Dyspraxia is a motor coordination disorder of development. The condition may not be apparent from the beginning making diagnosis and identification difficult in all children.
Boys are four times more likely to be affected than girls and dyspraxia may run in families.
Symptoms are apparent in only about ten per cent of the population and two per cent may show severe symptoms. (1)
There is no cure for dyspraxia but an early diagnosis and therapy means greater chances of improvement.
Who carries out the diagnosis of dyspraxia?
Diagnosis is usually done by a team of specialists. This includes a paediatrician or a children’s doctor, a physiotherapist, an occupational therapist and clinical and educational psychologist.
There may also be a neurodevelopmental paediatrician or a paediatric neurologist on the team. These paediatricians specialize in central nervous system development of children.
Assessing the progress of the child in school
Progress of the child in school has to be assessed with the help of six areas of learning. These include (2) –
- Development on personal, social and emotional levels
- Physical development
- Communication and language
- Problem solving, reasoning and numeral understanding
- Knowledge and understanding of the world around
- Creative development
Stages of diagnosis of dyspraxia
Initial assessment involves detailed account of the child’s developmental history which asks questions on when the child first sat, crawled etc.
The next step of the assessment involves evaluating intellectual development. Reading, writing and other skills are tested.
Motor skills are assessed. These look at gross movements like hopping, jumping, running, walking, throwing and keeping balance.
There are tests that look at finer motor skills. These include looking at fine coordinated movements like writing, tracing, copying, cutting out shapes, buttoning, buckling etc.
Diagnostic tests of dyspraxia
There some common diagnostic tools that are used for diagnosis in the United Kingdom and United States. These include some of the following tests. (2)
Movement Assessment Battery for Children (Movement ABC-2)
This can be used for children aged 3 to 16 years. It looks at both gross and fine movements and their deficiencies.
Manual dexterity, ball skills and static and dynamic balance maintenance are assessed.
Each of these parameters are qualitatively assessed.
Physical features like height, weight, weight in relation to height, hearing, speech, vision, posture or other physical defects are also assessed.
If any psychological factor affects the physical movement they are noted.
Test of Visual-Perceptual Skills (non-motor) (TVPS)
These look at the ability of the child to use visual cues to process information and recall, discriminate or understand the meanings of the cues.
Goodenough Draw-a-Man Test
In this the child is asked to make three drawings - of a man, a woman and the child’s drawing of himself.
It is used between aged 4 and 12.
It helps determine conceptual maturity and intellectual functioning
Developmental Test of Visual-Motor Integration (VMI)
This test can be used in children aged 2 to 18 years. It helps to diagnose reading, writing and copying difficulties.
The child is asked to copy a sequence of geometric forms using a pencil.
Test of Auditory-Perceptual Skills Revised (TAPS-R)
This test assesses hearing memory and recall. This includes sentence, number and word memory.
This test also assesses processing of heard directions and reasoning and thinking.
Further observation of motor skill, handwriting or computer use and handedness also help assess the patient and diagnose dyspraxia.
Criteria for diagnosis of dyspraxia
Criteria for diagnosis if dyspraxia are (3) –
- Motor skills significantly below the level expected for age and intelligence.
- This deficiency affects the child’s day-to-day activities and their achievements at school.
- There is absence of other neurological conditions like cerebral palsy.
- There is concomitant presence of learning difficulties along with motor deficits.