Interventions

Types of Disabilities Covered in IDEA

The umbrella term of special education broadly identifies the academic, physical, cognitive, and social-emotional instruction offered to children who are faced with one or more disabilities. Under the IDEA, these disabilities are categorized into the following areas:

Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder refers to a developmental disability that significantly affects communication (both verbal and nonverbal) and social interaction. These symptoms are typically evident before the age of three and adversely affect a child’s educational performance. Other identifying characteristics of those with ASD are engagement in repetitive activities/stereotyped movements, resistance to change in environment and daily routine and unusual responses to sensory stimuli.

Deaf-Blindness

Deaf-blindness refers to concomitant visual and hearing impairments. This combination causes severe communication, developmental and educational needs that cannot be accommodated through special education programs solely for those children with blindness or deafness.

Deafness/Hearing Impairment

Deafness means a child’s hearing impairment is so severe that it impacts the processing of linguistic information with or without amplification and adversely affects a child’s educational performance. Hearing impairment refers to an impairment (fluctuating or permanent) that adversely affects a child’s educational performance

Developmental Delay

Developmental delay is a term designated for children birth to age nine, and is defined as a delay in one or more of the following areas: cognitive development, physical development, socio-emotional development, behavioral development or communication.

Emotional Disturbance

Emotional disturbance refers to a condition that exhibits one or more of the following characteristics both over an extended period of time and to an exceptional degree that adversely affects a child’s educational performance:

• An inability to learn that cannot be explained by intellectual, sensory or health factors
• An inability to build and/or maintain satisfactory interpersonal relationships with peers and teachers
• Inappropriate types of behaviour or feelings under normal circumstances
• A general pervasive mood of unhappiness/depression
• A tendency to develop physical symptoms or fears associated with personal or school problems

Emotional disturbance does not apply to children who are socially maladjusted unless they are determined to have an emotional disturbance as per IDEA’s regulations.

Intellectual Disability

Intellectual disability is defined as a significantly below average functioning of overall intelligence that exists alongside deficits in adaptive behavior and is manifested during the child’s developmental period causing adverse affects on the child’s educational performance.

Multiple Disabilities

Children with multiple disabilities are those with concomitant impairments such as intellectual disability and blindness or intellectual disability and orthopedic impairment(s). This combination causes severe educational needs that cannot be met through programs designed for children with a single impairment. (Deaf-blindness is not identified as a multiple disability and is outlined separately by IDEA.)

Orthopedic Impairment

Orthopedic impairment(s) refer to severe orthopedic impairments that adversely affect a child’s academic performance. Orthopedic impairment(s) include those caused by congenital anomalies and diseases, as well impairments by other causes (i.e. Cerebral Palsy).

Other Health Impairment(s)

Other health impairments refer to a limitation in strength, vitality or alertness, resulting in limited alertness to one’s educational environment. These impairments are often due to chronic or acute health problems — including ADD/ADHD, epilepsy, and Tourette’s syndrome — and adversely affect the child’s educational performance.

Specific Learning Disability

Specific learning disability refers to a range of disorders in which one or more basic psychological processes involved in the comprehensive/usage of language — both spoken and written — establish impairment in one’s ability to listen, think, read, write, spell and/or complete mathematical calculations. Included are conditions such as perceptual disabilities, dyslexia (also dyscalculia, dysgraphia), brain injury, minimal brain dysfunction and developmental aphasia. Specific learning disabilities do not include learning problems that are the result of visual, auditory or motor disabilities, intellectual disability, emotional disturbance or those who are placed at an environmental/economic disadvantage.

Speech/Language Impairment

Speech or language impairments refer to communications disorders such as stuttering, impaired articulation or language/voice impairments that have an adverse effect on a child’s educational performance.

Traumatic Brain Injury (TBI)

Traumatic brain injury refers to an acquired injury to the brain caused by external physical forces. This injury is one that results in a partial or complete functional disability and/or psychosocial impairment and must adversely affect the child’s educational performance. TBI does not include congenital or degenerative conditions or those caused by birth-related trauma. TBI applies to injuries that result in impairments in one or more of the following areas: cognition, language, memory, attention, reasoning, abstract thinking, judgment, problem-solving, psychosocial behavior, physical functions, information processing, and speech.

Visual Impairment (Including Blindness)

Visual impairment, which includes blindness, refers to impairment in one’s vision that, even after correction, adversely affects a child’s educational performance. The term “visual impairment” is inclusive of those with partial sight and blindness.

In order to be deemed eligible for state special education services, IDEA states that a student’s disability must adversely affect his or her academic achievement and/or overall educational performance. While defining these adverse effects are dependent on a student’s categorical disability, eligibility is determined through a process of evaluations by professionals such as a child’s pediatrician/specialists, school psychologists and social workers. After a student is deemed able to receive such services, their progress is annually reviewed.

What are Primitive Reflexes?

Primitive Reflexes are primal movement patterns that develop in the womb. They help us through the process of birth and to survive our early lives, and operate automatically – like the knee jerk reaction. As we mature from birth to two years of age, these reflexes become inhibited by the development of higher brain functions. As we learn to move in more complex ways – the more primitive ways fade into the background. They are still there but are no longer needed.

Shocks and traumas (sometimes ever minor ones) can prevent the natural process of inhibition and this can lead to the body retaining the primitive reflex and being somewhat ‘stuck’ in a more primitive mode. Symptoms can be seen in physical movement but also in emotional and behavioral states.

What can happen if the Primitive Reflexes are not inhibited?

If they are not inhibited at the appropriate time they are said to be retained. The Primitive Reflexes should be inhibited by 12- 18 months of age. If this does not happen, the person may have these or other symptoms:

• Poor gross motor skills (jumping, skipping, etc)
• Poor fine motor skills (hand- eye coordination, manual dexterity)
• Problems with perception – at all kinds of levels
• Poor social skills
• Emotional issues e.g. anxiety, shyness, and aggression

What causes the Primitive Reflexes to be retained?

There can be many suggested causes but the major ones are:

• Severe stress during the pregnancy.
• Traumatic birth e.g. emergency caesarean.
• Prolonged or breach birth.
• Premature birth
• Significant upsets that cause shock – such as operations, concussions separation from Mom.

The most significant Primitive Reflexes are;

The Fear Paralysis Reflex

This reflex is the first one we know about. It is essentially the freeze response and is designed to protect you from shock or pain. From my own clinic experience – it will very often become activated if the body / nervous system feels that is under significant threat. The person is temporarily removed from pain or the threat of pain by being ‘absent’. I’ve worked with several children and adults whose freeze response began because of a car crash.

Some of the symptoms of a retained Fear Paralysis Reflex:

• A layer of fear that is present around most decisions or new experiences.
• Withdrawal
• Fear of new things
• Insecurity/ social isolation
• Temper tantrums- often screaming loud & long in a new situation or one they consider threatening- or May go into “freeze mode” unable to think & move at the same time
• Selective Mutism– failure to speak in certain situations and yet be able to speak freely otherwise
• Excessive anxiety over seemingly trivial matters
• Very often present in children with autism

The Moro Reflex

This reflex is basically the ‘fight or flight’ response. Our most basic reaction to threat is to freeze – after that we either fight or run. And again, these actions are controlled by the primal or instinct part of the brain. As babies the Moro reflex occurs so that we can do something to announce to Mom that we are in danger – that’s the theory behind why it is there. So what does it make us do?

In tiny babies their reaction to threat is to fling their arms open, scream and go pale or red in the face. This is the early ‘flight or fight’ reaction. Later in life we will still do this action if we get enough of a fright.

When the Moro reflex is retained the person is ‘stuck’ in fight or fright and the feeling that was present when the shock occured (i.e. car crash) is being triggered.

• The child may be hypersensitive and immature or over reactive.
• Moro driven people dislike change and are fearful of new things.
• A change of routine in the classroom, even for something pleasurable, may cause a child to throw a tantrum that seems a huge overreaction to the rest of us.

These children may also react in one of two ways with their peers:

• they may shrink away and be the withdrawn wallflower, observing but not participating, or
• they may want to be the boss of the game all the time.

Other behaviours include;

• constantly on the alert against perceived threat.
• The eyes are constantly wandering to the periphery of the page, the blackboard or the classroom, so that they don’t remain on task.
• They may also have difficulty when reading with the contrast of black print on white paper. Moro driven people can be extremely sensitive in many situations
• The constant stress involved in its frequent emergence can cause a depleted immune response.
• Difficulty showing and receiving affection as well as problems socialising, They often prefer to play with younger children.

The Bonding Reflex

The reflex has a huge impact on feelings of safety and security. If a child doesn’t feel safe in general, then a whole host of symptoms may be present. Common symptoms include;

• Shyness
• The need for constant reassurance ( needing Mom’s/ Dad’ attention)
• Over sensitive to others feelings
• Difficulties with authority
• The child may be inclined to reject themselves and others with hostility and aggression.
• Learning is made difficult because the child needs constant praise from the teacher.

The Palmar Reflex (11weeks in utero-3months of age)

These symptoms may indicate a retained Palmar reflex.:

• Poor manual dexterity
• Making movements with mouth when drawing
• Speech problems pencil grip
• The Palmar reflex is the automatic grasping movement of the hand if the palm is touched. It needs to be inhibited for efficient fine motor skills such as writing and sewing movements.

Asymmetric Tonic Neck Reflex (18 weeks in utero- 6 months of age)

These symptoms may indicate a retained ATNR:

• Difficulty copying symmetrical figures
• Balance affected if head moves to the side
• Awkwardness skipping
• Homolateral marching (same leg & arm)
• Difficulty crossing the midline of the body
• Poor eye tracking especially across the midline
• Difficulty writing if looking at the board
• Difficulty getting ideas onto paper
• Difficulty learning to ride a bike

The mother’s contractions at birth stimulates this reflex and the baby’s movements then cause another contraction to occur. Hand- eye coordination is developed through this reflex: The baby turns its head, the eyes fixate on the hand stretching out or grasping an object. This is the start of awareness of distance. This reflex needs to be inhibited for smooth cross pattern crawling and creeping to develop. Trying to focus on the body position for writing and hanging on to the pencil so that the arm does not extend and fling it away, can require huge effort so it is not surprising that these children avoid written tasks & find school assignments really stressful.

Spinal Galant (20 weeks in utero – 9months of age)

If retained you may see these:

• Fidgetting
• Bedwetting
• Poor short term memory & concentration

This reflex like the ATNR plays a part in assisting in the birthing process- as the hip moves it helps the baby into the birth canal. The lower spine on either side is very sensitive to touch so stimulation such as the elastic in underpants or moving against the back of a chair can result in a squirming movement. Stimulation on both sides of the spine simultaneously can cause defecation or wetting if this reflex is strongly retained. It may also affect fluency and mobility in sporting activities.

Tonic Labyrinthine Reflex

If retained you may see these symptoms:

• Poor posture / stooping or walking on toes
• Poor sense of balance
• Car sickness
• Poor sequencing skills
• Lack of organisation
• Poor sense of time
• Stiff jerky movements / poor muscle tone
• Difficulty judging distance, speed and depth

Some of these may seem contradictory symptoms. It is because there are two aspects to this reflex, one related to bending the neck down with the limbs bending & the other in tilting the neck back accompanied by straightening of the limbs. The development of this reflex takes the baby from its floppy curled up foetal position to one of strong muscle tone and the ability to straighten out & walk upright.

Symmetrical Tonic Neck Reflex ( 6- 9 months age — 9- 11months age)

These symptoms may indicate a retained STNR:

• Poor posture
• Can’t sit still
• Slumps when sitting at a desk
• Slow at copying tasks
• Poor hand –eye coordination
• Messy eater
• Clumsy
• Difficulty with overarm swimming

This reflex helps the baby to defy gravity & get up on hands and knees to crawl. It enables the child to move the two halves of the body independently. If retained the child may not crawl on hands & knees but do a “ bear walk” on hands & feet or shuffle along on their bottoms. A very important reflex for training the eyes to cross the midline, looking from one hand to the other as crawling develops. In reading they need to be able to read fluently across the page without losing the words on the midline. Crawling develops interaction between the vestibular, visual & proprioceptive systems. Without this, balance, space & depth perception will be poor.

Neurodevelopmental Technique/ Bobath Approach (opposite of Brunnstrom Approach)

Therapeutic Handling:

Therapeutic handling is used to influence the quality of the motor response and is carefully matched to the patient’s abilities to use sensory information and adapt movements. It includes neuromuscular facilitation, inhibition, or frequently a combination of the two. Manual contacts are used to:

• Direct, regulate, and organize tactile, proprioceptive and vestibular input
• Direct the client’s initiation of movement more efficiently and with more effective muscle synergies
• Support or change alignment of the body in relation to the BOS and with respect to the force of gravity prior to and during movement sequences
• Decrease the amount of force the client uses to stabilize body segments
• Guide or redirect the direction, force, speed, and timing of muscle activation for successful task completion
• Either constrain or increase the flexibility in the degrees of freedom needed to stabilize or move body segments in a functional activity
• Dense the response of the client to sensory input and the movement outcome and provide nonverbal feed-back for reference of correction
• Recognize when the client can become independent of the therapist’s assistance and take over control of posture and movement
• Direct the client’s attention to meaningful aspects of the motor task

Key Point of Control:

Key points are parts of the body that the therapist chooses as optimal to control (inhibit or facilitate) postures and movement. Proximal key points include the shoulders and pelvis, which are used to influence proximal segments and trunk. Distal key points upper and lower extremities (typically the hands and feet). Key points of control are also used to provide inhibition of abnormal tone and postures. Examples include:

• Head and trunk flexion decreases shoulder retraction, trunk and limb extension (key points of control: head and trunk)
• Humeral external rotation and flexion to 90 degrees decreases flexion tone of the upper extremity (key point of control: humerus)
• Thumb abduction and extension with forearm supination decreases flexion tone of the wrist and fingers (key point of control: the thumb).
• Femoral external rotation and abduction decreases extensor/adductor tone of the lower extremity (key point of control: hip).
• Facilitation: Components of posture and movement that are essential for successful functional task performance are facilitated through therapeutic handling and key points.
• Inhibition: Components of posture and movement that are atypical and prevent development of desired motor patterns are inhibited. While originally this term referred strictly to the reduction of tone and abnormal reflexes, in current NDT practice it refers to reduction of any underlying impairment that interferes with functional performance.

It can be used to:

• “Prevent or redirect those components of a movement that are unnecessary and interfere with intentional, coordinated movement,
• Constrain the degrees of freedom, to decrease the amount of force the client uses to stabilize posture
• Balance antagonistic muscle groups
• Reduce spasticity or excessive muscle stiffness that interferes with moving specific segments of the body.”

Program Details:

Our intervention strategies follow latest research, and we use a blend of evidence based approaches known to produce beneficial effects for the child. Focus of intervention is aimed at parent and caregiver education/facilitation and allowing the individual child flexibility in terms of choice, plays companions and materials, level of challenge, etc… Thus capitalizing on the child’s intrinsic motivation.

Types of Sensory Processing Disorders

There are certain subtypes of sensory processing disorder that may alter the course of treatment and diagnosis. The subtypes of SPD include:

Sensory Modulation Disorder: Children who have sensory modulation disorder have problems regulating the intensity and nature of responses to sensory input. The responses may be emotional or behavioral, negative responses to stimuli not averse to others, and the problems are exacerbated by stress. Common symptoms include:

• Withdrawing from light and unexpected touch
• Gagging and refusal to eat textured foods
• Dislike of teeth-brushing, hair washing, or nail cutting
• Avoidance of messy textures such as dirt or lotion
• Avoidance of messy textures such as dirt or lotion
• Strong preferences to certain types of clothing, including textures and fit
• Over sensitivity to sounds or visual stimuli

Sensory Discrimination Disorder: Children who have sensory discrimination disorder have problems discerning and assigning proper meaning to qualities of particular sensory stimuli. These children may struggle with recognition and interpretation of characteristics of sensory stimuli, have poor detection of difference or similarities in the stimuli, and often occurs with dyspraxia and poor skill performance. Symptoms may include:

• Difficulty manipulating an object when out of sight
• Difficulties following directions
• Challenges distinguishing between similar sounds
• Problems finding an image in a cluttered background
• Uses too much or too little force
• Poor balance
• Poor sense of movement speed

Postural-Ocular Disorder: Children with postural-ocular disorder have problems controlling or stabilizing the body during movements or at rest. Muscles may be hypo or hypertonic and joints may be unstable. Poor usage of vision and coulomotor control. Symptoms may include:

• Poor posture control or strength
• Poor equilibrium and balance
• Difficulty isolating head-eye movements
• Poor tracking of visual stimuli
• Avoidance of upper extremity weight bearing
• Discomfort climbing or fear of heights
• Tires easily
• Challenges establishing dominant hand (right or left handedness)

Dyspraxia: Children with dyspraxia have a deficit in their abilities to plan, sequence, or execute unfamiliar actions. Motor skills and movement may be awkward; these children may have poor ability to generalize learned skills to apply to other tasks, and may have poor timing, sequencing, and action of motor skills. Symptoms may include:

• • Trouble performing activities of daily living
  • Accident-prone and clumsiness
  • Resists new activities
  • Poor playing skills
  • Poor fine motor coordination
  • Poor articulation

Co-Occurring Disorders

Sensory processing disorder may occur with other types of disorders. The most common co-occurring disorders include:

• • • Autism
    • Asperger syndrome
    • Attention-deficit hyperactivity disorder
    • Language disorders
    • Learning disabilities
    • Post-traumatic stress disorder
    • Fragile X syndrome

Causes of Sensory Processing Disorder

The precise cause for SPD is still unknown, although researchers are spending much time learning more about the condition. Some of the potential causes for SPD may include:

Genetic: Children born to adults who have autism spectrum disorders may be at higher risk for developing sensory processing disorder. Additionally, children with Asperger syndrome or autism are at a higher risk for developing SPD. Boys are more likely than girls to have SPD.

Sensory Modulation Disorder: Children who have sensory modulation disorder have problems regulating the intensity and nature of responses to sensory input. The responses may be emotional or behavioral, negative responses to stimuli not averse to others, and the problems are exacerbated by stress. Common symptoms include:

Symptoms of Sensory Processing Disorder

Children who have sensory processing disorder cannot properly process the sensory stimuli from the outside world and may have trouble interpreting information from one or more senses. As no two children with SPD have the same type of sensory dysfunction, the symptoms will vary tremendously from child to child and may include:

Behavioral Symptoms:

• • • Withdraw when touched
    • Behavioural problems
    • Difficulties calming oneself after exercise or being upset
    • Refuse to eat certain foods due to the textures of the foods
    • Be hypersensitive to certain fabrics
    • Only wear soft clothes or clothes without tags
    • Dislike dirtying his or her hands
    • Do not engage in creative play
    • Lack variety in play – may watch the same television program over and over
    • Oversensitivity to sounds, especially hair dryers, washing machines, or sirens
    • Be oversensitive to odours – strong or mild
    • Have challenges with certain movements, such as swinging, sliding, or going down stairs
    • Notice or hear background noises that others cannot
    • May harm others during play accidentally

Physical Symptoms:

• • • Have odd posture
    • Clumsiness
    • Poor balance
    • Delayed fine motor control, such as handwriting challenges
    • Delayed gross motor development
    • Impairments in sleep, eating, and elimination patterns
    • Be in constant motion
    • Jump, swing, spin excessively
    • Fatigue easily
    • Alternate between constant motion and fatigue
    • Poor coordination
    • May fall often
    • High tolerance to pain

Psycho social Symptoms:

• • • Decreased ability to interact with peers
    • May stand too closely to others
    • Social isolation
    • Depression
    • Anxiety
    • Aggression
    • Fearful of crowds
    • Avoidance of standing in large groups
    • Fearful of surprise touch

Effects of Sensory Processing Disorder

As SPD may be undiagnosed, especially in older people, and left untreated for years, the long-term effects of living with SPD can cause significant impairment in their daily lives. Many healthcare professionals are not trained to recognize the symptoms of this disorder and as a result, diagnosis may be delayed for years.

The long-term effects of SPD may include:

• • Trouble maintaining a mainstream job
  • Challenges with interpersonal relationships
  • Inability to find pleasure in recreational activities that over stimulate the senses
  • Depression
  • Underachievement
  • Social isolation
  • Poor self-confidence
  • Decreased friendships
  • Low self-esteem

What is dyslexia?

In a person with dyslexia, the brain processes written material differently. This makes it hard to recognize, spell, and decode words.
People with dyslexia have problems understanding what they read. Dyslexia is a neurological and often genetic condition, and not the result of poor teaching, instruction, or upbringing. Between 5 and 15 percent of people in the United States have dyslexia.

Symptoms

• Dyslexia commonly causes difficulties in word recognition, spelling, and decoding.
• Dyslexia is different from delayed reading development, which may reflect mental disability or cultural deprivation.
• The most common signs and symptoms associated with dyslexia can be displayed at any age, but they normally present in childhood.

Childhood symptoms of dyslexia include:

Difficulty in learning to read
Many children with dyslexia have normal intelligence and receive proper teaching and parental support, but they have difficulty learning to read.

Milestones reached later
Children with dyslexia may learn to crawl, walk, talk, and ride a bicycle later than the majority of others.

Delayed speech development
A child with dyslexia may take longer to learn to speak, and they may mispronounce words, find rhyming challenging, and appear not to distinguish between different word sounds.

Slow at learning sets of data
At school, children with dyslexia may take longer to learn the letters of the alphabet and how they are pronounced. There may be problems remembering the days of the week, months of the year, colors, and some arithmetic tables.

Coordination
The child may seem clumsier than their peers. Catching a ball may be difficult. Poorer eye-hand coordination may be a symptom of other similar neurological conditions, including dyspraxia

Left and right
The child may confuse “left” and “right.”

Reversal
They may reverse numbers and letters without realizing.

Spelling
Some children with dyslexia might not follow a pattern of progression seen in other children. They may learn how to spell a word and completely forget the next day.

Speech problems
If a word has more than two syllables, phonological processing becomes much more challenging. For example, with the word “unfortunately” a person with dyslexia may be able to process the sounds “un” and “ly,” but not the ones in between.

Concentration span
Children with dyslexia commonly find it hard to concentrate. Many adults with dyslexia say this is because, after a few minutes of non-stop struggling, the child is mentally exhausted. A higher number of children with dyslexia also have attention deficit hyperactivity disorder (ADHD), compared with the rest of the population.

Sequencing ideas
When a person with dyslexia expresses a sequence of ideas, they may seem illogical or unconnected.

Types

Dyslexia can be broken down into different subtypes, but there is no official list of dyslexia types because they can be classified in different ways.
However, the following categories are sometimes used:

Phonological dyslexia:
The person has difficulty breaking down words into smaller units, making it hard to match sounds with their written form. This is also known as dysphonetic dyslexia or auditory dyslexia.

Surface dyslexia:
The person cannot recognize a word by sight, making words hard to remember and learn. This is sometimes called dyseidectic dyslexia or visual dyslexia.

Rapid naming deficit:
The person cannot quickly name a letter or number when they see it.

Double deficit dyslexia:
The person finds it hard to isolate sounds also to name letters and numbers.

Visual dyslexia:
The person has an unusual visual experience when looking at words, although this can overlap with surface dyslexia. Sometimes people refer to “directional dyslexia,” meaning it is difficult to tell left from right. This is a common feature of dyslexia, but it is not a type.
If a person has difficulty with math learning, the correct term for this is dyscalculia. It is not dyslexia.

Phonological Deficit:
Difficulty decoding or assembling words based on their sounds. Note that phonemic awareness is not a reading deficit per se since it involves only sounds and not letters.

Speed Naming Deficit:
Slow reading: poor use of sight. A sight word is a word that is instantly recognized by the reader: is not sounded out, and requires almost no effort to understand.

Comprehension Deficit
Poor understanding of what was just read.

By Sensory System

Auditory Dyslexia
Auditory Dyslexia involves difficulty processing sounds of letters or groups of letters. Multiple sounds may be fused as a singular sound. For Examples the word ‘back’ will be heard as a single sound rather than something made up of the sounds /b/ – /aa/ – /ck/. Single syllable words are especially prone to this problem.

Visual Dyslexia
Visual dyslexia is defined as reading difficulty resulting from vision related problems. Though the term is a misnomer, visual problems can definitely lead to reading and learning problems.

Attentional Dyslexia
Attentional Dyslexia in which children identify letters correctly, but the letters jump between words on the page. “kind wing” would be read as “wind king”. The substitutions are not caused by an inability letters or convert them to sounds, but instead result from the migration of letters between words-the first letters of one word switches place with the first letter of another word.

By Deficit

Phonological Dyslexia
Phonological dyslexia is extreme difficulty reading that is a result of phonological impairment, meaning the ability to manipulate the basic sounds of language. The individual sounds of language become ‘sticky’, unable to be broken apart and manipulated easily.

Surface Dyslexia
A type of dyslexia characterized by difficulty with whole word recognition and spelling, especially when the words have irregular spelling sound correspondences”.

Deep Dyslexia
Deep dyslexia is an acquired form of dyslexia, meaning it does not typically result from genetic, hereditary (developmental) cause. It represents a loss of existing capacity to read, often because of head trauma or stroke that affects the left side of the brain. It is distinguished by two things: semantic errors and difficulty reading non-words.

By Time of Onset:

Developmental Dyslexia
Developmental dyslexia is not so much a type of dyslexia, it is dyslexia. In fact our definition of it would be the same as our definition of dyslexia generally: Extreme difficulty reading caused by a hereditary, brain based, Phonologic disability. So why do people use the term instead of just saying dyslexia? The simple answer is they are trying to be more specific, distinguishing ‘regular’ dyslexia from the other types of dyslexia. In particular, distinguishing it from acquired forms of dyslexia that result from stroke or head trauma for example, which often present very differently. For more on developmental dyslexia.

Acquired Dyslexia
This type results from trauma or injury to that part of the brain that controls reading and writing. Late in life this can be the result of a tumor or stroke.

Other Dyslexia Types:

Directional Dyslexia
Directional dyslexia is distinguished by left-right confusion and tendency to become disoriented or lost. The term is also occasionally used to mean confusion with letters such as P and b or d and b, where there is confusion over the ‘direction’ of the letter. Generally, problems with direction are a symptom of dyslexia more than a sub type. Not all dyslexics have this problem.

Math Dyslexia (Dyscalculia)
Math dyslexia or dyscalculia is not, in fact, a type of dyslexia, but we included it here because the term is frequently used. According to the U.S National Center for Learning Disabilities, math dyslexia, or dyscalculia, refers to wide range of lifelong learning disabilities involving math, varies from person to person and affects people differently at different stages of life

As with reading, when basic math skills are not mastered early, more advanced math becomes extremely difficult. Approximately half of people with dyslexia also have dyscalculia, though far less research has been conducted regarding testing, assessment and remediation.

Language Disorder group, Articulary and Dyscoordination Group and a Visual spatial Perceptual Disorder group

They divided the children into three groups: (I) those with brain damage who could read, (II) those with brain damage who were dyslexic and (III) those without brain damage who were dyslexic. Interestingly enough they found a similarity between those with developmental dyslexia and those with brain-damage dyslexia. On the basis of these results and a battery of neuropsychological examinations, they divided dyslexia into three syndromes.

• Syndrome I Language Disorder- This syndrome is characterized with anomia, comprehension deficits, confused imitative speech and speech- sound discrimination. Vision and motor coordination is normal.
• Syndrome II Articulatory and Graphomotor Dyscoordination- Children with this syndrome have gross and fine motor coordination disorders. They have poor speech and graphomotor coordination.
• Syndrome III: Visuospatial Perceptual Disorder- These children score 10 points more on verbal IQ than performance IQ. Their visuospatial perception is very poor, as is their ability to store and retrieve visual stimuli.

What is dyspraxia?

Dyspraxia is a neurological disorder that impacts an individual’s ability to plan and process motor tasks.

Individuals with dyspraxia often have language problems, and sometimes a degree of difficulty with thought and perception. Dyspraxia, however, does not affect the person’s intelligence, although it can cause learning problems in children.

Developmental dyspraxia is an immaturity of the organization of movement. The brain does not process information in a way that allows for a full transmission of neural messages.<br.
A person with dyspraxia finds it difficult to plan what to do, and how to do it.

The National Institute of Neurological Disorders and Stroke (NINDS) describes people with dyspraxia as being “out of sync” with their environment.

Experts say that about 10 percent of people have some degree of dyspraxia, while approximately 2 percent have it severely. Four out of every 5 children with evident dyspraxia are boys, although there is some debate as to whether dyspraxia might be under-diagnosed in girls.

According to the National Health Service, United Kingdom, many children with dyspraxia also have attention deficit hyperactivity disorder (ADHD).

Symptoms of dyspraxia

Symptoms tend to vary depending on the age of the individual. Later, we will look at each age group in more detail. Some of the general symptoms of dyspraxia include:

• poor balance
• poor posture
• fatigue
• clumsiness
• differences in speech
• perception problems
• poor hand-eye coordination

Diagnosis of dyspraxia

A diagnosis of dyspraxia can be made by a clinical psychologist, an educational psychologist, a pediatrician, or an occupational therapist. Any parent who suspects their child may have dyspraxia should see their doctor.

When carrying out an assessment, details will be required regarding the child’s developmental history, intellectual ability, and gross and fine motor skills:

• Gross motor skills – how well the child uses large muscles that coordinate body movement, including jumping, throwing, walking, running, and maintaining balance.
• Fine motor skills – how well the child can use smaller muscles, including tying shoelaces, doing up buttons, cutting out shapes with a pair of scissors, and writing.
  The evaluator will need to know when and how developmental milestones, such as walking, crawling, and speaking were reached. The child will be evaluated for balance, touch sensitivity, and variations on walking activities.

Dyspraxia in children
Dyspraxia symptoms may vary depending on age. With that in mind, we will look at each age individually. Not every individual will have all of the symptoms outlined below:

Very early childhood
The child may take longer than other children to:

• Sit.
• Crawl –the Dyspraxia Foundation says that many never go through the crawling stage.
• Walk.
• Speak –according to the Children’s Hospital at West mead, Australia, the child may be slower in answering questions, find it hard to make sounds, or repeat sequences of sounds or words; they may also have difficulty in sustaining normal intonation patterns, have a very limited automatic vocabulary, speak more slowly than other children, and use fewer words with more pauses
• Stand.
• Become potty trained (get out of diapers).
• Build up vocabulary.
• Early childhood

Tying shoelaces can be a difficult task for children suffering with dyspraxia.

Later on, the following difficulties may become apparent:

• Problems performing subtle movements, such as tying shoelaces, doing up buttons and zips, using cutlery, and handwriting.
• Many will have difficulties getting dressed.
• Problems carrying out playground movements, such as jumping, playing hopscotch, catching a ball, kicking a ball, hopping, and skipping.
• Problems with classroom movements, such as using scissors, coloring, drawing, playing jigsaw games.
• Problems processing thoughts.
• Difficulties with concentration. Children with dyspraxia commonly find it hard to focus on one thing for long.
• The child finds it harder than other kids to join in playground games.
• The child will fidget more than other children.
• Some find it hard to go up and down stairs.
• A higher tendency to bump into things, to fall over, and to drop things.
• Difficulty in learning new skills – while other children may do this automatically, a child with dyspraxia takes longer. Encouragement and practice help enormously.
• Writing stories can be much more challenging for a child with dyspraxia, as can copying from a blackboard.

The following are also common at pre-school age:

• Finds it hard to keep friends
• Behaviour when in the company of others may seem unusual.
• Hesitates in most actions, seems slow.
• Does not hold a pencil with a good grip.
• Such concepts as ‘in’, ‘out’, ‘in front of’ are hard to handle automatically.

Later on in childhood

• Many of the challenges listed above do not improve or only improve slightly.
• Tries to avoid sports.
• Learns well on a one-on-one basis, but nowhere near as well in class with other children around.
• Reacts to all stimuli equally (not filtering out irrelevant stimuli automatically)
• Mathematics and writing are difficult.
• Spends a long time getting writing done.
• Does not follow instructions.
• Does not remember instructions.
• Is badly organized.

Dyspraxia in adults , symptoms include:

• Poor posture and fatigue.
• Trouble completing normal chores.
• Less close control – writing and drawing are difficult.
• Difficulty coordinating both sides of the body.
• Unclear speech, often word order can be jumbled.
• Clumsy movement and tendency to trip over.
• Grooming and dressing more challenging – shaving, applying makeup, fastening clothes, tying shoelaces.
• Poor hand-eye coordination.
• Difficulty planning and organizing thoughts and tasks.
• Easily frustrated.
• Less sensitive to non-verbal signals.
• Low self-esteem.
• Difficulty sleeping.
• Difficulty distinguishing sounds from background noise.
• Notable lack of rhythm when dancing or exercising.

Social and sensory – individuals with dyspraxia may be extremely sensitive to taste, light, touch, and/or noise. There may also be a lack of awareness of potential dangers. Many experience moods swings and display erratic behavior.

Visual Motor Skills:

Difficulty coordinating hand movements / skills using the eyes. Copying shapes, connecting dots, drawing through mazes, difficulty cutting on a line, or writing and drawing.

Visual Perceptual Skills:

Difficulty labelling letters / numbers / shapes, discriminating difference between forms, difficulty putting puzzles together, difficulty remembering forms, difficulty locating objects in a distracting background, matching similar objects / forms, and trouble copying when writing or drawing.

Postural Control:

Sits in a slouched manner at a table or desk, props head up with hand while sitting, fidgets constantly in chair, falls out of chair or falls down while navigating the environment, relies on railing to climb stairs, frequently bumps into people or objects, props self up against people or objects, has poor endurance and poor balance.

General Gross Motor Skills:

Difficulty maintaining balance when standing on one foot, difficulty negotiating playground equipment, unable to hop, jump, skip, gallop, or walk on a line, appears awkward when running, avoids physical education or sports activities.

In-hand Manipulation / Fine Motor Skills:

Drops or has poor control of small objects ( pegs, beads, coins ), difficulty using both hands at the same time or always uses one hand, has hand dominance confusion, difficulty grasping pencil, marker, crayon, hand muscle appear weak and movements seem awkward.

Psychosocial Skills:

Problem with transitions (stop and starts tasks with an adverse reaction), becomes frustrated or upset easily, has difficulty making friends, has low self-esteem.

Attention / Arousal:

Doesn’t respond to his/her name, looks “space out”, becomes easily distracted, fidgets often, misses verbal directions or needs directions repeated, impulsive, seems lethargic or over-active and cannot adjust arousal level for a task.

Play Skills:

Difficulty with sharing, becomes upset when losing a game, difficulty following rules, tends to play alone rather than with peers, doesn’t understand how to join peers in play or how to initiate play.

Sensory processing and / or Modulation:

The child could be under/over-responsive to ordinary sensations from the body or environment (sounds feel too loud or the person cannot tune into what is said, unexpected touch might feel uncomfortable or the person touches everything/everyone constantly) or sensory information is not processing accurately causing poor coordination and/or body in space awareness.