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| Dyspraxia | ||
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| ICD-10 code: | F82 | |
| ICD-9 code: | 315.4 | |
The Dyspraxia Foundation describes developmental dyspraxia as "an impairment or immaturity of the organisation of movement. It is an immaturity of the way the brain processes information, resulting in messages not being fully transmitted to the body." Dyspraxia is a life-long developmental coordination disorder (DCD) that is more common in males than in females, and has been believed to affect 8% to 10% of all children (Dyspraxia Trust, 1991). Ripley, Daines, and Barrett state that 'Developmental dyspraxia is difficulty getting our bodies to do what we want when we want them to do it', and that this difficulty can be considered significant when it interferes with the normal range of activities expected for a child of their age. Madeline Portwood makes the distinction that dyspraxia is not due to a general medical condition, but that it may be due to immature neuron development. The word "dyspraxia" comes from the Greek word "dys" meaning difficulty with and the word "praxis", meaning acting or doing. Part of a continuum of related disorders, dyspraxia is also known as developmental co-ordination disorder, and may also be present in people with autism spectrum disorder, dyslexia and dyscalculia, among others. Dyspraxia is described as having two main elements
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Assessments for dyspraxia typically require a developmental history, detailing ages at which significant developmental milestones, such as crawling and walking, occurred. Motor skills screening includes activities designed to indicate dyspraxia, including balancing, physical sequencing, touch sensitivity, and variations on walking activities. A baseline motor assessment establishes the starting point for developmental intervention programs. Comparing children to normal rates of development may help to establish areas of significant difficulty.
There are six main areas of difficulty which can be profiled within dyspraxia; the four main areas are listed below:
Developmental verbal dyspraxia is a type of ideational dyspraxia, causing linguistic or phonological impairment. Key problems include:
Difficulties with fine motor co-ordination lead to problems with handwriting, which may be due to either ideational or ideo-motor difficulties. Problems associated with this area may include:
Issues with fine motor coordination mean that major developmental targets include walking, running, climbing and jumping. One area of difficulty involves associative movement, where a passive part of the body moves or twitches in response to a movement in an active part. For example, the support arm and hand twitching as the dominant arm and hand move, or hands turning inwards or outwards to correspond with movements of the feet. Problems associated with this area may include:
Difficulties in areas relating to physical play may lead to dyspraxic children standing out from their peers. Major developmental targets include ball skills, use of wheeled toys and manipulative skills, including pouring, threading and using scissors.
The other two developmental profiles concern dressing and feeding.
People with severe dyspraxia often are incorrectly labelled as spastics, a term which has fallen out of favour recently due largely to derogatory connotations in modern culture.
Poor hand-eye coordination can create problems in many areas, including using scissors and glue. Difficulty with positional language leads to left-right confusion. Organisational difficulties include poor listening skills and memory retention, and weak sequencing skills. Dyspraxia may lead to immature behaviour due to frustration or developmental levels.
Within the United Kingdom there are several agencies that are able to support children with dyspraxia. They may provide reports on the child’s progress, including:
The following people may be involved in supporting a dyspraxic child:
The Paediatric Occupational Therapist provides information, advice and guidance on supporting dyspraxic children. They provide equipment for improving children’s access to activities and may implement programmes to support perceptual difficulties and develop fine motor co-ordination.
The Speech Therapist supports children whose dyspraxia has manifested in speech, and may provide a speech intervention program to be delivered in school.
The educational psychologist assesses children in relation to developmental profiles.
The health visitor may assist in a diagnosis of dyspraxia for pre-school age children.