Difficult conditions

10th October 1997 at 01:00

Carolyn O'Grady reports on a centre in Cardiff that specialises in helping children who have dyspraxia and dyslexia

From when she was very small, Cassia Flick was a puzzle to her family and school. She was, and is, healthy and of average intelligence. But even now, at the age of eight, she can't tie her shoelaces or use a knife and fork, draws rather like a three-year-old and has difficulty dressing. Although she has a sweet, warm nature, she doesn't relate easily to other children, partly because her eye contact is poor and her speech patterns are odd.

The school she attends "has been fantastic", says her mother Rebecca. It arranged an assessment with an occupational therapist and appointments with an educational psychologist. Her GP referred them to a child guidance clinic. But until recently everyone remained baffled by her condition.

Then this year Cassia's grandmother, who is a paediatric social worker, suggested that perhaps Cassia was dyspraxic - unable to make skilled movements with accuracy. She had read about the condition in connection with a new centre that opened in Cardiff in September to offer help for children and parents with both dyspraxia and dyslexia. The Flicks got in touch with the centre - and are now confident that Cassia suffers from dyspraxia.

The Dyscovery Centre is the brainchild of Dr Amanda Kirby, a GP who also writes on health matters and presents a regular health programme for BBC Wales. She is now director of the centre. As the mother of a child with dyspraxia and dyslexia, her experience was similar to that of the Flicks.

Few people are aware of dyslexia and dyspraxia, she says. "The services are very fragmented. These children need speech and language therapists, occupational therapists and physiotherapists. They need behavioural optometry, to encourage them to use their vision appropriately, for example to scan pages properly. And some need psychologists, because older children especially can develop behavioural and social problems if their difficulties are not addressed.

"At present there is no integrated approach, no co-ordination. Parents drag their children round from one service to another and each specialism has a different view on the subject. As a GP I thought: if I don't know how to access information and help, how is it for those who aren't in the system?" Dr Kirby's response was to suggest a one-stop shop for assessment, treatment and support to Healthcall, an independent provider of primary healthcare services. The company responded by letting her use premises for a multi-disciplinary assessment and treatment centre. The building has consultation rooms, a large exercise room equipped with special equipment, a boardroom that doubles as a teaching room and reception.

The Dyscovery Centre is not a charity and its services are not cheap: an assessment with leading therapists costs Pounds 220 and Pounds 100 for each additional therapist involved.

Treatment is multidisciplinary. On the staff are nine specialists working in different areas with psychologists and paediatricians available as consultants.

Parents who contact the centre are usually sent a questionnaire to discover whether the centre can be of use. At this stage, care has to be taken not to raise false hopes in parents who are looking for solutions to other problems, such as autism or mental health difficulties. Child and parent may then come to the centre for an assess- ment, after which they are given a report on the child's needs and appropriate help. Alternatively, they may be referred to another specialist or back to their GP.

The centre offers group or individual sessions for those who live locally (individual sessions cost from Pounds 20-Pounds 40; group sessions from Pounds 5-Pounds 25), and resource packs, backed up with telephone assistance for those who don't. This service costs about Pounds 40 a month depending on how many telephone calls are needed. Weekend and half-term workshops on, for example, social skills and handwriting are also held at the centre.

A bank of materials and fact sheets covering the various therapies and their benefits is also under development. "We want parents to understand what they are getting", says Dr Kirby. "The language can be difficult. When they are told that a child has `2 per cent auditory discrimination', for example, what does it mean?" (For the record, it means that a child has normal hearing but great difficulty in distinguishing different sounds.) The centre is now beginning discussions with South Glamorgan education authority on the possibility of researching and devising a screening package for schools and health visitors to help them identify children with dyspraxia or dyslexia.

It has also set up a Royal Society of Arts Certificate and Diploma for Teachers of Learners with Specific Learning Difficulties.

The Dyscovery Centre, 12 Cathedral Road, Cardiff CF1 9LJ. Tel: 01222 788666. On October 9 the centre is organising a teachers' awareness evening on dyslexia and dyspraxia which will include information on the RSA certificate and diploma.

DYSLEXIA AND DYSPRAXIA: THE FACTS

It is estimated that about 10 per cent of children are dyslexic to some degree. A specific learning difficulty that hinders the learning of literacy skills, dyslexia is a problem with managing verbal codes in memory. It is neurologically based and tends to run in families. Other symbolic systems, such as mathematics and musical notation, can also be affected. The effects can be alleviated by skilled specialist teaching.

Dyspraxia is an impairment or immaturity of the organisation of movement. It can also beassociated with difficulties of perception, language and thought. Children with dyspraxia are not just a little clumsy or late in learning to do everyday tasks, but have extreme difficulty in learning motor skills.

It is estimated that about 6 to 10 per cent of children are dyspraxic to one degree or another. Children with dyslexia and dyspraxia are healthy. They are of normal intelligence and do not have any known brain disorder.

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