Unlocking Dyspraxia: Signs, Causes, and School Strategies – Who to Consult?

[Updated on April 12, 2022]. How do you recognize a child with dyspraxia? How is it diagnosed, and what are the solutions? Answers from Marianne Delétang, president of the Fantastic Dyspraxic Association (FDA).

What is Dyspraxia?

Often called “pathological clumsiness“, dyspraxia belongs to the family of dys- disorders. It is a motor coordination acquisition disorder. In other words, a child with dyspraxia is unable or struggles greatly to coordinate their movements automatically and to plan them voluntarily, even though the muscles responsible for the movements function normally. Dyspraxia stems from a brain dysfunction that hampers the child’s development and is disabling in daily life. “Moreover, in most cases, dyspraxia – an invisible disability – is not an isolated disorder, but is often associated with attention and concentration deficits, dyslexia, dysgraphia, dysorthographia, or dyscalculia“, the president of FDA emphasizes.

What are the Symptoms of Dyspraxia in Children?

Clumsiness, a Sign of Dyspraxia?

The primary sign that characterizes dyspraxia is extreme clumsiness: meaning that despite considerable effort, the child is unable to perform a gesture that seems trivial to us. “In everyday life, this could be using utensils during a meal, dressing, drawing, tying shoelaces, buttoning a shirt, or writing. They might also feel uncomfortable with construction and assembly games, have significant troubles with math and calculations, struggle to mimic with their fingers, reproduce a drawing, or stick stickers… Such actions are automated for us but not for the dyspraxic child. Yet, these are intelligent children who most often have verbal skills“, Marianne Delétang points out.

Dyspraxia and Visuospatial Disorders

The child finds it very difficult to focus on an object or to follow it with their eyes (which generally affects reading learning), they may have problems orienting in space and time, struggle to distinguish left from right, or to follow a map. Having concentration and attention issues means they struggle to learn new gestures as learning them requires repetition and thus focus.

Bucco-linguo-facial Apraxia

Finally, the dyspraxic child may also exhibit bucco-linguo-facial apraxia and consequently have problems speaking, chewing, and sometimes swallowing.

What are the Causes of Dyspraxia?

• Developmental dyspraxia when the disorder is due to an undetected brain anomaly. The child is otherwise healthy. While the cause of this genetic disorder cannot be explained and no hypothesis has been scientifically proven, it is presumed there is a failure in the brain area responsible for development and movement.
• Lesional dyspraxia when the disorder of planning and coordinating movements is associated with a likely cranial trauma, potentially occurring at birth and/or in cases of prematurity.

How to Diagnose Dyspraxia?

“Sometimes, the signs of possible dyspraxia are visible from an early age (around 2-3 years), before schooling. In most cases, the child compensates so much that the disorder is not apparent at first glance, and it’s only at school that teachers or the school doctor will notice difficulties in doing certain things“, she explains. Suspicions of dyspraxia must thus be confirmed or refuted by a pediatrician or doctor who can then refer parents to specialists. The diagnosis can generally be made around 4 years of age, but the earlier it is made, the sooner intervention can begin. To establish a dyspraxia diagnosis and determine the nature of the disorder, as well as its severity, the child will undergo a series of multidisciplinary examinations: a neurologist will detect any issues with the nervous system, a psychomotor therapist or an occupational therapist will analyze the child’s motor difficulties, a speech therapist will determine any potential oral or written language problems, a psychologist or child psychiatrist can detect the psychological impacts of these difficulties, an ophthalmologist and an ENT specialist will rule out any visual or auditory problems.

Dyspraxia in Children: Who to Consult?

To help the child gain autonomy and precision, a multidisciplinary and personalized approach (symptoms vary from one child to another) involving several professionals is necessary. “To ensure long-term effectiveness of the intervention, it’s important that there is consistency among the different therapies and that each specialist takes into account the assessments of other professionals“, Marianne Delétang advises. She adds, “the earlier the child receives intervention, the better they can progress and compensate for various disorders“.

• A neuropsychologist, a pediatric neurologist, or a neurologist to reeducate attention disorders
• A psychomotor therapist and/or an occupational therapist: the former works on body schema in space (global motility). The latter works on fine motility (e.g., learning to type on a computer). The goal? To automate gestures like proper pencil grip, correct handling of utensils, tying shoes…
• A speech therapist to reeducate the language if needed, both orally and in writing (dyslexia, dysorthographia, dyscalculia);
• An orthoptist might be necessary to reeducate the child’s eye movements and help them better control their eye movements (if the child has visuospatial dyspraxia), a psychologist to support the child and discuss their feelings, worries, or doubts, and a posturologist to correct the child’s balance.

Dyspraxia and School: How Does It Work?

“With appropriate adjustments, a child with dyspraxia can fully participate in regular schooling and succeed in class”

The child with dyspraxia can certainly continue schooling in a regular environment, but depending on the severity of their dyspraxia, they may need more or less significant adjustments. For instance, “manual copies can be replaced with typed copies (with enlarged characters, colored text…), the child can take notes on a computer with specialized software instead of a notebook, they may be granted extra time during tests and exams, receive help noting homework in an agenda, have ergonomically adapted school supplies, and in the most severe cases, the presence of a school life aide (SLA) to compensate for planning and organization deficiencies“, Marianne Delétang provides as examples. Once parents have had this disability recognized by the Departmental House for Disabled Persons (DHDP), the child’s needs will be defined in what is called a Personalized Schooling Project (PSP) in which the parents, reeducators, the referring teacher (a teacher who assists the parents in their steps and acts as a liaison between the school and the DHDP), possibly a doctor and a psychologist, will discuss what is most suitable for the child. However, it’s important to note, “it is up to the parents to make the requests for recognition of disability to obtain appropriate adjustments. This can sometimes be difficult to achieve and the wait times are very long. Additionally, there is no uniformity across the country in the provision of aid awarded, and the number of SLAs is very low, for example“, she clarifies. It is especially important to inform the child’s teachers about the dyspraxia so they can communicate this to other children at the school. The teacher could, for example, ask the other students to be more understanding if they are inadvertently bumped or if the child is clumsy.

Getting Support from an Association

“The dys- disorders might seem trendy, but they are indeed disabilities that are more readily identified today than they were ten or fifteen years ago“, the president of the FDA wants to make clear. But beyond diagnosis, there are numerous elements (rehabilitation, recognition of disability, adjustments at school or depending on age, in the professional environment) that can be tedious and long to implement. “Therefore, do not hesitate to contact specialized associations as early as possible, which can help families and support them in their daily procedures“, she concludes.

A Book to Understand Dyspraxia

Nil is a very bright boy at school, he understands everything, but has trouble holding his pen. He loves playing in the playground, but struggles to catch the ball his friends throw to him. He loves playing knights, but has trouble stacking the pieces to build his castle. Nil is simply a dyspraxic boy. But with the help of his occupational therapist, he makes huge progress and gradually overcomes his challenges! This little book by May Benhayoun Sadafi simply and with concrete examples explains the difficulties that children with this developmental disorder can face in their everyday lives. Ideal for children from 6 years old.

• Contact the Fantastic Dyspraxic Association, an association of families whose children have dyspraxia or Developmental Coordination Disorder (DCD)
• Learn more about possible classroom adjustments on the Dys-Positive website.