Course:KIN366/ConceptLibrary/Dyspraxia

Movement Experiences for Children
KIN 366
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Instructor:	Dr. Shannon S.D. Bredin
Email:	shannon.bredin@ubc.ca
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Dyspraxia is a developmental disorder that is present at birth (Miyahara & Möbs, 1995; Missiuna & Polatajko, 1995; Gibbs, J. Appleton, R. Appleton, 2007; Pauc, 2010). Dyspraxia is a form of Developmental Coordination Disorder and is classified as exhibiting difficulties in the organization and planning of movements (Vaivre-Douret, 2014). Dyspraxia is not as well known as other developmental disorders within society and there is confusion within professionals as to a clear definition. It is commonly associated with a child’s lack of motor skills or having the prevalence of being clumsy (Dewey, 1995; Miyahara & Möbs, 1995). Today it is officially recognized by the World Health Organization as a developmental disorder that affects one’s motor functions (Pauc, 2010).

Clarification

There is often a misunderstanding regarding Dyspraxia and related terms within the medical field. Dyspraxia, Clumsy Child Syndrome and Developmental Coordination Disorder (DCD) are all used to describe developmental motor impairments (Missiuna & Polatajko, 1995; Gibbs, et al., 2007; Vaivre-Douret, 2014). It is important to clarify that Dyspraxia is a subtype of Developmental Coordination Disorder and cannot be used interchangeably (Missiuna & Polatajko, 1995). Currently within medical professionals the words are still commonly used synonymously (Baxter, 2012) and often children with Dyspraxia are diagnosed with DCD (Lalanne, Falissard, Golse, & Vaivre-Douret, 2012). Dyspraxia is a form of DCD and that depicts children with increased planning difficulties (Baxter, 2012). The disorder Clumsy Child Syndrome should not be used due to the negative connotation the word clumsy portrays to children with motor impairments (Peters, Barnett, & Henderson, 2001; Gibbs, et al., 2007). It is also important to note that Dyspraxia is not adult apraxia presented in children (Vaivre-Douret, 2014). Dyspraxia is not acquired whereas adult apraxia is obtained through a lesion within the brain (Vaivre-Douret, 2014). There is much confusion to a clear definition of Dyspraxia and future research needs to emphasize a distinct definition used across disciplines.

Etiology

Dyspraxia is developed at birth and is not due to brain damage or lesions (Vaivre-Douret, 2014). Dyspraxia is a result of the underdevelopment within the organization and planning processes of the brain (Pauc, 2010). However there is little known about the precise cause of Dyspraxia (Miyahara & Möbs, 1995; Vaivre-Douret, 2014). It has been suggested that Dyspraxia is at greater risk to be obtained if there are prenatal and/or perinatal risks present (Miyahara & Möbs, 1995; Vaivre-Douret, 2014). Dyspraxia is commonly found as a co-disorder and coincides with other language impairments and learning disorders such as ADHD and Dyslexia (Dewey, 1995).

Attributes

Common Characteristics

Children with Dyspraxia display characteristics of varying degrees within this disorder (Jones, 2005). One of the main indicators is the acquisition of being accident-prone (Missiuna & Polatajko, 1995; Pauc, 2010). It is important that if a child is accident prone that they are not labeled clumsy instead the appropriate process is performed for the distinction of why the child is acquiring this characteristic. Children could also display a number of motor difficulties within balance, posture and motor integration (Pauc, 2010). Children with Dyspraxia will also have trouble within everyday tasks such as writing, eating and using tools due to the inadequate development of their manipulative skills (Pauc, 2010). Planning, time management and personal organization underperformance could also be present (Dyspraxia Foundation, 2013). Verbal and visual disparities have also been shown as a common characteristic amongst children with Dyspraxia. Children will demonstrate imparities to the development of speech and language (Pauc, 2010). Children may also experience challenges with their vision and display poor hand-eye coordination (Pauc, 2010). This could be displayed through reading difficulties or poor tracking of objects (Pauc, 2010).

Effects on Well-being

There are a variety of challenges that a children with Dyspraxia face within social experiences and their personal well-being. Due to their challenges with movement experiences they can develop anxious feeling around physical activity participation. This can lead to children developing a belief that they have inferior abilities than their peers (Jones, 2005). This perception can lead children to decrease their participation in sporting teams and peer play (Missiuna & Polatajko, 1995). Without interventions and support a child with Dyspraxia can experience low self-esteem and lack of confidence (Jones, 2005).

Diagnosis

Early intervention has shown to reduce the symptoms that one will experiences in adulthood (Miyahara & Möbs, 1995). Currently there is no overall preferred method of diagnosing Dyspraxia. Methods vary from monitoring of the child's behaviour to assessments by professionals. The observations of everyday tasks such as how the child sits and their physical reaction to a variety of commands can display the symptoms of Dyspraxia (Pauc, 2010). Muscle testing can also be used including: The Finger–to-Nose test, Walking up stairs, and The Provoked Romber’s test (Pauc, 2010). More formal testing can occur to allow for treatment plans that are directed to the child’s specific needs. This can include a variety of testing directed towards a child’s visual-perceptual, cognitive and motor abilities (Dewey, 1995). Assessing the child’s convergence and tracking can depict if the child possesses insufficiencies with their visual abilities (Pauc, 2010). This can be examined by moving an ispoter brough from 16 inches towards the nose (Pauc, 2010).

Classification

Ideomotor Dyspraxia (IM)

Ideomotor Dyspraxia is one of the “pure” forms of Dyspraxia that has been identified. It is defined as the visual-motor dimension of Dyspraxia and encompasses the effects on motor skills that require the ability of vision (Lalanne, et al., 2012). A major feature within Ideomotor Dyspraxia is the deficits to achieve skilled motor tasks (Miller, Chukoskie, Zinni, Townsend, & Trauner, 2014). IM leads to the significant loss in the attainment of success within digital praxis, limitation of gestures and digital gnosis within children (Vaivre-Douret, Lalanne, Ingster-Moati, Boddaert, Cabrol, Dufier, ... & Falissard, 2011).

Visual Spatial/Visual Constructional (VSC)

Visual Spatial/Visual Constructional Dyspraxia depicts the second “pure” form of Dyspraxia. It is described as the visual spatial dimension of Dyspraxia and effects the manipulation of dimensional objects (Lalanne, et al., 2012). VSC has been characterized by the inability to visually interpret related parts and the visual construction within the organized world (Vaivre-Douret, et al., 2011; Vaivre-Douret, 2014). Challenges children with VSC experience are with tasks such as puzzles and manipulating Lego blocks (Lalanne, et al., 2012).

Mix Dyspraxia (MD)

Mix Dyspraxia identifies a combination of the two “pure” forms, Ideomotor and Visual Spatial/Visual Constructional Dyspraxia, as well as unique traits. Specific features of Mix Dyspraxia include weakened upper and lower limb coordination and manual dexterity (Vaivre-Douret, et al., 2011; Vaivre-Douret, 2014).

Treatment

There are a variety of ways that a child can be treated for Dyspraxia to improve their symptoms and way of life. Currently these include chiropractic assessment and application of a proscribed exercise regime (Pauc, 2010). Chiropractic assessment can allow the development of a specific program plan directed towards the child’s challenges. The implementation of a proscribed exercise regime can allow the practice at home while improving a child’s abilities (Pauc, 2010).

Examples of Exercises

The following are daily exercise described by Pauc (2010) that a child can complete on a daily basis to obtain valuable practice for their limitations within Dyspraxia The laterized exercises will be used if the child’s actions are largely controlled by one side of their body. Pauc (2010) stated the following:

General exercises:

1. With hands by the side, head in the neutral position and eyes closed, walk up and then down 3 stairs, 3 times, 3 times a day. Never go higher than 3 steps. When you can do 3 repetitions perfectly, do 5, then 7, then 10.
2. Once you have mastered forward stair walking, do it backwards with the same progressions.
3. Once you can stair walk forwards and backwards, start forward stair walking again but this time carrying a tray with a plastic tumbler full of water on it.

(Pauc, 2010)

Laterized Exercises:

1. Each day when brushing your teeth–use your left hand and stand on your left leg
2. Teach yourself to use a Yo-Yo using your left hand. Learn as many tricks as possible
3. Trace mazes using your left hand

(Pauc, 2010)

Recommendations

There are numerous recommendations that can be implemented within all levels from professional to the child themselves. These recommendations include: (1) Collaboration, (2) teacher training, (3) Adapting Curriculum (4) Child’s Perspective. The collaboration of sectors of professional will allow for the multidimensional development of the definition and interventions within Dyspraxia. This includes educating a variety of agencies and health care professionals (Jones, 2005). Teacher training will increase the child’s experience within school. This includes techniques and strategies within the classroom, physical education class and other aspects of school. A specific approach that has been shown to be extremely beneficial in the classroom is the focus on mental imagery and/or cognitive strategies (Vaivre-Douret, et al., 2011). Within the school system it is also recommended that there is a process of adaptation to the physical activity curriculum. This is important so that the needs of the mainstream children and the children who may have limited ability will be met (Jones, 2005). When evaluating the curriculum it is important to understand the variety of abilities that children have (Jones, 2005). Developing equity will allow for positive change for everyone within the school system. The final recommendation to aid the success of children with Dyspraxia is to allow the child to express their perspective. It is especially important to allow the child to express their difficulties and work together to establish goals and strategies for improvement (Jones, 2005).

References

Baxter, P. (2012). Developmental coordination disorder and motor dyspraxia. Developmental Medicine & Child Neurology, 54(1), 3-3. doi: 10.1111/j.1469-8749.2011.04196.x

Dewey, D. (1995). What is developmental dyspraxia. Brain and Cognition,29(3), 254-274. doi: 10.1006/brcg.1995.1281

Dyspraxia Foundation. (2013).About Dyspraxia. Retrieved from http://www.dyspraxiafoundation.org.uk/about-dyspraxia/

Gibbs, J., Appleton, J., & Appleton, R. (2007). Dyspraxia or developmental coordination disorder? Unravelling the enigma. Archives of disease in childhood, 92(6), 534-539. doi: 10.1136/abc.2005.088054

Jones, N. (Ed.). (2005). Developing school provision for children with dyspraxia: a practical guide. SAGE. Retreived from http://site.ebrary.com/lib/ubc/detail.action?docID=10218282

Lalanne, C., Falissard, B., Golse, B., & Vaivre-Douret, L. (2012). Refining developmental coordination disorder subtyping with multivariate statistical methods. BMC medical research methodology, 12(1), 107. doi: 10.1186/1471-2288-12-107

Miller, M., Chukoskie, L., Zinni, M., Townsend, J., & Trauner, D. (2014). Dyspraxia, motor function and visual–motor integration in autism. Behavioural brain research, 269, 95-102. doi: 10.1016/j.bbr.2014.04.011

Missiuna, C., & Polatajko, H. (1995). Developmental dyspraxia by any other name: are they all just clumsy children?. American Journal of Occupational Therapy, 49(7), 619-627. Retrieved from http://ajot.aota.org/article.aspx?articleid=1870456

Miyahara, M., & Möbs, I. (1995). Developmental dyspraxia and developmental coordination disorder. Neuropsychology Review, 5(4), 245-268. doi: 10.1007/BF02214648

Pauc, R. (2010). Dyspraxia in general chiropractic practice. Clinical Chiropractic, 13(2), 148-152. doi: 10.1016/j.clch.2010.04.008

Peters, J. M., Barnett, A. L., & Henderson, S. E. (2001). Clumsiness, Dyspraxia and Developmental Co‐ordination Disorder: how do health and educational professionals in the UK define the terms?. Child: care, health and development,27(5), 399-412. doi: 10.1046/j.1365-2214.2001.00217.x

Vaivre-Douret, L. (2014). Developmental coordination disorders: State of art.Neurophysiologie Clinique/Clinical Neurophysiology, 44(1), 13-23. doi: 10.1016/j.neucli.2013.10.133

Vaivre-Douret, L., Lalanne, C., Ingster-Moati, I., Boddaert, N., Cabrol, D., Dufier, J. L., ... & Falissard, B. (2011). Subtypes of developmental coordination disorder: research on their nature and etiology. Developmental neuropsychology, 36(5), 614-643. doi: 10.1080/87565641.2011.560696