Diagnostic Criteria (DSM-5, 2013:74)
DSM-5 classifies DCD as a discrete motor disorder under the broader heading of neurodevelopmental disorders. [2] The specific DSM-5 criteria for DCD are as follows:
- Acquisition and execution of coordinated motor skills are below what would be expected at a given chronologic age and opportunity for skill learning and use; difficulties are manifested as clumsiness (e.g. dropping or bumping into objects) and as slowness and inaccuracy of performance of motor skills (e.g. catching an object, using scissors, handwriting, riding a bike, or participating in sports)
- The motor skills deficit significantly or persistently interferes with activities of daily living appropriate to the chronologic age (e.g. self-care and self-maintenance) and impacts academic/school productivity, prevocational and vocational activities, leisure, and play
- The onset of symptoms is in the early developmental period
- The motor skills deficits cannot be better explained by intellectual disability or visual impairment and are not attributable to a neurologic condition affecting movement (e.g. cerebral palsy, muscular dystrophy, or a degenerative disorder)
Definitions used for Dyspraxia/DCD in Ireland
The terms ‘dyspraxia’ and ‘DCD’ are used interchangeably to describe this condition in Ireland. The Department of Health and the Department of Education and Skills (DES) use the term ‘dyspraxia’ and list it a physical and sensory disability. The NCSE (2011) uses the term ‘dyspraxia’ and list it as a low incidence physical disability with an entitlement of 3 hours additional Resource Teaching per week. Dyspraxia DCD Ireland (2016) uses the term Dyspraxia/DCD to define the disorder.
Identification and Assessment of Children with Dyspraxia/DCD
In Irish Primary Schools, early identification and intervention is the policy of the DES with a staged approach to identify all children with SEN and to provide suitable provision for them (DES, Circulars SP Ed, 24-03; 02-05; NEPS, 2007).
At Stage 1 of the assessment process
Class Teachers may identify children’s difficulties with the help of checklists, indicators and developmental profiles. (Addy, 2003; Drew, 2016; Macintyre, 2001; Portwood, 2000). A short support plan is devised and delivered preferably with the support of the children’s parents.
At Stage 2 of the assessment process
Children who are identified with mild characteristics of dyspraxia/DCD will be referred to support Teacher/s for supplementary teaching. The school will seek a formal assessment for children who have more severe characteristics of dyspraxia/DCD.
At Stage 3 of the assessment process
Children who are formally diagnosed with Dyspraxia/DCD which is a low incidence Physical and Sensory disability are entitled to 3 hours additional Resource Teaching per week.
Formal Assessment
This seldom happens before the child’s 5th birthday. The following is considered good practice:
An in-depth profile of the child is assembled through input or interviews from Parents, Teachers, Child, results of informal and formal school assessments to inform formal assessment. Then the child is usually referred to one of the following Health Professionals:
- Occupational Therapist (OT)
- Physiotherapist
- Speech and Language Therapist (SLT)
- Neurologist or Paediatrician
- Educational Psychologist (EP)
Causes of Dyspraxia/DCD
Most researchers claim that there is no known single cause for Dyspraxia/DCD but a number of interdependent factors including neurological, genetic, hereditary, nutritional and environmental factors may cause an immaturity of neurone development in the brain. The DSM 5 states that impairments in the underlying neurodevelopmental processes especially in visual motor skills have been found but concludes that the neural basis for DCD remains unclear.
Prevalence of Dyspraxia/ DCD
5%-6% prevalence rate of children aged 5 to 12.
Co-occurring Disorders with Dyspraxia/ DCD
It is internationally recognised that Dyspraxia/DCD frequently overlaps with another disorder.
‘Disorders that commonly co-occur with DCD include speech and language disorder, specific learning disorder (especially reading and writing), problems of inattention including ADHD (the most frequent coexisting condition with about 50% co-occurrence), autism spectrum disorder, disruptive and emotional behaviour problems and joint hypermobility syndrome’ (DSM-5, 2013:77)