Appreciating the impact of dyspraxia on a child

The neurological condition of dyspraxia/ apraxia is poorly understood by our community. Yet it affects children in every school in one of its many forms. The breakdown of the word itself is dys = difficulty and praxis = action. Quite simply the child cannot act to initiate movements needed for either their mouth or body effectively and planning these movements takes immense effort. Frequently the more intention (desire) the child has to achieve the movement the less successful they are. It is a lifelong condition but can be invisible to the outside world.

The ability to move your body or mouth is essential to participate in our world. We measure knowledge and skill using movement. Schools rely on the output generated by our body (such as handwriting) or our mouth (giving answers verbally) on the demand of the teacher or test.

Learning how to move is a developmental process. It takes time and interaction in our environment to create easy automatic movements.

In typically developing babies we see a gradual progression of movement skills from lying to rolling to sitting to crawling to walking. We see a progression of movement needed to speak from cooing noise to babbled noise, to recognisable, even if unclear, words to clear words.

This is the skill development pathway, establishing movements that are easy to make and essentially take minimal mental thought for a typically developing child.

But when a child is dyspraxic they can't establish these movement sequences easily.

- Children can have difficulty starting a movement pattern at all, appearing to show no action when it is expected.

- Children can have difficulty controlling their movement patterns, so the action they intended to take results in something very different, often appearing clumsy or rushed in their actions.

- Children can do each individual action but not be able to sequence all the necessary muscle movements in the right time and place, appearing unable to coordinate all their movements.

These are all motor planning or movement planning difficulties.

Unfortunately, different terms are used under the umbrella of motor planning difficulties. These different terms occur because of the different body parts affected or because of the country the child lives in.

Difficulty planning movements of the body is usually called dyspraxia or developmental coordination disorder.

Difficulty planning mouth movements to speak is called childhood apraxia of speech, dyspraxia or developmental dyspraxia depending on the country using the term.

Any single child can present with one, some, or all of the mouth and body movements affected by motor planning issues.

One child may have speech sound difficulties and not be able to be understood by other people and yet excel at sports needing complex body movements.

One child’s speech can be clear and easily understood and yet they trip and fall over frequently, they find handwriting impossible and they are always picked last at sport.

Both have a neurological condition stopping them from forming and executing the movement patterns needed for different body parts. They are both dyspraxic.

What is movement planning?

Movement planning is a developmental skill commonly described as "motor planning" that starts with big, easy movements and developing to smaller more refined movements.

Most children are clumsy when they first start to walk.

Many children will be hard to understand when they first start talking.

It is only as developmental growth occurs and higher expectations are placed on the motor planning system of the brain, that these planning difficulties emerge. Over time, the demands for movement planning become more complex in order to fully participate in society so dyspraxic children need long-term support.

What does it look like?

By 8-10 years of age, the movement planning system of our body and mouth should be efficiently neurologically "wired" to achieve the complex movement patterns needed to connect with the world around us.

- Kicking a football on the run towards a small opening.

- Writing effortlessly all the ideas in our head, without fatigue.

- Presenting a speech into a microphone that is clear and easily understood by everyone listening to it.

- Eating at a restaurant with a knife and fork without spilling food or drinks across the table.

These are indicators of an efficiently developed motor planning system that is ready to learn even more complex movements needed for adulthood - driving a car, learning to sew, or engaging in the quick-witted banter essential for teenage group acceptance.

But for the dyspraxic child, none of the above is achieved in that timeframe. Some of those things may always need accommodation and support to the activity to be undertaken.

Why does it matter?

Some children will suffer terribly from anxiety as their faulty movement plans result in them being the butt of everyone's jokes and always picked last at sport.

Some children will make a show out of their clumsiness for laughs to hide the hurt.

Some children will avoid sport carnivals and team sports, often pleading headache or tummy ache.

Some children won’t pass stage 3 of swimming lessons and opt out as soon as they realise they are the biggest kid still in that class.

Some children will suffer frustration and anger as people fail to understand their words or give them time to express themselves.

Some children will write a few short sentences in the time it takes their friends to write a page, despite all the ideas in their head.

Some children will never be measured by our school system as having gifts and talents as the system measures output based on movement abilities but currently fails to accommodate the children who have movement challenges.

All of these children will be more exhausted participating in every activity needing movement than other children. They are physically and emotionally drained completing tasks most people wouldn't even consider difficult.

Dyspraxia is a lifelong condition where a child constantly has to work just to speak, to play, to run and to do activities most people take for granted. Schools and communities can do so much more to make their lives easier with understanding and simple accomodations and altered expectations.