As a Chartered Physiotherapist, I have specialised in the assessment and treatment of children with Dyspraxia / Developmental Co-ordination Disorder (DCD) and other coordination difficulties.
I offer a comprehensive service for these children (aged 5 years to 15 years) throughout Kent (United Kingdom).
Physiotherapy Assessments and Treatment for Children with Dyspraxia
Dyspraxia affects as many as 6% of primary school children. It has been given many labels over the years, including clumsy child syndrome, but the most recent and preferred term today is Developmental Coordination Disorder (DCD).
What are the symptoms of Dyspraxia?
The following problems may be experienced by a child with Dyspraxia:
- a general clumsiness and poor coordination, often tripping over or bumping into objects
- poor balance and falls easily, often ‘falling over thin air’
- late reaching their major developmental milestones, e.g. sitting, crawling, standing, walking
- poor handwriting, which is often illegible and/or slow
- an inability to sit still, often being fidgety or restless
- difficulty dressing/undressing, particularly with buttons, zips and shoelaces
- poor sense of direction and visual-spatial processing difficulties (including spatial awareness)
- unable to ride a bicycle or is slow to master the skill
- difficulty organizing themselves and their thoughts, making essay planning and timekeeping challenging
- poor ball skills, e.g. throwing, catching, kicking
- sensory processing difficulties which may manifest as disliking loud noises, hair washing, clothing labels and messy play
- dislikes/difficulty with P.E. lessons and games, with their poor coordination and spatial awareness difficulties being intensified by the fast-paced environment. Some children will go to any lengths to avoid the humiliation of P.E. lessons!
- difficulty using a knife and fork, often being a messy eater
- poor short-term memory and forgetfulness, with remembering/following instructions being a particular challenge
- difficulty copying text from the blackboard, due to poor motor coordination in the eye muscles
- difficulties with motor planning
- may have difficulty with social skills, perhaps being a ‘loner’
- daily struggles with school life may manifest as behavioural difficulties, perhaps being disruptive in class or becoming the class ‘clown’
- easily distracted with poor concentration
What are the Diagnostic Criteria?
The DSM V diagnostic criteria for Developmental Co-Ordination Disorder (American Psychiatric Association, 2013) are:
A. Motor performance that is substantially below expected levels, given the person’s chronologic age and previous opportunities for skill acquisition. The poor motor performance may manifest as coordination problems, poor balance, clumsiness, dropping or bumping into things; marked delays in achieving developmental motor milestones (e.g., walking, crawling, sitting) or in the acquisition of basic motor skills (e.g., catching, throwing, kicking, running, jumping, hopping, cutting, colouring, printing, writing).
B. The disturbance in Criterion A, without accommodations, significantly and persistently interferes with activities of daily living or academic achievement.
C. Onset of symptoms is in the early developmental period.
D. The motor skill deficits are not better explained by intellectual disability (intellectual development disorder) or visual impairment and are not attributable to a neurological condition affecting movement (e.g., cerebral palsy, muscular dystrophy, degenerative disorder).
The Dyspraxia Assessment
The Dyspraxia Assessment is suitable for children aged 5 years – 15 years and can assist in providing a diagnosis of Dyspraxia / Developmental Coordination Disorder (DCD).
The Dyspraxia Assessment also highlights the child’s specific areas of difficulty and thus enables individualised advice and treatment to be given.
The Dyspraxia Assessment lasts approximately 2½ – 3 hours and most children find it to be fun.
The Dyspraxia Assessment consists of a number of components, including:
- The Movement Assessment Battery for Children (Movement ABC-2) forms an important part in the diagnostic process. A child scoring below the 15th percentile on this standardised assessment of motor skills may qualify for a diagnosis of DCD.
- The Quick Neurological Screening Test, Third Edition (QNST-3) consists of a series of 15 tasks that have been adapted from standard traditional neurological exams and developmental scales and are used to assess the development of motor coordination and sensory integration.
- Structured clinical observations are made through the observation of specific movements and activities appropriate to the age of the child.
- Primitive Reflexes are assessed since retained Primitive Reflexes can have an impact on movement, learning, emotions, sensory processing and behaviour.
- The Kaufman Brief Intelligence Test (Second Edition) is administered in order to determine the child’s intellectual ability and verify that any motor coordination problems are not due to more pervasive developmental problems.
- Questionnaires (which are completed by the child’s parents and/or teacher prior to the Dyspraxia Assessment) also play an important role in the diagnostic process. These include the Movement ABC-2 Checklist which is used to ascertain whether there is significant interference with academic achievement or activities of daily living.
Assessments take place at the individual child’s home or school within Kent (United Kingdom) and are priced at £450.