Dyspraxia and Issues with Physical Education - Article Example

Dyspraxia and Issues with Physical Education Introduction Dyspraxia or developmental dyspraxia is an impairment or immaturity of the organisation of movement (Dyspraxia Foundation, 2009). It is also known as developmental coordination disorder and clumsy child syndrome. According to the American Psychiatric Association (2001), developmental dyspraxia is "marked impairment of motor coordination which significantly interferes with academic achievement or activities of daily living and is not due to a general medical condition." Because of the difficulties children with dyspraxia have in demonstrating fine motor and gross motor skills, there is often confusion as to how to handle them in physical education sessions and whether to include them in sports. This confusion is more in cases of mild dyspraxics who are able to improve and do well with some amount of appropriate training and modulation. Inability to cope up with daily routines, poor performance in academics and physical fitness sessions and the stress of interventions, comments from peer groups and frustrations contribute to social isolation and psychological consequences in these children. This article deals with evaluation and analysis of issues and trends in physical education in children with dyspraxia, recognition of social processes and psychological issues in these children and whether these children should be segregated or included in physical education and sports. Discussion Developmental dyspraxia is mostly diagnosed in childhood. It occurs in 2 to 5% of children between the ages 5 to 11. It affects boys more than girls (Dorset Country Council, 1998). Infact, boys account for 70% of dyspraxic cases. The most important symptoms of dyspraxia are poor motor coordination, clumsiness, lack of movement fluency and the difficulty in application of motor skills mastered in one setting to another setting. Children with dyspraxia have difficulty in performing motor activities which require coordination like writing, cutting, building bricks, threading beads, ball skills, using cutlery at mealtimes and dressing. In physical education, they lack balance and stability and have difficulty in coordination of movement. The have difficulty in following instructions, remaining on task, articulation, paying attention, organization and time management. They have improper social skills, mathematical skills and literary skills and have difficulty in mixing with peers. They also do not exhibit age appropriate behavior (Dorset Country Council, 1998). Visual perception deficits and spatial awareness problems may also be there. The earliest sign of dyspraxia can be seen in preschool years when children are late in learning to sit, walk and run and show difficulty in hopping and skipping. The children also exhibit inordinate difficulty in fastening buttons, tying shoe lace and riding bike. Some children may exhibit speech and pronunciation difficulties. Dyspraxia may overlap with other conditions like Attention Deficit Disorder, Dyslexia, Aspergers syndrome and Disorder of Attention, Motor Control and perception. It is important to identify these associated conditions so that wholesome support and intervention can be provided. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the following criteria may be used to diagnose developmental coordination disorder. 1. Performance in daily activities that require motor coordination is substantially below given the persons chronologic age and measured intelligence. This change may manifest as marked delays in achieving motor milestones (e.g., walking, crawling, and sitting) and as dropping things, clumsiness, poor performance in sports, or poor handwriting. 2. The disturbance in criterion 1 substantially interferes with academic achievement or activities of daily living. The disturbance is not due to a general medical condition (e.g., cerebral palsy, hemiplegia, muscular dystrophy), and it does not meet criteria for a pervasive developmental disorder. 3. If mental retardation is present the motor difficulties are in excess of those usually associated with it. Dyspraxia is not a curable condition but early diagnosis and intervention can substantially decrease the motor difficulties in children. Children with dyspraxia will need school- based support and other forms of intervention and help from physiotherapists, occupational therapists, speech and language therapists, pediatricians and educational psychologists. In most of the children, these interventions will not be necessary indefinitely and basic skills like writing and eating will improve with minimal support. However, a few of them may need help even in adulthood (Dewey, 1995). The exact cause of developmental dyspraxia is unknown. Neurological immaturity is the most probable cause of this condition. Failure of the neurones of the right hemisphere of the brain to form precise pathways during the development of brain leads to lack of accuracy in the instruction of the brain for performing movements (Bowens and Smith, 1999). Prematurity and family history of coordination disorders or other developmental disorders increases the risk of this condition. Dyspraxia is enigma to many people. While many consider it as a medical disorder, some call it a social disorder (Gibbs et al, 2007). Children with dyspraxia have limited ability to mingle with other children, leading to lowered self-esteem, decreased self-confidence and social isolation. Problems with movement can contribute to knock-on-effects on social and family life and also on the achievements on the academic side. Low self esteem arises out of frustration and feelings of failure. In those with severe symptoms, behavioral problems may ensue because of inability to cope with the physical deficits. This in turn may have a devastating effect on the families too. According to Schaffer et al (1985) children with dyspraxia are at increased risk of hyperactivity, behavioural problems, aggressive activities and antisocial activities and these are again dependent on the social circumstances of the child. Decreased physical competency when compared to peers can make dyspraxic children feel depressed and withdrawn, become disruptive and attention seeking and underestimate themselves (Lacey, 1997). Children with dyspraxia have difficulty in adapting skills to different settings. This deficit in adaptability hinders their learning games and playing with other children. These children also have difficulty in taking care of themselves and performing routine day-to-day activities. The deficits in skills vary from child to child. While some children develop competence in certain areas and learn to compensate for the debilities, others are not able to do this. To improve social integration of the child, lots of public praise at the appropriate time must be offered (Barrettt et al, 1997). Children with normal motor skills development achieve gross motor skills like kicking a ball or catching a ball much before they master fine motor tasks like threading a needle and writing (Chesson et al, 1990). Those with dyspraxia have problems with both gross motor and fine motor tasks, thus making them difficult to participate in school physical education. These children have difficulty in planning and sequencing movements required by the action that is aimed at. The sequences in the action are full of confusion and non-fluent, because they tend to correct earlier mistakes at an inappropriate time during the course of action. When the child is subjected to pressure, these confusions are only exaggerated and performance worsens. That is why mild dyspraxics who have been doing well at home start experiencing problems after they enter school where they are expected to perform tasks within a time limit. Physical education at secondary levels poses a problem because there are more team games which are much more competitive and the dyspraxic youngster is made aware of his condition when he lets down the ball or misses it. These aspects make him unwelcome in the team (Boon, 2000). Posture is poor in dyspraxics and hand dominance appears very late. These children have defects with visual perception too. Hence they have difficulty in judging distances. Motor processing difficulties can affect articulation of mouth and tongue too and can lead to speech problems. Rarely, dyspraxic children can have deficits in kinesthesis and spatial awareness and this can make them bump into other people and objects. This may lead to name calling in the playground. Children with dyspraxia need special attention and individual coaching in physical education. Teachers must help the dyspraxic child adopt better and comfortable sitting posture. They must break down the physical activities into simple movement components so that the child is able to grasp the sequence of action. Dyspraxic children must be encouraged to play games that have control emphasis or are stopped on command. The environment must be an unpressurised one before allowing the children to participate in group activities. Physical educators must point out improvements and praise and encourage the children. They must encourage reflection and help the children develop a problem solving attitude. Many parents have poor understanding of the condition due to meagre information provided by health professionals. They also go through a great deal of stress while handling the child. The parents feel isolated, helpless, angry and depressed. Chesson et al (1990) reported that parents treat dyspraxic children different from normal ones causing feelings of low self-esteeem and frustration. Dyspraxic children vent their feelings of frustration on parents for failures in school (Gibson, 1996). Since dyspraxia has devastating psychosocial effects on the children and families (Chia, 1997), those suffering from the condition need social and emotional support interventions in addition to physical therapy. Schools need to have a sympathetic approach to these children (Daly, 1992). It is important to remember the fact that children with dyspraxia cannot learn by just watching others, they need to be taught the skills. These children will need hand-over-guidance to feel the movements. The instructions must be very clear and must be delivered one at a time, giving the child ample time to organize the body and place it in the right position. Since these children find it hard to throw, catch and hit balls, some modified equipment may be of use to help them participate in physical education. Large-sized bats, balls with ribbon tails and bean bags may be useful. Reinforcement of movement patterns can be made easier by using counting, music, rhyming or repetitive phrases. Using a gym mat, a hoop or a marked spot will help the child come back to that place when instructed. Cones and lines on floor can indicate the activity area and prevent the children from over shooting while moving around. Children must be encouraged to verbalize the plans of movement and beat their own records. Physical educators must concentrate on initial learning because this is the most impressionable part of learning and it is most often difficult to repattern an incorrectly learned skill (WiseGeek, n.d.). Grouping technique helps an athlete to learn and perform better. In this technique movements are chunked into larger movements (Integrated learning therapy, n.d.). Since children with dyspraxia cannot apply their skills in a team effort or in a changing setting, they prefer not to participate sports. Even when they do take part, the constantly are smitten by the feeling that they are the ones who are letting down the team. It may be appropriate for physical educator to allow dyspraxic children to concentrate on skill development rather than team games. Rewards and appreciation come a long way for these children. Non-competitive sports like climbing, rowing, martial arts, cycling, swimming and yoga are more appropriate for dyspraxics. As far as running is concerned, dyspraxic children are able to do well on tracks meant for running, but cross country running is not possible for them because of uneven ground. These children have increased risk of tripping and bombarding at other objects while cycling and hence must wear helmets (Dyspraxia Foundation, 2009). More and more organizations have now recognized the need to have special training and equipment for dyspraxics. Adaptive physical education classes help dyspraxics to take part in sports and Special Olympics. The prerequisite to participation is teaching motor skills (Cameron and Cappello, 1993). Conclusion Dyspraxic children find it difficult to take part in physical education and sports because of their debilitating fine motor and gross motor skills and also because they lack the capacity to apply skills learnt in one setting to another. Along with their physical impairment, feelings of inability to help their team make them feel frustrated and not take part in competitive team sports. While many dyspraxics, especially those with mild symptoms improve with training and do well even in sports, those who have higher grades of disability cannot make it. Dyspraxics do well in non-competitive sports and it is easier to train them in these. Physical educators must train these children on one-on-one basis and concentrate on improving skills one by one in an organized manner without creating a pressurized environment. References American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR). Washington DC: APA. Barrett, J. Ripley, K. and Daines, B. (1997). Dyspraxia : A Guide For Teachers and Parents (Resource Materials for Teachers). London: David Fulton Publishers, Ltd. Boon, M. (2000). Helping Children with Dyspraxia. London: Jessica Kingsley Publishers. Bowens, A. and Smith, I. (1999). Childhood Dyspraxia: Some Issues for the NHS. Nuffield Portfolio Programme Report No.2. 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