Dyspraxia / DCD (Developmental Coordination Disorder)

1. Dyspraxia / DCD (Developmental Coordination Disorder) Youth Justice Project 2010/2011

2. Aim:Give some straightforward information about a very complex condition. Youth Justice Project 2010/2011

3. DYSPRAXIA Other names for dyspraxia include: • Developmental Co-ordination Disorder (DCD) • Perceptuo-Motor Dysfunction • Motor Learning Difficulties • It used to be known as Minimal Brain Damage and Clumsy Child Syndrome.

4. What does ‘Dyspraxia’ mean? • Dyspraxia = difficulty with doing • ‘Dys’ means ‘difficulty’ • ‘praxis’ means doing, acting

5. DCD– A Definition: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), Performance in daily activities that require motor coordination is substantially below that expected given the person’s chronological age and measured intelligence. This may be manifested by marked delays in achieving motor milestones (e.g., walking, crawling, sitting), dropping things, “clumsiness”, poor performance in sports, or poor handwriting.

6. Definition continued • Motor difficulties significantly interferes with academic achievement or activities of daily living. • The disturbance is not due to a general medical condition (e.g., cerebral palsy, muscular dystrophy and does not meet criteria for a Pervasive Developmental Disorder. • If learning difficulties are present, the motor difficulties are in excess of those usually associated with it.”

7. Verbal Dyspraxia The Dyspraxia Foundation Developmental verbal dyspraxia is a condition where a person has difficulties in making and coordinating the precise movements which are used in the production of spoken language, although there is no damage to muscles or nerves. (Ripley, Daines and Barrett 1997). 

8. Prevalence • DCD is thought to affect up to 10% of the population and up to 2% severely. • Males are 4 times more likely to be affected than females. • Risk factors are prematurity, prenatal difficulties and a family history of dyspraxia.

9. Causes • Research is still finding out the reasons why children develop dyspraxia. • However, it suggests that it's due to an immaturity of neurone development in the brain.

10. Brain Functions Left hemisphere Right hemisphere Concepts Colour Music Shapes and Patterns Art Creativity Visualisation Holistic thinking Symbols Speech & language Sequencing Sound processing Abstract thinking

11. Think about this ball activity

12. The future? Like dyslexia, DCD is not thought curable, but early identification, treatment and educational support can help to overcome motor difficulties. Thus minimising the difficulties experienced in adult hood.

13. DCD: The Warning Signs Children • A history of lateness in reaching developmental milestones e.g. walking • Poor fine motor co-ordination skills: handwriting, fastening buttons, using a knife and fork etc. • Poor gross motor co-ordination skills: difficulty riding a bike, skipping, hand/eye, eye/foot coordination poor etc. • Speech and language difficulties: unclear speech, poor pronunciation. • Poor at sports and/or the creative skills like drawing/ craft. • Delay in establishing laterality, and/or problems crossing midline.

14. DCD: The Warning Signs Continued • Spatial difficulties: bump into objects, dislike of jigsaws. • Sensory difficulties: over excitability, over sensitive to sound/light/taste/touch and/ or reduced proprioceptive feedback (see notes). • Organisational difficulties e.g. Dressing. • Motor planning difficulties e.g. planning route across classroom. • Auditory, visual short term/working memory difficulties. • Associated movements e.g. hands flapping when running. • Difficulty in forming peer relationships.

15. DCD: Warning signs in adults People who have dyspraxia often find the routine tasks of daily life such as driving, household chores, cooking and grooming difficult. They can also find coping at work is hard. People with dyspraxia usually have a combination of problems.

16. Gross motor co-ordination skills (large movements):

17. Gross motor skills cont.

18. Fine motor co-ordination skills (small movements):

19. Fine motor co-ordination skills (small movements) cont.

20. Poorly established hand dominance: • May use either hand for different tasks at different times

21. Speech and language: • May talk continuously and repeat themselves. Some people with dyspraxia have difficulty with organising the content and sequence of their language • May have unclear speech and be unable to pronounce some words • Speech may have uncontrolled pitch, volume and rate

22. Eye movements: • Tracking. Difficulty in following a moving object smoothly with eyes without moving head excessively. Tendency to lose the place while reading • Poor relocating. Cannot look quickly and effectively from one object to another (for example, looking from a TV to a magazine)

23. Perception (interpretation of the different senses): • Poor visual perception • Over-sensitive to light • Difficulty in distinguishing sounds from background noise. Tendency to be over-sensitive to noise • Over- or under-sensitive to touch. Can result in dislike of being touched and/or aversion to over-loose or tight clothing - tactile defensiveness • Over- or under-sensitive to smell and taste, temperature and pain

24. Perception cont. • Lack of awareness of body position in space and spatial relationships. Can result in bumping into and tripping over things and people, dropping and spilling things • Little sense of time, speed, distance or weight. Leading to difficulties driving, cooking • Inadequate sense of direction. Difficulty distinguishing right from left means map reading skills are poor

25. Learning, thought and memory: • Difficulty in planning and organising thought • Poor memory, especially short-term memory. May forget and lose things • Unfocused and erratic. Can be messy and cluttered • Poor sequencing causes problems with maths, reading and spelling and writing reports at work • Accuracy problems. Difficulty with copying sounds, writing, movements, proofreading

26. Learning, thought and memory cont. • Difficulty in following instructions, especially more than one at a time • Difficulty with concentration. May be easily distracted • May do only one thing at a time properly, though may try to do many things at once • Slow to finish a task. May daydream and wander about aimlessly

27. Emotion and behaviour: • Difficulty in listening to people, especially in large groups. Can be tactless, interrupt frequently. Problems with team work • Difficulty in picking up non-verbal signals or in judging tone or pitch of voice in themselves and or others. Tendency to take things literally. May listen but not understand • Slow to adapt to new or unpredictable situations. Sometimes avoids them altogether

28. Emotion and behaviour cont. • Impulsive. Tendency to be easily frustrated, wanting immediate gratification • Tendency to be erratic and have 'good and bad days' • Tendency to opt out of things that are too difficult

29. Emotions as a result of difficulties experienced: • Tend to get stressed, depressed and anxious easily • May have difficulty sleeping • Prone to low self-esteem, emotional outbursts, phobias, fears, obsessions, compulsions and addictive behaviour

30. Reduced self confidence/esteem Stress Impact- on home life, work/study environment, and social life.

31. Average Exceptional Mild Moderate Very Severe Confident/Robust Poor Self-Esteem/Fragile Dyspraxia Severity Ability Personality

32. Why is a child’s motor development important? • Motor development influences a child’s social, emotional, and intellectual development. • Movement enables interaction with others. • A child that can move easily and perform tasks, will practise those skills which he finds difficult without damaging self-concept or confidence.

33. Think about what you have read in this presentation • Can you think of any particular individuals who you feel has these difficulties? • How do they impact on the situations they find themselves in? • What could you do to help?

34. Try this activity • Put on a pair of rubber gloves and try to unwrap a sweet – this is what it feels like to not get sensory feedback.

35. Try this activity • Print off the maze handout. Put it in front of a mirror and try to follow the maze through with a pencil, only looking in the mirror.

36. Try this activity • Lay out a line on the floor with masking or parcel tape. Try walking along it whilst looking through the wrong end of a pair of binoculars.

37. Helpful Addresses • Dyspraxia Foundation- www.dyspraxiafoundation.org.uk • Dyscovery Centre- www.dyscovery.co.uk