Dyspraxia and Apraxia

What Are Dyspraxia and Apraxia?

Dyspraxia is the partial loss of the ability to coordinate and perform skilled purposeful movements. Apraxia is the complete loss of this ability. Dyspraxia and apraxia together are called Global Apraxia.

The root word “praxia” means execution of voluntary motor movements; the “dys” means partial ability or partial loss; the “a” means absence of something. In certain cases, dyspraxia and praxia may be acquired due to a stroke or head injury.

Dyspraxia was formerly known and still referred to as Developmental Coordination Disorder (DCD), which is the term to describe dyspraxia in children whose neurological development does not progress normally due to a motor-learning disability. In other words, the brain is unable to plan and coordinate motor movement; hence, there is a speech and/or motor-planning disorder.

The etiology of DCD is a motor neuron development and maturation problem in which the following areas may be affected:

  • Gross and fine motor skills
  • Motor planning and how to organize and execute movement
  • Speech and language
  • Ability to carry out activities of everyday living

Childhood Developmental Apraxia of Speech (DAS) or Developmental Verbal Dyspraxia (DVD) is a speech disorder in which the brain has difficulties getting the tongue, lips and jaw to move correctly for talking. Children with this disorder know what they want to say but cannot coordinate the muscle movements needed to make the sounds, syllables and words.

Childhood Apraxia of Speech (CAS) involves the “intelligibility” of the child’s speech such as:

  • Distortions of consonants and vowels
  • Distorted sound substitutions
  • Repetition of words with error inconsistency
  • Prosodic errors. Prosody refers to the pitch, rate and the rhythmic features of speech.

Symptoms of Dyspraxia and Apraxia in Babies and Toddlers

  • Hypertonia or hypotonia (muscle tone)
  • Delay in reaching developmental milestones – especially speech
  • Impaired oral motor muscles such as the face and tongue which are needed to speak
  • Not cooing as an infant
  • Struggling to combine sounds
  • Eating issues
  • Difficulty in imitating a sequence of movement
  • Difficulty in performing physical activities such as climbing stairs, running, hopping and jumping as compared to other children the same age
  • Difficulty chewing solid food
  • Difficulty with pincer grasp and holding a pencil/drawing. Drawings may appear immature for the child’s age
  • Difficulty performing daily activities and self-care tasks such as getting dressed
  • Taking longer to acquire new skills
  • Falling over a lot and appearing clumsy
  • Problem grasping the concepts of “in”, “on”, “in front of”, etc.
  • Difficulty establishing relationships with peers
  • Problems with social behavior
  • Anxiety or agitation
  • Delayed language development or problems with speech
  • Less babbling than peers

Symptoms of Dyspraxia and Apraxia in School-Aged Children

  • Difficulty participating in group situations
  • Much better participation in a one-on-one setting
  • Problems with math
  • Handwriting problems (dysgraphia)
  • Poor drawing skills
  • Difficulty with expressing thoughts in writing
  • Difficulty in copying things from the board in school
  • Difficulty in dressing themselves and with zippers, buttons, snaps, tying shoe laces
  • Difficulty holding a pencil, pen, drawing utensil, paint brush, and scissors
  • Problems with organizing and planning
  • Poor concentration
  • Poor listening skills
  • Inability to follow instructions
  • Poor memory, both visual and auditory
  • Avoidance of physical education in school or physical activities with friends
  • Anger and frustration
  • Poor social competence
  • Academic problems in learning to read, write and spell
  • At risk for bullying
  • Low self-esteem
  • Behavioral problems
  • Prone to temper tantrums
  • Poor physical fitness because of fine- and gross-motor coordination issues
  • Poor ball skills
  • Clumsiness
  • Lack of coordination
  • Feelings of nervousness, anxiety and frustration speaking in class
  • Sensitivity problems with their mouths, such as not liking to brush teeth or eat crunchy foods
  • Hypersensitive to touch, sounds and smells
  • Impulsiveness
  • Lacking of a sense of direction, position or time
  • Stressed by new and unpredictable situations
  • Preference for repetitive and familiar activities
  • Difficulty in understanding what other people say
  • Needing accommodations in class for assignments and longer time for tests

What Your Doctor May Tell You About Dyspraxia and Apraxia

Your child’s doctor may tell you that more boys than girls are affected but girls may experience more severe symptoms. The pediatrician may suggest a neurologist to perform a neurological exam and look for dysmorphic features. The doctor may ask your child to perform normal everyday tasks and observe your child’s play.

Your child’s doctor may want to do other tests to rule out associated conditions with this disorder such as:

A multidisciplinary management plan may be initiated by your child’s doctor with other healthcare professionals such as an:

  • Occupational therapist
  • Physical therapist
  • Educational psychologist
  • Neuropsychologist
  • Speech and language pathologist

If your child has dyspraxia or apraxia of speech, your child’s pediatrician may recommend an alternative or augmentative form of communication such as:

  • Sign language
  • Communication board
  • ACC (Alternative Communication Device)
  • An iPad or tablet

Another Way to Think About Dyspraxia and Apraxia

Methylation Issues

Children with dyspraxia and apraxia typically have a genetic mutation known as the MTHFR which creates methylation issues so that these children are unable to detoxify their body and brain from unwanted environmental toxins that have typically contributed to their conditions.

A defect in the methylation process can cause many issues including language and cognitive impairment, as shown here and here. The easiest yet most effective way to support your child’s methylation process is through the skin, where there is maximum absorption of nutrients.

Nutritional Deficiencies

Vitamins, minerals and nutrient deficiencies are crucial contributing factors to dyspraxia and apraxia because the brain is typically starving in children with these conditions. The perfect storm that can create the starving brain can consist of:

  • Nutritional (vitamins and minerals) deficits
  • Malabsorption issues of nutrients and fats
  • Environmental allergies
  • Food sensitivities and intolerances
  • Poor gut bacteria in the microbiome
  • Lack of fats in the diet for the brain

All of these may be contributing factors to learning and behavioral issues, and the inability to plan and coordinate motor movements.

Fatty Acid Deficiencies

Dyspraxia and apraxia have been found to have an underlying fatty acid deficiency and abnormal fatty acid metabolism. In addition, many children with dyspraxia or apraxia have been found to have low cholesterol. Fats are critical! The brain is 60% fat and requires good fats to function efficiently. About 50% of a child’s intake of food in the first two years is consumed for brain growth, and good fats are essential for the growing brain.

Essential Fatty Acids (EFA) provided in the diet and by supplementation are essential and a key underlying factor to proper brain and eye functioning for children with dyspraxia and apraxia.

Some of these beneficial EFAs are:

  • Omega-3 fatty acids such as:
    • DHA (docosahexaenoic acid)
    • EPA (eicosapentaenoic acid)
    • ALA (alpha linolenic acid)
  • Omega-6 fatty acids such as:
    • GLA (gamma linolenic acid)
    • CLA (conjugated linoleic acid)

EFAs need to convert in the body to the long-chain Highly Unsaturated Fatty Acids (HUFA) for proper brain and eye functioning. The conversion of EPA to HUFA can be blocked due to:

  • Excess saturated fats
  • Hydrogenated fats
  • All trans fatty acids, which are poor-quality fats found in processed foods
  • Zinc deficiency
  • Stress hormones such as cortisol, adrenaline, norepinephrine and epinephrine

The conversion can also be impaired in children with eczema, asthma and other allergic conditions. Hyperactive children typically cannot convert EFAs to HUFA because these children are typically zinc deficient, and zinc deficiency leads to poor EFA processing in the body. Salicylates (food additives) can block the conversion of EFAs to prostaglandins, which are important in brain function; many children with ADD/ADHD have a sensitivity to salicylates.

Males have a greater need for EFAs; hence more boys have dyspraxia or apraxia than girls.

Children do not “outgrow” essential fatty acid deficiencies; those deficiencies can manifest as neuropsychiatric mood disorders such as:

  • Anxiety
  • Depression
  • Mood swings
  • Aggressive behaviors

Neurotransmitter Deficiencies

Without enough good fats, neurotransmitters in the brain – the messengers that send information to the brain cells – cannot do their job. Poor fat intake means a possible brain disconnect that affects the entire body – emotional, behavioral, cognitive and language.

Neurotransmitters create muscle strength and muscle growth needed for motor movement. Amino acids, both essential and non-essential, are needed to create neurotransmitters. Animal-based protein such as fish, meat, poultry, dairy and eggs all contain complete proteins and provide essential amino acids the body needs and cannot make itself.

A vegetarian diet does not contain complete protein and lacks good quality fats found in these proteins, so supplementation may be needed. Whole foods rich in protein, complex carbohydrates and healthy fats all contribute to healthy brain functioning.

Research About Nutritional Deficiencies in Dyspraxia and Apraxia

DHA Supplementation

Research published in the American Journal of Clinical Nutrition showed that after taking DHA tuna oil and thyme oil for three months, 15 children with dyspraxia made significant improvement in their hand-eye coordination in areas such as dexterity, balance, coordination and fine motor movements. Thyme oil greatly increases the efficiency of DHA; it is an antioxidant and protects the oils against oxidation.

Vitamin E and Omega-3 Fatty Acid Supplementation

A study from Nationwide Children’s Hospital of 187 children between the ages of 2 and 15 and diagnosed with verbal apraxia received vitamin E (800 IU/day) and omega-3 fats (560 mg DHA + 1390 mg EPA/day) while having blood drawn to measure for digestion (absorption issues as well as digestive inflammation).

Remarkably, 181 families (97%) reported “dramatic improvements” in multiple areas of behavior that included:

  • Speech
  • Imitation
  • Coordination
  • Eye contact
  • Behavioral issues
  • Sensory issues
  • Digestive symptoms

Five families saw no improvement, and one family reported a worsening of symptoms that caused them to stop supplementation with one week. The blood tests showed many the children also suffered from food allergies, especially gluten; researchers found that 70% of the children had a gluten allergy compared to only 12% of the rest of the general population. 83% of families reported digestive problems in their children before the study, suggesting that allergies, digestive issues, apraxia and behavioral issues may all be interrelated and possibly improved with vitamin E, omega-3 fat supplementation and a gluten-free diet.

Signs of Fatty Acid Deficiencies:

In infants:

  • Extreme restlessness
  • Crying
  • Poor sleep patterns
  • Difficulties in feeding
  • Colic
  • Constant thirst
  • Frequent tantrums
  • Head banging
  • Rocking the crib

In children:

Laboratory Testing:

While lab tests cannot identify developmental delays, they can pinpoint potential root causes of your child’s delays. Laboratory testing may include blood, urine, stool or saliva with the intent on:

  • Correcting underlying deficiencies and dysfunctions
  • Restoring body and brain functioning
  • Improving problematic behavioral or developmental symptoms

so that the child may attain their greatest potential and have the best quality of life possible.

Important testing of various contributing factors include:

Dyspraxia/Apraxia Healing Checklist

Heal the gut:

The first step is to heal the gut – the gastrointestinal tract and its microbiome – which is the hub of the good bacteria (probiotics) in the body. By healing the gut, the immune system can be improved because 70% of the immune system is found in the gut.

A baby’s microbiome can be disrupted by a mother’s poor diet, antibiotics, NSAIDS (non-steroidal anti-inflammatory drugs) and usage of birth control pills because mothers transfers their poor microbiome to their baby. Mothers who use preconception antibiotics may have babies with serious gut issues, which can lead to behavioral problems and developmental delays.

Antibiotics kill bad bacteria but also good bacteria (probiotics) as well as white blood cells, which protect the immune system, in the process. Antibiotics don’t discriminate, causing the intestinal flora and good bacteria to be destroyed, leaving the immune system compromised and unable to protect the body from future infection.

Constant usage of NSAIDs, which are common anti-inflammatories such as Motrin, Tylenol and ibuprofen, in either the pregnant mother or child can result in leaky gut syndrome and/or SIBO (Small Intestinal Bacterial Organism), which can lead to autoimmunity. Leaky gut and SIBO can lead to an inability to absorb nutrients and minerals needed for the brain and the body.

If the gastrointestinal tract and the microbiome have too many pathogenic viruses, bacteria, yeast and/or parasites, then the vagus nerve may transport these pathogens to the brain, causing the brain to have imbalances in the neurotransmitters and delays in the child’s development.

A compromised immune system before three years of age can cause developmental regression. Chronic infections, such as Lyme disease, viruses, pathogenic bacteria and mold, compromise the immune system, causing excessive inflammation, disrupting development and affecting the brain and a child’s development.

Make Lifestyle Changes

  • Get 10 hours of sleep per night (or more if your child is under 10)
  • Get outside every day
  • Get an hour of exercise or movement per day
  • Sync circadian rhythm by getting up when the sun does and going to bed after it sets
  • Limit screen time as much as possible
  • Use blue-blocking lightbulbs and glasses at night, especially when looking at screens
  • Put bare feet in wet ground when possible
  • Drink half body weight in ounces of water

Eat a Clean Diet

Use Only High-Quality Fats

  • Coconut oil
  • Olive oil (unheated)
  • Avocados
  • Medium-Chain Triglycerides (MCT) oil
  • Grass-fed ghee
  • Duck fat
  • Grass-fed beef tallow
  • Cod liver oil (unheated)
  • Walnut oil (unheated)

Remove Vegetable Oils and Trans Fats

  • Canola
  • Corn
  • Soy
  • Safflower
  • Sunflower
  • Hydrogenated vegetable oils (Crisco, etc.)
  • Margarine

Include High-Quality Protein with Every Meal

  • Pasture-raised eggs, chicken and other fowl
  • Grass-fed beef, lamb and other red meats
  • Wild-caught fish
  • Legumes
  • Nuts

Eliminate High-Glutamate Foods

These foods and ingredients can exacerbate neurological symptoms because of the excitoxicity they cause in the brain. These are some of the most-common, high-glutamate foods to remove:

  • Monosodium glutamate (MSG)
  • Hydrolyzed vegetable protein
  • Soy protein isolate
  • Yeast extract
  • Gelatin
  • Barley malt
  • Bouillon
  • Natural flavors
  • Artificial flavors
  • Soy sauce
  • Corn starch
  • Others

Add Fermented Foods and Probiotics

These will keep the gastrointestinal system and microbiome healthy and strong which in turn will keep the immune system strong.

  • Eat kefir yogurts, if dairy is tolerated
  • Eat fermented vegetables such as sauerkraut and kim chi
  • Eat umeboshi plums, which are very alkalizing
  • Eat miso soup, if soy is tolerated
  • Take a quality probiotic, such as VSL #3, Gut Pro, Dr. Ohirra’s Live Cultured Probiotics, Garden of Life, Klaire Labs. Work with your practitioner for a more targeted probiotic.

Optimize Blood Sugar

Blood sugar that is too high can lead to excess inflammation and hormonal imbalances.

Blood sugar that is too low can lead to attention and behavioral problems.

We recommend keeping blood sugar optimized so that it's neither too low nor too high.

Do an Elimination Diet

Children with chronic health conditions often have hidden food sensitivities and intolerances that exacerbate their symptoms. With an elimination diet, remove potentially inflammatory foods such as:

  • Casein
  • Gluten
  • Soy
  • Corn
  • Eggs
  • Fish
  • Shellfish
  • Nuts
  • Peanuts

Clean up Your Environment

  • Identify and remove possible environmental triggers, such as mold, dust, pet dander, and electromagnetic fields (EMFs)
  • Identify and remove possible toxic exposures in the home from purchased products, such as detergents, soaps, lotions, and other cleaning and personal care products
  • Remove animals (both live and stuffed!)
  • Remove carpets
  • Use non-toxic cleaners
  • Use non-toxic building materials

Lower Stress Levels

Viruses, bacteria and other pathogens become more active when the body is in a state of stress.

By teaching your child ways to self-regulate with practices such as prayer, reiki, meditation, yoga, qi gong, tai chi and the Emotional Freedom Technique (tapping), they can become good advocates for themselves and become active participants in the recovery process.

Practitioners of techniques such as EMDR (Eye Movement Desensitization Retraining) and jin shin jyutsu can lower stress levels for your child, as well.

See a Homeopath, Naturopath or Homotoxicologist

These practitioners can diagnose and treat gastrointestinal disorders naturally so that the child’s immune, sensory, neurological and nervous systems develop without being compromised.

Ask Your Practitioner to Run Some Laboratory Tests

  • Enzyme-Linked Immunosorbent Assay (ELISA) for possible food sensitivities and allergies
  • Nutritional deficiencies in vitamins and minerals, especially vitamin D
  • NutrEval by Genova Diagnostics Labs for malabsorption, gut dysbiosis, cellular energy, mitochondrial metabolism, neurotransmitter metabolism, vitamin deficiencies, toxin exposure and detoxification need
  • Organic Acid Test (OAT) for yeast overgrowth, other microbial infections and oxalates
  • Inflammation markers such as C-Reactive Protein (CRP)
  • Fasting blood sugar and insulin levels
  • Comprehensive Digestive Stool Analysis (CDSA)

Have Your Child Tested for PANS/PANDAS

Pathogenic infections and environmental offenders can cross the blood-brain barrier and cause neurological symptoms known collectively as PANS/PANDAS. However, not many practitioners know how to test for and treat these conditions. Common tests are:

  • Serum Anti-Streptolysin O (ASO) titer
  • Serum Anti-Streptococcal DNase B (ASDB) titer
  • Cunningham panel
  • Lyme disease and Lyme co-infections
  • Specific viruses, especially herpetic viruses
  • Mycoplasma pneumoniae infection
  • Heavy metals and other toxins
  • Mold

Use Digestive Aids with your Practitioner's Guidance

  • Betaine hydrochloric acid
  • Digestive enzymes with DPP-IV for gluten and casein intolerances
  • Proteolytic enzymes
  • BiCarb
  • Bromelain
  • Papaya

Use Supplements with Your Practitioner's Guidance

Always work with your practitioner to determine the brand, type and dosage of supplements. Common supplements include the following:

  • Cod liver oil
  • Probiotics
  • Vitamin D3
  • Methylated B complex vitamins
  • GABA, especially PharmaGABA
  • N-acetylcysteine (NAC)
  • Magnesium, zinc, selenium, iodine and other minerals
  • Others

Help Your Child Detoxify

  • Make sure your child is pooping every day. Learn more about how to clear up constipation and diarrhea.
  • Have your child exercise or move every day. Sweating carries toxins out of the body.
  • See a homotoxicologist, naturopath or homeopath for drainage remedies and detoxification aids.
  • Optimize blood sugar to allow the liver to spend more time detoxing rather than processing sugar.
  • Ionic foot baths can help detox unwanted pathogens and are easy to do with children.
  • Infared saunas can detox heavy metals through the skin by sweating. However, this form of detoxification may not be suitable for young children who lack the ability to sweat.
  • Epsom salt baths add sulfur transdermally to help with detox.

Integrate Retained Primitive Reflexes

Most, if not all, children with neurodevelopmental disorders including learning disabilities, have retained primitive reflexes.

Find a therapist that is trained in integrating primitive reflexes, which can cause imbalances in the way your child's brain performs.

See a Chiropractic Neurologist

Chiropractic neurology is patient focused and utilizes the latest assessment techniques to create an individualized protocol to rehabilitate the central nervous system and develop neuroplasticity (changes in the brain) when addressing neurological conditions.

Children with developmental delays, cognitive issues and deficits have improper communication between the right and left sides of the brain.

See a Behavioral/Developmental Optometrist

A developmental optometrist can check for convergence and tracking problems with your child's vision. He or she can correct these issues with vision therapy, lens and prisms. Doing so can improve hand-eye coordination and school performance.

See a Craniosacral Practitioner

Craniosacral therapy can reestablish central nervous system functioning. These practitioners use approaches rich in vestibular, proprioceptive and tactile input and may also do oral motor therapy.

See a Neurofeedback Practitioner

Neurofeedback is approved as a level-one intervention by the American Academy of Pediatrics for ADD and ADHD, which are learning disabilities.

Even if your child doesn't have ADD or ADHD, they may still benefit from neurofeedback.

Find a practitioner that can perform a QEEG (quantitative electroencephalograph) brain map first so you can understand how your child's brain works.

See a Sensory-Integration Occupational Therapist

These occupational therapists address a variety of sensory issues with a child using hands-on equipment. This type of therapy calms down the nervous system to help integrate the senses and retained reflexes.

See a Chiropractor

A chiropractor can perform spinal cord adjustments, which can improve communication in the nervous system.

See an Auditory Therapist

Many children with learning disabilities have auditory processing problems that may be causing problems with focus and concentration.

An auditory therapist can devise a listening program that is specific to your child's needs. These programs can retrain the brain, calm down the nervous system and reduce sound sensitivities.

Find a Brain Gym Practitioner

A Brain Gym practitioner can have your child do exercises for sensorimotor coordination, self-calming and self-management.

Work with a Health Coach

Our Epidemic Answers health coaches are trained to understand the root causes of your child's chronic health condition.

They provide hands-on helping with the practical matters of healing such as cooking healthy foods, removing toxins from the household and helping you work more efficiently with your practitioner.

See an Acupuncturist

Acupuncture can help lower stress and anxiety associated with sensory processing. It can also help with blood-sugar and hormonal regulation.

See a NAET or BioSET Practitioner

Children with chronic health conditions typically also have food allergies and/or food sensitivities and intolerances.

NAET (Namudripad's Allergy Elimination Technique) and BioSET are two non-invasive methods of allergy elimination.

Use Sensory Therapies and Tools

Still Looking for Answers?

Visit the Epidemic Answers Practitioner Directory to find a practitioner near you.

Join us inside our online membership community for parents, Healing Together, where you’ll find even more healing resources, expert guidance, and a community to support you every step of your child’s healing journey.

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