Dyspraxia diagnosis & screening
The signs of dyspraxia vary with age and development. Younger children may display clumsiness and delays in achieving milestone motor skills, like tying shoelaces, buttoning shirts or zipping trousers. Older children may have problems with the motor aspects of assembling puzzles, building models, playing ball and printing or writing.
Many children do not show difficulties with the early milestones of sitting and crawling, but later show difficulties with more complex activities, which require the involvement of the cerebellum, the brain’s skill centre. Like dyslexics, people with dyspraxia demonstrate an inefficient cerebellum, which affects the process of learning and skills automation. These are tasks that can normally be performed ‘without thinking’, but present unusual difficulties for someone with dyspraxic symptoms.
Dyspraxia’s shared symptoms
Often, dyspraxia shares symptoms with the following associated disorders or conditions:
- Expressive Language Disorder
- Specific Language Disorder (SLD)
- Attention Deficit Disorder (ADD)
- Attention Deficit Hyperactivity Disorder (ADHD)
- Autistic Spectrum Disorders (ASD)
In making the diagnosis, dyspraxia must be distinguished from motor impairments that are related to a general medical condition. Problems in coordination may be associated with specific neurological disorders (e.g. cerebral palsy, progressive lesions of the cerebellum), but in these cases, on neurological examination there is definite neural damage and severely abnormal findings. If Mental Retardation is present, dyspraxia can be diagnosed only if the motor difficulties are in excess of those usually associated with the Mental Retardation.
A dyspraxia diagnosis is not given if the criteria are met for a Pervasive Developmental Disorder. This is a severe condition where sufferers have difficulty using and understanding language, relating to people, objects or events. They often avoid eye contact, are uncomfortable with changes in routine or unfamiliar familiar surroundings and sometimes have strange behavioural patterns and repetitive body movements.
Individuals with ADHD (Attention Deficit Hyperactivity Disorder) may fall, bump into objects, or knock things over, but this is usually owing to impulsiveness or being easily distracted, rather than to a motor impairment. If criteria for both disorders are met, both diagnoses can be given.
DSM IV diagnostic criteria for dyspraxia
The following are the different criteria used by specialists to define those who have dyspraxia:
- Performance in daily activities that require motor coordination is substantially below that expected, given the person’s chronological age and measured intelligence. This may be manifested by marked delays in achieving motor milestones, (e.g. walking, crawling, and sitting) and by dropping things, clumsiness, poor performance in sports or poor handwriting.
- Physical difficulties which significantly interfere with academic achievement or activities of daily living.
- The difficulty is not due to a general medical condition (e.g., cerebral palsy, hemiplegia, or muscular dystrophy) and does not meet criteria for a Pervasive Developmental Disorder.
- If Mental Retardation is present, the motor difficulties are in excess of those usually associated with it.