Dyspraxia PDF

Dyspraxia By Dr.Elham Moamen Lecturer of Phoniatrics, Faculty of medicine Suez canal university  Definition Praxis is the ability to conceptualise, plan, and organise movements to complete motor tasks. Dyspraxia is a neurological diso...

Dyspraxia By Dr.Elham Moamen Lecturer of Phoniatrics, Faculty of medicine Suez canal university  Definition Praxis is the ability to conceptualise, plan, and organise movements to complete motor tasks. Dyspraxia is a neurological disorder that affects an individual’s ability to plan and process motor tasks.  Definition Dyspraxia: Partial loss of the ability to do something with accuracy. Apraxia: Complete loss of the ability to do something even though they understand the command and have a willingness to perform the movement.  Synonyms Developmental dyspraxia Perceptual motor difficulties Minor neurologic dysfunction (MND) Developmental coordination disorder (DCD)  Types of dyspraxia Motor Dyspraxia (limb-kinetic apraxia ): The inability to make precise movements with your finger, arm or leg. Challenges with writing, dressing, or climbing stairs. Verbal Dyspraxia (Childhood apraxia of speech): Challenges with speech and language. Oral Dyspraxia: Challenges with mouth and tongue movements. It may create difficulties with eating and swallowing.  Types of dyspraxia Constructional apraxia: The inability to draw or copy simple diagrams or to construct simple figures. Ideational dyspraxia: Affects the ability to perform more complicated tasks that require a sequence of events, such as cooking or setting a table. Ideomotor dyspraxia: Affects the ability to do simple on-off tasks, such as picking up an object or waving.  Clinical picture Signs of motor dyspraxia in babies and toddlers Delays in developmental milestones can be the early sign of dyspraxia Has difficulty playing with toys that involve good coordination, such as cubes and puzzles. Has some difficulty learning to eat with spoons and forks.  Clinical picture Signs of motor dyspraxia in older children Difficulty with walking up and down stairs. Difficulty with balance — they may bump into objects, fall frequently or seem clumsy. Difficulty with sports and activities, such as riding a bike and catching, throwing or kicking a ball. Difficulty with writing, drawing/coloring and using scissors compared to other children their age. Difficulty getting dressed, fastening buttons, brushing their teeth and tying shoelaces.  Diagnosis DSM-5 classifies DCD as a discrete motor disorder under the broader heading of neurodevelopmental disorders. Acquisition and execution of coordinated motor skills are below what would be expected at a given chronologic age and opportunity for skill learning and use; difficulties are manifested as clumsiness (eg, dropping or bumping into objects) and as slowness and inaccuracy of performance of motor skills (eg, catching an object, using scissors, handwriting, riding a bike, or participating in sports). The motor skills deficit significantly or persistently interferes with activities of daily living appropriate to the chronologic age (eg, self-care and self- maintenance) and impacts academic/school productivity, prevocational and vocational activities, leisure, and play.  Diagnosis The onset of symptoms is in the early developmental period. The motor skills deficits cannot be better explained by intellectual disability or visual impairment and are not attributable to a neurologic condition affecting movement (eg, cerebral palsy, muscular dystrophy, or a degenerative disorder)  Diagnosis A detection of dyspraxia can be made by a clinical psychologist, a pediatrician, a phoniatrician or a physical therapist. Assess the child’s developmental milestones Assess the intellectual ability Assess the Gross motor skills – how well the child uses large muscles that coordinate body movement, including jumping, throwing, walking, running, and maintaining balance. Assess the Fine motor skills – how well the child can use smaller muscles, including tying shoelaces, doing up buttons, cutting out shapes with a pair of scissors, and writing.  Treatment There’s no cure for dyspraxia (developmental coordination disorder), but different types of therapies, such as physical therapy, can help patients with dyspraxia improve their motor skills and coordination. One of the main types of therapies is called task-oriented intervention. It involves working with patient to identify specific tasks that cause difficulties and finding ways to overcome them by breaking down the movements into smaller steps.  Childhood Apraxia of Speech (Verbal dyspraxia) It is a motor speech disorder that cause poor speech sounds production.  Aetiology The cause of CAS is unknown. In some cases, damage to the brain causes CAS. Damage may be caused by a genetic disorder or syndrome, or by a stroke or traumatic brain injury.  Clinical picture Does not always say words the same way every time; Tends to put the stress on the wrong syllable or word; Distorts or changes sounds; or Can say shorter words more clearly than longer words. Children with CAS may have other problems, including difficulty with fine motor skills; delayed language; or problems with reading, spelling, and writing.  Assessment Assess the child’s oral–motor skills. Assess speech melody (intonation), and how they says different sounds. Assess how well the child says speech sounds alone and combined in syllables or words. Assess mental abilities and receptive language of the child Full neurological examination  Treatment The goal of treatment is to help the child say sounds, words, and sentences more accurate and clearer. The child will learn how to Plan the movements needed to say sounds and Make those movements the proper way at the proper time. Use all the senses when learning how to say sounds. *Touch” cues, like putting their finger on their lips when saying the “p” sound as a reminder to close the lips; *Visual” cues, like looking into a mirror when making sounds; or *Listening” cues, like practicing sounds with a recorder and then listening to hear if the sounds were made correctly.  Treatment Augmentative and alternative communication (AAC). In order to communicate, the child may use gestures or may learn to use picture boards or computers. GOOD LUCK