Abstracts for September Conference

Abstracts for papers and posters accepted for the Professional Conference 2002 at Brighton on September 13/14

Paper presentations

Title: Tension, Anxiety and the Assessment and Treatment of Dyspraxia Patricia Sims MRCSLT, The Nethercott Practice, Braunton, Devon

This paper is based on empirical observations made during twenty years of clinical experience in all types of establishment. It suggests a new direction for research and a new light in which to consider assessment and treatment of dyspraxia.

Tension and anxiety are attributes of us all and are necessary to our existence and development. However, even when they are at normal, acceptable levels inherent tension and anxiety can cause problems in development. When children�s personality traits which can be related to tension or anxiety are considered, utilising a comprehensive personality checklist, it becomes clear that the traits overlap throughout a variety of learning difficulties, and help to decide their diagnosis.

The role played in dyspraxia by a young child�s tension or anxiety, and related inattention and poor kinaesthetic and spatial awareness, are discussed in relation to the early programming of unrefined or dyspraxic motor responses which persist ads a person�s norm.

It is shown that in order to properly appreciate the nature of dyspraxia, an overall look at children�s learning difficulties needs to be taken with some comprehensive research into the role played by tension and anxiety through traits. The various symptoms of dyspraxia are viewed in the light of tension and anxiety. The male : female ratios given for dyspraxia and other learning difficulties are addressed.

The relevance to treatment is discussed.

Title: Differences between dyspraxics and dyslexics in sequence learning and working memory. Jeffries, SA & Everatt, J University of Surrey, Guildford 

Dyspraxics and dyslexics, who have co-ordination and linguistic difficulties respectively, often have problems with sequence learning and working memory. This study investigated differences and similarities between the two groups in these areas. Ten dyspraxics, 11 dyslexics and 23 controls participated. All were past secondary education, with ages ranging from 16 to 66 (mean age 28 years). Males comprised 25% of the sample. The initial six tasks confirmed specific learning difficulties. Five sequencing tasks assessed working memory by requiring the immediate recall of audio, visual, spatial and visual-spatial stimuli, via a verbal or motor response. On visual, spatial and visual-spatial tasks with motor responses, the dyspraxic group�s performance was the worse of the three groups, whereas the dyslexic group achieved the highest test scores. However, dyslexics were the poorest group in the auditory/verbal tasks, with the dyspraxic group producing the highest average scores. Phonological versus visual-spatial difficulties appeared to affect performance in sequence tasks, suggesting that different rehearsal subsystems of working memory may be impaired accordingly and that these groups may experience problems with literacy learning for differing reasons. Conversely, dyslexics may have good visual/spatial abilities whereas dyspraxics appear to have good phonological ability. Such findings have implications for assessment and remediation techniques. Looking for specific dyspraxic deficits that affect learning and linguistic skills as well as dyslexic deficits. Multi-sensory remediation could be used to emphasise the phonological and visual-spatial abilities of dyspraxics and dyslexics respectively, thus balancing subsystem components of working memory and enhancing rehearsal strategies to prevent information decay.

Title: Developmental Co-ordination Disorder in preterm children born < 32 weeks gestation age Foulder - Hughes Local Anaesthesia PhD Med Dip COT, Cooke RWI Institute of Child Health, University of Liverpool.

This study aimed to discover whether children who were born very preterm. <32 weeks gestational age, are at an increased risk of developmental co-ordination disorder (DCD), when compared to children born at full term. The preterm cohort consisted of children who were born in the Liverpool postal code region during 1991 - 1992, who were at mainstream school, followed up at age 7 or 8 years. Children were assessed alongside age, sex and class mate control children, who were born at full term > 37 weeks. A total of 280 preterm subject children, and 210 controls were assessed. Motor function was assessed using the Movement SBC, (with 5th %ile used as a cut off point to define DCD), the VMI to test visual motor integration function and the WISC IIIR UK, to screen intelligence levels. There were highly significant statistical differences between the subject and control groups on all of the standardised assessments (P=<0.001). The incidence of DCD in the preterm group was 30.7% (n=86), compared to 6.7% (n=13) in the control population. Total, verbal and performance IQ results were lower in the preterm group (p=<0.001), however, there was a correlation between poor fine motor skills and problems with visual motor integration and performance IQ scores and ultimately total IQ. Our research has demonstrated that preterm children are significantly more likely to develop DCD and associated performance and intelligence difficulties, than children who were born at full term. The difficulties may ultimately affect school performance and activities of daily living, so further research is required into the benefits of suitable intervention.

Poster Presentations:

Title: The improvement made with self esteem following physiotherapy Treatment for Dyspraxia. Michele Lee MCSP SRP, Sue Yoxall MCSP SRP, Polly Smith BSc OT The Lee Medical Practice, Denham, Buckinghamshire

This poster considers the vital role self esteem plays a vital role in the development of a child. The importance of self esteem has been discussed by many authors in relation to the influence it has on intellectual, social and gross motor movements (Laszlo & Bairstow (1985), Lee & French (1994) and Portwood (1999)). There have also been reports on the effects of poor self esteem as a result of failure leading to truancy and in some cases delinquency (Chu 1998, Lee 1998, Portwood 1996, 1998, 2000).

Several authors have commented on the subjective improvement noted by parents and professionals on children�s self esteem following treatment (Lee& French 1994, Addy 1996, Portwood 1996 and Lee & Smith 1998). However, to date there has been very little evidence using objective testing to prove these subjective findings.

The authors completed a study of 25 children with a diagnosis of Dyspraxia or Developmental Co-Ordination Disorder using the B/G Steem to ascertain the level of self esteem prior and following treatment. Results show that initially, 46% of the study group had scores that were considered to be low to very low prior to treatment. 35% showed normal scores and 19% showed high scores.

To date there have been 18 completed treatment programmes and these children have also completed the B/G Steem score sheets again. Each child has made a mean improvement of 3.6 points ( scores have ranged from 1 - 10 points) with no child not making an improvement. These scores have placed all the children�s self esteem scores with in the normal to high category.

The authors are confident that further results of the remaining 7 children will to show similar improvement.