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Dyspraxia

A Difficulty in the Organisation of Movement

By

Dr Saim Soomro

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What is Dyspraxia?

• “An impairment or immaturity in the organization of movement which leads to associated problems with language, perception and thought.”

This is the definition as per The Dyslexia Foundation 1997.

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Definition - 2

• In another definition, dyspraxia can be defined as “motor difficulties caused by perceptual problems, especially visual – motor and kinaesthetic – motor difficulties”.

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Definition - 3

In 1972, Jean Ayres defined Dyspraxia as:

“The inability to plan and execute non –habitual movements.”

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Dys + Praxis

• ‘Dys’ means ‘Faulty’• ‘Praxis’ means ‘The ability to use the body

as a skilled tool’.• Children with dyspraxia find that moving

with efficiently flowing movements does not come easily to them. They find this particularly difficult, especially in the face of a new challenge.

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Cause

• Why such a situation arises in what is estimated to be one out of 20 students is not clearly known but it is believed that one of the reasons could be trauma at birth or a significant lack of lipids (fatty acids) in the diet of the child, a few weeks after birth.

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Neurological Theory

Gerald Edelman in 1992 suggests that the condition is caused by the failure of the neurons in the brain to develop correctly. This failure of the neurons to form adequate connections means that the brain takes longer to process information and there is a greater likelihood of the brain losing the suggestion and the child therefore failing to respond to requests given to him.

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Co ordination

• Co ordination between different body parts is responsible for different kinds of actions.

• Depending upon the nature of activity, different kinds of co ordination is required.

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Whole Body Co ordination

• This involves the large muscle groups like running and jumping.

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Eye – Hand Co ordination

• This is required for tasks like catching, throwing or hitting a ball, wielding a racquet etc.

• Requires knowledge of ‘Body Boundary”.

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Fine Motor Co ordination

• Required for activities like drawing, painting, writing

• Eye-hand co ordination and visual –spatial awareness contribute to fine motor skills.

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Speech Muscle Co ordination

• The muscles in the mouth, lips and soft palate must work in synchronization to produce speech.

• Another set of muscles help in the regulation of the tone and pitch of speech.

• A problem in any of these areas would impede the child’s ability to articulate speech clearly.

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Crossing the Body Midline

• This is the ability to use the right hand on the left side of the body and vice versa.

• Tying shoelaces, wearing socks, trousers etc. are some activities that require crossing the body midline.

• Causes problems with two handed co-ordination like opening a jam bottle.

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Crossing the Body Midline

Tasks that would be easy :

Keyboarding or playing the piano because each hand operates on its own side of the body.

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Perceptual Motor Development

• It is the study of how children learn to move effectively & efficiently in different environments.

• Dyspraxic children frequently are unable to transfer learning from one environment to another.

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Movement

• Three components:– Ideation– Planning– Execution

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Ideation, Planning & Execution

• Ideation is knowing what to do.

• Planning involves building a mental model of the action.

• Execution is actually carrying out the movement.

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Execution

• Execution contributes to feedback so for the next repetition, the child is able to fine-tune the movement better.

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Sequencing

• A good degree of sequencing is involved in planning and execution and a difficulty in sequencing can disrupt the child’s ability to carry out a movement.

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Indications of Dyspraxia

• Appears irritable.

• Takes time to be comforted.

• Sleeping difficulties.

• Constantly seeks reassurance.

• Likely to bypass the ‘crawling’ stage.

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Indications - 2

• Picks up objects using ‘palmar’ grip.

• Unable to manipulate a toy with each hand.

• Reacts with distress to high noise levels.

• Gets easily bored of ‘Hide and Seek’ games.

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Indications - 3

• Delayed motor development.

• Delayed toilet training.

• High levels of motor activity.

• Repetitive behaviour

• Highly emotional

• Concentration limited to a few minutes

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Indications - 4

• Extremely excitable.

• Awkward and clumsy.

• Poor ground awareness – no sense of danger when jumping from heights.

• Avoids using constructional toys

• Peer group isolation

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Indications - 5

• Unestablished laterality. Problems crossing the midline.

• Persistent language difficulties.

• Slow response to verbal instruction.

• Problems with comprehension.

• Problems with sequencing

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Movement and Intellectual Development

• “It is widely accepted that the development of controlled movement has a part to play in the intellectual development of children. Children need to experience movement in order to learn about themselves, the relationship to the environment and the interaction between the two.” (French & Lee, 1996)

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Remedial Strategies - 1

• Problems with movement may be more difficult to eliminate than other deficiency classifications. (Cowden and Eason 1991)

• The child with dyspraxia needs regular practice sessions that are short and intensive.

• Lack of practice worsens the condition.

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Remedial Strategies - 2

At Home:

• Keep the environment simple.

• Use a large digital clock which has an alarm.

• Create methods whereby the child can be as independent as possible.

• Furniture to be at appropriate height.

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Remedial Strategies - 3

Create lists of routines that will help the child with organisation:

List on Front Door

1. Schoolbag

2. Pencil Box

3. Lunch Box

4. School Books…

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Remedial Strategies - 4

School Equipment:

• Find a colourful schoolbag that is easily identified.

• Choose velcro fasteners.

• Attach a laminated timetable inside the flap of the bag.

• Get lunchboxes that can open easily

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Remedial Strategies - 5

At School (cont’d):

• Have a large see through pencil box.

• Have a water bottle that stands easily and opens easily

• Colour code notebooks & textbooks, subject wise.

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Remedial Strategies - 6

In Class:

• Remove distractors like charts, pictures from the child’s environment.

• Ensure child sits away from doors, windows etc.

• Ensure that desk and chair is comfortable and well balanced.

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Remedial Strategies - 7

• Provide an inclined board for writing.

• Check for glares on the blackboard due to bulbs and outside light.

• Always send letters home conveying information.

• Ensure that the child knows his way about, outside class.

Controlled Movement – A Must

• Essential part of the child’s day –in the form of games, yoga, dance etc.

• Contributes to intellectual development.

Picture courtesy:

Yoga & Movement Expert, Shri Jagdish Bramta. –http://jagdishbramta.com

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References:

• 1)Macintyre Christine, “Dyspraxia 5-11. A Practical Guide”. David Fulton Publishers (2001)

• 2)Porter Madeleine, “A Handbook of Dyspraxia”

• 3)Raja Bela, “Children With Learning Difficulties – How to Help. A Guide for Parents and Teachers”. Vakils, Feffer & Simon Pvt Ltd (2006)

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THANK YOU