How dyspraxia can exhaust children and exclude them from social activities

Ask a parent of a child with dyspraxia what happens around 4pm, and many describe the same scene. Their child has spent a whole school day gripping pencils, fastening buttons and keeping up in the playground. By the time they get home, they are exhausted.

That exhaustion can easily be mistaken for bad behaviour or laziness. But we conducted a national survey of 241 parents of children aged five to 18 and our results may help explain why some children struggle so much at the end of the day.

Dyspraxia, also known as developmental coordination disorder (DCD), affects around two children in every class of 30. It makes movements that most children learn almost automatically slower, more demanding and less reliable.

Families can spend years looking for answers. Our survey found that the average wait between first seeking help and receiving a diagnosis was 2.8 years. During that time, a child may be seen as unmotivated rather than as someone for whom everyday movement requires considerable effort.

In the survey, 98% of parents said everyday movements took their child longer than other children. Another 92% said their child was more fatigued by them, while 82% said their child was more tired at the end of the day.

Parents identified eating, dressing, writing, drawing, personal care and cutting with scissors as among the hardest tasks. Activities that many children carry out with little thought may require sustained concentration for a child with DCD.

After a day of that, physical activity can become another demanding task.

School, friendships, fun and feelings

Overall, 59% of parents said their child did not enjoy physical activity. At ages five and six, around a quarter said this was the case. By ages 15 and 16, the figure had risen to 82%.

UK government guidelines recommend that children average at least 60 minutes of moderate to vigorous physical activity a day across the week. In our survey, 36% met that target, compared with 45% of children nationally.

Activity also fell sharply with age in our survey. Children aged seven and eight averaged close to an hour a day, compared with around 22 minutes among 17- and 18-year-olds. Physical activity commonly falls during adolescence, so our survey cannot show that DCD caused this decline. However, wider research suggests that school-aged children with DCD spend less time doing moderate to vigorous physical activity than children without DCD.

Anxiety may be part of the reason. In all, 62% of parents said their child often or always felt anxious when learning or performing movement activities, while 56% said their child often or always withdrew from them.

Repeatedly struggling with movements that classmates seem to perform easily can also make children self-conscious about taking part. Avoiding those activities may then reduce opportunities to practise the skills they find difficult, making participation harder still.

PE was a particular concern. Overall, 37% of parents said their child did not enjoy PE, and 43% felt their child was not adequately supported in lessons. One parent said PE teachers “haven’t got a clue” about DCD. Another described a boy who had felt included by one teacher, only to lose his adjustments when a new teacher arrived.

Many of the children were struggling emotionally too. On the Strengths and Difficulties Questionnaire, a widely used measure of children’s emotional and behavioural difficulties, 64% scored high or very high for emotional problems and 63% for problems with peer relationships.

Difficulties with peer relationships may also be connected to opportunities to take part. Playground games, PE and organised sport are places where children spend time together and friendships develop. A child who is repeatedly excluded or left on the sidelines can therefore miss out on social experiences as well as physical activity.

One parent described a boy who loves football and attends training every week: “he rarely gets picked to play in the match – at best he gets ten minutes right at the end if he’s lucky.”

His experience illustrates a wider problem. Children with DCD may want to participate, but fatigue, repeated difficulty and exclusion can make that participation increasingly hard to sustain.

What parents and professionals are asking for

When asked what should change, 72% of parents pointed to teacher training. They wanted teachers to understand how to support a child with DCD, from handwriting to PE. Only 56% of children had a written plan setting out the support they needed at school, even though 81% of teachers knew about their movement difficulties.

Support from health services was inconsistent too. Around two-thirds of the children had seen an occupational therapist, and a third had seen a physiotherapist, usually for between 13 and 18 months. One parent described therapy as life-changing for their son. Yet 78% felt the therapy their child received was insufficient, while another said that once the diagnosis arrived, the family felt left to manage alone.

An advisory group of parents, young adults with DCD and professionals reviewed the findings. They called for DCD to be included in teacher training and continuing professional development, and for families, teachers and GPs to be given clearer information about the route to diagnosis.

They also argued that support should begin while children are still waiting for a diagnosis, and that health and education professionals should be more aware of the connection between DCD and emotional difficulties so that children can be offered psychological support when needed.

DCD is defined by difficulties with movement and coordination, but its effects can spread into physical activity, school life, friendships and emotional wellbeing. Earlier recognition and better support could help children continue taking part in the activities they enjoy, rather than gradually withdrawing from them as they grow older.