Word on Health

Word On Dyspraxia

Our grateful thanks to the Dyspraxia Foundation for their input to this weeks report and for the use of the information below. Please visit their website to find out more by clicking here.  They also operate a telephone helpline service via 01462 454 986 which is available from 10am-1pm Monday to Friday.

As you heard 'on air' (if you haven't caught up with this week's report scroll down the screen and hear it via our radio player) the findings of a new study released to coincide with Dyspraxia Awareness Week has revealed a significant gap in the diagnosis – and therefore, treatment – of dyspraxia, otherwise known as developmental co-ordination disorder (DCD), amongst young women and girls. 

The nationwide poll , commissioned by the Dyspraxia Foundation, reported that over half (53%) of all female respondents said that their primary school teachers were unaware of their difficulties (compared to just 39% of the males questioned). 47% of teenage girls reported the same situation in secondary school, as opposed to 32% of males. 

As we heard, experts at the Dyspraxia Foundation believe such findings may reflect teachers’ perceptions of dyspraxia as a largely “male” disorder, leaving girls often overlooked in the classroom. It may also be possible that girls with dyspraxia are simply better at masking their difficulties by putting in extra effort and recruiting the assistance of friends to help them cope.

Many individuals may also experience difficulties with memory, perception and processing, along with poor planning, organisation and sequencing skills which can have a significant, negative impact on everyday activities. Dyspraxia can also affect articulation and speech.

The national survey questioned 1156 people (537 were individuals with dyspraxia; 619 were parents of someone with dyspraxia). Although the average age for diagnosis of dyspraxia / DCD is 7 to 8 years, this new research suggests that many people (both male and female) are not diagnosed until they are much older. 

Of the 467 adults with dyspraxia who revealed their gender, 69% (320) were female and 31% (147) male. For the ‘child’ population the figures were almost exactly opposite (73% had sons, 28% had daughters), reinforcing the argument that dyspraxia/DCD is under-recognised in girls -  who will often have to wait until adulthood before being diagnosed.

The findings also suggest that the ratio of boys:girls who receive a positive diagnosis of dyspraxia/DCD in childhood is around 3:1 – whilst existing evidence (Lingham et al 2009) puts the ratio of males:females with severe motor co-ordination difficulties at 2:1. 

Sally Payne, Paediatric Occupational Therapist and Trustee of the Dyspraxia Foundation comments; “This survey really has underlined a pattern we’ve observed for some time and whilst the results do reinforce a concerning trend of many girls sliding under the radar of relevant healthcare professionals, it does allow us to push on with plans for developing specific materials, tools and resources for girls and adolescents as well as for their parents and teachers.

“In many ways, it is testament to the resilience, coping mechanisms and ‘emotional intelligence’ of females that they are seemingly able to disguise some of the difficulties that might be more obvious in boys. But sadly, as they get older, issues such as developing social skills, applying make up, choosing clothes and coping with personal hygiene and periods may become harder to cope with and will inevitably make situations such as starting college, leaving home or finding a job difficult and exhausting. Through our helpline and social media platforms, we have heard of many cases where anxiety, self-doubt and a severe lack of confidence can soon set in. However, this could so easily be avoided by early diagnosis and intervention.”

“Whilst this comprehensive survey has flagged up some very real issues which must be addressed by schools, families and support services, it’s also vital that we are not too disheartened by some of the negative findings – and remember that the team at the Dyspraxia Foundation is always here to help both young men and women as they come to terms with a diagnosis! So many of them will go on to prove to everyone that dyspraxia is not going to stand in their way of achieving their goals!”

The average age of diagnosis for male respondents was 17 years, suggesting they were mostly diagnosed by ‘paediatric’ specialists. By contrast, the average age of diagnosis for adult females was 22 years. Poor service provision and unclear diagnostic pathways for adults with dyspraxia means that it is much harder to receive a diagnosis after the age of 18 years. It is likely therefore, that females with dyspraxia are missed across the age range.  

So what is Dyspraxia it is a disorder that is surprisingly common in both children and adults. It is a hidden condition, which is still poorly understood. Movement Matters, an umbrella organization representing major national groups in the UK that represent people with coordination difficulties offers the following definition:

Developmental Coordination Disorder (DCD), also known as dyspraxia, is a common disorder affecting fine and/or gross motor coordination in children and adults. DCD is formally recognised by international organisations including the World Health Organisation. DCD is distinct from other motor disorders such as cerebral palsy and stroke, and occurs across the range of intellectual abilities. Individuals may vary in how their difficulties present: these may change over time depending on environmental demands and life experiences, and will persist into adulthood.

An individual’s coordination difficulties may affect participation and functioning of everyday life skills in education, work and employment. Children may present with difficulties with self-care, writing, typing, riding a bike and play as well as other educational and recreational activities. In adulthood many of these difficulties will continue, as well as learning new skills at home, in education and work, such as driving a car and DIY. There may be a range of co-occurring difficulties which can also have serious negative impacts on daily life. These include social and emotional difficulties as well as problems with time management, planning and personal organisation, and these may also affect an adult’s education or employment experiences.

The Dyspraxia Foundation adds to the Movement Matters description, recognising the many non-motor difficulties that may also be experienced by people with the condition and which can have a significant impact on daily life activities. These include memory, perception and processing as well as additional problems with planning, organising and carrying out movements in the right order in everyday situations. Although dyspraxia may occur in isolation, it frequently coexists with other conditions such as Attention Deficit Hyperactive Disorder (ADHD), dyslexia, language disorders and social, emotional and behavioural impairments.

The Dyspraxia Foundation also provides support to people affected by verbal dyspraxia (also known as ‘childhood apraxia of speech’) which can occur alongside motor coordination difficulties, or as a separate condition. 

What causes Dyspraxia (DCD)?  For the majority of those with the condition, there is no known cause. Current research suggests that it is due to an immaturity of neurone development in the brain rather than to brain damage. People with dyspraxia have no clinical neurological abnormality to explain their condition.

How would I recognise a child with Dyspraxia(DCD)?

The pre-school child

  • Is late in reaching milestones e.g. rolling over, sitting, standing, walking, and speaking
  • May not be able to run, hop, jump, or catch or kick a ball although their peers can do so
  • Has difficulty in keeping friends; or judging how to behave in company
  • Has little understanding of concepts such as ‘in’, ‘on’, ‘in front of’ etc
  • Has difficulty in walking up and down stairs
  • Poor at dressing
  • Slow and hesitant in most actions
  • Appears not to be able to learn anything instinctively but must be taught skills
  • Falls over frequently
  • Poor pencil grip
  • Cannot do jigsaws or shape sorting games
  • Artwork is very immature
  • Often anxious and easily distracted

The school age child

  • Probably has all the difficulties experienced by the pre-school child with dyspraxia, with little or no improvement
  • Avoids PE and games
  • Does badly in class but significantly better on a one-to -one basis
  • Reacts to all stimuli without discrimination and attention span is poor
  • May have trouble with maths and writing structured stories
  • Experiences great difficulty in copying from the blackboard
  • Writes laboriously and immaturely
  • Unable to remember and /or follow instructions
  • Is generally poorly organised

Dyspraxia (DCD) can also affect adults, and those who suffer from the condition often find the routine tasks of daily life such as driving, household chores, cooking and grooming, difficult. They can also find it hard coping at work.

Treatments  At present, there is no cure for Dyspraxia (DCD) but there are many strategies that can help. Occupational therapists will look at fine motor and perceptual skills, together with activities of daily living such as household tasks and organisational skills, and help develop strategies to improve these. They can suggest suitable equipment to help with these tasks. Speech therapists can help with speech or language problems and also sometimes with communication and social skills. Counselling can help to overcome some of the problems. Drugs such as anti-depressants can be of use where depression and anxiety are a big problem.  

For more information contact the Dyspraxia Foundation.  The charity operates a helpline service via 01462 454 986 which is available from 10am -1pm Monday to Friday.

Listen to this weeks radio report

All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.