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Developmental Motor Dyspraxia
(10 most asked questions)
by Susan Lowe
Occupational Therapist
(B.App.Sc (OP) Syd, Dip O.T. NSW)
This article is a reflection of my current understanding of the literature and my experience working with children with Dyspraxia. Knowledge is often the result of collaboration between parents, teachers, therapists, doctors and children - so please contribute to our "knowledge bank" by submitting any comments or questions you have after reading this article. You can E-mail them to information@dyspraxia.com.au (Place "response to Developmental Motor Dyspraxia Article" in the subject line).
1. What is Motor Dyspraxia
Different labels have been used over time by different professional groups to describe children who have difficulty with movement or 'doing'. One of these labels is Developmental Motor Dyspraxia which is used to describe children whose coordination difficulties are specifically a result of problems with praxis (choosing, planning, sequencing and then executing movement). The words themselves mean:
| Developmental |
- from birth. |
| Motor |
- gross motor (large body movements eg. jumping). |
| Dys |
- difficult or inefficient functioning. |
| Praxis |
- planning and sequencing to "do" a skill.
A skill is a task which has a purpose. It is something which is learnt and doesn't just happen by itself. Handwriting is an example of a skill. |
Therefore, Developmental Motor Dyspraxia is: difficulty in consistently planning, sequencing and then executing efficient and coordinated movement - at will or on command - to perform age appropriate skills.
2. How did Dyspraxia develop? Why is my child so uncoordinated?
Children are not born with fully developed praxis (motor planning).
- It is a learning ability which does not mature by itself. It requires interaction with the environment to develop (eg. a child first needs a ball and a floor to learn how to catch a bounced ball).
- Motor planning develops steadily from birth. Every skill which we now routinely perform, we initially needed to consciously motor plan in order to learn and then later, after practice, we could do it spontaneously - without even thinking. Once a skill is learnt it no longer requires motor planning eg. driving a car.
For some children this process comes unstuck. Research does not give us any clear reasons why.
3. Is it genetic? Are my other children likely to have the same problem?
No! Although some parents state that they had similar problems as children.
4. Was it avoidable?
NO!
5. Is Dyspraxia 'fixable'?
Will my child get better?
Will the problems ever go away?
YES and NO. A child may always have Dyspraxia but the impact of motor planning difficulties on his life will decrease. Motor planning is required for learning NEW skills. Therefore, Dyspraxia has a huge impact on the preschool, early primary aged child who is learning many, many new skills within a relatively short space of time. Once a skill is learnt, less motor planning is required - and therefore Dyspraxia becomes less invasive.
6. Will the problems get fixed by themselves?
Depending on severity, but normally YES - but much more slowly and not as efficiently than if treated. Because motor planning is required for learning new skills - the more a child is exposed to that skill and practices it, the less of a problem they will have. However, children often avoid skills which are too difficult for them and refuse to practice!!! I have found that children respond quite quickly and happily to specific strategies which enable them to know 'what to do' and 'how to do'. These strategies enable a child to approach skills with more confidence - and then practice with a degree of cooperation and enjoyment. Different therapists use different strategies, but I use task analysis which helps a child directly at their skill level by breaking a skill down into its small sub-component parts - each part is learned separately before being put back together into a whole skill. Occupational therapists can analyse a skill, such as cutting or handwriting or jumping or catching a ball - and teach one step at a time in a developmental or sequential order.
7. How often will my child need therapy?
How long will it take before my child reaches our goal?
Depending on the degree of Dyspraxia, some children benefit from attending therapy for just one school term - others need much longer. Some parents like to bring their children to therapy frequently- so as to keep therapy homework focused. Other parents find that less frequent sessions allow them time to juggle the demands of family and to have a balance between 'work, rest and play'.
8. What things will Dyspraxia affect at home and at school?
Each child is effected in different ways to different degrees. A checklist for Dyspraxia might list the things a child does not do rather than the things he does. The following can often be observed in a child with motor dyspraxia.
Difficulty in:-
- coping with a new situation.
- coping with changes to routine.
- learning rules.
- learning new skills - it takes a lot longer.
- gross motor - jumping, hopping.
- fine motor - cutting, handwriting.
- daily living - dressing, eating.
- beginning movement, beginning to 'do' an activity.
- responding quickly.
- generalising learnt skills
- with control, quality.
- with timing, rhythm.
- with force of movement.
- with spatial organisation.
- using 'appropriate' cues.
- problem solving.
- analysing what is needed for task performance.
- preparing for the next stage of task performance.
- meeting the specific demands of the task.
- performing a task when feeling pressured.
- doing a number of things at the same time.
- doing a skill consistently. This creates frustration to not only the teacher and parent - but also the child - when he can do something one day but not the next.
- doing a task as it becomes more complex or increase in length.
The child may:-
- present with delayed skills - remaining in the early stages of skill acquisition.
- need to go right back and begin again at the very beginning of the task when experiencing difficulty, instead of just 'getting on with it'.
- have difficulty organising daily routines - dressing, getting ready for school (more than other children of the same age).
- have difficulty using tools - cutlery, scissors, pencils - lots of handwriting problems (although not all handwriting difficulties are the result of motor Dyspraxia).
The child with Dyspraxia is often:-
- passive - not involved in gross motor or fine motor tasks.
- shy.
- anxious.
- tired - because of the significant, conscious effort required to perform.
- stubborn and uncooperative.
- frustrated.
The child naturally wants to avoid motor tasks.
9. 1:1 in therapy works well, but my child's difficulties are still a problem in the classroom. How can a teacher work with a therapist, when the teacher has 30 other children?
There is no easy answer! I use a skill based approach and try to adopt strategies which transfer well to the classroom. A communication book with brief messages between therapists and teacher is useful. I also use a card which goes onto the child's desk which says 'This week I am trying to .......'. Either words or drawings act as a reminder to both the child and teacher of a skill or strategy which is being worked on in therapy. Communication (either verbal or written) between therapy and the classroom is so important, as the therapist needs to know if a strategy is or is not working or if an ability is or is not being generalised into the classroom.
10. What general things can I do to help my child at home?
- begin from a position where a child can do nothing but succeed.
- work from simple to complex.
- make implicit rules explicit - don't assume a child knows what is expected.
- make the goal of the activity clear.
- ask questions - what do you need to do now? - rather than telling the child what to do, model correct skill performance so the child can imitate - use shared tasks and turn taking.
- provide an accepting environment which supports risk taking.
- choose skills which the child wants to do.
- have frequent and good communication with preschool or school teacher.
- maintain child's motivation with a variety of enjoyable activities - fun and challenging at the same time.
- praise for effort - not product.
- emphasis what the child can do - not what they can't do.
- keep to set routines.
- be sympathetic but firm.
- provide plenty of time.
In conclusion, practice leads to progress through little steps. We need to listen to each other and encourage each other till we see the end in sight.
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