Dyspraxia

What is dyspraxia?

Dyspraxia, also known as developmental coordination disorder (DCD), is a chronic condition that begins in childhood that causes difficulties with motor (movement) skills and coordination.

Dyspraxia can cause a wide range of issues with movement and coordination. Some of these may be noticeable at an early age, while others may only become obvious as your child gets older. Dyspraxia can affect your child’s coordination skills, which can make riding a bicycle or playing sports difficult. It can also affect their fine motor skills, such as writing or fastening buttons.

In the latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), developmental coordination disorder is subcategorized as a motor disorder within the broader category of neurodevelopmental disorders. It was previously listed as a learning disorder.

Dyspraxia in adults

When it’s not used in the context of childhood developmental coordination disorder, the term “dyspraxia” has a broader meaning.

Healthcare providers may also use the term “dyspraxia” to describe movement difficulties that happen later in life because of damage to your brain, such as from a stroke or brain injury. Providers may refer to this as acquired dyspraxia.

What is the difference between dyspraxia and apraxia?

Healthcare providers sometimes use the terms “apraxia” and “dyspraxia” interchangeably. However, apraxia is often more severe than dyspraxia. Apraxia means that you completely lose the ability to do something even though you understand the command and have a willingness to perform the movement. Dyspraxia means that you partially lose the ability to do something with accuracy.

Apraxia also has several different subtypes, including childhood apraxia of speech, limb-kinetic apraxia (the inability to make precise movements with your finger, arm or leg) and constructional apraxia (the inability to draw or copy simple diagrams or to construct simple figures).

Who does dyspraxia affect?

The first signs of dyspraxia (developmental coordination disorder) begin in childhood during the developmental period. As it’s a chronic condition, dyspraxia can persist into adulthood as well.

Dyspraxia more commonly affects men and people assigned male at birth than women and people assigned female at birth.

Your child may be more likely to have dyspraxia if:

• They were born prematurely before the 37th week of pregnancy, especially if they were born before the 32nd week of pregnancy.
• They were born with a very low birth weight (less than 4 pounds).
• They have a family history of developmental coordination disorder.

How common is dyspraxia?

Dyspraxia (developmental coordination disorder) is relatively common. It affects approximately 6% of school-aged children.

What are the signs and symptoms of dyspraxia (developmental coordination disorder)?

Dyspraxia (developmental coordination disorder) can cause a wide range of issues with coordination and motor skills. While most people with dyspraxia show signs of the condition by the time they start school, some people have mild forms of the condition that are more difficult to detect.

Signs of dyspraxia in babies and toddlers

Delays in reaching expected developmental milestones can be an early sign of dyspraxia in babies and toddlers. For example, your child may take longer than expected to roll over, sit, crawl or walk.

You may also notice that your child:

• Has difficulty playing with toys that involve good coordination, such as stacking cups.
• Has some difficulty learning to eat with spoons and forks.

Signs of dyspraxia in older children

Signs of dyspraxia in older children include:

• Difficulty with walking up and down stairs.
• Difficulty with balance — they may bump into objects, fall frequently or seem clumsy.
• Difficulty with sports and activities, such as riding a bike; jumping; and catching, throwing or kicking a ball. They may avoid participating in activities because of their lack of coordination.
• Difficulty with writing, drawing/coloring and using scissors compared to other children their age.
• Difficulty getting dressed, fastening buttons, brushing their teeth and tying shoelaces.
• Restlessness — they may swing or move their arms and legs frequently.

Your child may become frustrated when trying to perform these tasks.

Children with dyspraxia are also more likely to develop overweight or obesity since they may be reluctant to exercise due to difficulties and frustration with coordination.

What causes dyspraxia?

Performing coordinated movements and motor skills is a complex process that involves many different nerves and parts of your brain. Any issue in this process could potentially lead to difficulties with movement and coordination (dyspraxia).

Researchers aren’t sure of the exact cause of dyspraxia. But being born pre-term (before 37 weeks of pregnancy) and having a low birth weight put children at higher risk for having dyspraxia.

How is dyspraxia diagnosed?

Although signs of dyspraxia (developmental coordination disorder) are present from an early age, they can be easy to miss, as children vary widely in their rate of development. Because of this, a definite diagnosis of DCD doesn’t usually happen until a child is 5 years old or older.

Dyspraxia should be diagnosed by a team of professionals qualified to examine the specific criteria for the condition, which may include a:

• Pediatrician.
• Occupational or physical therapist.
• Child psychologist.
• Pediatric neurologist.

There are no medical tests that can definitively diagnose dyspraxia. Instead, your child’s team of healthcare providers will ask detailed questions about your child’s medical history, development and symptoms. They’ll assess your child’s gross and fine motor skills, coordination and balance. They’ll also assess your child’s mental ability to see if it’s within the expected range for their age.

Healthcare providers will also need to rule out other possible causes of your child’s motor difficulties, such as cerebral palsy or muscular dystrophy.

For a child to be diagnosed with dyspraxia (developmental coordination disorder), they typically need to meet all of the following criteria:

• Their motor skills are significantly below the level expected.
• Their lack of motor skills and coordination affects their daily activities and achievements at school.
• Symptoms of dyspraxia first developed during an early stage of their development.
• Their difficulty with motor skills isn’t better explained by other medical conditions.

How is dyspraxia managed and treated?

There’s no cure for dyspraxia (developmental coordination disorder), but different types of therapies, such as occupational therapy and physical therapy, can help children and adults with dyspraxia improve their motor skills and coordination.

As dyspraxia affects everyone differently, your child will benefit most from an individualized treatment plan to manage their physical difficulties and improve their confidence.

One of the main types of therapies providers use to help children with dyspraxia is called task-oriented intervention. It involves working with your child to identify specific tasks that cause difficulties and finding ways to overcome them.

For example, an occupational therapist can help your child improve difficulties with specific tasks by breaking down the movements into smaller steps. They then teach your child to use these individual movements and practice them regularly.

Your child may also benefit from adapting certain tasks to make them easier to perform. For example, adding special grips to pens and pencils can make them easier to hold.

What can I expect if my child has dyspraxia?

It’s important to remember that no two children with dyspraxia (developmental coordination disorder) are affected in the same way. The best way to know what to expect is to talk to healthcare providers who specialize in diagnosing and treating dyspraxia.

Other conditions that often co-occur or share symptoms with dyspraxia include:

• Attention deficit hyperactivity disorder (ADHD). About half of children with dyspraxia also have ADHD.
• Language difficulties.
• Dysgraphia.
• Mental health conditions, such as anxiety and depression.
• Autism spectrum disorder.

If your child has symptoms of any of these conditions, it’s important to make sure they’re properly diagnosed and receive treatment.

How can I take care of my child with dyspraxia?

One of the most important things you can do to help your child is to be an advocate for them, which involves understanding the challenges and letting your child know you’re going to support them no matter what — at home, at school and as they grow.

If your child is eligible for special education, you’ll work with professionals to develop an Individualized Education Program (IEP) that will help your child in school.

When should my child see their healthcare provider about dyspraxia?

Your child may need support to help them learn ways to overcome difficulties with motor skills and coordination throughout their life. If you notice that your child is having difficulties with a new movement task, such as writing or learning to drive a car, talk to their healthcare provider and/or occupational therapist.

A note from Cleveland Clinic

If your child has dyspraxia (developmental coordination disorder), they may experience frustration when they understand how to perform a certain action, such as throwing a ball, but are unable to accurately perform the movement. Your child’s care management will likely be long-term to help them better perform tasks and improve coordination. Offer support and encouragement as your child reaches new milestones for motor skills and coordination each day.