Kids Health Info

Brain injury - Dyspraxia

  • What is dyspraxia ?

    Children with dyspraxia have problems with smooth and coordinated movements. Dyspraxia is often present after a brain injury. Dyspraxia brought on by a brain injury can improve with time and therapy.

    "Motor planning" describes the ability to plan and choose the right movements in the right order to achieve a skill or goal. A child/young person may have the understanding of what is required, and have the ability to do the movements needed, but is not able to successfully put it together in response to a command or to conscious intent.

    Dyspraxia can affect the oro-motor (mouth) area, causing difficulties with speech sound production, or it can affect the whole body. The degree of difficulties can range from mild to severe. Fortunately, this is a problem that often improves with time, practice and therapy, unlike the developmental dyspraxias (present from birth) which are more difficult to treat.

    What are the symptoms of dyspraxia?

    Sometimes a child can perform an action and at other times they can't.  This is called a variability of ability. For example, a child can be seen to do something spontaneously (e.g. scratching an itchy nose).  However, they are not able to perform the same action when asked, even though they may understand the instruction "touch your nose". This can be frustrating and hard to understand, and a child/young person may be wrongly labelled as "lazy", "uncooperative", "not trying" or even "naughty". For the child/young person themselves, the difficulties caused by dyspraxia can be very frustrating and can have a negative effect on their self-esteem.

    Once a child re-learns a task or skill, they are usually able to continue to do this successfully. However "generalisation" (i.e. using the same skill to do a smiliar but different activity) is difficult for people with dyspraxia. For example, a child may have re-learnt how to get dressed with their usual clothing.  However, if they are given something different to wear or if they have to do this task in a different location, they may encounter difficulties until they re-establish that particular skill in the new environment.

    Who do I see and how is it diagnosed?

    The child/young person's therapists (physiotherapist, speech or occupational therapist) usually diagnose dyxpraxia, and these are the people who can give advice about treatment strategies and how to best assist your child.

    Strategies to assist

    • Simply understanding that a child has a problem with dyspraxia will be a huge help. Once people realise the child is not being lazy or uncooperative, the pressure and stress is taken out of a situation.  This can make it easier for everyone to deal with.
    • Changing the focus of the task, re-wording a verbal request, giving a visual cue (e.g. a gesture) as well as a verbal cue are all ways that can help individuals with this problem.
    • Allow time and be patient with the child. Sometimes a child can complete a task, but it takes longer because they have to consciously think about the sequence of motor steps.  Think about how an adult learns to drive a manual car - needing to think through the steps of which way to move the gear stick and operate the clutch while steering the car and taking notice of the traffic.
    • Break down complex tasks into smaller steps, and complete each smaller step before moving on to the next one.

    Key points to remember

    • Dyspraxia is when a person has difficulty organising and planning their movements.
    • Dsypraxia that occurs after a brain injury can improve with time, practice and therapy.
    • Usually the child's occupational therapist, physiotherapist, or speech pathologist will identify dyspraxia and will be able to help with strategies and therapy.

    For more information

    Developed by the RCH Paediatric Rehabilitation Service,based on the dypraxia factsheet produced by the Brain Injury Service, The Children's Hospital at Westmead.First published Feb 2007. Updated November 2010.

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This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.