Developmental Coordination Disorder
Developmental Coordination Disorder is a marked impairment in the development of motor skills and coordination; this has a significant impact on child/young person’s occupations, particularly their self care skills and their school life. In order to be given a diagnosis of DCD other underlying medical reasons for the difficulties must be ruled out. This needs to be done by a Doctor or a Paediatrician. An assessment of motor skills and self care skills can be done by an Occupational Therapist. It is also important to note that there must be a discrepancy between the child/young persons learning ability and their presenting motor and self care skills. For example a 7 year old whose learning ability in school appears to be at the level of 5 years would be expected to have at least the self care and motor skills expected for a 5 year old.
Dyspraxia falls under the DCD umbrella and is associated with specific difficulty in motor planning.
DCD/Dypsraxia and its associated difficulties appear to change with the age of the child/young person. In primary school the child/young person tends to have difficulties with their play skills and learning basic self care skills as well as learning to write and participating in PE. As a child/young person moves in to secondary education their difficulties tend to manifest themselves in their organisational skills and the planning of their work. They may avoid team games and also struggle with their social relationships as well as often having low confidence and self esteem.
Dyspraxia – A ‘hidden’ disability
Dyspraxia is a hidden disability because it often goes undetected for some time. Children ge described as being clumsy or uncoordinated. This is very frustrating for the child because Dyspraxia does not affect intelligence and therefore, they know how to do it but their bodes just don’t do it how they want it to be done. The motor sequencing of an action is affected and everyday tasks such as learning to write become particularly challenging.
Types of Dyspraxia
There are 3 types of dyspraxia–motor, oral, and verbal.
Motor Dyspraxia
Motor dyspraxia affects a child’s ability to plan, sequence and execute movements in a smooth and coordinated manner at will or on command. Children with motor dyspraxia may have trouble with:
- Timing and rhythm
- Responding quickly and accurately
- Problem solving
- Sequencing activities
- Learning a new skill
- Coordinated movement
- Handwriting
- Generalising skills and consistent performance of learned skills
- Delayed developmental milestones such as crawling or walking
Oral Dyspraxia
Oral dyspraxia is a disorder in which it is difficult to plan, sequence and initiate non-speech movements such as sucking, blowing, chewing and swallowing. A child with oral dyspraxia may:
- Dribble or drool excessively
- Have trouble licking an ice cream cone
- Have trouble chewing
- Exhibit difficulties with eating and swallowing
- May lose food out of the front of the mouth
Verbal Dyspraxia
Verbal dyspraxia is a speech disorder that affects a child’s ability to plan, sequence and initiate the movements required for talking. Children with verbal apraxia may exhibit:
- Highly unintelligible speech
- Simplify words
- Had limited babbling as infants with only a few consonants and vowels
- Demonstrate “lost” or groping movements with tongue or lips
- Have delayed expressive language
- Have inconsistent errors in speech (butterfly may come out bufferty or pubberfy or futterby)
- Have more difficulty with multi-syllabic words
- Have vowel errors
- Prosody and intonation are “choppy”
- Automatic phrases (e.g. counting, alphabet, I love you) are easier to say than new phrases or sentences
- Imitating words correctly is very difficult
Verbal dyspraxia can also be called Childhood Apraxia of Speech or CAS.
It is a rare speech disorder.
Below is a checklist which teachers can look through to see if they are concerned about a particular childs planning ability in class. If there are enough symptoms noted, a referral to an occupational therapist or developmental paediatrician is advised.
Checklist for How to Recognise a Child with DCD/Dyspraxia in the Classroom ….
Gross motor difficulties
o Falls, trips and bumps
o Seems awkward when walking up and down stairs, may do one at a time
o Seems awkward when running, may have their arms out to the side or seem unbalanced.
o May struggle in PE with catching and throwing, balance and negotiating apparatus as well as following actions.
o Doesn’t seem to be aware of their own body’s boundaries seeming to have poor spatial skills
o Fidgets in their chair or when on the carpet or tends to slump over their desks or need to lean against a table or others when on the carpet.
o May struggle to ride a trike or a bike in the playground.
o May struggle in swimming lessons to coordinate their bodies or may lack strength in the water struggling to stay afloat.
Fine motor difficulties
o Appears to struggle using their two hands together when using scissors
o Drawing skills are below what you would expect for their level of learning
o Pre/writing skills are behind what you could expect given their verbal skills and their reading ability.
o Tends to avoid construction tasks or appears to find these tricky
o Has delayed self care skills.
Sensory difficulties
o Seems to have difficulties regulating own activity levels
o Seems to have difficulty regulating their own emotions
o Appears to be unable to filter out extraneous noise or visual stimulus
o Can be overly sensitive to loud noises
Cognitive difficulties
o Poor attention span
o Difficulties with short term memory
o Difficulties sequencing tasks
o Seems to have poor problem solving abilities
o Finds it hard to listen, think and do all at the same time for example creative writing in literacy.
o May talk themselves through tasks to help them organise their thoughts and their actions.
Organisation difficulties
o Difficulties transferring skills
o Difficulties organising own belongings, tray, school bag, equipment for lessons.
o May not have a tidy appearance, leaves clothes twisted, inside out, back to front, shoes on wrong feet.
o Loses or forgets things.
o Gets confused or muddled in their thoughts, their speech or actions.
o Struggles to follow a timetable & navigate around the school.
o Doesn’t tend to like change in routine at the last minute.
o Most significant difficulties are with new/novel tasks which are not routine or well rehearsed.
o Tends to look to others for prompts as to what to do.
Social and Emotional difficulties
o Seems to lack confidence
o Often seems to be the quiet child at the back of the class or the other extreme the ‘class clown’.
o Can get easily frustrated, angry or anxious
o Often prefers to play with younger children or prefers adult company
o Doesn’t make friends easily, limited play during break times.
o Often needs to take control of social situations or will prefer to be on their own.
References:
Sourced from www.kids-first.com.au
NHS Coventry Occupational therapy services resource pack
