Dyspraxia is a term that describes the sensory processing difficulty children and adults have when they struggle to plan and organise their movements. The term is commonly used to describe anyone who is clumsy or has poor coordination. In this post we discuss some of the common myths surrounding the term dyspraxia.
Myth 1: My child is clumsy – they must have dyspraxia!
Dyspraxia was first described by Jean Ayres when she was outlining her theory of Sensory Integration. It is also one of the sensory issues included in the Lucy Miller’s Sensory Processing Disorder model. For occupational therapists there is much more to dyspraxia that just being clumsy.
The term dyspraxia originates from the latin ‘dux’ meaning difficult or bad and ‘praxis’ meaning action. So, in short, it is a ‘difficulty in doing actions’. In the sensory world we like to think of action as movement. So, if you’re dyspraxic you experience difficulty with making actions happen.
Praxis includes three different areas or parts:
- Ideation: Ideation means coming up with an idea. Or having the idea of what to do. So, if you have a box of Lego in front of you, your idea might be to build a castle. If you have an empty paper towel roll, you might have an idea to turn it into a telescope.
- Planning: Planning is figuring out how to do your idea. With the Lego, you might decide you need all the long bricks to create the outline of your castle. Then you might plan where the doors will go and where to put the windows. Whilst building you are constantly figuring out which bricks to put where to bring your idea to life! With the paper towel roll, you need to organise its direction so you can look through it easily.
- Doing: Doing is the part where your body moves. So, for the Lego it involves using your fingers to put the bricks together and having the ability to line bricks up so that they fit. It includes making sure you press with the right amount of force (or proprioception). With your telescope, you need to move it into the correct position so you can see through it, whilst making sure you don’t poke your eye.
To diagnose dyspraxia, there must be difficulty with ideation and/or planning
In order to have dyspraxia, sensory integration therapists would expect that there is difficulty with at least two of these areas. Some people with dyspraxia may have difficulty with all three areas. So, they are not just clumsy with their movements. They must also have difficulty either thinking of an idea of what to do and/or figuring out how to do it. If the child or adult only has difficulty with doing, then this would not meet the criteria for dyspraxia as initially described by Ayres.
Myth 2: Dyspraxia and DCD are the same
People often use the terms Developmental Coordination Disorder (DCD) and dyspraxia interchangeably. One reason for this is that dyspraxia is not actually a recognised diagnosis, even though the term is used frequently.
DCD is a formal diagnosis. Children with DCD must have delays with their motor skills greater than would be expected for their age. Their difficulties need to affect all areas of their life, so both at school and home. The delays in their motor skills must also not be due to another condition, such as cerebral palsy. It is recommended that this condition is not diagnosed until after the age of seven. Often there are challenges with organisation, planning and time keeping.
It is very common for children with dyspraxia to receive a diagnosis of DCD and for the terms to be used interchangeably. This is, firstly, because children with dyspraxia typically meet the criteria for DCD and their motor skill ability is poor. Secondly, although the term dyspraxia is commonly used to describe motor planning difficulties and clumsiness, it isn’t a formal diagnosis. It is not listed in the diagnostic manuals or in the international disease classification document. Therefore, paediatricians and occupational therapists use the term DCD when giving a formal diagnosis, even if they refer to dyspraxia as well.
So, is there a difference?
These days the terms are used interchangeably. The term dyspraxia is probably more widely known than DCD. Some individuals prefer the term dyspraxia. Also, it is now recognised that the difficulties experienced continue into adulthood. So, some people feel the term ‘developmental’ is unhelpful as it suggests the difficulties will be grown out of.
Sometimes, a DCD diagnosis might be given if there are only difficulties with motor coordination. So, the individual might not have difficulties with ideas or planning, they only have difficulties making movement itself. For me, as a sensory trained occupational therapist, I would only use the term dyspraxia if an individual had difficulties with planning and organisation, as well as their motor skills. This is a small distinction but it links back initial Sensory Iintegration (SI) studies.
Individuals with dsypraxia may also have difficulties with touch sensory processing as well. This was a pattern observed by Ayres in her original SI work.
Does this matter?
Knowing whether a person has DSD or dyspraxia does matter as the two conditions require different treatment approaches. If the child or adult only has challenges with the motor performance, then practising their motor skills will help improve their abilities. If, however, they have difficulties with ideation and planning, they will also need support to develop their ability to think of ideas and to plan what they will do.
This is very important to remember if you are the one helping a child or adult with dyspraxia. Firstly, they will need more help and time when learning new tasks. Secondly, they will not necessarily generalise (transfer) skills they have learnt from one activity to the next one. I have seen a child unable to transfer the skill of putting on his winter coat to putting on his autumn coat. Because the coats were different for him, it was like learning the skill of putting on a coat all over again. He was not being difficult or naughty; he genuinely could not transfer the skill.
Finally, they will need support to either come up with ideas, figure out how to plan their idea or both. This is different to children who have the idea and know what to do but have poor coordination and just need to work on their motor skills.
Myth 3: If a child has dyslexia then they also have dyspraxia
Dyslexia refers to a difficulty with reading. It is completely different to dyspraxia. Children and adults with dyspraxia may also have dyslexia, but they are definitely not the same thing! You can read more about dyslexia here. Another term people often confuse with dyspraxia and dyslexia is dyscalculia. Dyscalculia refers to difficulty with numbers and mathematics. The three terms refer to three very different difficulties. All three can occur together but do need to be treated with different support strategies. Dyspraxia can often occur alongside other sensory processing difficulties, such as poor sensory modulation. It is also frequently present in children and adults with autism and Asperger’s Syndrome.
Myth 4: Children and adults who are dyspraxic can’t be good at sports
These children and adults often just need more practice than others! They will find the initial learning stage much more difficult than others do. However, with practice and clear instructions, they can learn and also succeed at sports. It is very important to find a patient coach or teacher and just make sure you allow more time for them to practice and learn. Their own motivation and confidence building is very important to help them to succeed.
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