Dyspraxia?

[PrinceRogersNelson]

I was wondering if some knowledgeable people can tell mw whether they think my DD might have dyspraxia?

She is 3.6 yrs old and was seen by a peadiatrician last week from the child development team. She was assessed on many different things and basically was put at 24 months for her locomotive skills and 30 month for her speech and language and her understanding.

These are the reasons I think she may be dyspraxic, but I don't know if she is just too young to tell:
She cannot hop or jump. She cannot scoot and needs to hold on to something to go up and down stairs.
She can run, but it is very ungainly and her hands do flap.
She falls over for no reason. Her legs just seem to go from under her.
She trips over a lot.
She is very weak, she doesn't seem to have any strength in her limbs and I have been told she is hypermobile.

Her speech is very delayed. She is talking more, but it is highly repetitive. She cannot pronounce things well at all and there are lots of speech sounds she simply cannot make. It is very hard to understand what she is saying.
When I mentioned dyspraxia to a SALT they said it couldn't be as people with dyspraxia tend to make lots of mistakes with speech and her speech whilst delayed is the same every time.

She has a very high pain threshold and she doesn't sleep well.

She is quite hard to communicate with. You need to work hard to get her to concentrate and repeat instructions many times before she will do something, although she is getting better at this.

She is very sociable and loves pre school and her childminder, but she does seem to be on the edge of things rather than in them.

She is being seen by an educational pyschologist in the next couple of weeks and I have asked them to bear it in mind and if they think not to tell me why.

Am I barking up the wrong tree, or could this be something worth looking at?

Thanks and sorry it is so long.

Her hypermobility could explain a lot of the things you are seeing, particularly if she has low muscle tone, too. People with hypermobility tend to get very poor feedback about where their limbs are in space (proprioception) since their ligaments tend to be stretchier than their brain calculates for, hence the clumsiness. There are likely to be similar factors behind her unclear speech.

I'm 42 and I still stumble and bump into things a lot.

I will add, though, that while I'm no expert, everything I've read about hypermobility and dyspraxia has them intertwined quite closely. I think your SALT might have been over-generalising and it's definitely a tree worth barking up.

Hello, I don't know an awful lot about dyspraxia, but I'm surprised that the child development team were not more helpful. It may be worth contacting a more senior member of the team and insist on a fuller examination/diagnosis.
A lot of what you describe is similar to my daughter at that age. She was born very prematurely (24 weeks) so had a difficult start in life. But as the years go on (she's now 10), her physical abilities have improved (or maybe she finds a way round them) to the extent that she can ride a bike without stabilisers now. Quite a breakthrough!

Firstly welcome to the board

I dont think the SALT is the right person to say whether it is dyspraxia or not.

Dyspraxia can come in many shapes and sizes and affects every child differently.

Your Dd needs to be assessed by an occupational therapist, physiotherapist and a developmental paediatrician to get a full picture of what her issues are.

The ED pysch report would be put together with the reports from the other proffs.

The best place for this to happen would be at your CDC, some areas have all the disciplines under one roof. I think you should go to your GP and ask for a referral.

Good luck

Sorry have just read your OP properly and seen that you have already been seen by the child development team, sorry.

The paediatrician did say she was going to speak to a more senior colleague about her physical problems. I will try and chase them up. Some people I see think she has problems others think she will catch up and be fine. It is so confusing :(

It is confusing when people say different things.

Part of the problem is that often the proffs are reluctant to "label" children when they are still little.

Does your Dd go to nursery/preschool?

If she does have they mentioned any concerns. They are supposed to complete a development profile for every child and if children are delayed they should be talking to parents.

I think I would ring the paed asap and find out what the senior collegues opinion was.

If she is hypermobile, you can get a referral to physio and get some excersises to strengthen the muscles around the joints.

She might also need orthotics in her shoes to stop her feet rolling around, my Dd3 doesn't fall over at all when she is wearing shoes with aorthotics in but without them would trip over fresh air.

You might find that at an early age, the professionals are reluctant to dx, and offer delayed development as a coverall.
There are so many symptoms that cross over each other with dyspraxia, apraxia, verbal dyspraxia, hypermobility, dyslexia etc. It is quite hard at an early age to attribute specifically to one route cause - even more so as often these dx are co-morbid.
The main thing is that you get support for the symptoms.

I think that is the problem - there doesn't seem to be any support.

The paediatrician said to keep doing what we are doing and she will see her again in 4 - 6 months for a follow up.

She is at pre school and is seen by a SENCO who doesn't really know what to suggest so she has asked the ed psych to see her which she will at the beginning of July.

She is on the waiting list for a Speech and language assessment.
I will try and call the paediatrician again.

I guess I feel that with a diagnosis we could start helping some more, but that is probably wishful thinking right?

I agree that a Dx would help you to know which way to turn.

One of the best pieces of advice i was given was by a Mental Health nurse when Dd3 was being assessed for ASD. She said that we should treat her as if she did have the condition as it could do no harm.

I am not saying that your Dd has ASD or dyspraxia, what I am saying is that if you do some reading and find some strategies that work with children with dyspraxia you could try some and see how you get on.

If you see progree that is great, if you don't you have lost nothing from trying.

For us it changed the way we managed Dd3 and made things much easier for us.

Just coming back to this.
The ed pysch went in to see my DD at pre school today and very kindly called me back to discuss what she thought.

In one way it is great as the ed psych really seemed to 'see' DD, and the things that I know are not quite right she saw too.

She said that whilst she is quite chatty (although with a speech and language delay) everything is on her terms.
She doesn't have motivation to do things from other people. She will do it if she wants to, but does not respond to social praise.
She said that whilst she does enjoy other people they almost seem like another toy to her.
She cannot really be directed easily and has trouble concentrating and doesn't join in group activities.

Umm, can't really remember what else. But she wants to refer her to the social and communication team and said that autism would be something to be looked at.

I have been told so many times that categorically she does not have autism as she is too sociable.

Christ this is lonely :(

Hi princerogers. Sorry you've had this news. But the EP is doing the right thing letting you know she has concerns because the earlier you get on with this the better for your DD's prospects. The EP can't DX autism or dyspraxia etc, but can advise you to see the people who can DX. IMO there is a lot of crossover of symptoms for dyspraxia and ASD, my DS has ASD and the child I support as a TA has both.

There are quite a few people on this board with girls with ASD or other DX and they can present quite differently to boys and confuse the profs. Keep on posting, you'll get lots of support and hopefully feel less alone. The fact that your lovely girl is so sociable can only be helpful for her. Try to see any DX she may get as a signpost to support rather than a negative thing. My advice is that while you may be understandably and justifiably upset, your DD is still the same gorgeous girl she has always been, she hasn't changed. What takes time is realising that your hopes and expectations may have to change and it is a grieving process. ((((hugs))))

Princerogers I too am sending (((hugs))) your way. It is very hard to hear this.
Ellenjane has said what I would also say i.e. ASD is difficult for prof to diagnose in girls, it is often co-morbid with Dyspraxia.
Girls seem to be able to mimic good social skills and confuse the diagnosis of ASD so it's unusual for them to be caught this early.

You will need time to get over this although it can be a relief to have your concerns heard and dealt with. I think we all secretly hope that we are going to be told that all is well and that our DC will grow out of this 'phase'.
Best wishes.

Thank you so much for replying.
I have so many questions and have done so much googling.

What do I do in the meantime whilst we are waiting for things to move on?
The ed psych has been the only person to mention ASD, will it be taken away by the next person I come in contact with?
Who will diagnose if it is the case?

In what way is ASD different in girls?

Most importantly what can we do now to help her? I know no professional is going to help without a diagnosis but is there anything me and her dad and extended family can do? I am clueless.

Lastly - our DD has troubles at night. She does often sleep through, but at least 2 nights a week she will wake up and when she does she cannot get back to sleep without one of us, with her. She is often inconsolable and if m mum is babysitting she can get absolutely hysterical. It is hard to explain but she is a different child at night. Is this linked in some way?

Gah - this is so confusing. I don't want to jump the gun, but at the same time don't want to waste time getting help.

Thanks for reading my ramblings.

Hi there, your dd sounds a lot like my son he is 5.2 yrs now, he was dx with speech dalay at 2 then later it was changed to development delay and language impairment now however his pead mentioned that he wouldnt be suprised if dyspraxia was dx when he gets older as he says they sometimes tend to diagnose that around age 6,

i agree you need more help as from age 2 my son has been under a pead,salt and he also has a specialist hv and ed psych.

he is currently on waiting list for to see an op which the pead says would help with the dx of dyspraxia and also on waiting list to be assessed for autism.
i know this post doesnt offer much advice i just realy wanted to say your not alone.
i look at it as no matter what dx they give the problems are still the same so yes a dx could open doors but i jst focus on the help he needs and what i can do for them problems even though i havent been given a formal dx yet.

Girls tend to be naturally more empathic and communicative than boys so the normal red flags for autism can be 'hidden' by this difference. Have a look at the NAS society website for the triad of impairments and Tony Attwood's books are often recommended for girls. Maybe start a new thread asking for specific advice for girls with possible dyspraxia or ASD?

My son (7years) has just been through a multidisciplinary assessment and has just been diagnosed with Fine motor dyspraxia and Sensory modulation disorder - he is sensory seeking. We did this privately and it cost a fortune, but I have to say it has absolutely been worth it, as I have had years of being pulled aside, we can't explain his behaviour, and we wanted for once and for all to understand, and didn't want to take years going through the public system (which is what we were told it would really take).
A lot of what you describe fits with DS, except the gross motor stuff, which he is fine with...except when he has to do complex things which involve sequencing and planning (EG hopping and jumping fine running not bad, but try and teach him freestyle...hoepless)
Anyway I know that what we did, is financially beyond most people, but the 3 people who have been crucial for DS - Were his OT, the physio and the speech and language therapist.......they are 3 that work together. We had paid for years of SLT, but because the SLT in this assessment knew of the findings of the OT and physio, she did some very diff testing (or just approached in differently?), which showed that his Speech and Language problems are are direct result of the dyspraxia and sensory issues.

God I know it is lonely, but if you are able to get her the right help, you will be amazed at the progress she can make. The point is, it has to be directed in the right way. To give you some hope we had a meeting with DS school yesterday, the head of Juniors and Headmaster can not believe his progress, he is a different boy at school.

If you want to know who we saw (they are based in London) PM me - honestly I can not speak highly enough of these 3 - esp the OT who DS see's twice a week now (but that will not be forever)

there is also stuff you can do to help her, that doesn't need to cost a lot - we do brain gym exercises every morning - to start with this was painful, DS couldn't touch his opposite hand to his opposite knee, now he can do it without thinking....he is a little older, so he follows a brain gym video on youtube before breakfast. But google brain gym, and look at the videos, I am sure any of the exercises would help......

Oh and one piece of advice - don't listen to "professionals" who want to offer advice /diagnosis/assumptions which aren't within the realm of what they are qualified to diagnose, they are often wrong..... Many people have assumed DS has Aspergers and at times I have thought they must be right, but this is what the speech therapist said to me "I know many are barking up the social communication tree, but essentially DSs problem is not a social communication issue, his issue (dyspraxia and sensory disturbance) affects his social communication"
It makes it less lonely knowing what you are dealing with and being able to get your child the help that they need.

OP if it is ASD, then you will learn that it is a spectrum and every child present differently but with the same underlying themes of difficulty with social communication, incl play skills, sensory processing difficulties and gross/fine motor problems.

IMO (and some of the research bears this out too) girls with ASD tend to be self-aware and pick up that they dont 'get' social cues. So they become more vigilant in social situations and mimic whats normal for their group. Because the social rules are not innate for them, this means they have to work a lot harder in social situations but it also means that some professionals will be fooled by their seeming ability. Does that make sense?

Whether your DD has these issues or not, she sounds like she could benefit from work on her core muscle strength. Also look into the different stages of play- she may need more guidance from you around this. Many SALTs use the Hanen approach to teach this.
I also get lots of ideas from this guy. He has lots of videos on Youtube. Good luck.

Thanks again everyone. Lots to look at and digest. I had a few tears today when I dropped her off at pre school and talked to their SENCO and DD's key worker.

Realisation is beginning to hit that this is not just going to sort itself out.
Avoiding friends too as just don't feel they will understand and I couldn't bear for them to say the wrong thing.