This page talks about the causes and characteristics of dyspraxia, and the ways in which it can affect people with an autism spectrum disorder (ASD). It also offers some strategies you can use to support a child who has dyspraxia and ASD.
What is dyspraxia?
Dyspraxia is a lifelong condition in which a person's movement and coordination are affected so that both are difficult. This can include coordination of both fine and gross motor skills; for example, the coordination of fine movements for fiddly tasks such as tying shoelaces or the coordination of large limb movements, such as running, hopping, throwing and catching.
Someone who has dyspraxia will often also display difficulties with sequencing and language, and maintaining attention.
What is the cause of dyspraxia?
No-one knows the exact cause of dyspraxia. Current research suggests that it is due to a delay in the development of the brain. However, researchers have yet to agree on exactly which area of the brain is affected. Although no specific gene has been identified, families with a child who has been diagnosed with dyspraxia often report that another member of their family has the same kind of difficulties. The prevalence of dyspraxia is higher in boys than girls, and is thought to occur in up to ten percent of the population.
A number of terms are used to describe dyspraxia:
- developmental co-ordination difficulty (DCD)
- perceptuo-motor dysfunction
- motor learning difficulties.
A child may also be diagnosed with verbal dyspraxia. Such a child may have difficulty coordinating the movement of the muscles used for producing speech. They may be given a diagnosis of general or verbal dyspraxia, or both.
What are the characteristics of dyspraxia?
Early indications that a child may have dyspraxia include:
- generally being slow in reaching developmental milestones
- difficulty with feeding
- missing out the crawling stage and going straight to walking
- being slow to develop speech.
Common difficulties that someone with dyspraxia may experience include:
- a limited ability to concentrate
- difficulty in picking up small objects especially in younger children
- not being able to complete jigsaws or to sort games out properly
- difficulty in holding a pencil or handwriting
- difficulty in understanding prepositions such as 'in', 'on' or 'behind'
- inability to sort out shapes or toys effectively
- difficulty with throwing and catching games
- inability to follow sequential instructions
- difficulty in dressing or tying shoelaces
- difficulty in using a knife and fork
- confusion and changing between use of their right and left hand
- inability to recognise danger
- tiring easily
- general irritability or limited social skills
- poor posture and spatial awareness
- inappropriate verbal responses.
Dyspraxia and ASDs
Dyspraxia is a separate condition to ASD but it is possible for a child to be diagnosed with both conditions. For both conditions, early recognition and intervention are important to provide the best support for the child.
A paediatrician, child development team or educational psychologist is usually involved in diagnosing dyspraxia. A paediatrician, clinical psychologist or psychiatrist usually carries out assessments for an ASD.
As some of the characteristics of the two conditions overlap, meaning that both have many similar characteristics, it is important that the person making the diagnosis has the relevant experience and knowledge to make a thorough assessment.
Both conditions can occur to different degrees - they are on a spectrum - so every individual will have different areas of strengths and weaknesses. Some children are also able to develop strategies to help mask their difficulties.
It is common for children with ASDs, especially those with Asperger syndrome, to experience difficulties with co-ordination in early life. In his book, The Complete Guide to Asperger Syndrome (2006), Tony Attwood devotes a chapter to issues of movement and coordination, noting that the child with Asperger syndrome has a different way of moving and general immaturity in most activities involving coordination and balance.
ASDs are characterised by impairment in social intelligence and a difficulty in this area is a fundamental part of the diagnostic assessment. The poor social skills and behavioural problems that are sometimes associated with dyspraxia are an additional issue to the problems of coordination and balance, possibly a result of the child feeling more isolated due to the existing difficulties they have.
Strategies for working with a child with dyspraxia and an ASD
If a child has a diagnosis of both an ASD and dyspraxia, it may be appropriate for them to be assessed by an occupational therapist or physiotherapist who can devise a programme to help with any difficulties with balance and coordination. You can try some of the following general strategies.
- Use large, brightly coloured foam balls to keep your child's attention. These are also easier to catch and don't hurt if they hit you or your child! Or use balloons to practise catching - balloons move much more slowly and so the chance of catching them successfully is increased.
- Demonstrate activities by standing next to the child rather than facing them.
- Try trampolining. Many children with ASDs find trampolining therapeutic and it is also helps to improve balance.
- Use pen grips to help with writing and a ruler with a ridge to make it easier to secure. Play with toys like LEGO to help manipulation.
- Draw more as it is a great way to improve handwriting skills, but also an enjoyable activity for your child.
- Make sure tasks and instructions are clear to your child and only give one instruction at a time, using picture symbols or text if necessary.
- If your child finds it hard to cope with the interaction as well as the coordination and movement involved in team games, let them do more individual sports like running or working out in a gym (Jackson, 2002).
Above all, remember to make sure your child can achieve and enjoy the tasks you set them. Praise them for every step, no matter how small it seems to you, as it's a big achievement to them.
As with ASDs, numerous therapies and interventions are available for children with dyspraxia. The National Autistic Society cannot recommend any individual therapeutic programmes. If you are thinking about these, it is a good idea to research them as much as possible before committing yourself to any. Our information sheet, A checklist for alternative therapies, has information about the kind of questions you might want to ask before starting a programme. Please contact our Autism Helpline on 0845 070 4004 for a copy. Our website at www.autism.org.uk/interventions and Research Autism's website at www.researchautism.net/alphabeticalinterventionlist.ikml also lists information about different interventions and therapies.
The Dyspraxia Foundation
8 West Alley
Helpline tel: 01462 454 986 (Monday to Friday, 10am to 1pm)
The Dyspraxia Foundation aims to raise awareness of dyspraxia, provide support to people with dyspraxia and their families, promote better diagnosis and treatments for dyspraxia, and help professionals working with people with dyspraxia.
Provides details of academic studies about autism and dyspraxia.
Suppliers of equipment
Tel: 01775 640 972
Physiosupplies sells a range of physiotherapy equipment, which you can buy direct from its website or you can order items by telephone.
Goyt Side Road
Tel: 0845 230 1177
ROMPA sells a range of products for people with sensory difficulties.
29 Saltaire Road
Tel: 01274 581 007
SpaceKraft sells a range of sensory products.
References and recommended reading
Attwood, T. (2006). The complete guide to Asperger's syndrome. London and Philadelphia: Jessica Kingsley Publishers
Curtis, J. (2002). Does your child have a hidden disability? London: Hodder & Stoughton
Jackson, L. (2002). Freaks, geeks and Asperger syndrome. London and Philadelphia: Jessica Kingsley Publishers
Kirby, A. (1999). Dyspraxia: The hidden handicap. London: Souvenir Press (E & A) Ltd
Portwood, M. (1999). Developmental Dyspraxia: Identification and Intervention - A Manual for Parents and Professionals. London: David Fulton Publishers
Sims, P. (2000). Reasons and remedies. Barnstaple: Mortimore Books
Terrell, C. and Passenger, T. (2005). Understanding ADHD, Autism, Dyslexia and Dyspraxia. Dorset: Family Doctor Publications