There are many labels given to children with coordination difficulties. Some terms used are:

• Dyspraxia, clumsy child syndrome

• Minor neurological dysfunction

• Dyslexia (Coordination deficits may be present, but not associated with organisational problems)

• D.A.M.P (Deficits in attention motor control and perception)

DCD tends to be an umbrella term encompassing all of the above conditions.

Dyspraxia occurs in between 5 and 7% of the population, and is more common in boys than girls about 2 to 1. Children learn and develop through movement and play, social and emotional development occurs through interaction with others by gesture, play and speech.

A child that moves with ease and performs movements well tends to have confidence in himself and a positive self image is built.

He will practice skills that are difficult without a threat to his self confidence.

The child also judges his own motor performance by comparing himself with others.

A child with Dyspraxia finds he cannot succeed with activities and therefore develops low self esteem and low self confidence. He will eventually stop attempting new activities due to a fear of failure. This feeling can occur in school work and in PE.

The specific treatment programme of structured exercises I provide over 8 sessions will help to improve coordination, planning and muscle control.(it is based on the LEE Medical Programme originally designed by Michele Lee MCSP UK).

Please note: This programme will not help muscular Dystrophy patients there are other more suitable programmes for this condition.

There have been studies that have shown the majority of parents knew there was a problem by the time their child was three but a formal diagnosis was not made until they were between 7 and 8 yrs of age. By this time the child was comparing himself to others and a poor self confidence had developed.

However this Therapeutic Treatment programme has a positive affects and rebuilds their self confidence rapidly by perfecting and improving their motor muscle movements so that they will reach the same milestones as unaffected children by the time they are teenagers and will feel confident and able to participate in sports with their peers instead of dropping out of most sporting activities

An example of one milestone is throwing and catching a ball. However, as with all skills these improve as we develop and get older:

At 2 yrs: Can throw football (big ball)

At 3 yrs: Throws and catches a football

At 4 yrs: Can use a ball and bat

At 5 yrs: Can play a variety of ball games (small and big balls)

At 6 yrs: Bounces, throws and catches a tennis ball with dominant hand

At 7 yrs: Throw, clap and catch

At 8 yrs: Throw, clap twice and catch

At 9 yrs: Throw, clap three times and catch

Kicking a ball is another milestone:

At 2 yrs: Walks towards the ball and kicks it

At 3 yrs: Kicks ball forceable

At 4 yrs: Kicks ball with improved skills

At 5 yrs: Can trap and stop the ball

How you might notice your child has Dyspraxia:

• Delay in reaching milestones e.g. standing, walking and hopping. It is worth noting that some children never crawl, they bum shuffle!

• Poor writing and drawing abilities

• Unable to sit still

• Disorganised, messy, difficulty in planning activities properly

• Frequently falls and trips

• Loner (gets on with younger or older kids more than his peers)

• Messy eater – spills drinks etc.

• Runs with hips flexed so appears to lean forwards and be more bent

The role of the physiotherapist in Dyspraxia

The physiotherapist’s primary goal is to enable the child to be able to reach the age appropriate level of milestones. If at assessment we find that these milestones are notably delayed then with an appropriate individually tailored exercise programme that the child undertakes we should be able to help the child to achieve these milestones.

For example you might have noticed your child can’t stand on one leg without excessive wobbling, whereas other children of their age can, or they cannot walk up stairs without holding on to the banister while other children can. With the specifically targeted exercises this programme provides this milestone can be reached and by the time the child is a teenager he will have caught up with his peers.

An hour long initial assessment, in which the following are assessed:

• Muscle tone, hyper mobility is very common in dyspraxia

• Range of joint motion

• Coordination. Balance

• Bilateral integrity

• Spatial awareness

• Hand-eye coordination

• Foot-eye coordination

• Core strength

As mentioned above once the specific areas where deficits are noted, I as Physiotherapist will design the appropriate home exercise programme. This is provided and explained during the session and the child is sent home to carry out the programme for either a week or two weeks. At the next session I will take the programme to the next level and the child will go home with a new set of exercises. The programme takes approximately 8 sessions on average and then a yearly follow up review is advised.

However when a growth spurt occurs, top up sessions may be required as the child tends to get weaker and lacks stability as a consequence. This is due to the muscles stretching to keep up with the new bone growth. Some muscles may become weak again and need to be targeted with the appropriate corrective exercise programme.

In summary, we aim to achieve the goals agreed with the parents and child using a tailor made home exercise programme.

Here are some examples of the goals that parents and their child want to achieve:

• I don’t want to fall over or trip as often.

• I don’t want to bump into objects as often.

• I want to be better at PE and sport, be able to run and catch more effectively.

• I want to write more clearly.

Physiotherapy is one strand of the programme. It is important to involve parents, the child teachers and other health professionals such as Occupational Therapists (OT).

At the end of the programme we try to find physical activities that can continue to maintain the regained strength and coordination. This can best be achieved by finding a sporting activity that is suitable for and more importantly enjoyed by your child. For example judo, swimming, rowing, horse riding, tennis, football etc etc.