Dyspraxia Overview and Types

Dyspraxia Overview

• Dyspraxia is a neurological disorder impacting an individual's ability to plan and execute motor tasks.
• Praxis is the capacity to conceptualize, plan, and organize movements to complete motor tasks.
• Dyspraxia results in partial loss of the ability to perform a movement accurately.
• Apraxia represents a complete loss of the ability to perform a movement despite understanding the command and willingness to complete the task.

Synonyms for Dyspraxia

• Developmental dyspraxia
• Perceptual motor difficulties
• Minor neurologic dysfunction (MND)
• Developmental coordination disorder (DCD)

Types of Dyspraxia

• Motor Dyspraxia (limb-kinetic apraxia): Inability to perform precise movements with limbs (e.g., writing, dressing, climbing stairs).
• Verbal Dyspraxia (Childhood apraxia of speech): Difficulty with speech and language.
• Oral Dyspraxia: Difficulties with mouth and tongue movements, potentially impacting eating and swallowing.
• Constructional apraxia: Inability to draw, copy or construct simple shapes or diagrams.
• Ideational dyspraxia: Difficulty performing complex tasks requiring sequential steps (e.g., cooking, setting a table).
• Ideomotor dyspraxia: Inability to perform simple, repetitive movements (e.g., waving, picking up objects).

Symptoms (Gross and Fine Motor)

• Gross Motor: Difficulty with getting dressed, balance, coordination, physical issues.
• Fine Motor: Challenges with handwriting, dressing, manipulation, buttons, shoelaces.

Symptoms (Cognitive and Communication)

• Concentration: Poor memory, easily distracted, limited focus, difficulty listening.
• Communication: Immature speech, words muddled.
• Classroom Difficulties: Difficulty organizing thoughts, poor listening skills, impacted by background noise, difficulty copying from board.
• Organisational: Finds planning tricky, struggles with tasks that require organization or sequencing.

Clinical Picture (Babies and Toddlers)

• Delayed developmental milestones.
• Difficulty playing with toys requiring coordination (e.g., blocks, puzzles).
• Difficulty learning to use utensils (e.g., spoons, forks).

Clinical Picture (Older Children)

• Difficulty with walking (stairs, balance).
• Clumsy, frequent falls.
• Challenges with sports and activities requiring coordination (e.g., bicycle riding, catching or throwing).
• Difficulty managing tasks such as writing, drawing, cutting, dressing, or fastening clothing.

Diagnosis

• DSM-5 classifies Developmental Coordination Disorder (DCD) as a neurodevelopmental disorder affecting motor coordination.
• Difficulty executing coordinated movements below expected levels for age.
• Clumsiness, slowness, inaccuracies in motor skills impact daily life (self-care, academics, leisure).
• Onset of symptoms is in the early developmental period.
• Other conditions (intellectual disability, visual impairment, motor disorders) are ruled out.
• Clinical psychologist, pediatrician, phoniatrician, or physical therapist assesses developmental milestones, intellectual ability, gross and fine motor skills.

Treatment

• No cure for dyspraxia.
• Task-oriented intervention, focuses on identifying and addressing specific tasks causing difficulties through breaking movements down into smaller steps.
• Physical therapy can improve motor skills and coordination.
• Augmentative and Alternative Communication (AAC) strategies (e.g., gestures, picture boards, computers) may support communication.

Childhood Apraxia of Speech (CAS)

• Motor speech disorder causing poor speech sound production.
• Difficulty coordinating the muscles needed to produce speech.
• Unpredictable speech patterns, may not consistently say words in the same manner, may stress the wrong part of a word.
• Distorts or alters sounds, shorter words are often easier to produce than longer ones.

Aeitology of CAS

• Unknown cause, but potential factors include brain damage (genetic disorders, stroke, trauma), or syndromes.

Assessment for CAS

• Assess child's oral-motor skills.
• Evaluate speech melody (intonation).
• Assess speech sounds, syllables, and words.
• Examine mental abilities and receptive language.

Treatment for CAS

• Plan specific movements required for speech production.
• Practice producing the movements effectively.
• Utilize sensory cues (touch, visual, auditory) during practice.
• Augmentative and Alternative Communication (AAC) may assist with communication.