Dyspraxia in Kids on the Autism Spectrum

“My son with high functioning autism is nearly 5 years old and the problem is his clumsiness. I was always clumsy as a kid, which was blamed on my left-handedness, but his is extreme. Today he has dropped two drinks and spilt milk down himself. He is also left handed, but he is grown up for his age, seems very intelligent, and has no other health worries. Is this part of having AS …is it just a phase for his age …or could there be a neurological problem?”

Most children with Asperger’s (AS) and High-Functioning Autism (HFA) have a history of delayed acquisition of motor skills (e.g., hand writing, pedaling a bike, tying shoe laces, catching a ball, opening jars, climbing monkey-bars, etc.), which is called “motor clumsiness.” These young people are often visibly awkward, exhibiting rigid gait patterns, odd posture, poor manipulative skills, and significant deficits in visual-motor coordination. Although this presentation contrasts with the pattern of motor development in autistic kids (for whom the area of motor skills is often a relative strength), it is similar in some respects to what is observed in older people with autism.

Dyspraxia is a disorder that affects motor skill development. AS and HFA children with Dyspraxia have trouble planning and completing fine motor tasks. This can vary from simple motor tasks (e.g., waving goodbye) to more complex tasks (e.g., brushing teeth). Dyspraxia is a lifelong disorder, and its severity and symptoms can vary from child to child. Also, it can affect individuals differently at different stages of life. Dyspraxia can affect many basic functions required for daily living, and is often broken down into the following categories: 
  • Constructional Dyspraxia (i.e., establishing spatial relationships, being able to accurately position or move objects from one place to another)
  • Ideational Dyspraxia (i.e., multi-step tasks such as brushing teeth, making a bed, putting clothes on in order, buttoning and buckling)
  • Ideomotor Dyspraxia (i.e., completing single-step motor tasks like combing hair and waving goodbye)
  • Oromotor Dyspraxia (i.e., coordinating the muscle movements needed to pronounce words)

Dyspraxia often exists along with learning disabilities (e.g., dyslexia, dyscalculia, ADHD, and other conditions that impact learning). Weaknesses in comprehension, information processing and listening can contribute to the difficulties experienced by children with Dyspraxia. These young people may also have low self-esteem, depression and other emotional and behavioral issues.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

AS and HFA kids with Dyspraxia may experience several difficulties.

Younger kids have problems with:
  • Being sensitive to touch (e.g., being irritated by clothing on skin, hair brushing, nail-cutting, or teeth-brushing)
  • Bumping into things
  • Establishing left- or right- handedness
  • Learning to walk, jump, hop, skip and throw or catch a ball
  • Moving the eyes—instead, moving the whole head
  • Pronouncing words and being understood

School-aged kids have problems with:
  • Doing activities that require fine motor skills (e.g., holding a pencil, buttoning, cutting with scissors)
  • Making social connections due to speech challenges
  • Phobias and obsessive behavior
  • Playing sports, riding a bike and other activities requiring coordination
  • Poor pencil grip and letter formation and slow handwriting
  • Sensing direction
  • Speaking at a normal rate or in way that can be easily understood

Teens have problems with:
  • Clumsiness
  • Cooking or other household chores
  • Driving
  • Over- or under- sensitivity to light, touch, space, taste, or smells
  • Personal grooming and other self-help activities
  • Speech control (i.e., volume, pitch, articulation)
  • Writing and typing

Early identification and intervention can greatly help an AS or HFA child with Dyspraxia. Depending on the severity of the disorder, therapy from occupational, speech and physical therapists can improve the child's ability to function and succeed independently. The following therapies most commonly help these young people:
  • Speech and language therapy: The speech and language therapist will first carry out an assessment of the youngster's speech, and then help him communicate more effectively.
  • Perceptual motor training: This involves improving the youngster's language, visual, movement, and auditory skills. A series of tasks, which gradually becoming more advanced, are set. The goal is to challenge the youngster so that she improves, but not so much that it becomes frustrating or stressful.
  • Occupational therapy: An occupational therapist will first observe how the youngster manages with everyday functions both at home and at school. The therapist will then help the youngster develop skills specific to activities which may be troublesome.
  • Active play: Experts say that “active play” (i.e., any play that involves physical activity), which can be outdoors or inside the home, gets the motor activity going in AS and HFA kids. Play is a way these young people learn about the environment and about themselves (particularly for those aged 3 to 5). Active play is where the youngster's physical and emotional learning, the development of language, special awareness, the development of what his senses are, all come together. The more these kids are involved in active play, the better they will become at interacting with others successfully.
  • Equine therapy: A team researchers evaluated the effects of equine therapy (i.e., therapeutic horse-riding) on a group of 40 kids aged 6 to 15 years with Dyspraxia. These young people participated in six horse-riding sessions lasting 30 minutes each, as well as two 30-minute audiovisual screening sessions. The researchers found that riding therapy stimulated and improved the child’s cognition, mood and gait parameters. The data also pointed to the potential value of an audiovisual approach to equine therapy.

Problems with Handwriting in Children with Asperger's and High-Functioning Autism:

AS and HFA children with Dyspraxia need help practicing simple tasks. Beginning at an early age, it is vital that moms and dads offer patience, encouragement, help and support. These young people often benefit from step-by-step progress into more complex activities. You can start with easy physical activities that develop coordination, and then move on to the more complicated tasks.

Here are just a few ideas that will help you make daily life easier for your AS or HFA youngster:
  • Avoid tight neck holes
  • Baggy t-shirts and shorts are easy and comfortable
  • Buy trousers with an elasticated waist to save dealing with buttons and zips
  • Don't fill cups too full
  • Keep keys and purses on a long chain which clips to clothing
  • Keep to a daily routine
  • Lay out clothing layer by layer, underwear on top
  • Post-it notes stuck at eye-level on doors are useful reminders
  • Shirt collars one size larger are easier to fasten
  • Sit down to eat
  • Transparent purses and pencil cases are good for being able to see contents easily
  • Trousers with a pleat at the front make identifying the 'right way around' easier
  • Use a damp towel under plates to stop them moving
  • Use a flexible straw when drinking to prevent spills

 ==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

Here are a few activities designed to help your AS or HFA child practice and develop “fine” motor skills:
  • Artwork like drawing, painting, pasting, and cutting are wonderful motor skill exercises.
  • Cut out animal shapes, then punch holes around the edges and have your youngster thread yarn. 
  • Cutting skills should be practiced (e.g., cutting forward on a line and moving the paper with the guiding or non-cutting hand). 
  • Even scribbling will encourage handwriting later.
  • Fill an egg carton with little snacks (e.g., goldfish crackers, Hershey Kisses). 
  • Help your child develop the ability to color within the lines. 
  • Help her develop the ability to copy lines, circles and crosses, and trace diamonds or triangles. Help develop a tripod grasp or a mature pencil grip, taking the pencil between thumb and index finger and resting on the middle finger. 
  • Jigsaw puzzles and light brite help greatly with fine motor skills.
  • Legos! As far as simple fine motor skills activities go, they are very popular!
  • More advanced skills such as adept use of silverware or tying shoelaces should be practiced. 
  • Peel stickers off of a cookie sheet and stick them onto paper.
  • Picking up and laying down pennies is a great exercise.
  • Picking up and sorting beads with clothespins is a good challenge.
  • Play “Scatterpillar Scramble” (a game you can buy at Target or Walmart).
  • Play dough provides four different types of motor skill fundamentals: cutting, rolling, squeezing and stamping.
  • Practice skills such as tying shoes, fastening buttons, zipping and snapping clothing. 
  • Put thin dowels into Styrofoam and put beads on them! 
  • Stringing beads, or even better - cereal with holes is another wonderful exercise.
  • Tape paper under a coffee table or other low surface and have your child lay on his back and draw on the paper.
  • Teach increasingly sophisticated finger motor tasks like playing video games, completing puzzles, playing instruments, and typing on a computer keyboard.
  • Tongs are fun to grab pompoms and sort into different color bowls.
  • Try tearing strips of paper from old phone books (the paper is thin and generally tears in a straight line).
  • Using short pieces of chubby crayon encourages a natural grasp.
  • Using simple hand movements while listening to songs helps kids build fine motor skills.
  • Water play using eye droppers and colored water to explore with is fun.
  • Writing and drawing on vertical surfaces strengthens core and arm muscles as well as fingers.

Here are a few activities designed to help your AS or HFA child practice and develop “gross” motor skills:
  • Balancing (e.g., on a low beam or plank at the playground, or a homemade balance beam)
  • Building and navigating obstacle courses indoors (e.g., with furniture, pillows, boxes, blankets, etc.) or outdoors (e.g., with rocks, logs, playground equipment, etc.
  • Cooking (includes pouring, shaking, sprinkling, kneading, tearing, cutting with butter knife, etc.)
  • Dancing (e.g., freestyle or through songs with movements)
  • Finger plays (e.g., songs like "The Itsy Bitsy Spider")
  • Large-scale arts and crafts activities
  • Manipulative toys like blocks, puzzles, or dolls with clothes to take on and off
  • Marching, jogging, skipping, and hopping, or musical instruments to form a parade
  • Playing pretend (e.g., the child uses her body to become a waddling duck, stiff-legged robot, galloping horse, or a soaring plane) 
  • Playing tag or other classic backyard games (e.g., Follow the Leader, Red Light/Green Light, Tails, Simon Says, Duck Duck Goose, Musical Chairs, etc.)
  • Pulling or pushing wagons, large trucks, doll strollers, or shopping carts
  • Puppet shows
  • Riding tricycles, scooters, and other ride-on toys
  • Sand play
  • Sidewalk chalk or any art project
  • Swimming and other water play 
  • Swinging, sliding, and climbing at a playground or indoor play space
  • Throwing, catching, and rolling large lightweight soft balls

From the first days of life, kids begin using their bodies to learn about the world around them. Motor experiences are the basis for all intellectual functioning for approximately the first 2 years of life. As young people continue to mature, their reliance on physical interactions with people and objects remains strong. Motor skills are an essential component of development for all children.

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