Dyspraxia or DCD? What’s in a name?

For many occupational therapists the question continues to arise regarding how to label the motor organization and coordination difficulties we treat in children.  Popular terms include developmental dyspraxia, dyspraxia, and developmental coordination disorder.  As previously noted in this blog, there can be strong feelings among different groups regarding terminology.  At this time there continues to be a lack of consensus on which term is most appropriate.

I came across an article recently which may be useful.  While I don’t agree totally with all that is reported, it can provide a nice summary of the situation.  This article,Dyspraxia or developmental coordination disorder? Unraveling the enigma”  by Gibbs, Appelton and Appelton is open access and available for download.  These authors propose that functionally the terms DCD and dyspraxia be considered synonymous and that the best approach is to avoid labels at all and simply focus on describing the child’s motor difficulties.  This approach is probably the most useful for therapists and can allow more flexibility in perspectives.  Therapists who work from a sensory integration perspective can describe the perceived sensory foundations, while those working from other perspectives can concentrate on those skills most relevant to them.  Ultimately, the label is not important.  What is important is how we can treat the problem and improve the lives of our clients.


Sensory Tips for Parents and Teachers #1 – Those Winter Clothes

As we now head into fall with winter right around the corner, many parents of children with SPD are beginning their seasonal struggle to dress their child for the cold weather.  Many children with SPD experience sensory defensiveness, especially tactile defensiveness.  This tactile defensiveness manifests as an over-sensitivity to touch information.  These individuals often do not like light or unexpected touch, yet may crave deep touch pressure and heavy muscle work (proprioception).  Because of their sensitivity to light touch, clothing can be a problem.  We all know that friend that only dresses in soft, sloppy clothes because dress clothes are just too constricting.  The girlfriend that would not be caught dead in nylons or panty hose because she JUST CAN’T STAND THEM.  These friends probably have a bit of touch sensitivity.  In children with SPD this preference for certain kinds of clothing can be particularly strong.  The child may avoid wearing socks or underwear.  They may wear the same shirt or outfit over and over until it is way past too small or is worn thin from washing.  Seasonal clothing transitions from short pants to long pants and vice versa may be problematic.  In cold months, keeping hats, mittens, coats and scarfs on the child may be a challenge.  So what’s a parent to do?

Some Solutions:

1. Have your child be a part of the clothes finding process.  As adults we have total freedom in deciding what we wear and when we wear it.  This control allows us to feel more comfortable.  Don’t buy clothes for your child without them trying it on first.  Have them be an active participant in selecting items in their wardrobe.

2. Natural fibers tend to be easier to tolerate.  When selecting clothing, natural fibers, especially 100% cotton, tend to be easier for the defensive child to tolerate.  Avoid scratchy synthetics.  Go for soft knits and fleeces.

3. Avoid those tags and watch those seams. Try to get shirts that have printed tags rather than sewn in tags.  If you need to cut out a tag, be sure to get all of it and don’t leave sharp edges behind.  Also check seams for irritating tags and make sure that your child can tolerate the seams in any given garment.  Elastic waist pants can often be easier to tolerate than pants with zippers and waistbands.  Purchase socks that are seamless, these are much easier to find in stores like Walmart and Target these days or by Googling on the internet.

4. Prepare early for seasonal changes.  Weather changes can be unpredictable in fall and spring, but it behooves parents to start the clothing transitions earlier rather than later.  With the child select those long sleeved shirts and long pants in early September before the cold weather sets in.  If possible, on cooler days have the child wear the new clothes to get used to them, even if it is part of a day.

5. Pre-wash and soften new clothes.  Pre-wash and soften up any new clothes.  Take advantage of that early preparation and wash the new clothing several times before expecting your child to wear them.

6. Find a coat the child will tolerate.  OK, easier said than done, right?  Think about coat choices and have your child help select one.  Avoid wool coats.  Will your child handle a puffy fiber-fill jacket or would he or she do better with a thinner fiber?  Is a waist-length jacket better or does your child prefer a longer hip or knee length coat?  Is a double-breasted button-up too much fabric?  Is a zipper easier to manage?  Will your child wear a hood or is that too much irritation on their head or neck?  Also think about whether your child will or will not layer up on clothes.  A somewhat lighter coat may suffice if the child will wear a warm sweatshirt or sweater on a regular basis under it.

7. What about those hats, scarves and mittens?  The need for hats, scarves and mittens may depend on the jacket or coat preference of your child.  If he or she has a jacket with a snug collar and a hood, does he/ she really need a hat or scarf?  Again, think of the fabric of these items.  There are also options in the hat and scarf lines.  A cowl style may give warmth and be able to be pulled over the head without being constricting.  Ear muffs or head bands may provide sufficient warmth versus a full cap.  Will a ball cap be enough cover for most days?

For hand covering, consider mittens over gloves.  Can you attach mittens to the sleeves of the jacket.  Are the jacket sleeves long enough the child can pull their hands in the sleeves rather than wearing mittens?  Again check the tolerability of the fabrics of the mittens.  You may love Aunt Susie’s home made mittens but they may drive your child crazy.  Consider washing mittens as well to soften them up.

Clothing changes with the seasons can be hard on both parents and child but some preparation and respecting a child’s clothing preferences as much as we respect our own can go along way to making the transitions easier.

Spiral Foundation’s NEW!! Book Club

In our ever-growing attempts to provide resources and materials to professionals and parents, the Spiral Foundation has partnered with Amazon to bring you our NEW! A-Store.  In our A-store/ Book Club you will find recommended reading for parents, professionals and children.  By purchasing your books…paper or Kindle versions alike!…through our store, you not only get a great recommendation, but also help support research and education activities in sensory integration.  So make us your first stop for your sensory-related resources!

Today for professionals we would like to highlight two wonderful MUST HAVE resources by Dr. A. Jean Ayres.  If you want to know more about praxis pick these up today!  Click on the pictures to go to our store.


Ayres Dyspraxia Monograph, 25th Anniversary Edition

Ayres Dyspraxia Monograph

This monograph is THE resource on beginning to understand the complexities of praxis.  This updated version includes bonus information by praxis expert, occupational therapist, Dr. Sharon Cermak as well as a new extensive bibliography of praxis references.

The Adaptive Response

The Adaptive Response

This classic DVD is the only resource from Dr. Ayres fully explaining adaptive responses in sensory integration intervention and detailing the various levels of adaptive response.  This resource is a MUST HAVE for every therapist practicing in the area of sensory integration or mentoring other therapists or students in sensory integration.

Happy reading and viewing and watch this blog as well as our Facebook page for more great resources.

In Memorium – Jane A. Koomar, PhD, OTR/L, FAOTA

Jane KoomarMany people are already aware that our beloved friend and colleague, Dr. Jane A. Koomar, passed away this year on February 23, 2013 after a three year battle with breast cancer.  Jane was the heart and soul of her private occupational therapy clinic, OTA The Koomar Center (previously known as OTA-Watertown).  She was an icon in her field and changed for the better the lives of thousands of children, parents and therapists.  The Spiral Foundation deeply mourns her loss but endeavors to continue her work with our research and education activities.

To see  a lovely memorium written by OTA and Spiral Foundation staff please visit our website, http://www.thespiralfoundation.org, or by clicking here.

Donations in Jane’s honor may be made to the Spiral Foundation to support research in sensory integration.