Early intervention vital for DCD sufferers

One child in every primary school class suffers from 'clumsy child syndrome' but early diagnosis can mean a better quality of…

One child in every primary school class suffers from 'clumsy child syndrome' but early diagnosis can mean a better quality of life. Padraig O'Morain reports

'The child is generally very quiet and easy-going, not one to get into trouble. Eventually you find that what you thought was a lovely placid child was one who did not explore his own environment. He didn't crawl at all. He didn't walk until later."

Oona O'Shaughnessy is talking about the gradual process by which parents come to learn that their child is affected by Developmental Coordination Disorder (DCD), also known as Dyspraxia or, more graphically, "clumsy child syndrome".

She is a member of the Dyspraxia/DCD Association, Cork. The city has the country's only designated unit for treating DCD, thanks to an initiative by the Southern Health Board and St Finbarr's Hospital. With an estimated 6 per cent of the population affected by the disorder - the equivalent, says the association, of one child in every primary school class - Cork may have set a headline which the rest of the country would do well to follow.

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The condition manifests itself in a variety of ways including: children tiring more easily than their peers; misjudging distances or the force to be used, consequently, children may have a plodding walk, slam doors or hold onto their pencil too tightly; and having difficulty reading and very bad handwriting.

All these and other aspects of DCD can make it hard for the affected children to play and socialise with peers and can lead to isolation.

"My boy Sean, at about the age of five or six, would go through the hall door to try to get out the gate and smack into the wing mirror of the car every time," O'Shaughnessy says. "Every door handle he would smash into, too. When he tried to kick a football, he couldn't connect his leg with the ball. Tying shoelaces, no can do. Bicycle, very tricky. Handwriting, totally illegible."

DCD, however, is not learning disability and these children can be helped in many ways to work around or overcome their difficulties.

"My son will sit his Junior Cert and Leaving Cert using a computer," she says. "Any of the big, long stories he has to write will go on the computer."

What is essential is that the condition be picked up and intervention begin early.

"The earlier it's picked up, the better the outcome for the child. The only hope for an independent life as an adult is lots and lots of intervention and lots and lots of therapy. The earlier you get about doing that the better chance of success you have," O'Shaughnessy says.

Dr Pat Henn would agree with her. He is co-ordinator of the DCD Unit at St Finbarr's Hospital, Cork and is seen by many parents as the moving force behind the unit's existence.

"By seven to eight the brain is hardwired," Dr Henn says, "and it's easier to get a five to six-year-old started on the basic skills."

With teenagers in second-level education, who didn't have a unit to go to as children, "it's about giving them strategies" such as encouraging them to use a laptop instead of writing by hand but "you are not going to be able to improve core skills at that age".

The unit uses occupational therapy, speech and language therapy and psychology in its work. It assesses the children, gives the parents exercises to do with them and visits their schools. If they wish, the children's resource teachers can come into the unit to see the programme at work. "The school's support for the child is very important but support for the school is also very important," he says.

The bad news is that the unit has a waiting list of over two years. John O'Sullivan and his wife Eileen, whose son Patrick has DCD, got the association going in 2002 to persuade the Southern Health Board to make the unit permanent and to press for more resources for it.

The demand for information on DCD, both from parents and professionals, is huge, they quickly found. When they organised a talk by Dr Henn on the subject last year, 78 people attended and another 50 had to be turned away for lack of space. A seminar this summer drew an audience of 180.

A booklet, Developmental Coordination Disorder - Practical Tips for Parents, which they produced with the DCD unit sold out straight away and has had to be reprinted. The association's work has paid off: "Recently we received a letter from the health board saying that the unit is now permanent," O'Sullivan says. He would like to see similar units in other regions.

The association is now pressing for more resources for the St Finbarr's unit. "A lot of professionals give time to the unit out of their own time," he says. And its catchment area is limited to north and south Lee "so if you're in Macroom, for example, you are outside the catchment area".

Copies of the booklet are available from John and Eileen O'Sullivan, "Rena", Upper Cloghroe, Cloghroe, Co Cork. Tel: 021-7332354.