Re-posted from OUR Journey Thru Autism

“I’m doing it! I’m doing it!” yells an exuberant 8 year-old boy as he rides away from me on his bike. This young boy has a diagnosis of autism spectrum disorder and dyspraxia and was so frightened to just sit on his bike with training wheels 4 months ago that he held on to me for dear life. Today he rides away from me on a two-wheeled bike on his own and tomorrow he will ride with his brother through the neighborhood.

Dyspraxia is a term used to describe children who appear clumsy, have poor balance, and have difficulty performing activities in their daily lives, such as dressing, coloring, and playing on the playground. Children with dyspraxia often have challenges with visual perceptual skills, motor planning, and academic demands. Dyspraxia falls under the diagnostic term Developmental Coordination Disorder (DCD), but is also frequently seen with other developmental disorders, including ADHD, hypotonia and autism spectrum disorders.

In the past people assumed that clumsy kids would eventually outgrow it, but research is now telling us that these challenges persist throughout the child’s life. Studies have also found that children who have motor skill deficits as children are less active as they grow older. Children with dyspraxia are especially at risk for developing sedentary lifestyles because of their lack of success being active. Intervention therefore aims at improving motor skills, improving problem solving when approaching a novel motor task, and helping children find recreational activities that will set the stage for them to be active for the rest of their lives.

Improving motor skills will vary depending on the child’s age and the individual challenges. Strength, flexibility, posture, motor control, motor planning, and sensory organization are all areas important to assess and problems identified can be improved. Postural instability and core weakness is very common in children with dyspraxia and can affect fine motor and gross motor skill development. Activities that can be helpful to address a variety of these areas at the same time are wheelbarrow walking, animal walks, carrying heavy objects, doing handstands against the wall, holding yoga postures, swimming and climbing on the playground or on homemade obstacle courses. Many strengthening activities can be integrated into a child’s daily life: have them help push the full laundry basket to another room, take the gallon of milk from the refrigerator and carry it to the table and carry things up/down stairs.

A problem-solving or cognitive approach can also be helpful for children with dyspraxia. Breaking down tasks into smaller parts and visualization can be helpful when approaching a novel activity. For example, if a child is practicing putting on their shoes, they can practice the last part of a task, just closing the velcro strap, for example, so that they experience success. Problem solve to remove other challenges to the task, such as having a child with postural weakness sit in a supported chair with their feet on the ground and back supported rather than sitting on the floor.

Activities and programs that address rhythmic movement and timing can also be helpful, as these provide a foundation for coordinated, efficient, automatic movement. Children with dyspraxia often have to think about their movement and aren’t able to make it become automatic. One strategy to help a movement become more automatic is to introduce cognitive tasks/distractions while doing a rhythmic task. For example, walking while singing, stair climbing while counting by 2’s, jumping on a trampoline while clapping and singing ABC’s. The Interactive Metronome  is a computer-based program that helps uses visual/auditory feedback and rhythmic movements to teach timing skills and improve attention and motor planning.

Being active can be challenging for children with dyspraxia, especially as they get older and sports become more competitive. Sports that can be part of an active lifestyle are worth the extra effort to help the child gain the necessary skills. Swimming, cycling, running, skating and skiing are great activities for children with dyspraxia to participate in with peers or with the family. Being active is critical to maintain health and is also so important for social and emotional well-being. Like the boy riding the bike, many child with dyspraxia may have difficulty learning this skill. However, once they master riding it is an activity they can do for the rest of their lives. It is worth the effort to spend the extra time needed to learn and find help from professionals when necessary to help break down the learning process.

Dyspraxia is challenging to children and their families and affects so many different areas of daily life, from independence with dressing , to playing with other children in the neighborhood, to succeeding in school.  Despite these challenges, there are man different approaches to help these children experience success and give them skills that they will use for the rest of their lives.

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  1. […] Reprinted with the express permission of Joni Redlich, DPT, as appeared on her Kid PT Blog, March 14, 2011 […]

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