Remedial Education

Language Disorder group, Articulary and Dys coordination 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. 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.

Later on in childhood Dyspraxia in adults

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.
• Less sensitive to non-verbal signals.
• Easily frustrated.
• 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.

How does one determine which sensory perception areas should be trained?

If the child displays more than one deficiency in the following areas, then these areas of sensory perception should be trained:

Visual Recognition

• Basic essentials cannot be understood from what is seen
• Visually similar things are not recognized as different
• Distinguishing important information from a multitude of stimuli is unsuccessful
• The ability to filter something out of the background is lacking
• The child must touch/handle everything in order to understand it
• Difficulties with distinguishing between colours and shapes
• Writing and recognition of letters is difficult
• Handwriting is untidy and difficult to read
• Lack of uniformity in the size of the letters
• Uneven reproduction of letters and numbers
• Confusion between letters which are different in placement (d/b, u/n)
• The ability to distinguish between visually similar letters, arithmetical symbols, and numbers (h-k, a-o, 7-4, 6-5) is severely lacking
• Inverted (left to right or right to left) reading or writing of numbers, for example 6 and 9
• Increasingly occurring copy errors
• Difficulties grasping amounts
• Omission of letters or numbers
• Difficulties with quantities over ten
• Difficulties with compound arithmetic problems
• Difficulties with structuring text exercises

Visual Memory

• Visual information is not retrained
• Difficulties in recognizing colours, shapes, images, patterns, and objects
• Memorization of word images does not succeed: words are often written properly ten times, then incorrectly again
• Difficulties with drawing patterns from memory
• Transposition of letters a-e-o, h-k, f-t, m-n
• The child cannot find his place in the text when reading
• Frequently checking the pattern while copying
• The writing is angular, curvatures and lengths are different
• The letters a-e-o appear the same

Visual Sequencing

• Visual sequences cannot be perceived properly
• Difficulties with grasping the succession of letters when reading together
• Reversing the sequence of letters when reading and writing
• Letters or syllables are missing, they are transposed or added
• Halting, slow reading
• Assistance articulating, prompting of a given text
• Switching the word order when writing
• Omission of letters, endings or words when writing
  • Duplication of letters
• Frequent subsequent additions of missing letters in a word
• Uneven line spacing and spaces of the letters within a word as well as between the words
• Reversal of the sequence of a story (for instance, while writing compositions)
• Distraction by small details and losing the place in the story
• Incorrect sequencing of numbers, omission of digits
• Difficulties counting and counting off
• Difficulties grasping amounts
• Slow learning of basic arithmetic skills
• Omission of intermediate steps when doing arithmetic

Acoustical Recognition

• The basics of the sounds heard cannot be grasped
• The ability to distinguish whether sounds are the same or not is severely lacking
• A sound is matched with the wrong letter
• Removing a letter from a word does not work
• Inability to distinguish between or transposition of similarly sounding noises, words or numbers
• Ability to distinguish between vocalized and non-vocalized consonants is severely lacking: g-k, b-p, d-t, s-z, f-v
• Ability to distinguish between diphthongs is severely lacking: ei-eu, eu-au
• Transposition of elongation and sharpening
• Difficulties distinguishing between m and n, for example between 3. and 4. case
• Difficulties repeating the same or similar words
• Difficulties repeating unfamiliar words
• Difficulties transcribing a series of spoken words

Acoustical Memory

• Cannot remember and repeat what was heard
• Frequent questions when reciting
• Omissions or additions of letters, syllables or words
• Failure to complete recitations
• Severe difficulty understanding what was heard
• Errors with b/p, d/t, g/k
• Poor vocabulary, frequent repetitions of words
• Short compositions with poor content
• Prompting of sentences
• Omission of parts of verbally assigned arithmetic problems
• Assistance articulating, prompting of a given text or arithmetic problem

Acoustical Sequencing

• Acoustical sequences are not perceived correctly
• Muddled explanations, loses the thread easily
• Difficulties with verbally presenting sentences with the correct word order and placed correctly in the thought process
• Difficulties avoiding becoming distracted by minor details when telling a story
• Halting, broken speech with inharmonious breathing

Spatial Orientation

• Spatial perception is not judged correctly
• Difficulties orienting oneself in an unfamiliar environment
• Ability to judge spatial and temporal measures (distances, amounts, and units) is severely lacking
• Memorizing a specified route is tiring
• Building to a pattern or blueprint (building games) is unsuccessful
• Difficulties learning to tell time
• Very slow learning to dress oneself
• Riding a bicycle and swimming are learned much later
• Ability to imitate rhythmic movements is severely lacking
• Problems with singing and movement games
• Ignoring given spatial instructions
• Uneven line spacing
• Cannot arrange the lines properly, writing outside the margins
• Losing the line when reading
• Inverted writing (right to left instead of left to right)
• Transposition of letters when distinguishing their position: b-d, b-p
• Numbers are transposed: 6-9, 36-63

Body Perception

• Difficulties orienting oneself to one’s own body
• Confusion between right-left, above-below, behind-before (in back of-in front of)