Dyspraxia

Dyspraxia: Developmental Coordination Disorder that affects Planning, and Motor Execution

Dyspraxia is a developmental coordination disorder that is neurological in origin and present from birth. This condition arises from dysfunction in the brain region responsible for orchestrating the sequence of movements needed to perform motor actions. However, the exact cause of this condition remains unidentified.

Dyspraxia is not a muscle-related disorder (the muscular system functions normally), nor is it an intellectual disability. On the contrary, children and adults with dyspraxia typically have strong verbal and non-verbal comprehension and reasoning skills. They can clearly explain the goals they wish to achieve (e.g., “I want to ride a bicycle”; “I want to tie my shoelaces”) and the steps required to accomplish them (i.e., they can describe the sequence of movements they need to perform).

Studies estimate that approximately 8% of the population is affected by dyspraxia. As it significantly impacts academic performance and athletic abilities, dyspraxia is a major cause of learning difficulties throughout life. Early identification and tailored interventions are crucial for addressing this disorder effectively.

The Two Types of Dyspraxia

1. Oral Dyspraxia
   This type affects the coordination of the tongue, lips, jaw, and palate muscles required to program a sequence of articulatory movements that transform sounds into words. Key symptoms include:
   • Delayed language production,
   • Poorly articulated words, and
   • Difficulty controlling speech rate and intensity.

It is essential to distinguish oral dyspraxia from other conditions like dysphasia (although they may co-occur) and dysarthria (since the orofacial muscles are not weak or paralyzed). Individuals with oral dyspraxia understand language well, know what they want to say, and understand how to express it.

1. Motor Dyspraxia
   This type involves difficulty coordinating the muscles and joints of the arms, wrists, fingers, hips, legs, and ankles to execute sequences of movements aimed at a goal (e.g., swimming, cycling, climbing stairs). Motor dyspraxia also involves challenges in integrating visual-spatial information with motor sequences, resulting in gestures and movements that are not always contextually appropriate.

Subtypes include:

1. • Dysgraphia: Difficulty coordinating finger movements for writing and drawing.
   • Construction Dyspraxia: Difficulty assembling parts of an object into a coherent whole (e.g., assembling model kits or furniture).

Dyspraxia and Self-Esteem

The developmental coordination disorder, or dyspraxia, often has a detrimental impact on self-esteem. Since athletic abilities are highly valued in school-age children, dyspraxic children are frequently excluded or ridiculed. They often feel incompetent in almost everything they do, leading them to avoid group activities, withdraw socially, and, in some cases, develop depression.

Challenges Caused by Motor Dyspraxia

Preschool Age

• Delayed motor milestones (rolling over, sitting, standing, walking);
• Balance issues;
• Difficulty running, jumping, throwing or catching a ball, skipping rope;
• Challenges climbing stairs and dressing;
• Frequent falls;
• Difficulty holding a pencil, using utensils, solving puzzles, or playing with building blocks;
• Trouble with cutting and crafts.

School-Age Children

• The same difficulties as preschoolers, with little or no improvement;
• Trouble copying information from the board;
• Laborious, immature handwriting and drawing;
• Difficulty organizing their school bag;
• Struggles with making their bed;
• Challenges in math and geometry, especially with tools like rulers, compasses, or protractors;
• Poor performance in physical education and sports (e.g., cycling, swimming);
• Difficulty with artistic activities (painting, dancing).

Adults

• Difficulty shaving, applying makeup, or styling hair;
• Challenges with household tasks like ironing, using a can opener, or folding clothes;
• Struggles playing musical instruments;
• Difficulty with carpentry or peeling vegetables.

Associated Disorders

Dyspraxia often co-occurs with other neuropsychological conditions, which vary greatly between individuals, highlighting the need for thorough neuropsychological evaluation. These include:

• Short-term memory impairments (verbal and non-verbal);
• Attention deficits (with or without hyperactivity);
• Executive function impairments (planning, organizing);
• Visual-perceptual difficulties.

Dyspraxia can also be part of broader neuropsychological syndromes such as:

• Nonverbal learning disabilities;
• Autism spectrum disorder.

Next Steps

If a child is suspected of having a learning difficulty related to dyspraxia, the first step is to obtain a comprehensive neuropsychological evaluation. This will help determine the nature and origin of the difficulties. Based on the findings, professionals can recommend appropriate academic accommodations to support the child’s learning and guide them toward suitable interventions.