With dyspraxia, there is often a difficulty in co-ordinating the left and right sides of the body and between the upper and lower body. This can lead to those who have dyspraxia often avoiding sporting activities, especially if ball-handling skills are required. Sometimes, they also experience a heightened sensitivity to noise and touch. Some children with dyspraxia can have speech difficulties, such as stuttering or slurring words when young. This is referred to as ‘oral dyspraxia’ or ‘verbal apraxia’. Many speech symptoms are referred for speech-therapy training.
Dyspraxia is often seen in children born prematurely and results from an immaturity of brain and cerebellar development. Recent research at Kings College London and Harvard Medical School in the USA show specific developmental problems in the brain and cerebellum in premature infants. Children with dyspraxia are often said not to crawl in the usual fashion as babies. However, many seem to have quite normal early milestones such as walking.
KEY FEATURES OF DYSPRAXIA
Children with dyspraxia may exhibit the following characteristics:
In younger children small objects can be difficult to pick up
Unable to properly complete jigsaws/games that involve sorting
Difficulty in holding a pencil and poor handwriting
Cannot sort shapes or toys effectively
Throwing and catching games are difficult
Low muscle tone (can lead to lax joints)
Difficulty in dressing or tying shoelaces
Using a knife and fork is unco-ordinated
There is confusion in laterality (telling left from right) – child changes between right and left hand, and may not develop a fully dominant side until much later than average
Inability to recognise or predict dangers
They can physically tire easily
They may demonstrate general irritability or limited social skills
There is often poor posture or body awareness
Often poor spatial awareness
They may give inappropriate verbal responses or seem immature
Limited ability to concentrate
Late development in language
Difficulty in understanding prepositions, e.g. in/on/behind/underneath
Unable to follow sequential instructions.
These are the most common symptoms described in dyspraxics. Some are rarer than others are; some of course are also elements of other problems like dyslexia or ADHD.
WHAT IS ASPERGER’S SYNDROME?
The term ‘Asperger’s Syndrome’ was coined by Lorna Wing in a 1981 medical paper. She named it after Hans Asperger, an Austrian psychiatrist and paediatrician, who published a paper in 1944. His work was not internationally recognised until 1990 – yet another example of how important breakthroughs can often be ignored.
Asperger’s Syndrome is a milder variant of autism. Both Asperger’s Syndrome and autism are, in fact, subgroups of a larger diagnostic category. This larger category is called either Autistic Spectrum Disorders (ASD) mostly in European countries, or Pervasive Developmental Disorders (PDD) in the United States (DSM IV). In Asperger’s Syndrome, affected individuals are characterised by social isolation and eccentric behaviour in childhood. Individuals with Asperger’s are considered to have a higher intellectual capacity compared to those with autism while also suffering from a difficulty with social interaction. There are impairments in two-sided social interaction and non-verbal communication. Though grammatical, their speech is peculiar due to abnormalities of inflection and a repetitive pattern. Clumsiness is prominent both in their articulation and in gross motor behaviour (the way we move the limbs of our bodies). They usually have one or more areas of obsessive interest and often less than usual interest in things more appropriate and common to their age group.
According to the DSM IV guidelines, which provide the diagnostic criteria for almost, if not all, psychological conditions, Asperger’s Syndrome is diagnosed by the presence of some, or all of the following behavioural characteristics:
Lack of ability to use non-verbal communication behaviour such as making eye contact, using facial expressions and body postures in social interaction
Failure to develop peer relationships appropriately
A lack of spontaneous ability to share enjoyment, interests or achievements with other people (e.g. by a lack of showing or pointing out objects that may be of interest)
Also, there are typical repetitive patterns of behaviour that include at least one of the following:
A preoccupation with one or more particular subjects to an abnormal level
Inflexible adherence to unusual routines or rituals
Repetitive mannerisms (e.g. hand- or finger-flapping, twisting or complex whole-body movements)
Persistent preoccupation with parts of objects
The disturbance causes significant impairment in social, occupational or other important areas of functioning but no significant general delay in the use of language (e.g. single words used by age two years, communicative phrases used by age three years, etc.)
There should be no significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour (other than in social interaction) and curiosity about the environment in childhood.
As you can see, just working out which labels to use is not easy. However, it is important to remember that these are only labels and the combination of symptoms found in real life number far more than the number of labels. The fact is that labelling of dyslexia, ADHD, dyspraxia and Asperger’s Syndrome has been far too rigid. The symptoms of these learning difficulties often occur together, making them extremely difficult to categorise. For instance:
75 per cent of dyslexics also have symptoms of ADHD, dyspraxia or both
84 per cent of ADHD sufferers also have symptoms of dyslexia, dyspraxia or both
64 per cent of dyspraxics have symptoms of ADHD, dyslexia or both
The following table looks at how conventional assessment puts symptoms into categories. However, look how much crossover there is between them:
KEY 1 = Mild/sometimes present 2 = Common symptom 3 = Usually a severe symptom
| LEARNING BEHAVIOUR SYMPTOM SUMMARY | ||||
| SYMPTOMS | DYSLEXIA | DYSPRAXIA | ADHD | ASPERGER’S |
| Poor reading (difficult, tiring, jump words) | 3 | 2 | 2 |
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