Playtimes HK Magazine April 2018 Issue | Page 53

features In children with dyspraxia, the two hemispheres of the cerebral cortex are not working in harmony to produce the desired results, thus ideation, planning and motor execution are hindered stage, preferring to "bottom shuffle" and then walk. Later, they will avoid tasks that require good manual dexterity. According to the American Medical Association, the diagnostic criteria for dyspraxia or DCD are: A. Performance in daily activities that require motor coordination is substantially below that expected given the person’s chronological age and measured intelligence. This may be manifested by marked delays in achieving motor milestones (e.g. walking, crawling, sitting), dropping things, clumsiness, poor performance in sports, or poor handwriting. B. The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living. C. The disturbance is not due to a general medical condition (e.g. cerebral palsy, hemiplegia, or muscular dystrophy) and does not meet the criteria for a Pervasive Developmental Disorder. How Occupational Therapists Support Dyspraxia Occupational therapists are able to assess children with movement and coordination barriers to determine the exact nature of the difficulties and how it affects the child's day-to-day life. Therapy intervention focuses on how the child manages daily activities at home, school and play, and works on the assumption that children develop skills as a consequence of the interaction between the child, the environment and the task. Most importantly, occupational therapists use purposeful activity and play to work with the child to help him or her attain the highest-possible quality of life. Through this client-centred therapy, parents who have a child with dyspraxia or who query potential can attain specific information, programmes and exercises to best support their child's development. Other useful resources include: 1. Portwood, M., Developmental Dyspraxia: A Practical Manual for Parents and Professionals, 1996 2. Kranowitz, C.S., The Out of Sync Child, 1998, Skylight Press Book, A Perigree Book, New York, USA. 3. Website: dyspraxiafoundation.org.uk/ 4. Website: brainhighways.com/ Aynsley Carter MScOT is a paediatric occupational therap ist with Central Health. She is a member of the Canadian Association of Occupational Therapists, Sensory Integration Network based out of the UK and the Hong Kong Association of Occupational Therapy. The motor processes of carrying out an act successfully is a complex task that requires conscious imaging, planning, positioning, balance, muscle activation and coordination. Common characteristics of a child who may be presenting with dyspraxic barriers include: Play, developmental and educational characteristics 1. clumsy – difficulty transitioning from one body position to another 2. poor tactile discrimination – difficulty with feeling or localising a touch stimulus 3. inadequate body scheme – difficulty relating their bodies to physical objects in environmental space/ difficulty imitating actions of others /direction of movement may be disturbed, e.g. toys broken unintentionally 4. difficulty with sequencing and timing the actions involved in a motor task 5. slowness in learning activities of daily living (especially fastenings) 6. problems in gross motor skills and sports 7. problems in constructive or manipulative play and poor fine- motor abilities 8. handwriting difficulties 9. developmental articulatory deficit 10. accompanying soft neurological signs 11. accompanying learning disabilities Behavioural characteristics 1. Low self-esteem and poor self- concept 2. easily frustrated; avoids new situations 3. often manipulative 4. may prefer “talking” to “doing” 5. often late and forgetful 6. disorganised approach to tasks. April 2018 51