Steady progress

The dyspraxic student cannot avoid being clumsy, but interventions help, says Reva Klein

Sean was a laugh at school. A class clown. His long-suffering teachers would take a deep breath and think, "Here we go again" as the class erupted in laughter each time the boy made a comic turn out of falling over a chair, bumping into a wall or tripping over his own feet - which happened with unfailing regularity.

What other children saw as comic genius and his teachers believed was attention-seeking behaviour, his mother knew was a desperate defence mechanism. When you are dyspraxic, like Sean, it makes sense to make a virtue - or at least a joke - out of necessity. While Sean made out that he was being clumsy and bungling on purpose, the truth was that he could not help falling, tripping, dropping and bumping into things.

Trish Pullen knew instinctively that Sean was not quite right from birth. He was late with all his milestones such as sitting up, crawling, walking, talking. It took her three years to get a referral to a paediatric consultant because other health professionals thought she was being over-anxious about the boy's lack of co-ordination. This included speech difficulties as a result of problems co-ordinating his tongue. The paediatrician labelled his problem minimal cerebral dysfunction, a catch-all term that did, however, give him access to a physiotherapist and speech therapist.

Sean started at a mainstream primary school and Trish watched as he fell further and further behind his classmates. What he did learn quickly and adeptly was how to act the fool in order to hide his lack of co-ordination; his frustration also led him to become disruptive in order to get attention. Things deteriorated until, when he reached the age of 10, Trish made the difficult decision of moving him to a school for children with moderate learning difficulties.

The situation improved in some ways for Sean by being in a class of 10 at most and following an individual teaching programme, but his frustrations did not abate. Neither did the behaviour problems that resulted from those frustrations. Now 19, he is at a college in his home town of Aylesbury, following a vocational special needs course. It is not the answer to his problems, but it is one of the few options available to people with problems like Sean's. Trish says: "When he does painting and decorating he gets more paint on himself than on the walls because of his clumsiness. Luckily, he has a great sense of humour."

Dyspraxia is everywhere you look, although many people do not know the name of the physical awkwardness and absent-mindedness that they are seeing. It used to be known by the term "clumsy child syndrome", which, while disconcertingly blunt, actually says it all. Between 2 and 5 per cent of the population is believed to have the condition. Classified as a neurological disorder, it is a dysfunction in the way that messages are processed by the brain. In the school-aged child, it will show itself by the following features:

* poor gross and fine motor co-ordination, causing poor control of implements such as pencils and paintbrushes;

* difficulties with balance, causing frequent tripping and falling over; poor perceptual skills, causing difficulty in understanding the differences between shapes and in using constructional toys;

* poor conceptual skills of, for instance, maths;

* short attention span and short-term auditory memory, causing difficulty in following directions;

* under-developed social skills;

* problems with activities such as dressing, tying shoes;

* unestablished laterality, causing the child to use the right hand to complete tasks on the right side of the body and the left hand for tasks on the left side;

* awkwardness in PE and dance;

* poorly developed organisational skills;

* lack of awareness of potential danger.

Given the complexity of dyspraxia, the incidence of it (estimated by the Dyspraxia Foundation as affecting one child in every classroom in the country) and its high incidence of being accompanied with conditions such as attention deficit hyperactivity disorder, Asperger's syndrome and dyslexia, teachers need to be aware of what to look out for and how to deal with it. But only 50 per cent have even heard of dyspraxia, according to a survey carried out by the Dyspraxia Foundation, and far fewer know how to manage it in the classroom.

Madeline Portwood, educational psychologist for Durham education authority and chair of the Dyspraxia Foundation's education committee, was so concerned about the lack of understanding and expertise in dealing with dyspraxic pupils that she set up what is probably the most comprehensive training programme for teachers on dyspraxia in the country. Focusing on early identification and guidelines for establishing school-based intervention programmes, the training has reached more than 800 teachers in Durham. As a result of her initiative, which includes checklists and screening procedures for teachers to use and an intensive programme of physiotherapy and speech therapy, the majority of children are so improved after two terms that they no longer need special intervention. "More than 60 per cent can be turned around if intervention comes early," says Ms Portwood. "And an important element in effective intervention is making both classroom and home more compatible with their needs."

Given that only a quarter of children are recognised as dyspraxic when they start school, the first step for teachers is understanding why these children are tripping over themselves all the time to the delight of their classmates.


* Be sensitive to pupil's difficulties and devise strategies to minimise the frustration they have, particularly in relation to written work.

* Break down activities and tasks into smaller components.

* Offer encouragement to prevent the child feeling a failure.

* Teach the child strategies to improve memory and organisation, such as a diary and lists.

* When dictating, keep the number of words to a minimum and ask the child to repeat instructions.

* Make sure that all instructions are clear and precise, even if you seem to be stating the obvious.

* Because of poor visual memory, do not expect the child to be able to copy large blocks of text. Instead, use tricks to help with copying from the board such as using different colours for each line or a ruler to copy text line by line * Allow the child to complete a task before moving on to the next one, to avoid leaving them with a sense of failure.

* If needed, provide help for the child to find their way around school.

* If the child is unable to take part in a game in PE, enlist the advice of medical professionals to give the child activities that draw on their strengths and, when their involvement in a team game could be problematic, offer attractive alternatives.

* Allow access to wordprocessors, laptops or palmtops if available. Better still, a voice-processor with at least 80 per cent accuracy can be tremendously helpful.

* Work with parents. They know their child better than anyone else.

* Ensure good liaison with medical professionals.

* Encourage a close relationship with another child, who can act as a guide especially in the first few months after secondary transfer.

The Dyspraxia Foundation is a national charity promoting the awareness and understanding of dyspraxia and supporting families affected by it. It publishes information, organises conferences and has local groups across the United Kingdom. "Stepping Forward", a conference for teachers and other professionals working with dyspraxic children, young people and adults, takes place September 22-23 at Durham University.

For more information about the conference and general information about dyspraxia, contact the Dyspraxia Foundation, 8 West Alley, Hitchin, Herts SG5 1EG. Tel: 01462 454986455016.

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