this page so you can come back to it later! Date: 6
What is Occupational Therapy? Occupational Therapy is used to help individuals overcome challenges that may prevent them from completing activities important to them, these activities are called activities of daily living, or occupations. Occupational therapy in paediatrics assesses how conditions or difficulties are affecting a child’s activities of daily living, or in other words, their occupations. Occupations can be anything from getting washed and dressed, to their handwriting, or playing football with friends. In this case, Dyspraxia may make activities of daily living harder for individuals, which means children just need more time and sometimes more help to complete these activities. To help this process, Occupational Therapists work with patients and their families to consider what is most important to the patient and decide on activities or resources to help an individual access their occupations.
For children, this may include handwriting therapy to improve handwriting skills if you are struggling in school, or help with self-care activities such as dressing, doing buttons, zips or shoelaces if they are struggling to complete these tasks independently.
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How can Occupational Therapy assess my needs? You may be referred to Occupational therapy through the GP, paediatrician, school or privately to seek an assessment for dyspraxia. Before conducting a formal assessment for dyspraxia, the Occupational Therapist will often have an initial assessment, which is a first meeting where they will ask both the parent and child about their concerns. They may ask the child to complete some activities in session to help them understand their abilities, and from this will decide whether to conduct a standardised, formal assessment. Dyspraxia can be diagnosed through formal assessments, often carried out by Occupational Therapists or Physiotherapists. Once dyspraxia is diagnosed, they can help arrange therapy activities to make activities easier and more accessible. One way in which Occupational Therapists may try to assess for a diagnosis of dyspraxia is through a Movement ABC for children. This is a standardised assessment which assesses fine motor skills, throwing and catching, and balance, meaning it is done the same way every time, and scored the same way to provide official evidence for a diagnosis. The scores assess how in need a child is of interventions attaining to the areas mentioned above, and are used as an indication of dyspraxia for diagnosis. Other non-standardised assessments may be done before or at a later date, such as writing activities, gross motor skill analysis and practical tasks such as doing buttons and shoelaces.
From this assessment, the Occupational Therapist will be able to understand what the individual’s needs are, and will be able to tailor a treatment plan specifically to this. Different people, although they share the same diagnosis of dyspraxia, will have different needs and activities they find challenging. Identifying treatment goals with the child and the family can help the Occupational Therapist plan treatments to help the child work towards and achieve the activities important to them. 8
How can Occupational Therapy help? When taking part in occupational therapy sessions during treatment, various activities may be used according to your child’s needs. Possible activities may include: •
Fine motor control activities: o
Squeezing clothespin
o
Playing with water guns
o
Putting coins into piggy bank
o
This aims to help improve hand dexterity (ability to move
hand and fingers), by working on hand muscle strength, independent finger movements, thumb opposition, arching the palm of the hand, and in-hand manipulations
(moving an object from palm of hand to fingers). •
Gross motor skill activities: o
Throwing and catching to improve coordination
o
Shoulder presses and chair presses to improve upper limb and shoulder strength, as well as increase brain’s awareness of limbs (this is called proprioception)
•
Handwriting activities: o
Fluency patterns to improve pencil fluency (ability to move pencil continuously)
o
Dot to dots
There are many other activities that may be used, that your occupational therapist will talk you through as it is applicable to your child’s needs. The best part is that your child can do these activities at home too, your occupational therapist will most likely provide resources to parents and school to encourage the completion of activities in between therapy sessions to get the best out of therapy. 9
Suzie – A case study When we saw Suzie earlier, she was explaining all of the activities that she finds difficult. Suzie was referred to an Occupational Therapist who conducted a Movement ABC for Suzie and found that she had strong symptoms of dyspraxia, which led to her formal diagnosis. After assessing the activities that Suzie struggles with, and discussing these with Suzie and her mum, the Occupational Therapist came up with a treatment plan and goals for Suzie to help her with her activities. Suzie’s main areas of difficulty were: • • • •
Handwriting Buttons Laces Motor planning (hopscotch)
During therapy sessions, Suzie would do various activities, such as playing with theraputty, handwriting activities like tracing patterns and dot to dots as well as learning her letter formations. Suzie was also asked to pick up pegs, and move them around her hand to help make her hands stronger. These activities would help her handwriting, which she reported she found difficult to do neatly at school. They would also help her do laces and buttons, which she practised in each session. To improve her coordination and motor-planning, Suzie would do shoulder and core exercises, as well as physical activities to help her stability and strengthen her muscles to improve her gross motor skills. Suzie also did these activities between therapy sessions with her teaching assistant and mum, this helped her keep practicing her activities to improve her skills even more.
At the end of the treatment block, Suzie had a review with her Occupational Therapist, where they talked about the goals they set, and whether they were met. Because Suzie had worked so hard in her therapy sessions, and continued her activities throughout the week, her skills had massively improved. Even though not all her skills were perfect, Suzie and her Occupational Therapist agreed to discharge her so she could carry on practicing at home. 10
After completing the session, Suzie redid her drawing we looked at earlier, this time to show how her previous difficulties had improved after her therapy treatment block!
I now write a checklist of everything I have to do, and I don’t forget as much
I can now do buttons by myself, they’re still fiddly though!
My handwriting is a lot better now, it’s not perfect, but my teacher says I just need a bit more practice!
I’m getting better at hopscotch, and I don’t trip over as much, I scored a goal in football last week!
I can now tie my shoe laces using the double hoop method
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Your turn: Complete this at the end of your treatment block. Like you did before, use the template to draw yourself, and then write or draw about all the ways you think your activities have improved after your therapy sessions. You can look back at Suzie and your previous drawing to help remember!
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Key References: About occupational therapy (no date) RCOT. Available at: https://www.rcot.co.uk/about-occupational-therapy/what-is-occupationaltherapy (Accessed: 17 June 2022). Editorial, C. (2016) What Are The Symptoms Of Dyspraxia?, CureJoy. Available at: http://curejoy.com/content/symptoms-of-dyspraxia/ (Accessed: 17 June 2022). Developmental co-ordination disorder (dyspraxia) in children (2018) nhs.uk. Available at: https://www.nhs.uk/conditions/developmental-coordinationdisorder-dyspraxia/ (Accessed: 16 June 2022). Difficulty With Fine Or Gross Motor Skills - Movement Disorders - Symptoms - Neurological - What We Treat - Physio.co.uk (no date). Available at: https://www.physio.co.uk/what-we-treat/neurological/symptoms/movementdisorders/difficulty-with-fine-or-gross-motor-skills.php (Accessed: 16 June 2022). Dinehart, L. and Manfra, L. (2013) ‘Associations between low-income children’s fine motor skills in preschool and academic performance in second grade’, Early Education and Development, 24(2), pp. 138–161. doi:10.1080/10409289.2011.636729. Dyspraxia at a glance… (2013) Dyspraxia Foundation. Available at: https://dyspraxiafoundation.org.uk/about-dyspraxia/dyspraxia-glance/ (Accessed: 16 June 2022). Dyspraxia - Conditions - Neurological - What We Treat - Physio.co.uk (no date). Available at: https://www.physio.co.uk/what-wetreat/neurological/conditions/dyspraxia.php (Accessed: 16 June 2022). Dyspraxia (Developmental Co-ordination Disorder) (no date). Available at: https://patient.info/childrens-health/dyspraxia-developmental-co-ordinationdisorder (Accessed: 17 June 2022). Dyspraxia (2016) Foundation for People with Learning Disabilities. Available at: https://www.learningdisabilities.org.uk/learning-disabilities/a-toz/d/dyspraxia (Accessed: 17 June 2022).
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Hill, E. and Barnett, A. (no date) ‘Movement difficulties in children: the case of Developmental Coordination Disorder (DCD)’, p. 8. Information Sheets (2013) Dyspraxia Foundation. Available at: https://dyspraxiafoundation.org.uk/about-dyspraxia/information-sheets/ (Accessed: 17 June 2022). Jordán, O.R.C. and Infantes-Paniagua, Á. (2021) Fine Motor Skills and Academic Achievement: Special Consideration to Graphomotor Skills, Physical Education Initiatives for Early Childhood Learners. IGI Global. doi:10.4018/978-1-7998-7585-7.ch004. Neurological definition and meaning | Collins English Dictionary (no date). Available at: https://www.collinsdictionary.com/dictionary/english/neurological (Accessed: 16 June 2022). SCOTPUBLICHEALTH (2020) ‘The Role of Patient Information Leaflets in the Treatment of Patients’, #ScotPublicHealth, 26 April. Available at: https://scotpublichealth.com/2020/04/26/the-role-of-patient-informationleaflets-in-the-treatment-of-patients/ (Accessed: 16 June 2022). All images were accessed from http://clipart-library.com/
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