What is Dyspraxia/DCD?

Developmental Coordination Development (DCD)commonly known as Dyspraxia, is a neurological condition that affects fine and gross motor coordination (organisation of bigger and smaller movements) which can affect the performance of day-to-day activities (at home, in school, during play, at work). It's not related to intelligence, but it can sometimes affect cognitive skills.  "Early identification and intervention of children with, or at risk of, DCD is important to help prevent the potential negative developmental trajectories and psychosocial consequences associated with DCD" (Zwicker et al 2021)
 
Dyspraxia or Developmental Co-ordination disorder is more common than you would think with research showing that "The prevalence of dyspraxia in school-age populations is about 6% (or 1 in 20 people) and 10% of the overall population" (Farmer et al 2017).

Dyspraxia is different for everyone, with each person demonstrating their own strengths and challenges across the following areas

fine and/or gross motor skills, coordination and balance, speech, organisational skills, planning, sequencing, auditory and verbal processing, memory, social and emotional skills

Child and Adult Dyspraxia/DCD

 Developmental Co-ordination Disorder (DCD), also known as Dyspraxia in Ireland  and the UK, is a common disorder affecting fine or gross motor co-ordination in children and adults. This condition is formally recognised by international organisations including the World Health Organisation.  Individuals may vary in how dyspraxia impacts upon them and this may change over time depending on environmental demands and life experiences. 

Individuals may present with areas of difficulty related to fine and gross motor coordination such as aspects of self-care (shaving, doing up buttons, tying shoelaces), writing with a pen or pencil, riding a bike and undertakingsports activities. Conversely, many people with dyspraxia are excellent sports people, artists, and entrepreneurs. It is important to recognise that no two people with dyspraxia will present with exactly the same challenges although there are many similarities.

A person with dyspraxia does not 'outgrow' the condition as used to be thought but learns the skills to adapt and manage motor coordination and executive planning challenges.  As a person grows older the range of challenges they face will change from managing and planning school work and activities to managing and planning employment or further education situations.  Many people with dyspraxia report challenges with planning and organisation and time management, all of which can detrimentally impact upon their participation and functioning of everyday life skills in education, work and employment. This is why it is so important for a person with  dyspraxia of any age to recieve the necessary interventions and supports from health professionals, teachers, employers, family members and the wider community. 

It is relatively common for people with dyspraxia to experience other co-occurring conditions which can further impact on daily life. The most commonly occuring conditions include ADHD, ASD, Dyslexia, Dysgraphia and social and emotional difficulties.

What is ‘Dyspraxia’?

The term ‘dyspraxia’ is used in many different ways by different people, which can cause confusion. Some use it interchangeably with ‘DCD’ to mean the same thing. Others use it to refer to something quite different. Unlike DCD, there is no internationally agreed formal definition or description of the term ‘dyspraxia’ and it is not included in DSM-5. Despite this, in Ireland and the UK the term ‘dyspraxia’ is sometimes used in a very broad way to refer to children who have motor difficulties plus difficulties with: speech,organisation, planning, sequencing, working memory and various other psychological, emotional and social problems. However, there is little research evidence to support such a broad diagnostic category.

What is the difference between Developmental Coordination Disorder (DCD) and Dyspraxia?

Developmental Coordination Disorder (DCD) is the term used in DSM-5 to refer to a condition in which an individual has severe difficulties in learning everyday motor skills, which cannot be explained by physical,sensory or intellectual impairment. The main features of this condition are clearly described in DSM-5.  The term ‘dyspraxia’ is used in many different ways by different people, which can cause confusion. Some use it interchangeably with ‘DCD’ to mean the same thing. Others use it to refer to something quite different. Unlike DCD, there is no internationally agreed formal definition of the term ‘dyspraxia’, and it is not included in DSM-5.

 DSM IV

  • Motor coordination difficulties impact on daily functioning and / or academic ability
  • Not due to a learning disability
  • Not due to an underlying medical disorder
  • Not associated with Autistic Spectrum Disorder or other syndromes

 DSM V

Movement clumsiness has gained increasing recognition as an important condition of childhood; however, its diagnosis is uncertain. Approaches to assessment and treatment vary depending on theoretical assumptions about etiology and its developmental course.

Over the past century, many terms have been used to describe children with clumsy motor behavior. The wide variation in labeling has depended to a large extent on cultural or professional backgrounds. For example, medical professionals use medical terms (eg, clumsy child syndrome or minimal brain dysfunction), whereas educational professionals use educational terms (eg, poorly coordinated children, movement-skill problems, or physical awkwardness).

In addition, the various labels used have embodied assumptions about the etiology. Examples include developmental dyspraxia (which suggests underlying difficulties in motor planning), perceptual motor difficulties (which suggests problems in perceptual motor integration), minor neurologic dysfunction (MND), and sensory integrative dysfunction.

In response to the confusing and counterproductive heterogeneity of the labels, participants at an international multidisciplinary consensus meeting in 1994 agreed to use the term developmental coordination disorder (DCD), as described in theDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).[1]In 2013, the diagnostic criteria were further refined with the publication of theDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).[2]

The currently available data are insufficient to permit clear definition of the parameters of motor coordination difficulties in children. Various grades of severity and comorbidity seem to exist. Some children have only a relatively minor form of motor dyscoordination, whereas others have associated learning disabilities, attention deficit, and other difficulties.

In 1996, Fox and Lent reported that in contrast to the common belief that children grow out of motor coordination difficulties, such difficulties in fact tend to linger if no intervention takes place.[3] Intervention can be beneficial if initiated during the first years of life, while the brain is changing dramatically and new connections and abilities are being acquired.

Children with multiple conditions are at greatest risk for developing behavioral difficulties over time. Some evidence supports dividing DCD into subtypes on the basis of main features, such as ability to manipulate objects, speed of movement, ability to catch objects (eg, balls thrown, struck, or kicked during sports activities), or writing ability.

A discussion about including DCD, as currently defined, into the cerebral palsy category was held.[4] This inclusion would put DCD on the low end of the continuum of neuromotor disabilities, also described as minimal cerebral palsy, and result in a 20-fold increased incidence.[5]

Diagnostic criteria (DSM-5)

DSM-5 classifies DCD as a discrete motor disorder under the broader heading of neurodevelopmental disorders.[2] The specific DSM-5 criteria for DCD are as follows:

  • Acquisition and execution of coordinated motor skills are below what would be expected at a given chronologic age and opportunity for skill learning and use; difficulties are manifested as clumsiness (eg, dropping or bumping into objects) and as slowness and inaccuracy of performance of motor skills (eg, catching an object, using scissors, handwriting, riding a bike, or participating in sports)
  • The motor skills deficit significantly or persistently interferes with activities of daily living appropriate to the chronologic age (eg, self-care and self-maintenance) and impacts academic/school productivity, prevocational and vocational activities, leisure, and play
  • The onset of symptoms is in the early developmental period
  • The motor skills deficits cannot be better explained by intellectual disability or visual impairment and are not attributable to a neurologic condition affecting movement (eg, cerebral palsy, muscular dystrophy, or a degenerative disorder)

 How to Recognise Dyspraxia/DCD

The child with Dyspraxia/DCD may present with a combination of several of the following traits in varying degrees. These include:

  • Fine and gross motor co-ordination difficulties
  • Poor posture and balance and experiences greater than normal body fatigue
  • Difficulty with throwing and catching a ball, hopping, skipping, riding a bike
  • Lack of awareness of body position in space
  • Impacted sense of direction
  • Can be sensitive to touch and find some clothes, shoes uncomfortable
  • May experience difficulties with activities of every day living such as doing up buttons, shoelaces, shaving, applying make-up, food preparation and cooking. 
  • Speech problems - may be slow to learn to speak and speech may be incoherent. (particularly relevant to verbal dyspraxia)

Not all children with Dyspraxia/DCD have all these problems. Many parents will say that their children have some of these problems, but if your child has dyspraxia, either diagnosed or not, you may have observed a cluster of these difficulties.

There is no cure for Dyspraxia/DCD, but the earlier a child receives the necessary supports, the easier it will be for them to master fine and gross motor activities.   Occupational therapists, physiotherapists, and extra help at school can all assist children and teenagers with managing and overcoming  the challenges and will support them in preparing for adulthood. 

Dyspraxia/DCD is also known by other names including:

  • Clumsy Child Syndrome
  • Motor Learning Problems
  • Sensory Processing Disorder

 History

  • Interest since mid 1960
  • Prevalence 6% of 5 to 12 year olds
  • 3:1 Boys:Girls (girls may be under reported)
  • High co-morbidity with other disorders e.g. ADD/ ADHD – 40%
  • Children do not grow out of this disorder
  • Currently no biological explanation for Dyspraxia/DCD. Has been linked to genetic predisposition, premature birth and low birth weight. 

 

 

Starting School

Starting School - Guidelines for Parents / Guardians of Children with Special Needs

Starting School - Guidelines for Parents / Guardians of Children with Special Needs

Privacy Statement

Site Map