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Dyspraxia
What are the symptoms?
Dyspraxia is a disorder with great variation between one child and another. In severe cases there is global dysfunction affecting gross, fine and oro-motor skills. These children are likely to present early in the pre-school period with gross and fine motor delay, hypotonia and clumsiness with poor speech articulation. At the other end of the spectrum, problems become apparent at school age, with more subtle impairments in fine motor skills affecting buttoning, tying laces and poor handwriting.
Neuro-developmental examination may reveal signs such as left/right confusion, poor balance and postural maintenance, as well as hypotonia and weakness, poor rhythm and timing, and unusual patterns of sensory processing. Psychological assessment may show considerable discrepancies, typically with satisfactory verbal skills and relatively poor visual skills.
Besides the problems of motor control, there is usually significant impairment in skills relating to sequencing, organisation and planning as well as difficulties in attention control. These problems also contribute to the practical difficulties with skills such as dressing, and can have a major impact on written output and recording abilities at school.
The overall result is discrepant academic performance. The child shows ability by having good oral skills but is unable to achieve literacy or recording skills at the same level. Poor concentration and attention control and physical restlessness or over activity may be an additional problem. It is not uncommon for such children to be described by teachers as lazy or poorly motivated.
In older children and adolescents, there may be progressive educational underachievement for expected ability, avoidance of difficult tasks and disengagement from school life. Secondary emotional problems with low self esteem are more likely and this may be apparent from a young age.
In the past, dyspraxia was sometimes held to be a delay in maturation with motor problems resolving in the teen years. Recent longitudinal studies suggest that rather than resolving, dyspraxia may have important long term sequelae that persist into adult life. Motor problems may become ameliorated with therapy in childhood and practice, as well as with increasing neurological maturity. The organisational problems may continue to be a major impairment into adult life.
The risk of mental health problems, substance abuse and disruptive behaviour disorders are all increased.
Background
| How is it diagnosed? 
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