ADHD and Dyspraxia in Children

ADHD and dyspraxia are both neurodevelopmental disorders. ADHD is a condition that affects focus, attention, and impulsivity. Dyspraxia (also known as DCD, Developmental Coordination Disorder) is a condition that affects fine and gross motor skills, coordination and movement. It is often referred to as a “motor learning disability.” This means that it can be difficult for people with dyspraxia to learn new motor skills, or to execute previously learned motor skills.

Dyspraxia can occur in isolation, or it can be comorbid with other conditions, such as ADHD. In fact, research suggests that ADHD and dyspraxia often co-occur. One study found that 36 per cent of children with ADHD also met the criteria for dyspraxia. That’s a high number!

What is Dyspraxia?

Dyspraxia is a developmental disorder that affects movement and coordination. It can also affect speech, sensory processing, and social skills. Developmental Dyspraxia is characterised by problems with planning and executing movements.

Like ADHD, the exact cause of dyspraxia is unknown. ADHD is thought to be related to a combination of genetic and environmental factors causing the brain disorder. Dyspraxia is caused by problems in the brain’s development. Whilst there is no cure for either condition, there are treatments that can help lessen the symptoms.

Signs and Symptoms of Dyspraxia

Children with dyspraxia will often appear clumsy or awkward They generally have poor:

Gross Motor Skills – these are the large muscle skills such as independent sitting, walking and crawling, hopping, skipping, jumping
Fine Motor Skills – these are the smaller muscle skills such as holding a bottle or a pencil, using a knife and fork, drawing, doing up a zip, buttons etc.
Motor Planning and Sequencing Skills – the ability to draw on their past experience of a pattern of movements that gets them from A to B. For example, how to put a coat on, how to prepare their breakfast
Balance and Co-ordination – they can appear clumsy and awkward when using their whole body

Children with dyspraxia will often have difficulty gauging how much force to use for some activities using either too much or too little. For instance, applying too much pressure when writing with a pencil and constantly breaking the tip or ripping the paper; or not enough to say push shut a door.

Some of these signs can be seen from a very early age whilst others may appear later in childhood.

Infants may take longer to reach milestones such as lifting their heads, rolling over, sitting, crawling, walking and self-feeding, and playing with toys like shapes and bricks that involve coordination.

Older children may have difficulty with ball games, catching, throwing, kicking; drawing, writing and using scissors; getting ready for school including getting dressed, and doing up shoes and zips; they may also have difficulty staying still, moving or flapping their arms and legs a lot.

In the teenage years, dyspraxia has been closely linked with anxiety. This could be due to moving up to secondary school and lacking the necessary organisational skills that are required here to ensure the right class is attended, homework is completed and submitted on time, to the correct place. Also, when a child has come from primary school, there are always younger children there that they can play ‘safely’ with, without exposing their lack of coordination, speech issues, ‘messy’ handwriting. By the time they reach secondary school, everyone is at a dexterous level, and symptoms of dyspraxia may become more noticeable. This is definitely a time to watch out for signs of anxiety and depression if your teen appears to withdraw.

Generally, the signs for parents of children and teens to look out for with dyspraxia include:

Being overly clumsy and bumping into things
Poor posture and ‘slumping’
Tiring quickly
Trouble with fine motor skills (listed above)
Knocking things over
Difficulty negotiating uneven surfaces and stairs
Difficulty learning a new skill

The combination of ADHD and dyspraxia can make everyday tasks especially challenging.

Some components of dyspraxia can even look like ADHD.

Poor organisational skills
Forgetting rules and instructions
Poor memory
Difficulties processing too much information
Low Self-esteem
Trouble socialising and making friends
Constant movement

Children with ADHD and dyspraxia often have difficulty paying attention, staying organised, and controlling impulsive behaviours. These difficulties can make it harder for them to focus on tasks and stay on track.

Tasks that most people may find fun, like ball games, may be impossibly difficult for someone with dyspraxia due to their struggles with coordination. This would make the ADHD kick in, frustration and boredom! A meltdown may ensue. Or maybe they won’t want to stop, they will want to achieve this task, and be able to catch, but now their executive functioning is having to work overtime to try and help this and now they are becoming beyond tired and have to stop.

Would that child want to join a team that plays ball? Probably not. Their desire to be a team member is low. As is their self-confidence and self-esteem. Not to mention their fitness level. It’s one big vicious circle.

Oh and let’s not forget that our children with ADHD and dyspraxia may also have trouble with social interactions. They may be overly active or impulsively communicate, which can lead to misunderstandings. Or they may misunderstand social cues. Many children with dyspraxia are very literal and find sarcasm and metaphors difficult to grasp. This can cause issues when dealing with older children.

Diagnosis

If you think your child may have ADHD or dyspraxia, talk to your doctor, GP, Health Visitor or SENCO (Special Educational Needs Co-ordinator) at your child’s school. They can then start the referral procedure to a paediatrician. A diagnosis for dyspraxia is normally not given before 5 years old. Many children can appear clumsy and uncoordinated before this age. I often used to think my kids looked like little drunk people running around narrowly missing dangers! Some children’s milestones do come later, one of my twins always did something before the other, but they generally caught up. Leaving it till 5 years old will help the paediatrician get a full idea of the situation. They will then assess:

medical history
fine motor skills
gross motor skills
developmental milestones
mental abilities

Always ensure you have kept detailed notes of when things happened and what you have noticed during this time.

Diagnostic criteria

For a diagnosis of Dyspraxia/DCD to be made, your child will usually need to meet all of the following criteria (taken from NHS website UK):

‘their motor skills are significantly below the level expected for their age and opportunities they have had to learn and use these skills
lack of motor skills significantly and persistently affects their day-to-day activities and achievements at school
their symptoms first developed during an early stage of their development
their lack of motor skills isn’t better explained by long-term delay in all areas (general learning disability) or rare medical conditions, such as cerebral palsy or muscular dystrophy.

Dyspraxia should only be diagnosed in children with a general learning disability if their physical coordination is significantly more impaired than their mental abilities’.

Treatment for ADHD and Dyspraxia

ADHD and dyspraxia can often be managed with the right treatment, but it is important to get help early on.

There is no one-size-fits-all treatment for ADHD and dyspraxia, but there are a few interventions that can help. These include medication, behavioural therapy, and occupational therapy. Medication can be used to control ADHD symptoms, while behavioural therapy can help children learn new coping mechanisms. Please read the articles on ADHD medication and ADHD and CBT for treatment ideas for ADHD.

For children with Dyspraxia, the best treatment appears to be OT (Occupational Therapy). Occupational therapy can help with coordination and fine motor skills. They can also provide equipment and tools to help your child with dyspraxia.

An Occupational therapist will work with your child to find out which parts of dyspraxia impact their life most. They will often carry out an assessment in a variety of the child’s environments such as home, school, hobbies etc. The therapist will then focus on a task that your child is having difficulty with and break it down into smaller parts and work on these as individual sections. This could be anything from balance and coordination to handwriting adaptations. Your child will be taught to achieve each step before they can progress to the next action or sequence.

They will also work with your child’s school to offer advice on supporting your child in their environment and changes or strategies that they can implement. Ideas will also be suggested for parents/carers to do at home.

How to help your child with ADHD and Dyspraxia

While ADHD and dyspraxia can both be challenging for children, there are ways to help manage the symptoms of both conditions.

In School

Both ADHD and dyspraxia can affect a child’s ability to learn and succeed in school. Children with ADHD may have trouble paying attention in class or following instructions. Children with dyspraxia may have trouble sitting still or writing neatly.

Educational interventions can involve special accommodations in the classroom. (For in-depth ideas on ADHD in classroom interventions please click Can a child with ADHD be successful in school and ADHD and Preschoolers)

Extra time to complete their work,
A quiet place to work away from distractions
Allow them to take movement breaks when they need
A desk near the front of the classroom
Providing extra instruction on how to complete the task, broken down into bite-sized chunks
Visual timetables

At Home

Parents can also help their children by

Encouraging them to move their bodies as much as possible
Teach them some simple exercises to help improve their coordination.
Finding a sport or a club that they enjoy
Watching their diet, lower sugar and processed foods where possible
Helping them get organised for school/homework/clubs
Keeping in contact with the school to share what’s working and what’s not
Ensuring good sleep habits
Make sure they have enough stimulation, both indoor and outdoor activities
Using positive reinforcement to help them stay motivated and continue to work hard. It’s amazing what a sticker can do! (obviously not for your teens!).

By creating a routine, teaching organisational skills, and encouraging physical activity, you can help your child thrive despite their challenges. By following these tips, you can help your child to overcome some of the challenges associated with ADHD and dyspraxia.

The best way to treat ADHD and dyspraxia is to work with a team of professionals who can tailor a treatment plan to your child’s specific needs. With the right support, patience and understanding, children with ADHD and dyspraxia can lead happy and successful lives.

Here is a link to the Dyspraxia Foundation which has a lot of in-depth knowledge and support, including local groups in your area. I really hope this has helped. Let me know if you would like to add anything or offer some support or advice that I can add on?

I have started a private support group on Facebook for parents and carers who need support with their child with ADHD. It’s a friendly place to chat with others. Please do click this link ADHDinchildren to join. And for anyone on Instagram, I’m there too ADHD Mum.

Vicki x