Deborah Smith is a highly experienced paediatric occupational therapist with over 30 years’ experience working in the NHS, social care, education and the private sector. She carries out treatment sessions with children both within their education setting and at home. She also provides occupational therapy expert witness reports used in legal proceedings. Here she discusses the components of dyspraxia and how you might identify a student with dyspraxia.

by Deborah Smith
9th October 2019



Dyspraxia – the cause and symptoms

There is no known cause for dyspraxia and the statistics are unknown. Symptoms can be particularly marked around the time of a growth spurt, as it takes a while to acclimatise to the new size and shape of the body. Look out for tiredness, tripping up, and a student propping their head and forearm on the desk whilst working.

Praxis is derived from the Greek word ‘Praxis’, which means, ‘doing, acting, deed and practice’ (Safire, 2002). It is the ability by which an individual works out how to use their hands and body in skilled tasks such as playing with toys, using tools (including a pencil or a fork), building a structure, tidying a room, and engaging in many occupations (Ayres, 2002). The prefix ‘dys’ means ‘difficulty with’ and is seen in lots of medical terminology. 

Praxis has three components.

1. Ideation – the ability to understand the idea/concept to allow purposeful interaction with the environment (knowing what to do).

2. Motor planning – planning and structuring a response; knowing how to move, sequence and predict the end result (knowing how to do it).

3. Execution – the ability to carry out the planned sequence in a smooth process (being able to carry it out).

Feedback allows the body’s sensory systems to analyse and store the information about the task and how it went. 

Feedforward allows the memory store to release previous information about how a task was carried out, for analysis of any adjustments needed to carry it out subsequent times.

The joints of the body all have receptors in them, called proprioceptors. These help the brain to know where the body is in space, and to get ready for the tasks ahead. These receptors respond to being pushed, pulled and twisted. Deep pressure across the joints can be soothing, calming and organising.

Students with dyspraxia

Dyspraxia can affect a student in terms of learning physical movements or tasks, and also in their organisation, both of individual activities, and of desk work, homework and their approach to work. A student who has dyspraxia may have difficulty picking up new activities as quickly as classmates, be reluctant to join in, or play the clown. They may also appear ‘clumsy’ and disorganised in terms of bringing what they need to class, remembering homework, etc.

Here are the primary underlying deficits.

  • Visual and auditory perception dysfunction – problems with hearing and seeing presented information.

  • Poor spatial skills in 2D and 3D orientation.

  • Reduced visuo-motor or auditory-motor skills; poor rhythm skills.

  • Poor postural-motor skills, i.e. weak muscle tone, poor postural control, poor bilateral integration.

  • Delay in developing laterality, i.e. inconsistent use of the same hand, foot, eye and ear.

  • Poor fine motor skills, i.e. in-hand manipulation, two-handed coordination.

  • Speech and articulation deficits.

Here’s what you might see in class.

  • Clumsiness, bumping into things or people, dropping items, bumps and bruises.

  • Leaning on walls, desks and other people, standing too close to others.

  • Problems in learning new motor skills which involve motor planning and sequencing, i.e. team skills or ball skills.

  • Hesitation between tasks whilst processing takes place.

  • Disorganisation, perceived laziness, poor work habits, forgetting homework.

  • Difficulties with learning new tasks. Once learned, they will be able to perform them, but there will be a difficulty transferring these skills to other tasks.

  • Difficulties following daily routines.

  • Problems following verbal instructions.

  • A need to ‘verbalise’ to assist the planning of actions.

  • A need to observe others in order to formulate the ideas of what to do, possibly to ‘copy’.

  • Delays in learning everyday activities such as using scissors, tying shoelaces, fastening buttons and zips.

  • Difficulties with handwriting including low speed and poor presentation.

The accompanying resource will help you support students with dyspraxia.

References

Ayres (2002) in Bundy, A. C., Lane, S. J. & Murray, E. A. (2002) Sensory Integration: Theory and Practice. FA Davis, 71.

Safire (2002) in Bundy, A. C., Lane, S. J. & Murray, E. A. (2002) Sensory Integration: Theory and Practice. FA Davis, 71.






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