Summary of needs and disabilities

Developmental co-ordination disorder (DCD), also known as dyspraxia, is a condition affecting physical co-ordination that causes a child to perform less well than expected for his or her age in daily activities and appear to move clumsily.

Early developmental milestones of crawling, walking, self-feeding and dressing may be delayed in young children with DCD, and drawing, writing and performance in sports are usually behind what is expected for their age.

The problem is not due to general delays in development or a learning disability, and is not caused by cerebral palsy or another neurological disorder (conditions affecting the nervous system).

Although signs of the condition are present from an early age, children vary widely in their rate of development and DCD is not usually definitely diagnosed until a child with the condition is around five years old or more.

There are six general groups of symptoms. These include:

• general unsteadiness and slight shaking
• an at-rest muscle tone that is below normal
• muscle tone that is consistently above normal·
• inability to move smoothly because of problems putting together the subunits of the whole movement
• inability to produce written symbols
• visual perception problems related to development of the eye muscles.

In the past, children with dyspraxia may just have been thought of as clumsy and having problems with balance and coordination. Now it is recognised as a learning difficulty affecting some skills and abilities, but not general intelligence

The charity Young Minds says the number of children experiencing the condition is between 2% and 10% of the population. Boys are four times more likely to have dyspraxia than girls and the NHS says it may run in families.

Causes of Dyspraxia

Experts believe the condition is caused by the brain's information processing systems not being fully developed and messages not being transmitted properly.

Although not fully understood, the risk of dyspraxia may be higher in babies born prematurely, born with a low birth weight or whose mother drank alcohol, smoked or took illegal drugs during pregnancy.

Symptoms of Dyspraxia

Dyspraxia is often thought of as causing physical difficulties, but it can affect other areas of a child's life:

• Balance and co-ordination affects ability to hold pens, pencils and handwriting, and dressing, and eating skills using cutlery
• Following instructions, organisation and short term memory
• Speaking and listening, social skills and friendships.

Early signs of dyspraxia may be seen in babies who are slow to sit up, crawl, walk and get the hang of potty and toilet training. Later in life, children may seem awkward and accident prone and take longer to learn to ride a bike. They may be oversensitive to some noises, light, touch and other triggers.

Speech may be immature for a child's age and hard to understand early on.

As well as communication difficulties, a child with dyspraxia may think in a very literal way and have trouble with imaginative play.

A child with dyspraxia may have other learning difficulties, such as an autistic spectrum disorder, attention deficit hyperactivity disorder (ADHD) or dyslexia. The symptoms of dyspraxia may fade as a child gets older, but around nine out of 10 children with dyspraxia still have difficulties in their teens and adulthood.

Diagnosing Dyspraxia

An early diagnosis means help and support can be given to a child sooner. A GP will probably need specialist help in making a diagnosis of dyspraxia. This may come from occupational therapists, child health specialists (paediatricians), physiotherapists, clinical psychologists, neurologists and educational psychologists. Assessment will be made of whether a child has missed the usual milestones of development, issues with co-ordination and motor skills. Checks may be made for other problems and conditions, such as cerebral palsy, to rule them out. The NHS Dyspraxia diagnosis check list will look for all these issues:

• The child's motor skills are significantly below the level expected for their age and intelligence
• Lack of skills affects your child's day-to-day activities and their achievements at school
• Lack of skills is not caused by another medical condition
• If a child already has diagnosed learning difficulty, the motor skills are worse than expected for this condition.