Dyspraxia

Problem that is All in the Mind

Clumsiness is a symptom – as is poor handwriting – yet dyspraxia often remains undiagnosed and untreated

by Barbara Lantin

source: The Daily Telegraph (London)

Mary Colley has three A-levels and a history degree, yet she has difficulty opening her own front door. There is nothing physically wrong: it is what goes on inside her brain that is the problem.

At school, Mary was labelled a “clumsy child”, forever dropping her books and spilling food and drink down her front without noticing. Her handwriting was appallingly untidy, her spelling worse. She was hopeless at sport and had few friends.

Holding down a job proved difficult. She left her post at a press agency “by mutual agreement” after she kept mislabelling and mislaying photographs. That was 10 years ago and she has hardly worked since. Nevertheless, her verbal IQ puts her among the top two per cent of the population.

It was not until last year, when Mary was 43, that she found out she was dyspraxic. The diagnosis came as an enormous relief to a woman who never felt able to do her best.

Dyspraxia – also called developmental co-ordination disorder – affects up to ten per cent, two per cent severely. As with dyslexia, 80 percent of those affected are boys. The causes are unclear, though it is thought to be an immaturity in neuron development in the brain. The result is that messages are not transmitted in the brain in the normal way.

While awareness of the condition is increasing, the variety of symptoms and the fact that bright children quickly learn to mask their difficulties means that many cases still go undiagnosed. With treatment -0 most commonly physiotherapy and occupational therapy – great strides can be made. Without it, life can be very difficult for sufferers.

Problems in the first six months of life can be the precursors to dyspraxia. Madeleine Portwood, senior educational psychologist with Durham County Council, who specialises in the disorder, says: “Feeding problems, high levels of colic, projectile vomiting and delays in sitting up, walking, toilet training and talking might suggest a predisposition towards dyspraxia.

“Later on, there may be hyperactivity, very poor coordination of movements, lack of self-motivation and a need to be with people all the time. Such children may be messy eaters. They tend to avoid construction toys and jigsaws and can’t pedal a bike. Parents often feel there is something wrong, but professionals will not accept there is a problem. While the individual symptoms might not seem serious, taken together, they are significant.”

At nursery, dyspraxic children can come across as aggressive because their communication skills are poor. By the time they reach school, problems in co-ordination can be compounded by social isolation.

“They find it difficult to establish firm friendships and are singled out as loners. This can be a lifelong difficulty,” says Madeleine Portwood. “Their school career is often a catalogue of disasters. There are dyspraxics of all abilities and while some are very bright, no matter how good their ideas, they cannot commit them to paper. By the time they are eight or nine, these children can become very disaffected.”

Corey Jones, five, was a sickly and difficult baby. “I knew there was something wrong, but I didn’t know what,” says his mother, Marie. “As a toddler, he was all arms and legs. He couldn’t run about and play like his older brother – he kept falling over.

“He’d have terrible temper tantrums and night terrors. Most nights he would wake up screaming. His emotions are 10 times those of other children. It is impossible to reason with him. There’s never any rest when he’s around.”

Corey was diagnosed as dyspraxic earlier this year and immediately began a treatment programme. Physiotherapy and occupational therapy can improve motor skills and co-ordination: fine motor skills such as handwriting, also develop. More surprisingly, repeated exercises – b y reinforcing certain appropriate neuropathways in the brain – can improve organisational ability, behaviour and IQ levels, too.

Because the waiting list for physiotherapy and occupational therapy can be two years, Madeleine Portwood devised a school-based exercise programme which can be used by teachers and parents. Every day, Corey does 15 minutes of exercise, including walking heel to toe forwards and backwards, skipping and throwing a beanbag into a bin.

The improvement has been astonishing, says Gill Settle, his head teacher at Ushaw Moors Infants School, County Durham.

“As soon as he went on the programme, his attention increased and he was able to absorb more than one instruction at a time. He used to reverse his letters and would not recognise when his name was back to front. Now he can correct it himself. He is altogether calmer and quieter, but as soon as he stops doing his exercises, his behaviour deteriorates.”

Corey’s night terrors are down to one a week. They increase as soon as the routine is broken.

Had he not been diagnosed and treated, the gap between Corey’s progress and that of his classmates would simply have widened. Poor achievement can lead to low self esteem and anti-social behaviour. Madeleine Portwood believes that three-quarters of the children she sees with behavioural difficulties have dyspraxia. When she tested juveniles in a young offenders institution, she found that 61 per cent were dyspraxic; none had been diagnosed.

“It is crucial to recognise dyspraxia in childhood. I am not saying that every child who is dyspraxic will become a delinquent, but if children become disillusioned with the education system, they find other methods to occupy themselves.

“Others with the condition specialise in what they can do well. I know a number of doctors who are classic cases. They disguise the problem by using word processors and being meticulous in logging appointments and making lists. They avoid physical activities and concentrate on chess and bridge.”

Mary Colley got to university despite the conviction of her teachers that she would never make it. However, her subsequent decision to work in a photo library – where good organisational skills are essential – sent her self-esteem spiralling downwards.

“I am incredibly clumsy, even by dyspraxic standards. Anything that demands manual dexterity is a problem: I have terrible trouble with locks and keys.

“My house is cluttered and messy and I am always breaking and spilling things. I knock my son’s Lego down and it drives him crazy. I don’t seem to see it. I took a few driving lessons, but felt I was a danger on the road.

“I still have some communication problems. I tend to over-react to situations and am either very passive or rather aggressive. But I am better at listening than I used to be.”

A physiotherapist friend suggested that Mary might be dyspraxic, a diagnosis confirmed by a neurologist. She has since been working on her disability. Not only is she being counselled, she has also written a leaflet for adult dyspraxics, runs a newsletter and a helpline and has launched a support group, all with the aid of the Dyspraxia Foundation.

Earlier this year, Mary and 50 others attended the second national conference for adult dyspraxics, which she helped organise. For someone who has difficulty planning a meal for four, this was a remarkable achievement.

“Since I have known I am dyspraxic, my self-esteem has increased. For the first time, I feel I can do something to help others. I feel valued in my work. Suddenly, I know why I burn the toast and put frozen peas in the fridge instead of the freezer.

“I give the impression of being stupid, though I have always known that I am not. Having a diagnosis has changed my life.”

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How to identify dyspraxia

The pre-school child may be:

• late to reach the milestones of sitting, walking, speaking;
• unable to run, hop or jump or to throw or catch a ball;
• slow to learn to dress and to use a knife and fork;
• poor at holding a pencil;
• anxious, sensitive to touch and easily excitable;
• fidgety;
• forgetful and disorganised

The school-age child may:

• show no improvement over the pre-school child’
• be poor at PE;
• have difficulty with math, spelling and reading;
• have poor handwriting;
• be unable to remember more than one verbal instructions at a time;
• have a short attention span;
• find it hard to copy from the blackboard.

The Dyspraxia Foundation says: “Many parents will say their children have some of these problems, but you will know the difference between a normal child with any of these problems and a dyspraxic.”

The adult dyspraxic may have:

• poor posture and a clumsy gait;
• poor co-ordination;
• a tendency to fall, trip over and bump into things;
• poor manual dexterity – e.g. difficulty with sewing, DIY, art and craft work;
• difficulty riding a bike or driving a car;
• little sense of direction
• difficulty in following instructions
• poor memory’
• problems listening to others, especially in groups.

Where to go for help:For diagnosis in a child, ask you GP for referral to a paediatrician or child development centre. The assessment can be made by a psychologist, neurologist, physiotherapist, speech therapist or occupational therapist. The child’s school could help. Provision is variable, but dyspraxia is increasingly recognised as a disorder requiring treatment. For an adult, ask your GP for referral to a neurologist or clinical or educational psychologist.

Books: Penso, Dorothy. Perceptiuo-Motor Difficulties: theories and strategies to help children, adolescents and adults. Stanley Thorne. Portwood, Madeleine. Developmental Dyspraxia – a practical manual for parents and professionals. Durham Country Council Educational Psychology Service, Greencroft, Neville’s Cross, Durham DH1 4UH (0191 384 0707) Penso, Dorothy. Perceptiuo-Motor Difficulties: theories and strategies to help children, adolescents and adults. Stanley Thorne. Portwood, Madeleine. Developmental Dyspraxia – a practical manual for parents and professionals. Durham Country Council Educational Psychology Service, Greencroft, Neville’s Cross, Durham DH1 4UH (0191 384 0707) Penso, Dorothy. Perceptiuo-Motor Difficulties: theories and strategies to help children, adolescents and adults. Stanley Thorne. Portwood, Madeleine. Developmental Dyspraxia – a practical manual for parents and professionals. Durham Country Council Educational Psychology Service, Greencroft, Neville’s Cross, Durham DH1 4UH (0191 384 0707)

Organizations:Organizations:The Dyspraxia Foundation, 8 West Alley, Hitchin, Herts SG5 1EG (01 462 454 986) The Dyscovery Centre, 12 Cathedral Road, Cardiff CF1 9LG (01 222 788 666)(This is the first centre offering health and educational help for dyspraxic and dyslexic children. The centre has just been launched by Amanda Kirby, a GP whose 11-year old son has both conditions.:

source: The Daily Telegraph (London), Tuesday, September 16, 1997.

Web resources:  http:/www.ldonline.org/ld_indepth/parenting/motor_levine.htm

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