What is Dyspraxia? Clumsy Child Syndrome

Dyspraxia is a motor skills disorder with symptoms that can be recognized in children as young as 1 or 2 years old. If your child struggles with persistent clumsiness, gross motor movement, and physical coordination, you might consider pursuing an evaluation for dyspraxia, a condition with significant ADHD overlap.

Clumsy Child
Clumsy Child

What is Dyspraxia?

Dyspraxia is a neurological disorder that affects a child’s ability to plan and process motor tasks. Children with dyspraxia appear awkward when moving their whole body, or use too much or too little force. When a child has dyspraxia, he can’t imitate others, often mixes up the steps in a sequence, and can’t come up with new ideas during play. Dyspraxia is sometimes called “clumsy child syndrome” and is often considered ubiquitous with Developmental Coordination Disorder (DCD), a unique but very similar diagnosis also associated with poor eye-hand coordination, posture, and balance.

Up to 50 percent of children with DCD, which is more common in boys than it is in girls, meet the diagnostic criteria for attention deficit hyperactivity disorder (ADHD or ADD).1

Dyspraxia-related coordination difficulties affect all aspects of daily life — for example, brushing teeth, getting dressed, and doing laundry. Though dyspraxia research is growing, the condition is often misunderstood or diagnosed improperly. Well-intentioned professionals dismiss symptoms of dyspraxia by saying, “Oh, he’s just an active boy” or “She will come around eventually.” But an overdue diagnosis of dyspraxia can greatly affect the self-confidence and achievement of a child, even if he or she has an average or above-average IQ.

Symptoms of Dyspraxia

The following dyspraxia symptoms correspond to each stage of development in children:

0-3 Years Old

  • Delayed early motor development
  • Delayed language development
  • Repetitive behaviors and frequent motor activity
  • Highly emotional
  • Feeding difficulties
  • Sleeping difficulties
  • Toilet training may be delayed

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3-5 Years Old

  • Can’t stay in one place for longer than 5 minutes, constantly tapping feet or hands
  • Speaks too loud, easily distressed
  • No sense of danger
  • Clumsy, constantly bumping into things
  • Associated mirror movements (hands flap when running or jumping)
  • Trouble with fine motor skills — when handwriting, using scissors and eating utensils, tying shoes, buttoning clothes
  • Limited response to verbal instructions
  • Sensitive to sensory stimulation
  • Difficulty with speech, concentration and memory

Many of the signs listed above are similar to ADHD symptoms, and they persist through a child’s development. Additionally, a child with dyspraxia may learn well in a one-on-one setting, but struggle in a class with other children around. He or she may also avoid physical sports and particularly struggle with math and writing homework.

Diagnosing Dyspraxia: What To Do

Talk to your child’s doctor about your concerns. If you’re worried that your child might have dyspraxia, voice your concerns with her doctor. Pediatricians can diagnose dyspraxia, or they might refer you to a clinical or educational psychologist. Occupational therapists assist in the evaluation and treatment of dyspraxia but cannot make a diagnosis on their own. Any of these professionals will assess your child’s developmental history, intellectual ability, gross motor skills (use of the large muscles that coordinate body movement), and fine motor skills (use of smaller muscles for actions like writing or tying shoes). A norm-referenced assessment of these skills will allow the evaluating professional to compare your child’s results to the normal range of scores for a child his or her age.

A dyspraxia diagnosis is warranted if

  • Motor skills are significantly below the age-expected level
  • Lack of motor skill persistently affects your child’s daily activities and success at school
  • Symptoms arose during early stages of development
  • Lack of motor skills is not better explained by a general learning disability or rare medical condition

[Free Resource: Overcoming Common Learning Challenges]

Tell the school about your child’s dyspraxia. If you haven’t already, reach out to the administration at your child’s school regarding available and appropriate accommodations. You can also formally request an evaluation for special education services. Make a list of tasks that frustrate your child. Ask his teacher to look for school tasks that cause stress or irritability. Teacher observations assist caregivers and therapists in determining how to help.

Treatment Options for Dyspraxia

  • Occupational Therapy: An occupational therapist helps children with dyspraxia develop skills specific to the daily tasks that challenge them most.
  • Speech and Language Therapy: A pathologist will administer a speech assessment used to develop a treatment plan to help your child communicate more effectively.
  • Perceptual Motor Training focuses on language, visual, auditory, and movement skills. Children with dyspraxia are given a set of tasks that gradually become more advanced, challenging the child but not so much that become stressed.
  • Active Play: Anything that involves physical activity, inside or outside the home, helps improve motor play.

How to Help a Child with Dyspraxia

ADDitude’s Explaining Dyspraxia” article provides six helpful tips for parents to when building motor skills in children who have dyspraxia:

  1. Break complicated tasks into smaller steps. Master one before moving on to the next one. For example, when teaching shoe tying, make sure your child can independently complete the first step of making the knot.
  2. Use pictures or video modeling to illustrate the sequence of steps in doing a difficult task.
  3. Use multi-sensory teaching. Add songs, movements, scents, and textures to learning a new task. Use a song or rhyme when learning to tie shoes. When learning how to form letters, trace a letter onto sandpaper, paint it, or form it with scented dough.
  4. Create an obstacle course in or outside your home. Have your child try to complete the course without shoes to stimulate sensory receptors in the feet. Add beanbags, soft mats, swings, and cut pool noodles in half to make balance beams. Purchase a scooter board. The obstacle course builds motor skills in a fun way. Let your child plan the course and give her different commands, such as, “Now crawl like a puppy.” Imitating animals is fun and builds creativity and muscle strength.
  5. Allow children to use pencil grips, scissors with self-opening handles, and other therapeutic tools that hone fine motor skills. Begin with verbal and physical cues, then ask your child to name the next step.
  6. Look into Cognitive Orientation to daily Occupational Performance (CO-OP), an active treatment approach that uses mutual goal-setting, analysis of a child’s performance, and high-level cognitive (thinking) strategies to improve motor-based skills.

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1 Keen, Daphne, and Irene Hadjikoumi. “Attention deficit hyperactivity disorder in children and adolescents.” BMJ Clinical Evidence (Aug. 2015) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4551107/