By: Catherine Joachin
What is Dyspraxia?
Dyspraxia, clinically referred to as developmental coordination disorder (DCD), is a neurodevelopmental movement and coordination problem (Dyspraxia/DCD Ireland). The condition is marked by difficulties in planning out and executing motor tasks (National Institute of Neurological Disorders and Stroke). Poorly executed actions stem from a failure to relay messages to the nerves, making this a brain-based disorder (Cleveland Clinic, 2022). Dyspraxia can affect gross as well as fine motor skills (National Health Service).
Symptoms of dyspraxia include:
- Poor coordination and balance
- Clumsy, awkward, and effortful movements
- Difficulty performing daily activities
These impairments may manifest themselves in difficulties with writing, handling small objects, and poor performance in physical activities. Dyspraxia can also affect non-motor domains such as organizational skills, attention, and time management (National Health Service, 2020).
The condition affects approximately five to six percent of children (Ip, Mickelson et Zwicker, 2021). The etiology of dyspraxia remains unclear, however low birth weight, prenatal substance exposure, and genetic predispositions to developmental coordination disorder have been identified as risk factors (American Psychiatric Association, 2013). DCD does not impact intelligence and is not caused by any known intellectual disability or medical condition although this disparity could be the result of socio-cultural expectations placed on males to excel in sports, where an impairment in coordinated movements would be much more noticeable. While there is no cure for DCD, occupational therapy can help improve motor skills (Cleveland Clinic, 2022). If not interventions are implemented, difficulties can linger into adulthood as the condition is lifelong.
Dyspraxia and Epilepsy
Developmental coordination disorder is highly comorbid with other disabilities, notably attention deficit hyperactivity disorder (American Psychiatric Association, 2013). Dyspraxia is also significantly co-occurring with epilepsy, with one-third of children with active epilepsy being diagnosed with the condition (Cairney, 2015). Scabar and colleagues (2016) found that a high prevalence (75% of participants) of children with severe developmental coordination disorder experienced epileptiform activity during sleep, hinting at the existence of a biological predisposition.
Symptoms of developmental coordination disorder in children with epilepsy are commonly reported; however, research suggests that parents mistakenly attribute symptom presentation of autism spectrum disorder, which affects 5-30% of children with epilepsy, to developmental coordination disorder on the basis of early onset seizures, which too are marked by awkward movements (Reilly et. al., 2015).
A possible explanation for the relationship between DCD and epilepsy includes gene deletion, precisely 16p11.2, a common genetic marker for neurodevelopmental disabilities (Rein & Yan, 2020). 16p11.2 mutations can generate varying levels of delays and impairments in terms of language, social skills, and maladaptive behaviors, including epilepsy and developmental coordination disorder, the latter of which is present in a significant portion of carriers, 32-58% (Hanson et. al., 2014; Qureshi et. al., 2014).
In conclusion, while presenting symptoms of dyspraxia may be mistakenly interpreted as signs of clumsiness, these can severely impair everyday functioning. Further research directed toward exploring genetic and environmental causes is needed to understand the presence of epileptiform activity in the brains of individuals with developmental coordination disorder.
Resources:
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Cairney, J. (2015). Comorbidity in developmental coordination disorder and active epilepsy. Dev Med Child Neurol, 57:790-791. https://doi.org/10.1111/dmcn.13813
Cleveland Clinic (2022). Dyspraxia. Cleveland Clinic. Retrieved from: https://my.clevelandclinic.org/health/diseases/23963-dyspraxia-developmental-coordination-disorder-dcd
Dyspraxia/DCD Ireland (n.d.). What is Dyspraxia/DCD? Dyspraxia/DCD Ireland. Retrieved from: https://dyspraxia.ie/What-is-Dyspraxia-DCD
National Health Service (2020). Dyspraxia (developmental co-ordination disorder) in adults. National Health Service. Retrieved from: https://dyspraxia.ie/What-is-Dyspraxia-DCD
National Institute of Neurological Disorders and Stroke (2023). Developmental Dyspraxia. National Institute of Neurological Disorders and Stroke. Retrieved from: https://www.ninds.nih.gov/health-information/disorders/developmental-dyspraxia
Ip, A., Mickelson, E.C.R. & Zwicker, J.G. (2021). Assessment, diagnosis, and management of developmental coordination disorder. Paediatrics & Child Health, 26(6), 375-378. https://doi.org/10.1093/pch/pxab047
Reilly, C., Atkinson, P., Das, K.B., Chin, R.F., Aylett, S.E., Burch, V., Gillberg, C., Scott, R.C., and Neville, B.G.R. (2015). Features of developmental coordination disorder in active childhood epilepsy: a population-based study. Dev Med Child Neurol, 57: 829-834. https://doi.org/10.1111/dmcn.12763
Rein, B., & Yan, Z. (2020). 16p11.2 Copy Number Variations and Neurodevelopmental Disorders. Trends in Neurosciences (Regular Ed.), 43(11), 886-901. https://doi.org/10.1016/j.tins.2020.09.001
Scabar, A., Devescovi, R., Blason, L., Bravar, L., Carrozzi, M. (2006). Comorbidity of DCD and SLI: significance of epileptiform activity during sleep. Child: Care, Health, & Development, 32(6), 733-739. https://doi.org/10.1111/j.1365-2214.2006.00705.x
