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CLUMSY CHILD SYNDROME (dyspraxia)

I have a six year old son who has been diagnosed with Clumsy Child Syndrome (dyspraxia). I am unable to find any information on this particular condition.

Clumsy child syndrome refers to a boy/girl who performs fine and/or gross motor tasks in an immature, disorganised, erratic, slow, irregular, or inconsistent fashion. The motor skills are imprecise rather than grossly impaired, and the neurologic examination does not show any significant abnormalities including involuntary movements or disabilities. These children may have cognitive or perceptual problems leading to learning disabilities as well. What causes this is not well understood.

DYSPRAXIA

Most children who have this syndrome have what is called dyspraxia. This is a fancy term which refers to volitional movements that are not done skillfully in spite of an intact sensory and motor nervous system. In other words, all the movements can be physically accomplished except for the fact that the coordination is off making completion of the task difficult. The dyspraxia can then be further classified into subtypes:
  • Ideomotor Dyspraxia. Inability to perform single motor tasks when requested to do so verbally or by visual imitation. Examples include combing hair or waving goodbye.

     
  • Ideational Dyspraxia. In contrast to ideomotor dyspraxia, the ideational dyspraxic child is capable of executing simple gestures in response to verbal commands but has difficulty executing a sequence of multistep motor tasks. The child cannot make a plan to complete the task. An example would be the child who given a toothbrush, toothpaste, and a cup is able to use each item individually but unable to complete brushing his teeth in the usual sequence. He may pour the water from the cup onto the toothbrush rather than apply the toothpaste, etc.

     
  • Dressing Dyspraxia. This is a subtype of ideational dyspraxia in which the difficulties center around donning articles of clothing.

     
  • Oromotor Dyspraxia. This interferes with speech.

     
  • Constructional Dyspraxia. This relates to difficulty with spatial relations. Inability to imitate block designs is an example.

     

SENSORIMOTOR INTEGRATION

Some children are not easily identified as having a specific dyspraxic pattern but will display an overall immaturity and clumsiness when carrying out motor tasks. This relates to a problem with the child using feedback such as what he sees, hears, or feels to help him coordinate the task. This is commonly referred to as hand-eye coordination. This does not mean he has a sight or hearing problem but rather he doesn't use the information he gets from these senses to help guide him.

Nancy, what all this means is that your child has a basic difficulty in "catching on" to motor tasks, however if he sticks with it and doesn't get discouraged, improvement will gradually come. Keep encouraging him as you can imagine how frustrating it would be to know what you want to do but be unable to do it. Ask him if other children are teasing him as this can be the most frustrating part. As your child gets older, his ability to do these types of tasks will improve.

You should try to provide the opportunity to repeat the activities with which he has trouble many times in a noncritical, noncompetitive atmosphere. If he has trouble swimming, try practicing in the winter so when summer comes he will be ahead. If he has trouble with buttoning a shirt, do all of them except the last one. That way he can practice doing them and have a sense of completion of the task. These are just a few examples.

In addition, make his teachers aware of his problems as a continual exposure to frustrations of failure could do harm. Finally, if his coordination problems are significant enough, you may want to consider consulting an occupational therapist.

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