Help for falling without hurting himself (motor planning, dyspraxia??)
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Anonymous
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I suspected this was a concern with my child as well after a couple of really bad falls where DC didn't seem to get his arms out to brace for a fall... I mean DC has had a couple of black eyes and road rash from bad falls and hitting his face! It's very scary.
So I mentioned this to our OT who evaluated him. I don't remember what she called it but it was definitely a real thing that some kids have. Turns out she thought my kid didn't have whatever it was called. But if you are concerned, definitely call a couple of OTs and see if they can do an eval. |
Anonymous
Intellectual dofficulties? dyspraxia is usually part of an ADHD or asd diagnosis, no? what do you mean by intellectual difficulties? |
Anonymous
Dyspraxia is not part of ADHD or ASD. Can be part of cerebral palsy or many other neurological issues. |
Anonymous
what other kinds of neurological issues? |
Anonymous
Dyspraxia is separate from CP but both are neurological and can affect motor coordination. Intellectual disabilities may co-exist with any or all of the above mentioned, but a moment disorder doesn't automatically mean ID. OP, you may want to look here for unspecified motor disorders: http://www.theravive.com/therapedia/Unspecified-Neurodevelopmental-Disorder-DSM--5-315.9-(F89) There is probably someone at Childrens or KKI that specializes in motor disorders. |
Anonymous
This link does not work. |
Anonymous
OP here - he has trouble balancing on one leg at a time and is 'behind' on hopping. His original screening back when he was 3 mentioned things about the vestibular issues. He is also the lead scorer in his soccer league & doing really well in some other things - but i know different activities can be strengths/weaknesses with different skills. He's only gotten hurt the one time from it, and it took me a bit to connect it back to a comment that his PT had made before (ie. that he got so hurt from a fall b/c he probably hadn't braced himself & went flat down on his face (I wasn't there for the fall to see it, but then also remembered on time when he just went flat down after getting hit playing dodge ball.)) We'll work on the skill practice - set up to go see the OT/PT over break - but sounds like I should take him to a neurologist maybe to see if there is something beyond ... or if we know he has motor planning than we already know & wouldn't mind much else out? |
Anonymous
opps - "mind" meant to be "find". And thank you to folks for comments & support. |
Anonymous
http://www.theravive.com/therapedia/Unspecified-Neurodevelopmental-Disorder-DSM--5-315.9-(F89) Trying again. The end parentheses was hot linked in last post for some reason, but if you copy and paste it will work. |
Anonymous
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Here is the info from the link. (Not working for me now even after I copied and pasted it)
DSM-5 Category: Neurodevelopmental Disorder Introduction Unspecified Neurodevelopmental Disorder (UNDD) is a DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition), diagnosis assigned to individuals who are experiencing symptoms of a neurodevelopmental disorder, but do not meet the full diagnostic criteria for one of the Neurodevelopmental disorders. The symptoms cause distress, and impair functioning in social, educational/occupational, or other major areas of functioning. The diagnosis can be assigned when the clinician decides not to specify the reason the diagnostic criteria are unmet, or if there is insufficient information available at the time of the evaluation to make a more specific diagnosis (American Psychiatric Association, 2013). The amygdala is the brain structure most frequently implicated in NDD, which would include UNDD. A sub-cortical structure regulates our response to potentially dangerous environmental stimuli. Sensory input goes to the orbito-frontal cortex, and to the amygdala for processing on an ongoing basis. If the sensory input is deemed non-threatening, we note it and attend to the next incoming sensory stimuli. If the sensory input is recognized as a threat by the amygdala, the fight/flight/freeze response of the parasympathetic nervous system begins to activate. The amygdala acts much faster than the orbito-frontal cortex. The right frontal lobe is specifically involved with executive function- e.g., decision making- and inhibition, but processes information slowly relative to the amygdala. A threat to survival is often best dealt with urgently, which is the function of the amygdala- recognize threats, and prepare the body to engage, or withdraw, or sometimes, neuromuscular lock- e.g. - the freeze response- can be conducive to survival. Individuals with disorders along the NDD spectrum, including UNDD, have dysregulation in the amygdala, which results in inappropriate response to stimuli. An underactive amygdala can result in high-risk behavior, and inappropriate social behavior. An overactive amygdala can produce excessive anxiety and risk aversion, as well as avoidance of social interaction (Schumann, Bauman, and Amaral, 2011). Symptoms of Unspecified Neurodevelopmental Disorder According to the DSM-5, (American Psychiatric Association, 2013), NDD consists of a range of disorders first apparent in childhood including: Autism spectrum disorder CP (Cerebral palsy). Epilepsy Schizophrenia Bi-polar Disorder AD/HD (Attention Deficit/ Hyperactivity Disorder). OCD (Obsessive Compulsive Disorder). Disorders of communication, speech, and language. Tic Disorders, including Tourette’s Disorder FAS/FAE (Fetal Alcohol Syndrome/Fetal Alcohol Effects) FXS (Fragile X Syndrome) Rett Syndrome William’s Syndrome Down syndrome There are vast quantities of symptoms for the NDD spectrum, and the symptoms of each individual disorder on the spectrum may be unique, or overlap, which can contribute to diagnostic ambiguity. There is commonality in that symptoms are manifested as disruption in physical, intellectual, emotional, behavioral, and cognitive functioning, typically first apparent in early childhood ((American Psychiatric Association, 2013; Elsevier Ltd., 2013)... There's more to the article, but I wanted to address your questions about what other neurological disorders. More than likely, you'll need a differential diagnosis at some point to determine if the falling keeps happening is just related to the dyspraxia or something else. (BTW, many of these like FAS, Williams, or Down Syndrome, you'd already know if your kid had them.) There can be disorders of the inner ear that can affect balance. Also, sometimes thing like neuropathy can make someone's legs buckle. This could be related to an autoimmune disease or something like diabetes. My sense is that if your kid only does this occasionally and is doing so well in so many other areas, I don't know how doggedly I'd pursue it at the moment. Just my opinion. I'd start first with your pediatrician. It may be more of a wait and see kind of thing. Maybe as PP suggested "teaching him to fall" would be helpful since he seems to be able to acquire physical skills pretty easily. |
Anonymous
ADHD and asd are both neurological issues and often include aspects of motor planning or dyspraxia. |
Anonymous
Dyspraxia or DCD is a stand alone diagnosis as is CP. You can have dyspraxia AND X, Y, Z. Kids with autism or ADHD do not necessarily have motor planning issues. That's where a differential diagnosis comes in if necessary. |
Anonymous
I don't get why you disagreed with me and then posted a link noting that it can in fact be a part of neurological conditions like ADHD and asd. |
Anonymous
| These things are often called spd which is not a stand alone diagnosis. This is by not settled or clear cut. |
chitz
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Sorry I was not clear about what I meant when I mentioned neurological conditions/intellectual difficulties. I meant when a child does not have a reflex such as protective extension there could be several different causes and you want to tease it apart. It could be a neurologic condition that affects the motor portion that initiates the protective response or damage to the portion of the brain where the vestibular input is processed. I asked about intellectual difficulties because they will often be associated with these neurologic conditions (CP, Tourettes, etc). Let me be clear, I was not saying motor planning and intellectual disabilities go hand and hand. I was saying if you see other concerns such as intellectual difficulties I would see a neurologist. In your son's case I would get them tested by an OT or PT. The thing about soccer is that your head is in the midline position (upright and running forward). It rarely requires you to bend over or reach off the midline of your body, which is when vestibular input comes in play. I would say that the fact that he has trouble balancing on one foot, hopping and the previous PT mentioned vestibular issues is likely the reason for the underdeveloped protective reaction. Colleen Doyle Together in Movement |