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

  • A quick review of what dyspraxia is

  • Common signs and symptoms of dyspraxia

  • How dyspraxia is diagnosed

person's feet standing on a rock text what is dyspraxia

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

  • A quick review of what dyspraxia is

  • Common signs and symptoms of dyspraxia

  • How dyspraxia is diagnosed

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:

  • Difficulty learning new motor tasks

  • Preferring fantasy games or talking to actually doing things (so has good ideation but can’t figure out how to follow through with their idea)

  • Struggling to learn exercise steps or routines

  • Difficulty organising motor activities that require multiple steps

  • Finding drawing, colouring or copying more challenging

  • Having trouble playing with fine motor activities (e.g. blocks, beads)

  • Difficulty following directions that require two or three steps

  • Poor skills in ball activities and other sports

  • Frustration when unable to complete tasks due to poor motor skills

  • Poor timekeeping

  • Limited ability to organise materials and resources – including losing items and not arriving to class (or work!) with the correct materials

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

  • Empathy

  • Resilience

  • Humour

  • Creativity

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:

  • The child’s motor skills are significantly below the level expected for their age and the opportunities they have had to learn and use these skills. During the assessment, the therapist will compare the child’s skills to same aged children.  They will often use a cut off of the 5th percentile on the tests.

  • This lack of motor skill ability significantly and persistently affects the child’s day-to-day activities and their achievements at school.  So, the difficulty with motor skills can’t just be with one single task.  It will be persistent across all activities.

  • The symptoms were present throughout their early developmental stages.  So, the lack of coordination doesn’t just suddenly appear.  The child will have struggled learning motor skills from very early on.

  • Their lack of motor skills isn’t better explained by long-term delay in all areas (general learning disability) or another medical conditions, such as cerebral palsy or muscular dystrophy

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 skillsDue 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

  • Parent history and teacher questionnaires

  • Sensory questionnaires such as the Sensory Processing Measure or Sensory Profile

  • A standardised motor assessment such as the Movement ABC (MABC-2 or 3) or the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)

  • Observation of play, including imaginary play

  • Handwriting assessment

  • Some therapists may also use tools that assess visual perception and pencil control like the Beery VMI or the Developmental Test of Visual Perception to review all skill areas

  • Sometimes an assessment called the AMPS is used to help with activity analysis and goal setting, however as of 2024, updates and training are currently not available for this assessment so it is being less widely used.

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.

Girl kicking feathers

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.

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