Dyspraxia – Let’s explore the signs and symptoms
The term ‘dyspraxic‘ originates from the Green ‘dus’, bad or hard, and ‘praxis’, doing. So, the literal translation is hard to do or bad with doing. It is used to describe the difficulty children and adults have when they struggle to plan, organise and coordinate their movements. In this post I will explore
Dyspraxia – Let’s explore the signs and symptoms
The term ‘dyspraxic‘ originates from the Green ‘dus’, bad or hard, and ‘praxis’, doing. So, the literal translation is hard to do or bad with doing. It is used to describe the difficulty children and adults have when they struggle to plan, organise and coordinate their movements. In this post I will explore
What is dyspraxia?
The term dyspraxia is frequently used to describe anyone that is a little clumsy. However, dyspraxia is more than just a little clumsiness. Dyspraxic individual will also experience difficulties with ideation and/or planning as well as doing.
I have already explained in my post “What is Dyspraxia?” there are three components to dyspraxia.
If you’re not familiar with these we explore these in further depth in here. It is important that you understand these components first. In this post we will discuss they signs and symptoms of dyspraxia.
Dyspraxia symptoms – What might it look like if my child is dyspraxic?
I say child in the heading, but it is now widely recognised that dyspraxia is not something that is grown out of. It is a life long condition and continues to impact planning, orgainsaion and coordination into adulthood. Some common signs of dyspraxia include:
I have included more dyspraxia symptoms in our checklists at the bottom of our Sensory Issues Signs and Symptoms page. You can also download a longer list here.
Dyspraxia symptoms – Sophie’s story
Sophie is a really accomplished tennis player, in fact she has been selected for her county team. However, her parents are frustrated by the inconsistency of her performance. She can do so well at tennis, but can’t organise her books for school. She freezes and acts like a baby sometimes as well which they find very confusing. The OT assessment indicated that she had significant difficulties with planning, a common symptom of dyspraxia. Once she knew what to do, she was fine. However, she always struggled to figure out the steps when something was new or unfamiliar to her. This is when she needed extra help and time.
What are the core symptoms of dyspraxia?
As I described in our post What is Dyspraxia?, individuals with dyspraxia will experience difficulties with more than just their motor skills. They will also have difficulties with planning and organisation. This sometimes includes thinking of ideas for play as well.
This means that dyspraxia is more than just a movement disorder. Poor coordination, reduced balance and timing, poor handwriting and fine motor are the more obvious signs. However, individuals also experience challenges with memory, focus, planning and completing tasks. This leads to challenges with time keeping as well.
A 2023 study with adults found that actually the non-motor symptoms were more challenging to manage on a day to day basis. These included depressed mood, addition or anxiety.
A really important thing to remember about dyspraxia is that it impacts ability with new tasks the most. Existing skills may also not be generalised to a new activity. Difficulties with executive functioning, like time management and sequencing, are also reported.
What about strengths?
The strengths of individuals with dyspraxia include
Dyspraxia – a personal perspective
This video describes dyspraxia from a personal perspective, it’s 8 minute but worth the watch. Ellie explains her experience growing up with dyspraxia. It’s great to hear her say she’s, “Dyspraxic and fantastic!”
“Dyspraxia is a bit like your brain’s wires are a little jumbled up”
Ellie Madeira
Developmental Coordination Disorder (DCD) vs dyspraxia
It is important to understand that although the term is common dyspraxia is not a formally recognised diagnosis. The diagnosis that will be given for children who struggle with motor skills and planning will be Developmental Co-ordination Disorder. A diagnosis should not be given to children under the age of four, ideally five. This is because until this age, children are still developing and all children develop at different rates.
Whilst an occupational therapy assessment can contribute information, the diagnosis should be given by a paediatrician. The diagnostic criteria for Developmental Coordination Disorder are:
How do therapists test for dyspraxia/DCD symptoms?
Sensory integration trained therapists may use an assessment tool called the Sensory Integration and Praxis Test (SIPT). This tool was developed by Jean Ayres in the 1980s as she revised earlier versions of the tests. It is designed for children aged four to eight and can only be used by trained therapists. The SIPT is very detailed and takes time to use with the child and then score (3-4+ hours). It is not a practical assessment tool to for most therapists to use. It also doesn’t give a complete picture of functional skills. Due to the age of the SIPT, there are a new tools being developed to assess praxis called the EASI and the SP3D. These new assessments should be widely available to therapists by 2025.
Occupational therapists that do not use the SIPT will use other motor skill assessment tools and questionnaires to provide them with information.
Other assessment tools they may use to identify dyspraxia symptoms include
Signs of dyspraxia – Harry’s story
Harry prefers to watch in the playground and during sports as he knows he’s likely to fall over or drop the ball. He just can’t seem to figure out how to be in the right place at the right time. His mum gave him a new jacket this week and he can’t figure out the buttons as they are different to his old coat. They just don’t make sense. He hates it in art when the teacher tells him to be creative as his brain never seems to give him any ideas. His OT assessment indicated difficulties with both ideation and planning.
When assessing a child for dyspraxia, what will the occupational therapist be checking for?
The occupational therapist (OT) will be looking to see if the child has difficult coming up with ideas for play, or craft, or construction. For example, can they think of things to build when playing with Lego? Can they come up with an idea for a picture when drawing? Or can they think of a game to play with their toys?
They may look for issues with tactile discrimination. Tactile discrimination links to the child or adult’s ability to interpret touch sensory inputs. I discuss it further here.
The therapist will check if the child can plan and organise their ideas. Children with dyspraxia typically can’t figure out what to do. They may have an idea to create a cubby house, but not be able to figure out how to do this with the furniture and materials available. Their idea might be to draw a car, but they won’t be able to think about how to do this. They will not automatically think that the wheels could be made by drawing circles. Once they draw a car, they will likely still need help to draw a bus as they won’t necessarily generalise the plan to a new drawing. If given materials and an idea, can they create something? If you ask them to tidy up a space, can they figure out where to put things without very specific instructions?
Checking with parents and teachers
OTs will ask parents or teachers if the child finds learning new skills difficult. One of the biggest challenges children and adults with dyspraxia have is learning new skills. This is because they find ideas and planning difficult. New skills require a lot of planning. Once you have done the activity you have an idea on how to do it and then know how to do it again next time.
They will also ask about organisation of materials and time management.
What will the outcome of a dyspraxia assessment be?
This will depend on the service who has completed the assessment and why it has been requested. You may receive a summary or a longer report outlining the therapist’s findings and any signs of dyspraxia they have observed. If the referral has come from your paediatrician then the therapist will provide information to help to inform their decision on diagnosis.
A home programme or list of support ideas may be provided. This may include ideas to help with self care skills, handwriting an/or sports. These vary depending on the individuals needs and preferences.
Additional therapy may be recommended and this will vary depending on the service that provided the assessment. Some therapists will recommend direct 1:1 therapy. This could include using a sensory integration approach. There is evidence for the CO-OP approach and this is used by many teams. More services are also moving to a parent coaching model where they provide parents or teachers with support to help them to identify how best to help the child to succeed.
Understanding the symptoms of dyspraxia
Having an understanding of the signs and symptoms of dyspraxia can help you to know if an assessment is needed. If dyspraxia or DCD is diagnosed, then this helps parents, teachers and the individual to have an understanding of why they find activities more challenging than their peers. As Ellie said in her TED talk, having the diagnosis was empowering and helped her parents to seek out the right support. It also helped her to know the Brownies was a more suitable and enjoyable extra-curricular activity for her than Ballet. Understanding is the first step in providing support.
Where to next?
Now you have read about the symptoms of dyspraxia, next I would recommend our post on how to help you can read it here How to Help Children with Dyspraxia – 8 Support Strategies.
If you would like to learn more about dyspraxia I recommend my post – What is Dyspraxia? It’s much more than clumsiness!
If you would like to learn more about sensory processing and dyspraxia I highly recommend myonline training – Sensory Processing with GriffinOT, you can check out the free introduction to start you off.
Photo Credits
Feet on rock – Photo by Sebastiaan Stam on Unsplash, Girl 1 – Rajesh Rajput on Unsplash, Boy 1 – Jonas Mohamadi on Pexels, Girl with feathers – Photo by Mike Fox on Unsplash
Useful Reference
This NHS article on DCD also provides further information.