As an occupational therapist, I’ve had parents come to me with concerns about their child’s “clumsiness.” They worry that their child might have a motor skills issue. And if they’ve heard the term dyspraxia, they may ask about that condition specifically.
It’s a tricky topic. Being physically awkward or clumsy can be the result of a number of things—or of nothing. It could be a sign of a motor skills issue or dyspraxia, but it isn’t always a sign of a bigger problem. Some kids are just…well…clumsy.
It’s also a common myth that kids with dyspraxia are “just being clumsy.” But when kids with dyspraxia appear awkward or “out of sync” with their physical environment, it’s because they have a brain-based issue that makes it hard to plan and coordinate physical movement.
Often, concerned parents have seen something in their child that’s different from other kids. Perhaps they’ve noticed that she isn’t able to perform as well at sports or in dance class as her peers or siblings.
That alone usually isn’t cause for alarm. Some kids are just less coordinated than others, without having a significant issue. But when difficulty with motor skills appears in other areas, or creates a lot of challenges, it can raise a flag.
Often, those problems show up in school. A teacher may notice that a child has trouble joining in with friends during games that require motor skills. The child might also have a hard time imitating new motor actions when she’s singing songs or engaging in learning activities at school. Or she might show a lack of interest in (or have a hard time learning) activities that involve fine motor skills.
My role is to evaluate all of a child’s motor skills, including motor planning (learning new motor actions quickly with brief practice). I start by taking a history to find out if the child reached developmental milestones at the typical time. That includes things like crawling and walking.
Then I use standardized testing to assess her motor skills. Those tests involve motor tasks like throwing a ball and balancing on one foot. I observe how she performs motor actions, keeping in mind the typical strength and coordination of kids at her developmental level.
I also look at other abilities that involve movement. How does she do with navigating an obstacle course? How is her motor planning?
Finally, I look at non-movement factors that might play a role. Lack of core muscle strength is one. (Muscle weakness is not a sign of dyspraxia.) Inattention is another. I might also look for problems with visual-motor skills and handwriting.
In the end, I review all the findings to determine if the child needs occupational therapy. It really comes down to how great the child’s difficulties are and what benefit therapy might offer. Is she generally functioning well, even with some motor weaknesses? Or are her weaknesses getting in the way of learning and everyday living?
If there are other concerns related to motor planning or attention, I might suggest further evaluation. A neuropsychologist or a clinical psychologist can test for and diagnose dyspraxia and other learning and thinking differences that might be at play.
So, what do I tell parents who are concerned about their child’s clumsiness? I explain that kids all develop different skills at different rates. Some may have to work harder and practice longer to learn new skills. This doesn’t always mean they have a condition like dyspraxia or another learning or thinking difference.
But I also tell them that they know their child best. If they continue to be concerned, they should definitely talk to their pediatrician. Together they can decide whether it’s a good idea to get a formal evaluation.
Learn more about the signs and symptoms of dyspraxia. Find out what school accommodations might help. And if you’re concerned your child might have dyspraxia, find out what to do next.
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About the author
About the author
Keri Wilmot is an occupational therapist who works with children of varying ages and abilities in all areas of pediatrics.