Gifted Issues Discussion homepage Forums Twice Exceptional Psychologist's diagnosis for sons school

Cola, my ds has diagnoses of dysgraphia and Developmental Coordination Disorder (which is essentially the same thing you'll see referred to as "dyspraxia"). He also has a diagnosis of SLD/written expression. I'm going to give you a bit of a dump from my brain here - this is all related to my ds - your ds may have an entirely different set of impacts - but if anything here sounds familiar and you'd like more info, just ask!

Dyspraxia impacts each individual in different ways and in different degrees. For my ds, the most obvious impact is handwriting - and (jmo) I suspect his fine motor dysgraphia is really related to his dyspraxia. As you may have read, dysgraphia is a neurologic challenge in which a person doesn't develop automaticity of handwriting. My ds, who is 15 years old, still has to think about how he forms letters and numbers when he writes. This means his handwriting is too slow and too illegible to rely on to show his full knowledge. An impact that isn't quite as obvious, but is very real, is that his full working memory is taken up by the act of producing handwriting, hence nothing is left over to focus on grammar, spelling, punctuation, etc.

Dyspraxia is also a neurologic challenge in which automaticity doesn't develop for other types of fine motor and gross motor skills. My ds, for instance, didn't learn how to tie his shoes until he was in 4th grade (and it wasn't for lack of trying, he just couldn't figure it out). Then he had spring break, didn't wear tie shoes for a week, and he forgot. Little things like that. He learned how to write cursive in school but forgot over summer vacation. He has to think when he writes his name - you can watch him and see that he's slow and he's thinking about how to do it. When he has to sign his name in cursive, he usually practices it a few times first to be sure he gets it correct. He's slow with things like zippers, buttons, etc. He doesn't really move fast in general, and when he was younger, when I'd be in a hurry and ask him to run because he was shuffling along looking like he wasn't in any hurry - he'd honestly think he was already running. He doesn't like to play team sports because he's not coordinated with catching balls etc. He *loves* individual sports like mountain biking and skiing.

Another area that people with dyspraxia are sometimes impacted is speech. It wasn't obvious to us when our ds was younger, but his issues with written expression (he also had the diagnosis of disorder of written expression) was tied into an expressive language disorder, and speech therapy addressing it was tremendously helpful. We also realized as he grew that he has a tendency to speak in a monotone voice but he didn't realize it, and again, speech therapy helped. We also realized as he got older that the inability to fully express himself wasn't solely limited to writing assignments - he had the same difficulty with certain types of speech - but it wasn't obvious when he was younger because he talked *so much* and in such depth about things he really knew a lot about (mostly factual things).

There are other little odd quirks here and there. For a long time he didn't really have a good sense of being either hungry or full. He was very disorganized for a long time (homework, room, etc) - but that's gotten better as he's gotten older and started to put some structures in place himself to get around those challenges.

Hopefully none of that sounds bleak! What it does mean, though, is that accommodations are necessary at school, he might benefit from structure at home, and he'll need to know you are his advocate and that you are there to support him in a way that will help him become independent. We started our ds keyboarding right away after he was diagnosed. I scribed for him when he had written assignments for homework until he was fairly proficient at the keyboard, and I still scribe when he needs to get an assignment done quickly. Re written expression, we did a lot of work with his speech therapist determining where his challenges were, we practiced a lot and implemented tips the SLP came up with for him, and I scaffolded his writing assignments like crazy.

Repetition is a key for our ds - he needs to repeat the skills that are impacted by his dyspraxia over and over and over again to get them into his muscle memory (and even then, they are usually slow compared to the pace at which neurotypical kids move). When he was first diagnoses I read as much as I could find on each diagnosis (in books and online) and that was really helpful. We also had an AT evaluation in which the wonderful OT who did the eval pointed something out to me that I didn't realize - and it's really an important thing to understand for a kid with dyspraxia - you'll read about how kids with dysgraphia all of a sudden become proficient at writing simply by replacing handwriting with a keyboard. That did *not* happen with my ds - one reason was his expressive language disorder, but another very important one was - his dysgraphia was related to fine motor dyspraxia, it wasn't *just* an issue with automaticity of forming letters. He was able to learn how to type, but his typing is not as fast as a neurotypical child is able to learn to type, hence written homework still takes him a longer time than most students even when he's typing (which is why I scribe for him at times). Voice-to-text really is the quickest way for him to get his thoughts out, but the output requires careful proofreading and editing, and he's just not that thrilled with it at the moment.

I've gotta run - hope that all makes sense!

Hang in there,

polarbear

ps - our neuropsychologist has a chart (that she pulled from some literature somewhere - sorry I don't have a link!) showing the overlaps between dyspraxia, adhd, and autism spectrum disorders. There really is a significant overlap in symptoms for all three. Our ds was diagnosed with adhd at one point in time but it was later considered to be an incorrect diagnosis. One thing I've read about and pondered quite a bit is the relationship between ADHD and written expression - it's not uncommon to see children with ADHD diagnoses struggling with written expression. Did the evaluator recommend trying meds for your ds' ADHD or seeing a dr who could go through that decision with you? It's possible that if his ADHD diagnosis is accurate and you're able to find some way to mitigate the impact of the ADHD, you might see his written expression challenges lessen.