Dyspraxia: What is it? Does My Child Have It? What Can I Do?

By: Judy Benz Duncan, Occupational Therapist

Does your child have issues with coordination, balance, fine motor skills, memory, focus, being able to think of play ideas, or ability to plan and complete basic tasks?

Your child may have dyspraxia. Although the term dyspraxia is typically used to describe motor planning difficulties, or “clumsiness,” it involves more than a movement disorder, and impacts learning and daily routine self-care skills.

Dyspraxia is not a formal diagnosis, and often occurs alongside other sensory processing difficulties, such as poor sensory modulation or sensory processing disorders, and frequently seen in children who are autistic or are on the autism spectrum. DCD, or Developmental Coordination Disorder, is a formal diagnosis that your pediatric physician may give.

What is Dyspraxia or DCD?

The term dyspraxia is used to describe the sensory processing difficulty children (and adults) have when they struggle to plan and organize their movements (coordination, balance, timing), have difficulty with their motor (gross and fine) skills, cognitive perceptual issues related to memory, focus, thinking of ideas of “how” to play, understanding of time-keeping, and in completing an activity they are involved in.

Most kids with dyspraxia, or those diagnosed with DCD, struggle with fine motor, motor planning skills, coordination and task/play thought planning processes – a combination of challenges in these areas impact both learning and everyday life skills.

Three Parts to Consider with Dyspraxia

There are three parts to considering whether your child has dyspraxia or not.

1 – Ideation – being able to come up with an idea, having an idea of what they will be doing, being able to think up ways to play with their toys; For example, if you have a box of Lincoln logs, building blocks, Lego’s, or craft items, you may have an idea of what you would like to build or make with those items.

2 – Planning – being able to figure out the “how” of your idea. For example, you are able to take your blocks, or craft items and combine, organize, plan, and put them together to build or construct something along the lines of what your idea was. The end result does not have to be perfect, but at least needs to show there was planning and organization of thought!

3- Movement – being able to move your body parts to work on, use, and play with what you have made or during playtime activities. For example, you can coordinate your motor skills to stick items together, line things up, apply enough force and control to combine items, display gross motor balance and body part awareness during playtime.

In order to have dyspraxia, it is expected that there is difficulty with at least two of these areas. Some children may have difficulty with all three areas. A child with dyspraxia does not just have movement/ coordination difficulty – they must also exhibit issues with either the ability to think of an idea of what they want to do, as well as figuring out and plan how they will do it.

Signs and Symptoms of Dyspraxia

There are many common signs that your child may have dyspraxia. Dyspraxia may be mild or severe, and may impact each child in different ways. Each child is different, but you may see some of the following issues that may point you in the direction of professional evaluation and guidance.

o   Difficulty with motor activities that require more than one step, like hopping, jumping, skipping, running, catching or kicking a ball; has difficulty joining in on playground games; has trouble managing going up and down stairs

o   Appears “clumsy” or “awkward” in their movements and movement patterns; they may have a higher tendency to bump into things, to trip, or drop things

o   Problems with processing their thoughts, concentration, focusing on a task, being able to understand and follow directions of two or more steps; difficulty with learning new tasks or routines; difficulty with memory for directions

o   Needs a longer time to learn new tasks and skills including learning how to dress themselves, work clothing fasteners, brush their teeth and hair, learning how to play new games, learning how to ride a tricycle or other motor based activities

o   Difficulty with fine motor skills and eye-hand coordination; coloring, cutting, drawing, tying their shoes, buttoning, using silverware, handwriting or copy work, or play with blocks and beads may all be more challenging and frustrating for your child

o   There is a disconnect between talking and doing. Your child may like to talk about what they want to do, or talk about pretend play situations, but is unable to follow through or figure out how to put their thoughts / ideas into action

Evaluation for Dyspraxia

An Occupational Therapy evaluation for dyspraxia may look at some or all of the following:

• Gross motor skills

• Fine motor skills

• Play skills / Pretend play

• Tactile discrimination and sensory perception levels

• Sensory tolerance and/or tactile defensiveness

• Body part awareness and awareness of self

• Ability to organize thoughts, think/plan/do

• Depending on age, activities typically expected in a school or day care setting

• Ability to generalize (can they apply what they learned in one situation to another; for example, being able to put on a jacket does not mean they can put on a coat, it is like learning a new task all over again)

• The degree of direction and guidance they need to complete a task (routine task and new activity)

• Questions to parents or caregivers on developmental milestones, what issues are seen as the child having the greatest difficulty with, questions regarding daily routine 

Treatment Activities and Ideas for Dyspraxia

There is no “growing out of dyspraxia” however therapy can make a difference in your child’s life. Some therapeutic ideas and activities follow:

o   Just taking the time to listen to your child will help support them in their frustrations, and emotions they are experiencing

o   Be patient – breathe! Learning time takes longer and if you rush your child or get frustrated yourself, it will not end up helping them through the process

o   Show, rather than tell. Give your child a demonstration of how to do something rather than just give verbal directions

o   Allow for longer time periods when learning new tasks or activities. Remember if your child has dyspraxia, it also means they need more time to process and complete the task. Plan your learning times and practice times for when you have the time, not when you need to rush out the door

o   Teach your child to ask you to SHOW them when they need help, not just ask for verbal direction

o   Remember that even making a small change to an activity is seen as a whole new thing to learn to your child due to poor ability to generalize and transfer the information from one task to another

o   Hippotherapy or Equine Therapy (check for what is in your area!)

o   Active Play involving gross motor, and use of big muscles during play

o   Perceptual motor activities

o   Keep a big calendar, blackboard, or daily list in view to help track daily routine and planned events

o   Label containers, closet doors, dresser, toy box, etc. to help your child knows what goes where

o   Try adding Role-Play during Pretend Play times to help your child learn skills they may encounter in social play, in classroom interactions, on the playground (CLICK & GO for Pretend Play Blog here on TheraPlay4Kids.com) 

o   Set up obstacle courses inside using furniture, pillows and blankets, empty box to crawl through, a taped line to follow, creating areas to crawl on, under and through. Outdoors, you can use things like hula-hoops to jump in to and out of, adding in movement task “stations” that ask them to perform jumping jacks, commando crawling, bear walking, walking on a line or low balance beam, and other creative movements that challenge your child to balance, crawl, jump, skip, and run.

o   Balloon volleyball

o   Bubble Play (CLICK & GO for Bubble Play Blog here on TheraPlay4Kids.com)

o   Kick a ball (use different sized balls that will alter the movement pattern, balance, and force required)

o   Ask your child to repeat directions (physically demonstrating and telling you at the same time – keep it simple!)

o   Playing Hopscotch (can adapt to inside or outside, can alter the pattern, can have them carry a soft toy or bean bag while they play)

o   Playground or Kid-Park playtime (swings, see-saw, monkey-bars, wobble/rope bridges, slides, tunnels, rope ladders, merry-go-round); give experience on all as they will tolerate safely. Join in and have some fun too!

o   Use wide or thick crayons, pencils, markers, or use add-on grippers to improve grip and ability to handle

o   Body part awareness activities (CLICK & GO for Body Part Awareness Blog here on TheraPlay4Kids.com)

o   Practice fine motor skills through fun craft activities which is a great way to work on manual dexterity, manipulation of items of various sizes and textures, pinch, while also supporting turning their creative ideas into a work of art! Frame their creations or hang on the fridge too (CLICK & GO for Fine Motor Blog here on TheraPlay4Kids.com) 

o   Visual motor and visual tracking activities and games (search and find, look and find games)

o   Trampoline use (supervise for safety)

o   Riding on a tricycle, pedal-car, or scooter; once they can go in a straight line, alter the course adding in curves, turns, and obstacles

o   Help you wash the dog – a great activity that addresses so many skills!

o   Heavy work activities (CLICK & GO for Heavy Work Blog here on TheraPlay4Kids.com) 

o   Dancing – just crazy dancing in the living room, or in a small group; try dance songs that require specific movements, like the “Hokey-Pokey” or “I’m a Little Teapot”

o   Music and active gross motor games, like “Ring-Around-The-Rosie” or “Musical Chairs” or “Duck-Duck-Goose” or “Cake-Walk”

o   Swimming (always be there for safety!)

o   Kid classes for martial arts or yoga

o   Gymnastics (kid classes, or kid-safe areas at a facility)

o   Letting your child help with setting the table, meal preparation (stirring or mixing), and clean up

o   Let your child help with home tasks like folding towels and putting them away, hanging their clothes on a rod, wiping off the table after meals, putting silverware back in the drawer, mopping or sweeping, carrying out the bag of garbage, and so on (CLICK & GO for Home Skills / Self Help Blog here on TheraPlay4Kids.com) 

o   Memory games

o   Simon Says type of game

o   Auditory Processing Activities (CLICK & GO for Auditory Processing Blog here on TheraPlay4Kids.com) 

o   Don’t forget to praise all efforts and accomplishments!

o   Keep “practice” and learning sessions short – 10 to 15 minutes at a time is enough; vary times from day to day and vary the different activities that you work on every day

o   If school age, discuss having an IEP or 504 Plan for your child’s areas of need. If they already have a plan in place, are there specific accommodations and plans in place to address their dyslexia? An ideal IEP addresses all areas of your child’s needs, including several goals and objectives to focus on all those areas, including communication, fine motor development, sensory integration needs, behaviors, focus/attention, academics, and gross motor skills if needed, as well as any accommodation or modification needs the child may have.  (CLICK & GO for IEP Blog here on TheraPlay4Kids.com) 

Speak with your child’s pediatrician, OT, ST, PT, service providers for their input, advice and guidance before making or attempting changes – these ideas may or not be the best choice for your child, and working with those who do know your child is the best bet for success!

What other activities can you come up with?

Please share with credit to TheraPlay4Kids.com

Thanks for your support!

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