Dyspraxia - Trying to understand the nuances

[Anonymous]

Can a child who

• seems to have no awareness of his body in space,
• is emotionally immature,
• is highly distractible - super clumsy (falls out of chair very frequently),
• never could master a tricycle and was very long in learning to ride a bicycle and still doesn't enjoy it too much and,
• is a definite sensory SEEKER..

BUT also has

• excellent spatial awareness for things like geometry and block design,
• has always had advanced fine motor skills even at a very young age
• has always been advanced in his verbal expression.

...have dyspraxia?

He undeniably has ADHD, but this website suggest an overlap: https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/dyspraxia/understanding-dyspraxia
and I'm wondering if I look at his situation merely from the ADD perspective.. am I missing something critical? I always thought he was ADHD with SPD.

[Anonymous]

OP Here.. And this, I left out this..

• May talk continuously
• May forget and lose things
• Has trouble picking up on nonverbal signals from others

[Anonymous]

I find dyspraxia and SPD so vague as to be useless categories, particularly because there does not seem to be a well developed body of evidence based interventions. Instead I'd focus on whatever symptoms seem problematic to you and finding a trusted PT or OT to work on them. For as much as people like to talk about these diagnoses as if they were medical diagnoses like diabetes, they really are not - they are clusters of symptoms. In the absence of a need for a label (for IEPs or insurance) I don't find the label very helpful. So, address the symptoms. My 2 cents as the mom of a kid who appears ADHD or dyspraxic depending on how you want to look at him.

[Anonymous]

The only thing that seems surprising for a kid with dyspraxia is the excellent fine motor skills.

FWIW, my child who probably has mild dyspraxia and definitely ADHD is very similar, except his fine motor skills are delayed. He is 8 now and has really improved in sense of body in space--and is not really noticeably clumsy anymore. Also, he was a bit speech delayed but not enough to get services. Mostly I noticed how different he was than my three other kids. Once he started talking though, he didn't stopped. I think most people would say he is advanced verbally but he has retrieval quirks.

[Anonymous]

Mine is like that, nearly 8, except still can't ride a bike. But definitely had delayed fine motor skills; it has gotten better through OT.

[Anonymous]

Mine is like that too. Good fine motor skills, enough that I assumed she didn't need OT when she may need it. Eval is scheduled. FYI, bike riding took awhile, I wholeheartedly recommend bike classes at REI. Took us too sessions, but good at it now.

[Anonymous]

Fine motor would probably be affected if he had dyspraxia/DCD. A lot of what you mention might be due to the ADHD, the other issue that strikes me is he might have a underdeveloped vestibular sense, e.g.,:

http://vestibular.org/pediatric-vestibular-disorders
http://nspt4kids.com/healthtopics-and-conditions-database/vestibular-processing/

He might not have an actual disorder, but OT can help with balance, sensing his body in space, etc.

[Anonymous]

Agree with some PPs -- that dyspraxia is now a pretty catch up 'diagnosis' for a wide range of concerns (in part (maybe large part) b/c it is recognized by many insurance plans). How old is your son? Some advise would depend on if he's still preschool or older. What I learned from DS doing OT - there's a range of things and some kids that have issues with some may be strong in others. My DS rated super high on some of the evaluation measures and very low on others (and averages out as pretty normal. For instance, my son does not have attention issues which people often lump with dypraxia). The evaluations can often sound really scary and overstate some things (and miss some others) - since they are a tool and not a hard definition like you would have with a disease like 'cancer or no cancer'. My general advice based on our experience is - my son was clearly pretty clumsy in many ways, slower or less coordinated compared to many kids his age in some things, and was hesitant to try some things. Doing OT and some PT helped him build some of these skills, compensation skills and muscle memories that have served him well. He's unlikely to ever be a star athlete but can hang with the other kids now by first grade.

[Anonymous]

My daughter (almost 6) was diagnosed with dyspraxia at 20 months. My understanding of it is more in terms about one's ability to execute motor plans. Speech is my daughter's biggest challenge (she was a textbook example of a child with apraxia). But the rest of her body is also impacted, too. Her fine motor skills tested strong when she was very young, but now that she uses those skills more for writing and drawing, it's evident that motor planning is hard for her there too. (It's not holding the pen that's the challenge, it's her brain's ability to make her muscles move in the way that would result in an S, for instance.) Similarly, learning to walk was a challenge, just like learning to pedal was a challenge, just like learning to swim was a challenge. However, with help (particularly hand-over-hand demos -- beyond just verbal instructions or visual demos), and tons and tons of practice (more than most peers), she's learned to ride a bike (with training wheels), swim, and speak (nonstop).

Not sure that this is very helpful, but it feels like a different or separate understanding of dyspraxia. My daughter also sometimes seems to have some difficulty knowing where her body is in space, and also sometimes is a sensory seeker, but I've chalked those up to separate (but often comorbid) neurological differences (underdeveloped vestibular system, like PP said, proprioceptive dysfunction, etc.).

[Anonymous]

Anonymous wrote:Agree with some PPs -- that dyspraxia is now a pretty catch up 'diagnosis' for a wide range of concerns (in part (maybe large part) b/c it is recognized by many insurance plans). How old is your son? Some advise would depend on if he's still preschool or older. What I learned from DS doing OT - there's a range of things and some kids that have issues with some may be strong in others. My DS rated super high on some of the evaluation measures and very low on others (and averages out as pretty normal. For instance, my son does not have attention issues which people often lump with dypraxia). The evaluations can often sound really scary and overstate some things (and miss some others) - since they are a tool and not a hard definition like you would have with a disease like 'cancer or no cancer'. My general advice based on our experience is - my son was clearly pretty clumsy in many ways, slower or less coordinated compared to many kids his age in some things, and was hesitant to try some things. Doing OT and some PT helped him build some of these skills, compensation skills and muscle memories that have served him well. He's unlikely to ever be a star athlete but can hang with the other kids now by first grade.

Just as an example - he is awesome on balance (which is often listed as a big dyspraxia thing) but had trouble learning to climb a ladder and use a slide, or had trouble figuring out how to get out of a tire swing on a platform or how to hold a hockey stick (which I have nephews who were 'naturals' at it) ... but after the OT where he practices and developed feelings for lots of things, you can see how he applies it and how many of the movements also came to feel natural. Watching all of it, I am truly convinced that there's something neurological but the solutions are not clear cut - but helping the kid function was important to me & where I saw progress, no matter what the label is.

[Anonymous]

Anonymous wrote:Agree with some PPs -- that dyspraxia is now a pretty catch up 'diagnosis' for a wide range of concerns (in part (maybe large part) b/c it is recognized by many insurance plans). How old is your son? Some advise would depend on if he's still preschool or older. What I learned from DS doing OT - there's a range of things and some kids that have issues with some may be strong in others. My DS rated super high on some of the evaluation measures and very low on others (and averages out as pretty normal. For instance, my son does not have attention issues which people often lump with dypraxia). The evaluations can often sound really scary and overstate some things (and miss some others) - since they are a tool and not a hard definition like you would have with a disease like 'cancer or no cancer'. My general advice based on our experience is - my son was clearly pretty clumsy in many ways, slower or less coordinated compared to many kids his age in some things, and was hesitant to try some things. Doing OT and some PT helped him build some of these skills, compensation skills and muscle memories that have served him well. He's unlikely to ever be a star athlete but can hang with the other kids now by first grade.

That's great! If you are in the DC area can you share the names of your PT and OT? Did you get an IEP?

[Anonymous]

PP here. We worked with Lisa at Sensational Kids in Chevy Chase. Thought she was fantastic (best in the practice there) and they have a PT on staff too who wasn't as 'warm' but really did well with things that helped my DS a lot. Some folks recommended Skills on the Hill, but we were closer to Chevy Chase. I would avoid some of the evaluators since as mentioned the 'diagnoses' don't necessary match what you do to functionally help and support your kid (Lyn Balzer - spent a lot of money to get a very definitive sounding 'diagnosis' but realized later the ranges and perspective on the diagnoses I mentioned above.)

[Anonymous]

P.S. If you are in DC or MoCo, worth trying to get a city eval (Bright Beginnings) and/or the free MoCo one - since it may help get you in line for paid for services. But, for instance, since my DS testing very well in some things and low in others, his 'average' on the batteries never would've qualified us for any official support.