Diagnosing dyspraxia

[Saker]

My ds2 is 3 and I suspect may be dyspraxic ? he has poor fine and gross motor skills, lowish muscle tone and problems with co-ordination and motor planning. He also has unclear articulation and his language whilst quite good in some ways (e.g. he can string a reasonable sentence together such as ?I want to stay and stamp in the puddles some more?), can get quite muddled up in terms of trying to hold a conversation.

He has been seen by all and sundry and last week my dh and I suggested to the paed that he might be dyspraxic. The paed sort of agreed it was possible but prefers a label of global developmental delay and says that is too early to diagnose dyspraxia at this age.

Does anyone have experience of a child being diagnosed this little or am I being unrealistic? I am concerned that he might not get all the help he needs without a diagnosis but maybe there is a limited amount that can be done for dyspraxia other than what would be done for GDD at this age anyway? I would be grateful to hear other people?s experience in terms of diagnosis.

No idea, but I'm bumping this for you. HTH

Bump!

I don't know either but here's another bump!

IME dyspraxia is diagnosed later. My friend pushed for a diagnosis for her son but he was almnost 5

The little boy I know with dyspraxia got his diagnosis at around five from GOSH. His mum thinks this was a early diagnosis.

Not much help, sorry.

My son got his diagnosis + statement 2yrs ago aged 8 and I felt that was quite late, he's an August b'day and I think there was lots of confusion between him being the youngest in the class and a specific problem.
I felt there was a problem at around 3.5 yrs and wanted him to repeat his nursery year but was told he needed to stay with his peers.
I firmly believe that "mother knows best" but was quite ill with PND around that time as had just had no3 so was maybe not assertive enough - often it isn't until skills like writing come into play that a differential diagnosis can be made.
Good luck with it all

Hi, my little boy - also three - is also rather behind physically. I had a thread on Mumsnet about it. He struggles to run, can't jump, finds things like taking off his socks a real challenge, can't go up stairs properly etc etc - sometimes he really has no idea what to do with his arms and legs to achieve the desired result. He is noticeably slower, clumsier and less coordinated than his peers. However, he is bright, articulate, verbal, imaginative and expressive - so the lack of physical ability really stood out for me. Anyway, having it confirmed by the collective wisdom of Mumsnet that he really was quite behind, I pushed my HV to have someone look at him and he was assessed by a physio specialising in child development who said she thought he had sensory integration dysfunction. She gave me the number of a private occupational therapist who specialised in dyspraxia, motor planning problems and sensory issues, and she then saw ds and said he did actually have motor planning problems - very reluctant to use the 'D' word (!) but agreed that yes, he was probably dyspraxic. I'm still waiting for her report and suggestions (and bill ) but she has promised to include ideas to help him. He is also going to a special needs version of TinyGym, which he really loves, where the children (all under five) are gently encouraged to do things to develop their physical skills. I really liked the OT - and so did ds. She was great, positive, didn't think he had insurmountable problems and though he will almost certainly be a deeply unsporty child (um, like his mother - I'm sure he's inherited this tendency from me and do feel irrationally guilty about it) he will be able to run, go up stairs perfectly normally etc etc and even if he won't be star player on the football team, that needn't spoil his life in any way. I hope Sis sees this as she has been amazingly kind, informative and supportive to me. I was really very upset when told that, yes, my son was delayed as of course it's horrid to be told your child isn't the perfect specimen that he seems to you (though of course, he is still my perfect angel child). I think seeing the OT was great for me and for dh because it was reassuring. I am encouraging ds to do more but what she said that I thought was great was that his happiness is the most important thing, and keeping his self-esteem high, so we will encourage him to do things, but also nurture his very real skills and charm at the same time, as they are just as important - indeed more so - than his clumsy little walk and his shocking slowness on stairs. If, like me, you feel frustrated and want to do all you can before your ds goes to school, I do recommend finding a private OT. Where are you? Maybe I can help.

My DD had problems simular to you ds saker at 3 but she wasn't diognosed untill she was seven although she did see an ot at five.

Aloha,
Yes I read your thread before and was wondering how you had got on. I'm glad that you have managed to make some progress . Your ds sounds like he has lots of other talents to help see him through.

I am really at a loss what to do next, if anything. We have managed to get a 1:1 for my ds2 at preschool with some lottery funding which is good and he is currently attending a communication workshop for 8 weeks although I?m not sure that helps much. We have seen the OT once and were discharged. I asked to see her again for advice and she visited and gave some good advice, but I am finding it really hard to implement it as Ds2 is not interested in practising tasks he finds hard. Some things he is getting worse at ? for example he now eats absolutely everything with his fingers even Weetabix, even though he can use a spoon a bit, he just won?t try. Probably there isn?t a lot more than advice at this stage but it would be nice to have someone help me and reassure me that I?m doing the right thing. So I would be interested to know what a private OT would do vs the NHS one, Aloha.

I have been told that even if he is dyspraxic there is nothing else to be done at this stage and certainly it seems that as they don?t usually diagnose it this young, then there probably won?t be anything in place. I have considered taking him to the Dyscovery Centre but it?s a long way from us in Cardiff, and I am not sure if I would be dragging him there to be assessed a lot more just to make me feel better rather than to do any good.

I haven?t heard of Tiny Gym - where did you get that info? We have been going to Tumbletots but Ds2 just behaves his worst every time and it really gets me down so we have abandoned it now. A special needs class would be ideal but I don?t think we have anything like that round here (East Cambs near Newmarket).

Ds2 also has problems with language to some extent and imaginative play. He tries to do imaginative play but gets a bit stuck ? I think this might be down to motor planning. But it maybe that he has more going on than dyspraxia and that worries me too, although we have been told that he is not on the autistic spectrum. Mumeeee, what was your dd?s language like at 3? Though I have read that dyspraxics can have language problems, I?m sure this is part of the sticking point for the professionals.

Thanks for everyone?s elses replies so far ? probably I do have to accept that we have got as far as we can for the time being.

Saker, there are advantages to being in darkest, deprived South East London, and one of them is the kind of special needs provision. Ds got seen really fast because they had a vacancy at this playgroup. I think ds would hate tumbletots because a/he'd be crap and b/ it would be too regimented for him to cope with. This is a playgroup run through the NHS child development department for children with special needs - cp, limb disorders, GDD, autism, all sorts. To my shame I thought ds would 'shine' there, but of course, lots of the kids can do more than he can, but not so much more that he stands out, and there are none of those slightly depressing junior athletes who always made me feel a little bit sad about my ds. He really likes it too. The attention is very individual and self-directed. No pushing or regimentation. I think my private OT was lovely. She did think there were things we could do and that they could be fun - she had a real knack with ds and could suggest ways of making each task 'easy' for him so he never felt he was failing, which is a sure-fire way to make most kids want to stop doing things IMO. Is there really no special needs provision for under fives with what they call 'post-walking difficulties" in your area? What about toys and equipment to use at home to help develop his skills? Far from suggesting I was worrying too early both the NHS physio and the private OT (formerly head of dept at Southwark) said it was great that he was so young as this was a good time to try to make changes and help his development.

Ds2 was seen by physio in Feb but discharged as not being not too bad. He isn't that bad compared to children with physical disabilities such as CP I know, but at 3 y 2months he still can't walk upstairs without scrambling or downstairs without falling, he can't jump, pedal and his running looks like a 13month old child. You are right I have read loads about that it's best to start as early as possible and I feel so frustrated that we might look back in 3 years and think we have wasted all this time. I will see if anyone knows anything about a special needs group in the CDC here. Ds2 hated Tumbletots too because he can't do it all and there were always keen little athletes at his shoulder wanting him to get a move on. Also it is too structured as you say and he gets really cross. Thanks for all the info - and it's nice to know we're not the only one.

Saker, physically, he sounds exactly like my lovely boy - and just the same age. Ds is a September baby. No jumping, difficulties with stairs, really excessive dawdling/slowness while walking, no pedalling etc etc and this was enough for the NHS physio and the private OT to diagnose motor planning difficulties. Of course they aren't 'disabled' in the sense of being unable to walk, but both the people who saw ds thought there was stuff we could do to help, though they also pointed out that ds would be able to walk perfectly well, run and climb stairs etc in time - even if he would never be star player on the football team.

Saker just to encorage you it does get better in time. My DD could not ride a bike until 9 or tie her laces until 10. Does your DS enjoy swimming I found this helped.My DD did have a 8 week course with an OT and I also took her to a special dyspraxic course for a year. She did a lot of fun exercises which semed to help with her co-ordination and boosted her confidence.
Dyspraxia can be diognosed at an early age ,have a look at www.dyspraxiafoundationorg.uk there is a lot of information on this site. Talk to your GP or health visitor again.

Thank you aloha for your kind comments - I feel totally unworthy of them but appreciate what you said.

Saker, my ds is six (today!) and was diagnosed at five and a half but we have had a range of diagnosis from definately dyspraxia (paed neurologist) to definately not dyspraxia (OT)! Because of the timing - he was already five before we realised there was an issue that needed to be addressed! - we decided to go private rather than join the very long nhs waiting lists in our area. Although the OT did not think our son had dyspraxia, she did think he would benefit from eight sessions of OT as she thought he had sensory integration disorder(sid). She also seemed to indicate that the occupational therapy would be similar for dyspraxia and sid - but maybe I misunderstood.

I am sorry not be able to give more constructive advice other than to say that if you feel there is something there, then keep pushing for a proper assessment for your son because even if there isn't a cure for many conditions, there is plenty to help both your son and you cope with it once 'it' has been correctly identified!

Thanks Aloha, Sis and Mumeeee for your support. Ds2 has been assessed by lots of people including OT, SALT and clinical pyschologist so he is in the system at least. Like you the OT said he definitely wasn't dyspraxic although then all the advice she gave me was for a child with disorganised motor planning. The clinical pyschologist particularly noted that he had a problem with motor planning and the paed acknowledges that could indicate DCD (developmental coordination disorder) but I don't think he really thinks that is likely.

I think part of the problem is Ds2's language and "behaviour" which is not way out, but isn't completely typical of a "normal" child. This is what gives him a label of Global developmental delay and makes them reluctant to investigate DCD further. And maybe they have a point - I have read that language can be affected both in terms of speech clarity and organising thoughts and content in dyspraxic children, but that clearly isn't the case with your son, for example, Aloha. So what it comes down to is that I am very confused as you can see - and rambling a lot now so I will shut up .

PS Happy birthday to your DS Sis

Thank you! If you interested in (more!) reading, I found Jimjam's recommendations really helpful - particulary one called 'the out of synch child' by Carol Stock Kranowitz - I tried to do link to it on Amazon but it wouldn't work for some reason. It explained a lot about how certain syptoms 'fitted' a diagnosis whilst others didn't.

Oh, Sis, happy birthday to your ds!
I think that all these things are complicated and different in every child. I have also had DCD mentioned. I think basically they are saying, yes, he is behind and he does have problems organising movement and with his bodily awareness. I have found this helpful, eg in understanding why he finds walking along without touching anything challenging (needs more sensory feedback on his body) and why he has that "I don't know where to start" look when put on a scooter etc.
His speech isn't affected and in fact the OT said that she thought he'd developed his speech to cope with his physical difficulties, which also made sense to me.
What are your son's strengths in your view?

I will have a look for that book, Sis.

Aloha, my ds2 is a lovely affectionate child with a great sense of humour, but it is difficult to say that he shines particularly at anything. However he has recently got pretty good at jigsaws. This is funny because he found them really hard - less than a year ago he couldn't put two pieces together which was quite behind for his age. At this moment he is happily working away on a 60 piece one - he can't complete it all by himself but he is making a good attempt. This contrasts strongly with the fact that he can't do a basic shape sorter. This is partly why I think he might be dyspraxic, because he has worked and worked at jigsaws until he has got them sorted and now they come quite easily to him. Whereas cognitively if he was globally delayed say by a year I don't think he would be able to do this.

The thing about using language to compensate also sort of makes sense to me. Although his language is behind in some ways he would always rather speak or describe than use actions. He hardly points (though not thought to be autistic!), instead will describe where something is as best he can.

well, he has developed a very good line in a polite but firm refusal to do anything that he feels uncomfortable with; he is outrageously gorgeous!; when he was younger he used speech and reasoning as an effective coping tool...oh, sorry, you were asking saker...

Aloha also meant to say he definitely has the need to feel "solid" ground as you describe. He quite often lies down just to feel the ground I think and likes to press his feet against the side of his bed or another person. He also does things a lot better sitting in a proper chair at a table than just sitting on the floor. We have a trampoline which has helped him with his balance a lot and I would really recommend it if you have the space.

He's getting a trampoline for Christmas. Actually, just got beaten to one from a skip around the corner at the weekend - grrrr!
My ds also lies down to feel the floor and also (sometimes in the oddest places!) loves to press his feet against me too ('I'm putting my feet on the nice warm mummy')
And Saker, I think doing 60 piece jigsaws is amazing! That would be totally and utterly beyond ds. And lovely and affectionate is always wonderful, I think.

Saker, if you CAT me I will send you the list of recommended activities from the physio and from the OT when they arrive.

I meant to say, they might be relevant to your ds or not, but they aren't very taxing and are quite fun anyway.

That would be brilliant, Aloha, thank you. I keep getting told that input from preschool and home is the best thing for my Ds2 at the minute. However that doesn't take into account the pressure you then feel as a parent to be trying to do appropriate activities that will be beneficial. Part of the reason I long for organised therapy is just to take some of that pressure off me to be doing it all, so a list of activities would be lovely to give me something to follow. Sometimes I have to give myself a kick and think, relax, if we're enjoying ourselves it must be good whatever.

And thanks for your kind words - please don't think I am being too hard on my little boy - he is gorgeous to me of course - just trying to be realistic in terms of how he would be seen by the outside world.

This thread has helped me organise my own thoughts a bit about what I actually want. I spoke to the portage worker about it all today and she is going to find out about group physio or OT at the CDC. Plus she is going to think of other ways to help with play skills so I feel generally more positive.