What is dyspraxia?

 

Within diagnostic manuals, dyspraxia is officially referred to as DCD (developmental coordination disorder) and is categorised as a neurodevelopmental disorder. Neurodevelopmental disorders such as dyspraxia first arise in childhood and typically persist into adulthood. While symptoms persist into adulthood, it is classified as a neurodevelopmental disorder because symptoms first present during early childhood. Dyspraxia is categorised by the following:

  • A significant delay in the acquisition of gross and fine motor skills
  • Impairment in the execution of coordinated motor skills

Dyspraxia can impact one form of coordination more than another, though many find that both are impacted equally. Motor skills difficulties can manifest as:

  • Clumsiness (i.e. bumping into or dropping things)
  • Slowness (i.e. delayed response times)
  • Inaccuracy of performance (i.e. the inability to throw or catch a ball)

The coordinated motor skills of dyspraxic individuals are significantly below the expected level for their age. In early childhood, dyspraxic people may be delayed in achieving key milestones including but not limited to the following:

  • Sitting
  • Crawling
  • Walking
  • Speech
  • Writing
  • Cycling
  • Swimming
  • Negotiating stairs
  • poorly established hand dominance
  • Buttoning clothes
  • Tying shoes
  • Using zips
  • Completing puzzles

When these skills are achieved, the execution of movement may appear awkward, slow or less precise than peers on a typical developmental path. Dyspraxic people may drop things, stumble, bump into obstacles, or fall more frequently than their peers. 

Dyspraxic adults

Dyspraxic adults can have difficulty with activities requiring fine or gross motor skills. These activities may include the following:

  • Participating in or following team sports
  • Precision and legibility of handwriting
  • Assembling objects such as remotes/figurines/furniture etc
  • Shaving & other self care tasks without injury
  • Hair care (particularly for long hair)
  • Ability and confidence to drive a motor vehicle
  • Application of makeup
  • Preparation of food
  • Application of menstrual products
  • Swallowing or applying painkillers
  • Poorly established hand dominance
  • Typing accurately on keyboards

Speech and language (Verbal Dyspraxia):

  • May talk continuously and repeat themselves. Some people with dyspraxia have difficulty with organising the content and sequence of their language.
  • May skip words in a sentence or get words mixed up in their sentences.
  • May not always use the word intended, or say the word of something in the room or what they have over heard someone else say.
  • May not have a particularly ‘mature’ vocabulary, and may opt to use words that a shorter and easier to pronounce.
  • May have unclear speech and be unable to pronounce some words that they can pronounce well at other times.
  • Speech may have uncontrolled pitch, volume and rate.
  • Struggle to keep up with conversation that change and bounce between multiple people. May take a few seconds to process when someone has called them.
  • May say “What?” when first spoken to as they process what’s just been said to them.
  • Stuttering and ‘groping’ where they are trying to find their next word or trying to grasp the sound and shape of a word.

Eye movements:

  • Tracking. Difficulty in following a moving object smoothly with eyes without moving head excessively. 
  • Struggle relocating. Cannot look quickly and effectively from one object to another (for example, looking from a TV to a magazine)
  • Difficulty copying an image or text from a board, book, screen etc correctly and within a short time frame.

Perception (interpretation of the different senses):

  • Poor visual perception
  • Lack of awareness of body position in space and spatial relationships. Can result in bumping into and tripping over things like door frames, low tables and people, dropping and spilling things, stabbing oneself with cutlery.
  • Difficulty with noticing the speed on a moving object and distances, this can make driving, crossing the road and walking up stairs hazardous.
  • Restricted sense of direction. Difficulty distinguishing right from left makes map reading skills and following verbal directions difficult.

Learning, thought and memory:

Dyspraxia does not directly impact learning, however dyspraxic traits can make learning more difficult as a secondary issue. Usually these issues are a result of a lack of accessibility and understanding from others. Educational institutes are expected to help accommodate student's learning needs.

  • Difficulty in planning and organising thoughts that include physical movements.
  • Poor memory, especially short-term memory. May forget and lose things that were recently used/moved.
  • Difficulty focusing due to the stress of struggling to understanding new information given about a task, or a task that is difficult which involves movements.
  • Accuracy problems. Difficulty with copying text, movements and verbal tasks.
  • Difficulty in following instructions, especially more than one at a time or where the task has not been thoroughly explained well.
  • Difficulty with concentration while performing physical tasks as extra effort is required.
  • May do only one thing at a time properly, though may try to do many things at once to match peers.
  • Make take longer to finish a task.

Emotion and behaviour:

Dyspraxia does not directly impact emotion and behaviour. However, may experience the below as a result of navigating ableism and mistreatment from others, which can also result in low self-esteem and a lack of confidence in ones physical and verbal abilities.

  • Difficulty engaging in conversation with large groups of people where verbal skills are expected to be able to interject quickly. May appear tactless and interrupt frequently.
  • Struggle working in teams and may prefer to work alone on a project at their own pace.
  • May need time to adapt to new or unpredictable situations that require physical movements. Sometimes avoids them altogether and prefer to stick with what and who they know.
  • Impulsive. Tendency to be easily frustrated, wanting immediate gratification and feeling inadequate compared to others.
  • Tendency to opt out of things that are too difficult from fear of failure and being judged.

 

Is dyspraxia a learning disorder or intellectual disability?

Coordinated motor skills difficulties cause limitations in school work or vocational tasks, however, it is not a specific learning disorder nor is it an intellectual disability. Dyspraxia is unique from intellectual disabilities because:

An intellectual disability is characterised by below average intellectual functioning and adaptive behaviour which impacts an individuals ability to live independently. This separates intellectual disabilities from dyspraxia as dyspraxic people do not require support to live independently. It is possible for an individual to be both dyspraxic and have an intellectual disability, but the two are different.  

Dyspraxia is unique from Specific Learning Disorder (SLD), which is unique from intellectual disabilities because:

SLD is characterised by significant and persistent difficulties in learning and academic skills including reading, writing and arithmetic. This can impact academic performance, but it does not impact the ability to live independently thus separating it from intellectual disabilities. The writing difficulties that result from an SLD do not relate to the formation or legibility of handwriting, which can be impacted by fine motor difficulties. However, it does relate to the clarity or organisation of written language and the accuracy of spelling, grammar, and punctuation. This separates SLD from dyspraxia, however, it is possible for an individual to have both. 

While dyspraxia is not categorically considered a Specific Learning Difficulty (SpLD) or Specific Learning Disorder (SLD), the UK government and education sector include it under SpLD codes within EHCPs and PLASCs due to the absence of a specific code for dyspraxia. This practice ensures students can access support, yet there's a risk that they might not receive tailored assistance, emphasising the importance of individualised assessments to address their unique needs effectively. It is for this reason that there is an increased spread of misinformation about what conditions are and are not an SpLD/SLD. You can find out more here.

 

Does dyspraxia co-occur with other disorders?

Dyspraxia commonly co-occurs alongside other neurodevelopmental disorders. The presence of other neurodevelopmental disorders does not preclude the diagnosis of dyspraxia, though these disorders may also interfere with the execution of everyday tasks that require coordinated motor skills. Therefore, co-occurrence can complicate the assessment process and decisions around the necessity for a diagnosis in these cases are made at the discretion of the professional.

In the past, it was thought that dyspraxia was more common in boys than in girls. However thanks to awareness and advocacy efforts within the dyspraxic community this is starting to shift. Research from dyspraxia charities and organisations such as Dyspraxia Magazine has found that dyspraxia is just as common in girls as it is in boys. We hope to promote this topic further as an organisation to encourage peer reviewed research in this area and increase recognition of dyspraxic women. 

Disability rights and neurodiversity

In the UK, neurodevelopmental disorders are protected under the 2010 Equality Act which defines disability as:

  • A physical or mental impairment
  • An impairment that has a substantial and long-term adverse effect on your ability to do normal day-to day activities

Disability is a protected characteristic in the UK meaning that it is illegal for employers, educators, and police to discriminate against individuals with neurodevelopmental disorders. Disabled people’s rights to access goods, services and facilities plus their rights to buy and rent land or property are also protected. The 2010 Equality Act also protects the rights of those associated with a disabled person, for instance a parent or carer. 

While disability is a protected characteristic, many disabled people are still fighting for basic rights, as such the disability rights movement is both relevant and ongoing. The social model of disability has played a pivotal part in the formation of the disability rights movement. It has presented a lens for understanding disability as a social construct rather than a personal limitation and puts responsibility onto wider society to remove barriers and foster inclusive, accessible spaces for all.  

The neurodiversity movement parallels the social model of disability and confronts the idea that neurological differences are deficits that need to be cured or corrected. These narratives come from the medical model of disability which the neurodiversity movement and social model of disability are critical of. The neurodiversity movement recognises neurological differences as natural variations of the human brain and makes the case that society should embrace and accommodate these differences. 

To learn more about co-occurring neurodevelopmental disorders and terms relating to dyspraxia, check back soon for our bran new Dyspraxia Magazine Glossary.

 

 

Sources:

DSM-5

ICD-11

Citizens Advice

GOV.UK

America Psychiatric Association

Equality Act 2010 Guidance

Dyspraxia Magazine Diagnosis Rate Differences Based On Sex

Scop - Model of Disability

Disabled World

Health Harvard

Rowan - Diversity Equity Inclusion

Britannica - Neurodiversity

Neurodiversity Media