Polarbear, what are the hallmarks of dyspraxia? Who diagnoses it? My DS has had a few evals now, sees an OT regularly, etc.... No one has ever mentioned dyspraxia though it seems like he does have some of the symptoms of it. Are there specific tests for it?
Dyspraxia (more often called Developmental Coordination Disorder when diagnosed in the US) can be variable from person to person. I'd recommend googling dyspraxia+symptoms for some initial info - I'll try to post some useful links later today. I can tell you how it impacts my ds, but it may impact another child in a very different way... it's tricky! For my ds, the most obvious symptom is his handwriting challenge (which, for him, is fine-motor related). Other ways he's impacted might seem like laziness or slowness if you didn't realize he is dyspraxic or didn't understand what dyspraxia is. For instance, his overall movements are simply slow. Not glaringly so, but in the way that if he was usually moving at a speed that is a little more typical, and then you were with him trying to get ready to go somewhere and he moved at the speed he always moves at, you might find yourself hurrying him along in a big way. And he doesn't really see that he's slow, he feels like he's rushing and can be moving at the speed of a glacier. One example - we were late for school one day and I was hurrying my kids along to get into the building fast - when I do this with my other two kids, they speed up. DS wasn't speeding up, and he was lagging farther and farther behind. In exasperation I turned around and told him "Run, ds, run!"... and he (while walking slowly) replied "I AM running!"... and he really thought he was. He's not terribly coordinated at sports and prefers individual sports to team sports - this is getting a bit better as he matures (his enjoying the team sports, not his coordination). He still has a hard time telling which direction is which and confusing left and right. He didn't learn how to tie his shoes until he was in 4th grade, and then he forgot again over spring break when he wasn't wearing shoes that tied. He learned how to write cursive in 4th grade and later forgot how to do it. So for him, lack of ability to develop automaticity of skills requiring brain-to-muscle coordination in the same way most NT kids develop it is a big part of his dyspraxia. Some children with dyspraxia also have apraxia (speech is affected). DS doesn't have apraxia *now* but his neuropsych believes he had apraxia as a young child and no one caught it then. He didn't learn how to talk until he was over three years old, but once he did start talking it was in complete and complicated sentences so we never thought much about the not-talking or not-making sounds earlier as anything other than cute and quirky. He was also late learning how to walk, late learning how to crawl and didn't really want to crawl once he started crawling. There is such a large range of what is developmentally "normal" that we never saw any of his "late" early milestones as anything other than normal until he was older and we had other symptoms that correlated with them into something outside of "normal". DS is also extremely challenged with organization, and infamous for "losing" things that he's standing right on top of.
He also has some odd sensory quirks, and he feels like his stomach is full long before it's full, so he'll eat a tiny bit at a meal, think he's full, and an hour later be starving and need to eat again. I would have chalked this up to just typical kid stuff, except that a friend of mine who lives in another part of the US also has a child with dyspraxia and she had some issues surrounding eating and her dr told her that disconnects between the brain and stomach like this are symptoms of dyspraxia.
Lastly, my ds has an expressive language disorder - he's challenged (extremely) with putting his thoughts into written expression and also to a certain extent with verbalizing some types of expressive language. I think it's possible this is tied in with his dyspraxia.
The thing is - not everyone who is dyspraxic is affected in the same way, not every symptom is going to happen for every person.. so it's complicated!
(ps - sorry that's so long and rambling!)
I am thinking I am going to take all of his testing and evals to a neuropsychologist and get her 'take' - so to speak.
I think this is an *excellent* idea - and I think it's a good idea to have the neuropsych administer the WISC when you have him retake it.
I am not sure he can go through anymore testing at this point. He gets evals and testing for the vision every so many months too and I think he is getting burned out on testing.
Per my other reply, most kids find the neuropsych evals fun, although they may come out of it tired at the end of the day. It's very different from the VT sessions and evals - my kids have found those to be exhausting - but they are all "focused" (can't think of a non-eye-related word lol!) on vision, using your eyes, and your eyes get very tired. The neuropsych exams involve so many different types of short-time tests with breaks in between and a lot of talking and movement so that it's not tiring in the same way the VT things are.
And I do want him to do a WISC for the school psych in the spring so I can see if there is any improvement in working memory, processing speed and visual-spatial that I can maybe correlate with the year of OT twice a week and vision therapy. I think the school psych did a pretty thorough battery of tests and included a lot of observations, etc. that a neuropsych could use to look at and see what if anything jumps out at her.
I have found private testing to be much more valuable than the school. The main reasons:
1) You get more time and more insight from the neuropsych eval - you have an input meeting and a follow-up meeting to review the report *in detail* after the testing. You can continue to call up, schedule follow-up meetings until you fully understand what the neuropsych found.
2) More in-depth testing - there are tests that neuropsychs administer that school psychs don't. For instance, my ds has an obvious dip in processing speed. At school, they see that for what it is - an obvious dip in processing speed. At the neuropsych, there were additional tests to determine - is it fine-motor related, a visual issue, etc. We came out of the neuropsych knowing not only that ds was dsygraphic, but which type of dysgraphia it was (fine-motor). There were also executive functioning tests etc, and an ADHD eval including behavioral surveys from parents and teachers.
3) The neuropsych eval includes a parent interview which includes a detailed developmental history - this is where all those things we never recognized as parents from the early years and instead just thought of as cute quirky little things... were seen in a totality by a professional who realized that all together they pointed to a history of dyspraxia, not just randomly occurring cute little quirky things.
4) Recommendations that are wider and deeper than the school will give you. The school is only going to recommend services that they are required to provide, which means your child has to fall below a certain level of functioning. They are also only recommending services supplied by the school district or by people contracted by the district. A neuropsych is going to make recommendations based on what your child *needs*, not what the school district can (or is willing to) provide. We were given very specific recommendations for the types of therapies etc that would benefit our ds, as well as recommendations of *which* private professionals would be a good fit, which would be easier to get in to see, which were worth waiting for etc.
5) Our neuropsych also gave us a forward plan for what our ds would need as the years go by - not just for school, but for life.
6) (for us) Help with teasing out issues like "is this ADHD or is it dyspraxia or is it something else".
7) A credible report that we were able to use (and continue to use) when advocating at school.
Lastly, although it's expensive, I'd look at how much you are spending now and may very well have to spend later on for your ds - outside therapies etc add up over time, even when you're only paying a deductible. They are also a huge investment in time (your time and your child's time). For us, having that neuropsych advice to guide us as we made decisions about therapies etc was invaluable.
I was also thinking that over the summer he could do a program at one of those LearningRx places
http://www.learningrx.com/main-line/. I know it's a gamble but they seem to work specifically on strengtheing DS' areas of weakness processing and memory. Anyone have any opinion on a program like that? I'd just hate to see his low working memory and processing skills hold him back (and if the cause isn't ADD, what else could I do to help him, ykim?). Seems to me that those (WM and processing skills) would be pretty important for success in school just in general. Anyway, it's expensive - very expensive so it's just a thought right now.
I don't know anything about this program, and haven't taken a look at the link. Just fwiw, I think that this is an example where it was really helpful for us to have the neuropsych advice *first* before making decisions about programs like these. We were told by our neuropsych that WM an area that can improve over time and sometimes does improve during early-middle childhood, and we saw that happen with our ds *without* programs like this. He's also had a gradual improvement in executive functioning skills, which our neuropsych predicted might happen as he moved toward the early teens. Processing speed, however - our neuropsych believes that is something that most likely won't change... but she had very specific recommendations for how to *cope* with it, how to work-around the challenge, how to remediate what could be remediated, and how to approach AT etc.
polarbear
