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windylou

Dyspraxia and Asperger's overlap.

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Hi, my son has been referred to the OT for assessments for possible dyspraxia, as the title says may be overlapping his AS. I have just had a phone call from the EP (she was copied in the referral letter by the paediatrician) she has briefly observed my son in class today and he has really good pencil grip, was writing very small numbers at the time, his written work is a bit big that's all, and he didn't seem anxious. Therefore she does not believe he has any problems with his fine motor skills, and has made a note of it on his file.

 

My son can't do up his buttons he will attempt but get very frustrated and I end up doing it, Will not even attempt to do his zips, he can tie a shoe lace. He struggles with written work. Can write neatly but it takes him a long time, very upset at mistakes. The faster he tries to write the messier it gets and the more upset he gets over his mistakes. These are but a few difficulties.

 

The question is can dyspraxia be ruled out purely because of what the EP has said? Can his ability to do these things change from day to day? today being a good day?

 

I didn't go through all the difficulties I see with my son with the EP because I am sick of repeating myself. So I will be saving this for the OT appointment.

 

Feeling rather annoyed right now.

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Hello, Special_talent Thanks for the reply.

 

My son falls all of the time. Trips over his own feet. Has actually fallen face first and hurt his nose just from turning around. Never seems to get his hands out quick enough to catch his fall. Struggles to catch a ball. Avoids football or riding a bike because he said it is dangerous but he only decided this because he falls over the football when he tries to kick it, and he just tips to one side if he is on his bike....even manages to tip his bike with stabilizers on. When he was smaller we always thought he was clumsy (sorry) when he turned 5 he ended up with glasses because one of his eyes were very weak so this made sense as to why he was clumsy. He always misjudges picking up his drinks we realized that we have to remind him to concentrate and use both hands every time he has a drink. Won't use cutlery...never has but then he has always said it's because he likes to feel the texture of his food so not too sure about that. Drops his drinks, pencils and gets very frustrated with himself. Needed lots of encouragement to reach his milestones even though he did at the very end of the average bracket. And that is just the half of it!

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Just write all these things down and give them to the OT.

There are assessments she should do for dyspraxia, both physical and mental ones.

But everything you have said sounds like my son.

He cannot hold a drink and talk, or watch TV without spilling it.

He cannot brush his teeth or ride a bike - he has learnt to tie his laces.

He recently seems to be better at cutting up his food - previously it would shoot all over the place.

He often misjudges things.

He finds writing very tiring.

He finds physical activity tiring.

He struggles in any kind of group/ball game. He usually ends up running behind the group that have the ball!

 

Yes some days can be better than others. And what the EP write might actually highlight dyspraxia ie. having to concentrate and write so small.

 

Our OT did not diagnose for some years. She did say he had "motor co-ordination difficulties", which is what dyspraxia is. But she said that because NHS OT services do not provide any input for Dyspraxia. The NHS don't fund it. So she gave me some exercises to do with him at home. Unfortunately, for him and us, that was not enough, and this difficulty, along with many more, were not supported and it all fell apart for him some years ago and he refused school and became very anxious. I personally think he had some kind of breakdown. But it resulted in him getting a further diagnosis of an Anxiety Disorder and OCD.

 

When we saw the CAHMS Psychiatrist, she asked my son to try to very very quietly open the door. Then to try very very quietly to close it. He was concentrating so much on being quiet, that on both occasions he nearly fell over because he forgot to move his feet as he was opening/closing the door. So the Psychiatrist said he had "dyspraxic tendencies". [No-one seems to like to name the elephant in the room due to the funding implications!"

 

So I wrote to the OT again, and told her what the CAHMS Psychiatrist had said. And I said his Statement, by law, must identify each and every need. So I asked her to confirm or deny that he had Dyspraxia. She confirmed he had Dyspraxia. I also asked her to confirm that the NHS do not provide any 1:1 OT therapy for Dyspraxia [or Sensory Integration Therapy for your information]. And she confirmed that.

 

So at our Tribunal that helped us secure an independent school placement which had OT's on site that did work on these diagnosis. As that was the ONLY placement where he would receive any therapy, and he wouldn't in any LA mainstream or special school and he would receive it via the NHS either.

 

So very important that you slowly start to get all these details and information in writing. For the time being I would concentrate on meeting the OT and asking her to use standardised assessments to determine if he has Dyspraxia. If you suspect he has a Sensory processing Disorder too I would recommend that you speak with her about that as well, and also ask for standardised assessments [such as the Winn Dunn] to be carried out. Then when you get home type up a letter of what you discussed and what you asked her to do, and anything she has said to you and send it to her. You can only submit written evidence if and when you need it.

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This is a link to a publication by the College of Occupational Therapists UK.

 

As you will see from this publication, they take Dyspraxia and the prognosis for those children VERY seriously as a professional body.

 

Yet the NHS provides nothing.

 

I printed off this document and included it in my evidence. Dyspraxia is proven to give children poor life outcomes due to the severe difficulties it causes for those children and how it affects their progress academically and socially.

 

http://www.cot.co.uk/sites/default/files/publications/public/doubly-disadvantaged.pdf

 

This publication from the COT itself is strongly recommending that OTs are given funding to assess and provide therapy for these children. But so far it is not happening. It makes worrying reading.

 

As a parent with a child with Dyspraxia, I know how it affected my own sons self esteem and confidence, and still does now. It is grossly underestimated difficulty that affects both movement and throught processes such as sequencing.

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Thanks, I can't sleep because I'm so annoyed (that's really bad isn't it, not sleeping due to something so miniscule). Just wish someone would listen. It's not like I've only known my son for 12 months like they have. Oh well the answers that I gave to the peadiatrician's questions were enough for her to refer to OT. I will just wait to see what the OT has to say. Just can't believe the EP ruled it out after a 2 minute observation.

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Thanks, will do. I will ring the OT department and see how long the waiting times are, I think the sooner this is done the better.

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Have you read the document I linked to my post? See what the OT says, but if they try to fob you off you have their own Professional Bodies report about Dyspraxia and how important it is that the child is assessed and given support and therapy. This isn't a mniscule problem. It is a life long difficulty that will impact on all aspects of his life.

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