Dyspraxia

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DISORDERS OF MOTOR
PLANNING AND RESPONDING
Motor Disorders
Gross Motor
Developmental
Coordination
Disorder (DCD)
Fine Motor
Dyspraxia
Dysgraphia
1
Fred
Fred was a quiet baby and babbled very little. He makes more babbling noises now
(4 ½ yr.). He has never used words or jargon, but has developed a great deal of
gesture for use in communication. He understands everything we say to him and
enjoys stories and other verbal activities. He has begun to print words but only a few
of these are used for purposeful communication.
When Fred was 3 yr. and 9 mo. old he began to imitate animal noises. Most of these
were produced with vowel sounds and an occasional ‘b’ or ‘k’. I remember a few
weeks before his third birthday he repeated “bah, bah, bah” all one day. Thinking it
might mean “bye-bye”, I took him out in an attempt to satisfy his whish and
encourage him to continue, but he never repeated the sound after that day, so I may
have been mistaken.
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Fred cont.

3
At about the same time on three separate but identical occasions he
made the sounds “wah dow”. I interpreted it to mean “want down”
and helped him down. Then he learned to get down for himself and
the sounds to my knowledge have never been repeated. Whether
these were simply coincidences or not, I don’t know.expression, hand
and body movements, etc. He will frequently “act out” verbs like fall,
jump, etc. and sounds like escalator, revolving door, airplane, etc.
When he was three years and 10 months old, I suddenly realized that
Fred was reading words: dog, cat, etc. because he’d make the
sounds for the animal when he saw only the word. At three years and
eleven months he started making words all by himself with his
alphabet blocks. Later he started printing the words; he was unable to
make lower case letters well, but could translate lower case letters on
toy blocks into capital letters.
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Developmental
Coordination Disorder
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Dyspraxia
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Dyspraxia and Mislabeling

2 girls with Apraxia, a motor disorder,
mistakenly labeled:



6
hearing impaired
behavior disordered
Another woman (undergrad in this course) was
referred for testing at the age of 2 for not
speaking—now also w/ bad handwriting and
poor gross motor control, could run, however,
because less motor skill involved.
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Communication
Specific characteristics
of Apraxic speech
include


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un-sequenced sounds
or syllables
inconsistent speech
the loss of sounds or
words during
articulation
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Look at this link
Apraxia Video: listen to Brandon as an
example of dyspraxia
http://www.debtsmart.net/talk/inside_edition.html
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Communication cont.

Examples include
 "shif"
instead of "fish" or
 "miskate" instead of "mistake"
 pronouncing "gate" as it should be one day,
but replacing the "g" sound the next day with
"k" or "d" and saying "kate" or "date" (Hall,
Part I, 2000).
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10
Dysgraphia.

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History and handedness
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8 yr old Dysgraphic
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Vocabulary:
3 types of dysgraphia
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1.
memory dysgraphia
1.
motor dysgraphia
2.
1.
perceptual-spatial
dysgraphia
3.
1.
cannot recall the written
form of letters but can
copy
cannot form letters but
know that their writing
is poor
cannot form their letters
and do not know that
their writing or drawing
is poor
Learning Characteristics
1. Perception
2. Memory
RESPONSE CHARACTERISTICS
1. Fine motor
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16
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ADHD and Dysgraphic
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Perceptual or Motor
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Perceptual or Motor
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Emotional Characteristics
Students with dysgraphia are punished by…
1. staying in for recess to complete assignments
2. taking home excessive amounts of homework
People may assume that they are…
1. Lazy
2. Careless
3. Not intelligent
= Low self-efficacy & Low self-esteem
22
In contrast, writing forwards, backwards,
upsidedown, upsidedown & backwards with either
hand may look like giftedness:
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Interventions
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Deficit or Compensation Training?
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Read this link
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http://www.ldonline.org/article/6202
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MOTOR TICS
MOST develop:
1. eye tic first
2. facial tics or involuntary sounds
3. others within weeks or months
 common examples: head jerks,
grimaces, hand-to-face movements
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VERBAL TICS
Stuttering
 Sounds (burping, gagging, barking)
 Words (‘oh boy’)
 Coprolalia (fewer than 15% have
this)

 Occurs
in late childhood
 Most disruptive and disturbing (Jay, 2000)
29
TOURETTE SYNDROME
(VERBAL + MOTOR TICS):
IDEA Category within Other
Health Impaired (OHI)
Tourette’s (versus tic disorder)
Symptoms can:
1.
2.
3.

change over time
vary (frequency, type, location, or intensity)
improve in less extreme cases during
adulthood
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SOCIAL EMOTIONAL
Most problematic: in day-to-day &
during adolescence
Overall there is a higher risk of:
1.poor peer relationships
2.no relationships
3.withdrawn or aggressive social
behavior
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Academic Accommodations
General Principle:
1.Tics increase as a function of stress and calling
attention to tics increases them.
2. Tics decrease with relaxation or when focusing
on an absorbing task

ß
32
Model tolerance and do not allow teasing
by peers
Allow:
1. Short breaks
2. Placement options:
 movement around or outside the room
 access to a private room with a bean
bag chair—with a private signal
 exams in a private room for tic
release and allow more time
3. Tape student’s oral presentations
33
INTERVENTIONS
Pharmacological interventions increase
success
1. Anti-tic drugs block the activity of the
neurotransmitter dopamine.
2. Anti-OCD drugs help to restore the brain
chemical serotonin, which reduces
unwanted, thoughts.
(Many people choose tics over the
medications because of side effects, which
are sleepy, gain weight. In addition no
medication has been found that eliminates
tics completely.)
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Quiet and Withdrawn
16%
Yelling
5%
Pacing
21%
Random Talking/
Asking Questions
58%
35
1.
Changes in students
daily schedule: 2-hr.
school delays, lack
of aide in class,
early dismissals,
late bus arrivals.
2.
Unstructured
activities (breaks
and times when
waiting to load
buses)
36
Diagnosis of OCD or Perfectionism?
•Chris’ compulsions have to do with checking, ordering,
repeating, and getting things ‘just right’ (perfectionism) rather
than trivial concerns with contamination, something bad
happening, or being neat and clean (OCD).
•Behaviors are connected to an event in a realistic way and help
him to neutralize the unpredictability of the event.
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Diagnosis of ADHD?
First determine mild mental retardation might not better explain
his inattentive behavior.
Follow-up:
a. Now that he is given schoolwork based on his level of
reading, language, and math, Chris is able to listen and sustain
attention during his academics periods.
b. He remains in his seat during class, never runs about the
room, does not blurt out answers, and is able to wait his turn.
Conclusion: Chris is not ADHD; he has a mild intellectual
disability
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Accommodations for the teacher:
To address the child’s need for predictability and
self-determination, teachers must provide:
1. A stable daily routine/schedule
2. Advance warning of any changes
3. Opportunities to ask questions as this is his way
to reassure himself about a situation that is
making him feel stressed and anxious
4. An escape, if needed, to regain control
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Interventions for Chris to learn:
To address the Chris’ need for self-determination, Chris
must learn:
1. That when he cannot regain control, to ask for short
breaks
2. To use scripts to interact with his peers. (For
example, Chris does not know how to initiate a
conversation; he only uses statements and needs to
learn to ask questions.)
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