Childhood dyspraxia: An underestimated problem in Germany with serious consequences

Childhood dyspraxia, also known as developmental dyspraxia or specific developmental motor disorder (DCMD), is a neurological disorder that significantly impairs children's motor coordination. While it is receiving increasing attention in many countries, in Germany it is often underestimated or dismissed as merely motor clumsiness. However, the psychological and social impact on affected children is immense.

How do I recognize childhood dyspraxia?

Dyspraxia is a congenital disorder that is present from birth and is often genetic. It develops due to changes in brain structure and function that impair communication between different brain regions responsible for motor skills and coordination. Although it can be influenced by early childhood brain damage such as oxygen deprivation or premature birth, dyspraxia is often present from the beginning and is often passed down in families.

The symptoms of dyspraxia are diverse and affect not only motor skills but also emotional well-being. Parents and professionals should be particularly alert if children:

• have difficulty with gross motor tasks such as running, jumping or playing ball,

• show fine motor deficits, such as writing, painting, cutting or dressing,

• move awkwardly, often stumble or have problems with balance,

• delayed in learning to speak or unclear articulation,

• Everyday tasks can only be completed with great effort,

• are quickly frustrated and develop low self-confidence,

• develop social withdrawal strategies or react anxiously to challenges.

Because dyspraxia is often confused with ADHD or autism, it often goes undiagnosed. However, early diagnosis can be crucial for providing targeted support.

Diagnostic guidelines and ICD criteria

According to the International Classification of Diseases (ICD-10: F82, ICD-11: 6A04), dyspraxia is classified as a "specific developmental disorder of motor functions." Diagnosis is usually performed by specialized pediatric neurologists or developmental psychologists and includes standardized testing. The following criteria must be met for diagnosis:

• Significant motor deficits that cannot be explained by intellectual disability or neurological disease.

• Impairment in coping with everyday life , e.g. problems with getting dressed, writing or sports.

• Abnormalities in motor coordination that cannot be explained by a lack of practice or motivation.

• Persistence of symptoms for at least six months to rule out temporary developmental delays.

• Exclusion of other neurological or sensory causes , such as muscle diseases or vision problems.

  
  

A comprehensive diagnosis includes motor tests, neurological examinations, and a detailed medical history. Imaging or genetic analyses may also be used to rule out other diseases.

The suffering of the affected children

Children with dyspraxia often experience setbacks in everyday life. Their motor limitations can lead to them being excluded in kindergarten or school or labeled as "clumsy." This has massive psychological consequences:

• Low self-esteem: Constant failure and comparisons with peers can lead to self-doubt.

• Social isolation: Due to their coordination problems, affected children often avoid group activities or are excluded.

• Emotional stress: The stress caused by everyday tasks can lead to anxiety and depression.

• School problems: Difficulties with writing, sports or group tasks can make everyday school life considerably more difficult.

The Dilemma of Talents

Children with dyspraxia often face the dilemma that their special talents are not sufficiently recognized in Germany due to their motor difficulties and a lack of support. While they can develop creative problem-solving skills, good spatial awareness, and a keen attention to detail, these skills are often not recognized or encouraged because the focus is often on the motor deficits. Without targeted support, these skills remain in the background, denying the children additional opportunities to fully realize their potential.

Inadequate diagnostics and care in Germany

In short, the care and diagnosis of dyspraxia in Germany is inadequate.

There are several reasons for this:

1. Lack of awareness : Many doctors, teachers, and therapists are unaware of dyspraxia or do not take it seriously. It is often dismissed as a "motor clumsiness" without considering its far-reaching psychological and academic impact.

2. Inadequate diagnostics : In Germany, there are no uniform guidelines for diagnosis. The disorder is often overlooked or only recognized very late. There is a lack of standardized testing procedures and specialized physicians who specifically screen for dyspraxia.

3. Lack of therapy options : Even when a diagnosis is made, there are often not enough specialized occupational therapists, physical therapists, or speech therapists. Furthermore, necessary therapies are not always covered by health insurance.

4. Inadequate school support : In other countries, such as the Netherlands, there are targeted support measures, compensation for disadvantages, and integrative programs for dyslexic children. In Germany, such programs are almost completely lacking, so affected children are completely neglected in everyday school life.

It is estimated that around 5-6% of all children suffer from dyspraxia, which means that hundreds of thousands of affected children in Germany receive inadequate care and struggle with academic and social challenges on a daily basis.

Looking abroad: The Netherlands as a model

While Germany still has significant deficits, the situation in other countries is significantly better. The Netherlands, for example, has recognized dyspraxia as a serious neurodevelopmental disorder and offers:

• Specialized diagnostic centers: Specialists are specifically trained to detect dyspraxia.

• Therapy programs with a multidisciplinary approach: Children receive early access to occupational therapy, physiotherapy, and psychological care.

• Support in the school system: Individual support plans, compensation for disadvantages and special aids make everyday school life easier for affected children.

  
  

Current research and necessary improvements

Recent studies emphasize the urgency of early interventions. An integrative therapy approach using neuroplastic training methods has proven effective. Scientific guidelines for the treatment of dyspraxia now exist. The European Academy of Childhood Disability (EACD) recommends a multidisciplinary approach with individually tailored treatment plans. These guidelines emphasize the importance of early diagnosis and ongoing support from specialized professionals.

The following measures would be necessary in Germany:

• Better training for doctors and therapists: Dyspraxia must be included in medical curricula as a serious developmental disorder.

• Early diagnosis: Pediatricians and occupational therapists should conduct targeted tests early on and inform parents.

• More specialized therapy options: Occupational therapy, physiotherapy and psychological support should be available nationwide.

• Educational support: An individualized support concept with motor adjustments and compensation for disadvantages must be established in schools.

  
  

Conclusion

Childhood dyspraxia is far more than just a motor disorder. It significantly impacts children's emotional and social lives and requires early, targeted support. While countries like the Netherlands have established comprehensive diagnostic and therapeutic approaches, Germany lags far behind in terms of care. Hundreds of thousands of affected children do not receive adequate support and struggle with enormous challenges in their daily lives. There is an urgent need to improve medical and educational care to give these children the opportunity to realize their potential and lead independent lives.

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Childhood dyspraxia: An underestimated problem in Germany with serious consequences