Let’s start by talking about dyspraxia, formally known as Developmental Coordination Disorder (DCD). This umbrella term encompasses a condition that is fully classified as a neurodevelopmental disorder within the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 and DSM-5-TR).

Dyspraxia in the Diagnostic Context: DSM-5 and DSM-5-TR

The DSM-5, published in 2013, marked a fundamental step in the recognition of dyspraxia, formally identifying DCD as a neurodevelopmental disorder. Its diagnostic criteria focus on significant difficulties in acquiring and executing coordinated motor skills. It’s crucial that these difficulties are not just minor but interfere clinically significantly with an individual’s daily life activities, and/or their academic/occupational performance. This isn’t a matter of willpower or effort, but an intrinsic difference in how the brain processes and organizes movement.

With the release of the DSM-5-TR in 2022, the diagnostic framework remained consistent. No changes were introduced to the specific diagnostic criteria for Developmental Coordination Disorder. Any revisions in this manual version primarily concerned updates to the descriptive text, epidemiological statistics, or clarifications of certain formulations, without altering the substance of the essential diagnostic criteria. This means that the fundamental understanding of DCD, as outlined in 2013, has been maintained and consolidated.

Debunking the Myth: Dyspraxia is Not Just Clumsiness

Dyspraxia is, therefore, recognized as a specific neurodivergence, characterized by significant difficulties in the planning, execution, and automatization of movements. These difficulties are not attributable to other medical or neurological conditions and substantially interfere with daily life activities, academic/occupational performance, and social participation.

It’s crucial to debunk the common myth that dyspraxia is synonymous with simple “clumsiness” or intentional “lack of attention.” This is a misguided and harmful belief. On the contrary, dyspraxia is a neurological condition that affects how the brain processes sensory and motor information, and consequently, how it sends commands to the body to perform coordinated actions. It is therefore not a lack of effort, willpower, or intelligence on the individual’s part. People with dyspraxia often have to exert considerable cognitive effort to perform tasks that are automatic and intuitive for others. Imagine having to consciously think about every single step to take a walk or every movement to grasp a glass; this is the kind of effort a dyspraxic person might experience in daily activities.

The Multiple Manifestations of Dyspraxia: Beyond Physical Movement

The manifestations of dyspraxia are broad and can affect various areas of life, extending far beyond simple physical movement. They are not limited to a single aspect but touch various levels of motor and cognitive functioning:

• Gross Motor Coordination: These are the most visible difficulties. They manifest in activities requiring large movements and body coordination, such as walking smoothly and gracefully, running without tripping, maintaining balance (e.g., standing on one leg), riding a bicycle, or participating in team sports that demand quick and complex reactions.
• Fine Motor Coordination: Problems extend to activities requiring precision and manual dexterity. Think of legible and fast handwriting, tying shoelaces, using cutlery efficiently at the table, buttoning clothes, or manipulating small objects with precision. These actions, which are automatic for most people, can demand immense concentration and effort for a dyspraxic individual.
• Planning and Sequencing (Ideational Dyspraxia): One of the most complex and often underestimated manifestations is the difficulty in conceiving the idea of an action and planning the correct sequence of steps to carry it out. This applies even to seemingly simple tasks, such as preparing a multi-stage meal, assembling furniture by following instructions, or organizing a complex activity with multiple steps. This difficulty is not related to memory, but to the ability to “order” the steps.
• Eye-Hand Coordination: This refers to problems in coordinating visual information with hand movements. This is essential for activities like catching a ball, drawing precise lines, cutting with scissors, or navigating complex environments without bumping into objects.
• Oral/Verbal Dyspraxia: In some cases, difficulties extend to speech production. There may be problems with word scanning, clarity of speech (speech may seem clumsy or “mumbled”), modulating voice tone and volume, or overall speech fluency. This can make verbal communication more challenging for both the speaker and the listener.

Impact and Recognition of Dyspraxia

Dyspraxia affects approximately 5-6% of the population, with a higher incidence in males. It is crucial to understand that, contrary to popular belief, it is a condition that often persists into adulthood. Many dyspraxic adults have spent their childhood and adolescence without a diagnosis or understanding of their difficulties, attributing them to personal flaws.

Its consequences can be significant, deeply impacting personal autonomy (e.g., dressing, cooking independently), academic and occupational performance (e.g., difficulties with writing, task organization, meeting deadlines), social participation (leading to avoidance of sports or group activities due to embarrassment or effort), and, naturally, the individual’s self-esteem and psychological well-being. The constant feeling of not being good enough or having to work twice as hard for simple tasks can generate frustration, anxiety, and even depression.

Recognizing dyspraxia is the first and most fundamental step in providing adequate support. An accurate diagnosis and increased awareness, both for the individual and their surrounding environment (family, school, work), allow for the development of effective compensatory strategies, the request of reasonable accommodations, and the promotion of a more inclusive environment, enabling dyspraxic individuals to fully express their potential.

For further reading

Oltre l’Etichetta: le Neurodivergenze nell’Adulto

Corso professionale completo: valutazione e trattamento delle neurodivergenze negli adulti

Supervisione Neurodivergenze

Silvia Garozzo

Psicologa, Psicoterapeuta, Didatta, Supervisore