Tag Archives: Dyspraxia

Motor Deficits: Dyspraxia

I have had mild motor deficits all my life. Since I don’t know whether they have ever been diagnosed and if so, as what, I try to learn about conditions such as developmental coordination disorder, and strategies that work for people with similar problems.

Dyspraxia is similar to developmental coordination disorder (DCD). DCD is a somewhat misleading name for the whole construct of dyspraxia, as dyspraxia can, besides fine and gross motor skills, also affect speech as well as sensory processing. Dyspraxia is seen as a subtype of sensory processing disorder (sensory integration dysfunction) where the brain has trouble interpreting and responding to the body’s movements..

According to the National Center for Learning Disabilities (NCLD), there are several different types of dyspraxia. These are:

  • Ideomotor dyspraxia: where a person has trouble executing single-step motor tasks such as waving goodbye.

  • Ideational dyspraxia: problems occur with multi-step tasks, such as brushing teeth, making a bed or putting on clothes in the right order.

  • Constructional dyspraxia: affects ability to establish spatial relationships, for example, moving an object from one place to another correctly.

  • Oromotor dyspraxia: affecting the ability to control the muscle movements necessary for pronouncing words.

Dyspraxia can cause many different problems at various stages in development. The NCLD lists these difficulties by age. Young children may have trouble learning to crawl, roll over, walk, jump or skip. In adition, they may have trouble in the following areas:

  • Prnouncing words and being understood.

  • Developing hand preference.

  • Sensitivity to touch, such as clothes touching the skin, hair-combing or tooth-brushing.

  • They may bump into things frequently>./LI>

As children age, the following difficulties may emerge:

  • Poor pencil grip and handwriting.

  • Difficulty with fine motor tasks such as buttoning clothing and cutting with scissors.

  • Problems in playing sports.

  • Difficulty sensing direction.

  • Difficulty speaking at a normal rate or volume.

Additionally, children with dyspraxia may have trouble with social skills and have phobias or obsessions.

Teens and adults with dyspraxia may have problems in the following areas:

  • Speech control, such as volume, pitch, articulation.

  • Writing and typing.

  • Over- or undersensitivity to touch, light, smell, taste, etc.

  • Personal grooming and other self-help tasks.

  • Cooking and other household tasks.

  • Driving

The Dyspraxia Foundation lists many other symptoms of dyspraxia, such as motor overactivity, excitability, messy eating, lack of sense of danger (probably due to sensory seeking behaviors, as an example the Foundation lists is jumping from heights).

I do not have all symptoms of dyspraxia. For example, I am very much right-handed, though an old educational psychologist’s report says my lateralization was poor (at age eight). Some symptoms can also be explained by my blindness (such as my bumping into objects). I am, however, told that my messy eating, oromotor difficulties, difficulties with complex tasks such as making a bed, balance problems, and sensory over- and underresponsivity, are not normal for a blind person. I do not truly want a label for these, but I am finding that it is extremely hard for me to explain these problems to my treatment team, and they affect me to a great extent.

Finding Answers in Disability Limbo

A few months ago, I wrote a post about my need to belong somewhere within the disability community and my possibly intruding upon communities I don’t belong to. One such community is that for brain injury patients. As far as I was concerned, “brain injury” was always followed by “sustained after birth” or preceded by “traumatic” or “acquired”. Yet brain injury can occur at birth too. Only then it’s not called brain injury, right?

Since my autism diagnosis is being questioned again, I’m feeling an increased need to figure out what exactly is wrong with me. In part, this entails putting a name to what I have. Are my motor deficits diagnosable as dyspraxia, mild cerebral palsy, or are they not diagnosable at all? Am I autistic or not? Then again, putting a name to my disabilities is but one of my quests. As I’ve experienced, most communities are open to those with an uncertain diagnosis, so it’s not that I need to have a diagnosis to fit in with a support group.

Back when I was diagnosed with autism, I didn’t want a specific ASD diagnosis. The psychologist, who ultimately gave me an Asperger’s diagnosis anyway, said he wanted to do an assessment of my strengths and weaknesses. I don’t know whether a quick DSM-IV interview amounts to that, but to me, a lot of questions remain unanswered.

It could be my slight neuropsychology obsession, but I want to know why I have issues I do have. I want to understand, in a way, why I can’t function at the level I’m supposed to given my intelligence and verbal abilities. Is it normal to be unable to load the dishwasher but able to write a lengthy blog post? I don’t think a diagnosis, whether it’s autism or brain injury, will answer this question per se, but what will? It is most likely that I have quite bad executive dysfunction, but can this at all be validated? Should it?

It isn’t purely that I’m overanalytical and want to understand my every bit of brain function. It’s more that I’m struggling terribly with being seen as more “high-functioning” than I am in daily life. Not that I want to reinforce the stereotypes surrounding the Asperger’s diagnosis, but my mere existence won’t defeat them either, and I’m sick and tired of having to prove myself.

“Münchausen by Modem”?

i’ve been thinking of a few issues lately, and I want a way to write them out. Particularly, I’ve been thinking about various topics surrndoung my various diagnoses. I’ve only got a few diagnoses – not nearly as many as my Facebook group memberships would suggest -, but I’ve had many off-the-record labels.

Firstly, I have a diagnosis of Asperger’s or autism spectrum disorder. My parents say the diagnostician just gave me thsi label in order to get me services. My former therapist in the old city institution doubted my diagnosis too, thinking my theory of mind is too good for ASD. Now that whole theory-of-mind thing is controversial, but well. This therapist wondered whether a more correct diagnosis would be acquired brain injury, because I had a brain bleed as a newborn which resulted in hydrocephalus. I used this off-the-record label to gain access to some groups for brain injury and am finding them very supportive. (Yes, I did explain my situation in each of the groups and made sure I wasn’t seen as an intruder.) I’ve asked people in the autism groups for their opinion on the brain injury/autsim link, and 90% replied that autism is purely genetic. Kind fo shortsighted in my opinion.

I’ve also been thinking about my mild but slightly worsening motor deficits. I always self-identified as dyspraxic but have recently gotten to wonder what my diagnosis was as a child. I saw a physiatrist (physical disabilities doctor) until around age eight and have many of the syptooms and complications of mild cerebral palsy, including a significant left/right disparity, the need for a cast on my left foot at age five and scoliosis. These issues do not seem to happen to dyspraxics.

In a way, diagnosis shouldn’t matter. I know this. I worry sometimes that I’m only seeking for diagnoses so that I can collect an impressive list of labels. I remember about ten years ago reading something about “Münchausen by Modem”, ie. the tendency of some people to join Internet groups for diseases they don’t have. Am I a classic case of this? I’m not sure, but some people think so. At least, the people in the Dutch DID organization thought so. I guess it’s about time I work on developing a disorder-free sense of self.