Dyspraxia: Developmental Co-Ordination Disorder

By Dr. Amanda Kirby

This informative, practical book is intended to help parents and teachers with innovative ideas that they can use to encourage and support children to improve motor skills. It looks at every stage, through early years at home, at nursery school, primary and secondary school and into adulthood.

With information about causes and symptoms given in simple terms, as well as information about diagnostic procedures and the characteristics of the condition, Amanda Kirby shows that while dyspraxia cannot be cured, it can be overcome and its effects minimised. With the aid of this book a parent can ensure that their child is equipped with strategies to lead as normal a life as possible.

• Language: English
• Publisher: Souvenir Press
• Release date: Feb 1, 2011
• ISBN: 9780285639393

Dr. Amanda Kirby

Dr Amanda Kirby is a GP and a leading authority on Dyspraxia, as well as the mother of a dyspraxic child. She founded the Dyscovery Centre to help other families whose children have motor co-ordination difficulties.

Book preview

Introduction

The aim of this book is to give understanding and help to parents, teachers and anyone else who comes in contact with someone who has co-ordination problems which could be dyspraxia. It describes what dyspraxia is and what you can do about it. Confirmation of a diagnosis is important to parents but for many the main issue is what can I do now? The focus of this book is to provide some of those answers.

Until recently, when the word ‘dyspraxia’ was mentioned, many people assumed you were talking about dyslexia. This misconception is still prevalent today. Dyspraxia is the name given to a condition suffered by some ‘clumsy’ children and affects up to one in twelve people in the population, both children and adults. It is the hidden handicap. Children look the same as their friends but can have real problems at home and in school. The child with dyspraxia may not be able to do things like catching a ball, or his writing may be so untidy that others can’t read it. Some adults still have problems and may be disorganised or find it difficult to socialise with others. They may find it hard to drive a car or do certain tasks around the house.

The diagnosis is not new and has been around for a long time but under different labels. In the past it has been called ‘The Clumsy Child Syndrome’, and at one time children were even referred to as ‘motor morons’. Think back to your own schooldays and you will remember that there were always one or two children in the class who were bad at ball games and seemed a bit clumsy. They may well have been dyspraxic. Unfortunately, both their peer group and their teachers tended to regard them as lazy and stupid as well as clumsy. This was because of a lack of understanding and knowledge about their difficulties.

The child with dyspraxia is often of average or above average intelligence, and with the correct help will reach his full potential. He has a specific learning difficulty. However, without help his self-esteem may take a nose-dive and he may end up feeling that it is not worth making any effort at all.

Are you a teacher? You may be a teacher who is concerned about a child in your class who seems a bit clumsy and you don’t quite know what to do to help him. In this book there are some simple ideas that can be adopted in the classroom and used by all children. There may be a child who is very easily distracted and you need some strategies to cope with him. These are explained.

Are you the parent of a child who has been given the diagnosis of dyspraxia and you don’t know where to turn?

The questions

You are asking, what does the future hold? At the end of the book you will find names and addresses of helpful organisations, and a glossary defining the complicated terms that may be used in your child’s report by the health and educational professionals you may come across.

The early chapters in the book are written to help parents understand what they and others may feel about having a child in the family with co-ordination problems. Different chapters identify the child’s difficulties from pre-school to primary school, through to the secondary school stage and on to adulthood. The pre-school chapter describes where the child’s problems usually lie and gives advice on what to do about them. It also explains some of the other terms that professionals may use when assessing the child. Some difficulties described in this chapter will continue to cause problems as the individual grows up, so it would be useful to read it to gain some background understanding, even if your concerns are about an older child.

Chapter 12 addresses both the parents of a teenager and the teenager him- or herself. It looks at what problems may be experienced and offers ideas on how to resolve some of them.

The latter part of the book goes into more depth about how both dyspraxia and developmental co-ordination disorder (DCD) are diagnosed and discusses what the problem might be if it is not dyspraxia.

DCD is a term more often applied to children, some of whom are not dyspraxic, who have developmentally related co-ordination problems. The differences are explained in chapter 14. In addition, sometimes children are seen by paediatricians and neurologists and have a different problem from dyspraxia, despite having co-ordination problems. For example, they may have ‘global developmental delay’, affecting all aspects of development. There is more in-depth discussion about this and related issues in chapter 15. It includes some details about other specific learning difficulties, such as dyslexia and attention deficit disorder, which may overlap with dyspraxia.

It is only in the most recent years that there has been a greater understanding about dyspraxia, but it is still not known why some children have problems while others don’t. It is natural for parents to want to know why it has happened to their child, even to the point of wanting to know if it was their ‘fault’. Having a clear understanding of the difficulties helps them to see what to do about them. Again and again parents say, ‘Don’t tell me what is wrong, tell me what I can do to help my child’, and very understandable this is.

Most parents would love to have a crystal ball to enable them to see what the future holds for their child. Unfortunately we can’t provide that any more than we can wave a wand to magic away all the problems. Success for the child with co-ordination problems often takes longer to achieve and there may be hiccups along the way. The child may not always be able to take the traditional route, and some children may need to make several detours. That doesn’t mean they won’t end up having a successful adult life. The solution to the problems may not always be in the form of therapy but in understanding the right style of teaching for a particular child. At times it requires a consistent approach to see change. This may be frustrating for all concerned, including the child himself.

Realistically, all children have problems at some stage in their growing up. Like adults, they will have good and bad times. We all learn at different paces and some children learn faster than others. The pace of improvement and learning may also vary from time to time, for a variety of reasons. The child with dyspraxia will at times seem to take big steps and at times seem as if he is standing still, with no apparent progress.

The good news is that early recognition does mean earlier intervention. The first step in this process is to identify the strengths and weaknesses, and then to work on both. One of the most important keys to success for the child with co-ordination problems is maintaining self-esteem. If this can be done there is a greater chance of future success for the child, both academically and socially. He needs to have a belief in himself. The child with co-ordination problems may have experienced bullying during his school years, which will affect how he sees others around him.

The answers

The book takes a practical approach to these problems and gives solutions that may at times sound very simple. It shows parents that the answers for these children do not always lie in ‘therapy’. It is not ‘rocket science’—often the first steps to helping are practical, sound advice. Teaching has to be flexible to get the best from the child and the teacher may need to use whichever learning style is appropriate for the individual child rather than imposing her own style on him. This may mean taking a less conventional route to meet the child’s specific needs.

To help the child improve his co-ordination, it is important to understand what else is going on in his life. Many modern parents are very busy juggling work and family. Finding time for each child under the normal stresses and strains of daily living is sometimes hard to achieve. Even harder is trying to carry out a therapy programme in addition to everything else. How much time, for example, will a mother have with three children, all under 11 years of age, to put in place any therapy programme on a regular basis. She probably has at least seven other things to do before she can even think about starting any special activity time with one child. Yet teachers and therapists often expect a weighty programme to be diligently carried out. The parent or carer then feels dispirited and guilty because she is not following the programme at all. At the same time the therapist feels disheartened and wonders why she should bother when her programme has been ignored.

Teachers and therapists need to be realistic in their expectations of parents and carers, even to the point of setting extremely simple and short activities to start with. The aim should be to try to involve the whole family. For example, a family outing going swimming can also be seen as an opportunity for the child to work on building up his shoulder strength by getting in and out of the pool or by catching and throwing a ball. Everyone else can then join in, rather than taking him away for his ‘therapy’. The other children are consequently less likely to become jealous of the attention that Mum has given to their brother or sister.

Therapy or play?

If parents give ‘therapy’, it is often when both parent and child are too tired to enjoy a session and both parties end up getting angry and frustrated. In an ideal world therapy should be seen as child’s play, but it is necessary to practise in order to become proficient at it. If the child is seeing a therapist and being given guidance, it is important to remember that one hour with the therapist or teacher each week is only one hour of treatment. There are 167 other hours that need to reinforce what has been taught. The therapist should be seen as guiding the parent and seeking active involvement from her if the best results are to be achieved. Even a short session of ten minutes per day can make a difference. The best way of helping the child is to have a partnership with health, education and the family.

If the child sees the help that is given to him as fun and not an enforced session, then he is more likely to come back for more. Remember that in school he may be pressurised to do certain tasks which he already finds difficult. He may be getting told off for not trying hard enough or not concentrating enough. If help at home is not dealt with sensitively and in a supportive environment, he could view this as being punished for his problems.

Finally, the book refers to the child as a male most of the time. This is not because girls do not have these problems but because at least three times the number of boys compared with girls seem to have co-ordination problems of the type described.

1   The Child and the Family

Mothers of children with problems carry a tremendous emotional load. Few occupations carry as much and those that do carry a different kind. Fathers of neurologically handicapped children do not escape from the burden, but they carry it differently.

(A. Jean Ayres, PhD, Sensory Integration and the Child)

What do parents feel when they are given the diagnosis of dyspraxia or DCD or, worse, no label at all? What effect does this have on parents or carers, not to mention the individual?

Parents are usually seen in a children’s centre and a paediatrician will tell them what is wrong. If she does not give a specific label she may just describe the problem. The parents often have insufficient time to consider what questions to ask and may go away feeling mystified, not really understanding what they have been told. They may not know how to help their child and could be unaware of the implications. They may have other children and are likely to be comparing the child to them. As they leave the centre they may experience a flood of emotion and feel that they don’t know what to do or where to turn. All the problems of school and home still remain to be worked out. What does it mean now? What does it mean for their child’s future?

HOW DO PARENTS FEEL?

Before parents have been given a diagnosis they already know that their child is different from other children and they can see that he or she has some difficulties. When they decide to have their child ‘tested’ they expose themselves to a range of emotions. If you are a parent, not only of a child with co-ordination difficulties, but also of a child who is different from the average, you may feel some of the following emotions:

Frustration. Why has it happened to me? Who should I turn to for help? I don’t understand what is wrong. If only he (or she) tried harder I am sure he could ride his bike.

Anger. Why me? Why don’t my friends have the same problems that we have? I feel angry with my husband; he doesn’t seem to understand what I have to go through, having a child with all sorts of difficulties and trying to cope with the rest of the family Everyone thinks I am just making it up.

Guilt. It must be something I did wrong. Maybe I didn’t eat properly during the pregnancy; maybe the delivery was too fast or too slow. Perhaps it is something in my genes. Sometimes I shout at my son, and afterwards I feel that I shouldn’t have, but I just can’t see why he can’t do some of the simplest things.

Isolation. We feel as if we are the only people in the world with a child with these problems, and nobody else seems to understand My child looks normal, but I know he is different. I wish I could talk to someone about it.

Ignorance. What should I do to get help? Who should I turn to? There seems to be little information around.

Relief. For many parents, being given a diagnosis can bring a sense of relief. They may well have known there was something very wrong, sometimes for a long time, but didn’t have a name for it. The acknowledgement of the label tells others that they were right. The name means that they can now tell other people what the problem is. It also makes it a ‘real’ problem, with answers to questions that may have been running around for a long time. It allows them to seek help and gain support. It says they are not being overprotective and it acknowledges and confirms their concerns. It also means they can join a support group. They are no longer alone.

Parents have to work through these feelings and understand what has happened in the past and what can be done about the problem in the years to come. Before children are born we have ideas about how we want them to be brought up and aspirations for the future. Sometimes, having these dashed is one of the hardest things to come to terms with. We then have to decide how much we should expect from our child. Many parents feel the need for guidance and a plan of action. Often, with the DCD child, small steps need to be taken, success achieved and then a plan set for the next stage in his life. A lot of the questions that are asked relate to school. Should the child stay where he is? Should he be in a special unit? Is a private school better than a state one? Many of the answers depend on the individual child, the stage of his education and the problems that he is experiencing at the time, and may need reviewing at different ages.

Ben’s story  

When he was seven Ben was given the diagnosis of dyspraxia by an occupational therapist. This was in contrast to other reports which had outlined his problems but had not given a diagnosis.

The occupational therapist thought that it might give the parents some hope to be told it was dyspraxia, because he did have some co-ordination problems, although there were others as well.

The diagnosis made the parents think that if they got help for the specific learning difficulty, all would then be fine with their child. In reality Ben was at least three years behind in all ‘milestones’ and he was also ‘globally delayed’ (having a low IQ). This meant that the possibilities for his future were limited.

The parents became angry when they were later told that Ben didn’t have dyspraxia after all. This was not what they had expected to hear, and all they wanted was to be given some hope. Until then nobody had bothered to explain the implications for the child’s learning. The label that had been given in an attempt to help had in fact not been helpful at all, but had masked the true diagnosis and the need for the parents to understand what they could realistically expect for their child.

Magic wands and quick fixes don’t exist for these children, although parents always hope that there may be a ‘cure’ around the next corner. They need to accept that change will be slow, and at times this can seem hard when all they want is to protect their child from his problems. The DCD child needs a consistent approach to his learning, both in school and at home, if he is