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So you think your child may have Developmental Dyspraxia?
Where do you go from here?
While parents recognise too well the need to have the disorder diagnosed, it is often difficult to do so because symptoms can be shared between other possible disorders. However, we need a 'hook to hang it on', a starting point for getting help for our children, even if the diagnosis is only a possibility.
Your family doctor may know something about Developmental Dyspraxia and where to refer you to, however the likelihood is that he might not. You can however, ask him for a referral to a paediatrician.
A paediatrician will examine your child, and possibly rule out other similar disorders. He may refer you to a paediatric neurologist. He will also suggest what you should do next. If you go to the paediatrician privately the cost is not subsidised, but they can be seen within the hospital system.
A paediatric neurologist (usually based in a hospital) may give your child a series of neurological tests and examinations, intended also to identify or rule out other disorders. He will also talk at length with you, bear in mind that Developmental Dyspraxia does not show up on normal neurological examination and he may find out more by simple observation and by talking with you. He will refer you to the people most likely to help your child.
The teams at Child Development Units around the country (usually connected with main hospitals), will be able to examine and treat your child. The team may include paediatricians, Occupational Therapists (OTs), Speech/Language Therapists (S/LTs) , Physiotherapists, Cognitive Therapists, Neuro-developmental Therapists, etc.
A Paediatric Occupational Therapist assesses your child's movement and will then decide from the results what your best course of action will be and probably design a course of treatment specific to your child's individual needs. This may include a course of therapy lasting for a limited time (6 weeks to a year), or they may design a home programme which you can do with your child on a regular basis. Sensory Integration-based treatment is designed to help your child to sort, store and integrate the incoming sensory information so that it can be reliably retrieved and used for further learning. Seen through a hospital, the paediatric OT's services are subsidised by the Government, but privately, of course, you will need to pay.
If your child's speech and language are affected, a Speech/Language therapist will assess the difficulties, and prescribe a course of treatment based on the Nuffield Dyspraxia programme. This programme was developed in the Nuffield Institute in London specifically for children who have Developmental Verbal Dyspraxia. Phonic skills can be helped by a course in Phonic Awareness which is available in some areas.
Dyspraxia seldom occurs in isolation - it usually has other disorders accompanying it, such as A.D.D., mild cerebral palsy, dyslexia, etc., and these may well be the prime disorders. Thus other therapists may also need to be involved, such as physiotherapist, cognitive therapist, psychologist, etc., but you will be advised of these by the supervising paediatrician.
If your child has difficulties with school-work, poor handwriting, difficulties in forming concepts, problems with reading or maths, etc., it may be advisable to have an assessment done by a teacher or assessor of Specific Learning Difficulties. These can be found at the Seabrook McKenzie Centre in Christchurch or in the S.P.E.L.D. organisation. At Seabrook McKenzie, the assessment is performed by testers who are also qualified psychologists; it is long -- in two sections of about an hour each -- and looks first at the basic I.Q., followed by a battery of Specific Learning Disorder (S.L.D.) tests. The outcome of this is a long but comprehensive report showing exactly how your child learns, where the difficulties lie, and recommendations of your best course of action. They may also recommend lessons with a qualified remedial teacher trained in S.L.D. While this is not subsidised and can be reasonably expensive, there are always ways around getting this help, so you should broach the matter with them.
If your child has behavioural difficulties, you may need to consult a family therapist or a psychologist. These people also assess cognitive development. Once again, this can be through the health system, or privately and with fairly high costs to you. In Christchurch at Whakatata House (Child and Family Services) there is a team of psychologists, as well as an O.T. who can help. This is through the health system, but you need a referral from your doctor.
If your child is under five years, an Early Intervention team (such as the Champion Centre in Christchurch) will assess and treat your child holistically. A team of S/LTs, OTs, physiotherapist, cognitive, family and play therapists will co-ordinate your child's therapy to promote satisfactory development.
If your child is at school, the teacher may fell that it would be beneficial for your child to have a teacher-aide. This is someone who will work 1-1 with the child for a limited number of hours per week, and provides help in the areas of most difficulty. Teacher-aides are usually paid for from the Special Education Grant given to the school by the government, but it needs to be negotiated with the Principal and teacher of the school by you. You can take a support person with you for this interview. The fund often falls short of the needs of the school and the children, so don't expect too much.
Also at school, your child's needs can be assessed by the Specialist Education Services, who may recommend that the child be eligible for Ongoing Resource Scheme funding, which will help him get assistance and therapy through the school. The children eligible for this have serious impairments.
Your child may have difficulty controlling the many muscles which allow him to use his eyes, or eye-tracking, and may need to be seen by a Developmental Optometrist, who may give exercises to do at home, and/or glasses. Difficulty with eye tracking makes it hard to copy from the blackboard or from a book.
There are a number of small private clinics around, which are well able to help your child, for example, in Christchurch the Novalis House Medical Centre gives a holistic view with a basis in the anthroposophical philosophy of Rudolf Steiner, in Lower Hutt the Children's Therapy Clinic can provide assessment and therapy services for children and in Auckland the Wilson Home have a good team. Most of these are privately run and have their own fee structure about which you should enquire.
There are several needs assessment organisations, such as Life Links who may assess the child and family's difficulties and tell you of other options.
The sad fact of the matter is that if you can see any of these therapists through the health service then the costs are subsidised by the Government, but their waiting lists are often very long indeed. If you choose a private therapist, you will also pay the bill; they may also have waiting lists, but not nearly as long.
Financial help may also be available from Family Income support, and they should be consulted.
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