Developmental Dyspraxia in Children and Adults

WHAT IS DYSPRAXIA?

Dyspraxia or Developmental Coordination Disorder (DCD) is a

neurological condition which is more common in premature babies. It

affects the organisation of neurological signals between the brain and muscles and often includes sensory differences. (Over or under-sensitive to stimuli)

Dyspraxia also has a genetic link and a close relative is likely to have dyspraxia, dyslexia or a related condition.

People with dyspraxia are often creative thinkers with a lot of empathy for others, and have average to above average intelligence but, due to the difficulties they experience at school, they maybe under achieving and have developed low self esteem. 

IN CHILDHOOD

Dyspraxic babies may show difficulty with co-ordinating the muscles needed for suckling and feeding, and may be late to crawl, walk or talk. They may be hypersensitive to sound or bright light, certain foods textures or touch and not sleep well.

Children with dyspraxia find it difficult to learn to tie shoe laces, get dressed or get organised to go out. They may dislike team games because they are poor at co-ordinating movement such as kicking or catching balls. They tend to “fall over thin air”, bump into things, and have frequent sprains and bruises.

We now know children do not ‘grow out of it’, as used to be thought, though some improvement in co-ordination can be seen as children mature, especially if they do sports such as running, horse riding or rowing which require repetitive strong movement, but the other more subtle effects of Dyspraxia can still make life difficult for adults. 

IN SCHOOL

Dyspraxia is a Specific Learning difficulty (SpLD)

In the classroom these children find difficulty copying from the board because this requires the eye muscles to focus on the board (binocular vision) then refocus down on the paper as well as using fine motor skills to form the letters.

Difficulty with handwriting is common, but this is a problem with making the marks on the page due to poor muscle control rather than reversing letters (d b and p etc) as is seen in Dyslexia.

Children with Dyspraxia are generally very good readers (unless they have dyslexia as well). These conditions may overlap which makes learning doubly difficult for them.

Early diagnosis by a multi disciplinary team in a Child Development Centre is very important.

If it’s not diagnosed children may be labelled ‘lazy’ or ‘stupid’ and are often bullied at school. Humiliation and frustration can cause behavior problems or depression. Luckily, with the appropriate support from home and school many of the difficulties can be understood and overcome. One of the best aids to handwriting is to learn to touch type at an early age and use an “Alphasmart” or laptop in class. Individual sports like Martial Arts, running or rowing can provide exercise and real achievement rather than team games.

SIMILAR AND OVERLAPPING CONDITIONS

Dyspraxia can occur in mild to severe forms, but may be associated with other neurodiverse conditions like Dyslexia, Dyscalculia, Attention Deficit Hyperactivity Disorder (ADHD) Autistic Spectrum Disorders (ASD), Irhlen’s and Joint hypermobility. This is why a detailed medical history and assessment by specialists is necessary. In childhood this is best provided by a team led by a Paediatrician – but Dyspraxia is not seen as a high priority and services may be limited.

LEAVING HOME

The person with dyspraxia faces new difficulties when leaving home. If they go to College or University the environment is a challenge because they tend to have poor organisational skills and poor spatial awareness so tend to lose their belongings and get lost easily.

Getting ideas down on paper is often difficult, even with a computer.

Organising their time is frequently a problem resulting in lateness at lectures, or missing deadlines for assignments.

In addition, if they are living away from home activities like shopping, cooking, eating a balanced diet, keeping clean and socialising are all likely to be areas of difficulty.

Living at home, or remaining longer in Halls before embarking on the adventure of sharing a flat can be helpful.

Mental health problems (anxiety, depression and self harming) are not uncommon. Students may fail the course before they seek help with their dyspraxia.

Learning to drive a car requires co-ordination and spatial awareness. Some never learn to drive and often need several attempts at the driving test before they pass. Statistics show they are safe drivers once they have learnt, though they find it best to avoid distractions like talking when driving. 

IN WORK

There is frequently a history of stress at work with periods of short term employment or unemployment, even for graduates.

The difficulties at work may involve one or more of the following:

  • Poor time-keeping.
  • Slow speed of work.
  • Difficulty remembering instructions unless written down.
  • Untidy appearance.
  • Poor social interaction.
  • Frequent periods of illness (due to falls or stress).
  • Difficulties operating machinery.
  • Poor performance in noisy open plan offices (sensory overload).
  • Clumsiness, accidents, breakages.
  • Difficulty driving, and getting lost.
  • Lower performance than expected for someone with the same academic qualifications.
  • Low income or debt.
  • Anecdotally, women with dyspraxia are more likely to be abused by their partners.

On the positive side, people with Dyspraxia are often very creative, loyal, kind, hard working and enthusiastic. They can see the bigger picture and get on with essentials and can be highly valued in the work place. For example CGHQ (Government Communications Headquarters) highly values people with Dyspraxia and other neuro-diversity because of their particular strengths.

Other helpful adjustments may include part-time secretarial or PA support, templates, a quiet office, noise cancelling headphones, having written instructions and clear priorities. It is best to develop strengths, and get strategies to help with any weaknesses.

They may prefer to work independently and become entrepreneurs and innovators.

Flexi-time is often a help, and if overloaded, going part-time enables some to stay happily in work.

Famous people with Dyspraxia: Albert Einstein (could not tie his own shoe laces as an adult) Jamie Oliver, Richard Branson, Daniel Radcliffe (Harry Potter), Florence Welch (from Florence and the machine), Cara Delevigne (Supermodel), David Bailey (Photographer), Jamie Lambert (Winner of Britain’s Got Talent 2014) and Max Kaufman (Captain of the winning University Challenge team, 2008)

WHERE TO GET SUPPORT AND HELP

There are NHS multi disciplinary teams under a Paediatrician comprising Occupational Therapists, Physiotherapists and Psychologists in CHILD DEVELOPMENT CENTRES. They will assess children up to a certain age, which may be 0-19 or as low as 10 years (This cut-off age varies in different NHS Trusts).

Recent research shows it takes on average 2.5 years to get a diagnosis, and there is often poor follow up.

If the family and school can work together to support a child emotionally, academically and financially, there is a good chance of success in later working life.

However if the family or school are not aware and cannot fund help it is known that a high proportion of adults with dyspraxia are unemployed, in prison, or in psychiatric care who have fallen through the net without diagnosis, remediation or advice.

More research needs to be done in this area.

Unfortunately once out of the Peadiatric system there are NO SUPPORT SERVICES in the NHS for ADULTS WITH DYSPRAXIA, except if they become mentally ill, but even then the underlying cause may not be suspected.

Many find the stress of being ‘bright but unemployed’ causes depression and anxiety.

Through the Equality Act 2010 a diagnosis of Dyspraxia opens doors and enables someone to get “reasonable adjustments” to support them at work.

Access to Work – a government scheme- can provide valuable support at work. It might include having a part time PA/organiser, getting help with travel or specific help with computers /accounts. It is free or low cost to the employer. An occupational therapy assessment is helpful in providing a diagnosis and recommendations for employers.

WHERE TO GET AN ASSESSMENT

In childhood go to your GP who should refer you to your nearest Child Development Centre. The ideal age to get a diagnosis is 5-6 years with a top up at 16-17 before college.  Get a letter from school and list the difficulties at home when going to see the GP with your child.

For Children if you have no local provision by the NHS try:

OTs in Independent Practice www.cotss-ip.org.uk. Go to the Directory and put in your area and ‘dyspraxia’. Phone Help line: 0800 389 4873

or try Dyspraxia UK www.dyspraxiauk.com

For Adults the most appropriate diagnostic assessor to cover work as well as academic needs is a specially qualified Occupational Therapist.

Contact Dyspraxia UK www.dyspraxiauk.com or

The Dyscovery Centre (S. Wales) www.dyscovery.org

Both have helpful websites and information.

FINANCIAL HELP

If entering University or College it is best to get an assessment well in advance of entry so that ‘reasonable adjustments’ can be made before you start the course. You may need to start this process a year in advance.

Some funds towards the cost of an assessment may be available from your University or College. Once diagnosed as having ‘complex needs’ you should be eligible for DSA (Disabled Students Allowance) though the criteria are changing so get some advice from the college or University.

Occasionally your GP or JobCentre Plus, will fund a private assessment, but generally you will have to pay for it yourself. Costs range from £685 – £785 from a specialist Occupational Therapist.

If you are facing financial hardship, Charities may be able to help. Try your library for advice on local charities supporting health, well being and education. If you are a member of a church or trade union you can ask them for help.

 

 

 

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