What’s the relationship between DCD and dyspraxia?

Many are understandably unsure of the relationship between Developmental Coordination Disorder (DCD) and dyspraxia. Though I’ll try to clear the issue here, I admit, it’s complicated.

First, the definition of “dyspraxia” is not always very clear and its current usage is not exactly synonymous with conceptualizations of praxis in general. I actually try to avoid the term dyspraxia altogether these days because it is not a terribly useful term due to its lack of clear definition. I prefer the term “praxis deficits,” which is more accurate. Praxis deficits may include problems with ideation or motor organization issues of motor planning, bilateral coordination, sequencing, or projected action sequences – all of which are aspects of praxis. Dyspraxia tends to refer only to motor planning problems and depending on the profession, can be even more restrictively defined as only problems with imitation of gestures. This is far more restrictive than our current understanding of praxis in general which can include problems with tactile-based motor planning, vestibular/prop-based bilateral coordination and sequencing problems, and ideational deficits.

The term was originally developed to try to standardize identification of motor performance problems (including praxis issues) in children so there was some uniform terminology and assessment for researchers. DCD was eventually included in the DSM as diagnosis. As a diagnosis, DCD is used very broadly and is usually perceived as an umbrella term that encompasses praxis deficits. The problem with the research and the hard core DCD people is that the gold standard assessment of DCD is the Movement ABC which, from a sensory standpoint, only taps into vestibular issues and does not address tactile-based motor planning. So, the majority of children identified in the DCD literature, if they only use the M-ABC, will be those with bilateral coordination and sequencing problems and not those with tactile-based motor planning. The hard core DCD people tend to make a distinction between “motor coordination” problems (which they usually identify as issues of balance, running, ball skills, etc. – what we identify as bilateral coordination and sequencing and projected action problems) and “motor planning” or “dyspraxia” problems (which they identify as problems of imitation of gestures).

So long answer to the question – the answer is not clear. DCD is generally perceived by OTs as a larger umbrella diagnosis with praxis deficits such as motor planning problems (dyspraxia) falling under the umbrella. However, your hardcore DCD people, including many in Canada and the UK, can be quite adamant that they are different issues. The DCD research literature will capture problems with praxis but they will largely focus on children with more vestibular/ bilateral coordination/ sequencing problems; though you have to read carefully as an OT will use the DCD term but may make a point of capturing kids with tactilebased issues as well.

There is amazingly little research specifically on praxis and even less recent research. Most current articles are in relation to imitation skills in children with autism. I think it is most important to realize DCD research will reflect mostly skill-based vestibular activity and, unless done by an OT, will not reflect specific problems in tactile-based motor planning.

For more stories, info, resources, facts and tips, go to www.thespiralfoundation.org

 

 

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