Developmental Coordination Disorder (Dyspraxia) in ADHD
HTML-код
- Опубликовано: 5 июл 2024
- Developmental Coordination Disorder and ADHD
00:00 Introduction
00:26 Definition of DCD or dyspraxia
00:45 Symptoms of dyspraxia or DCD
01:27 Comorbidity of DCD with ADHD review
03:02 Why is DCD so often seen n ADHD: Study of cortical development in children with ADHD
08:16 The unmet needs of children and youth with DCD
Developmental dyspraxia, or developmental coordination disorder (DCD) occurs in 30-50% or more of children and teens with ADHD and remains a highly comorbid condition even into adulthood in those with ADHD. This short video discusses this overlap or comorbidity, what the symptoms are of DCD, why it may occur at such a high rate in those with ADHD (delayed frontal cortical development), the professionals and their treatments often recommended for DCD, and some of the unmet needs of children and teens experiencing DCD.
Websites and articles referenced in the video:
Definition (from the National Health Service, UK): www.google.com/search?client=...
Symptoms of DCD or dyspraxia (from Wikipedia): en.wikipedia.org/wiki/Develop...
Frequency of DCD in children and youth with ADHD review in Perceptual and motor Skills (2017):
journals.sagepub.com/doi/abs/...
Phillip Shaw study on delayed gray matter development in children with ADHD from the Proceedings of the National Academy of Sciences (2007)
sciences.ucf.edu/psychology/c...
Unmet needs of children with DCD from Pediatric Research (2021):
www.nature.com/articles/s4139...
Oh, snap. I’ve always been called ‘clumsy’, that I must walk funny bc I tend to bump into furniture/doorways etc; that i have the ‘dropsies’ bc I fumble and drop stuff. I’ve always had balance problems but no inner ear issues. MYSTERY SOLVED.
It's funny how the experience differs in ADHD
I have ADHD and OCD yet my coordination is planes above others my age even tho I don't do any sports and I have a cyst near cerebellum
Try zing performance, it fixes this dramatically
Thank you Dr Russell. I got diagnosed with ADHD at the age of 31 by seeing a neuropsychologist, as an ethnic woman, I have encountered so many obstacles along the way in my life to get here. I have been gaslighted, being made to feel like I exaggerate/look for attention. They tried to diagnose me with personality disorders, depression, anxiety you name it. Not until I started ADHD medication and my whole life changed.
I have tried telling mental health professional about my coordination issues. I Have tried to drive a car and ride a bike so many times and it's super hard. I am rarely taken seriously. Until this day I am not officially diagnosed with any coordination disorders because I am often dismissed.
What I found surprising sometimes is that taking Ritalin actually helps with coordination. It's a bit odd to me. Sadly now I got covid few months back and got recently diagnosed with post viral fatigue. So I have a long way to go again. Coordination issues, sensory issues are way worse.
Anyway, thank you for being here for us.
❤
Get better and adopt something hard but slow, like yoga or tai chi. They both give you enough time to understand each movement. Anyways, it's really hard to imagine that people are neurologically different after all. I would say basic knowledge of those must be part of what teachers learn, so they can intervene earlier when the signs start to appear. Also, the more we speak up about it the more it will be common knowledge.
I would add that the dismissal of our reality is one the things that hurt the most and the one that gives you a lot of low self esteem. The "I can't do this because I'm bad" feeling. Instead we need to think of it as "I can't do it yet because I need another route".
Hello Lady, I do not want to be a party pooper on your encouraging news of a proper diagnosis. Now you KNOW all that criticism was unwarranted. Try working on those criticisms that were internalized. Sorry I digress. I’m a late diagnosed at 50 who just turned 60. My intention is to warn you so that you aren’t surprised. Please know that as hard as ADHD is, it, unfortunately gets much, much worse during menopause. Menopause is a bear in and of itself. With ADHD on top, it being a bear on steroids. I just think women should know. Best wishes for your continued success and discovery!
@@drrodopszinBrilliant remark. Thank you!
My son was diagnosed with Dyspraxia and had terrible handwriting thankfully, he got help with it so he was able to write a bit legibly but that affected his school performance. Fortunately, in today's world academic degrees don't count much so it didn't affect work/life success (he's an adult now).
My advice is no matter what issues/disadvantages your child has don't make that the focus of his/her existence. Build their confidence in other areas. He learned swimming which helps with overall body coordination and table tennis which also helps hand-eye coordination. Today, he can proficiently ride a bike and drive.
Every child is unique, nurture them, support them, and love them for who they are.
Dr B., I think you are one of the coolest, most solid, impressively intelligent, awesome human beings and it makes me feel good every time I watch one of your video's that you are for us, while in the past, most of the world has been against us. Thank you. I've been walking into walls all my life. 😊
"ditto" 😊
I’m club level tennis player, 6 months on stims has done more for my game than 6 years. Not only did I see a notable improvement in immediate performance, but I learn much more from each session as I observe myself with far greater self awareness. This has lead to improvements in my performance even when I’m not on the stims. I have also noticed improved hand eye coordination across a number of sports. Tennis is a great example as it requires you to track a fast ball consistently in a rally than may last up to 60 seconds, and to do that for up to two hours.
Blimey. As a kid in the 70s, no hand-eye co-ordination meant endless humiliation and bullying - even from the teachers. My family liked to play sport on holiday. What a nightmare that was. I was always the youngest too, in my family and neighbourhood groups. Bloody awful experience. Even now, my hand writing is terrible and german class the other day, the teacher wanted to see my work. Oh dear. I get so frustrated when I try to write that it makes a bad situation worse. I can draw quite well though.
God dang it Bobby and here I thought all my life that those were my moral failings! It was ADHD & friends all along! What a massive relief.
I have ADD and am on the spectrum. As a youth playing sport I looked awkward AF; however, I played representative sport at the highest level, 3 different sports.This developmental relationship makes sense to me.
From every video like this I feel that the reactive nature of schooling system where we react only to "the abnormal" is a developmental disorder of the State itself. Instead probably we would need proactive, say, yearly check for these common problems, to get situational awareness, to understand the scale, to build up the organization that can tackle this.
Heavens! How good it is to see you. I just saw a "Harvard eminence" in ADHD say nonsense, like ADHD is a metabolic problem in essence, and that no meds should be given, instead follow a good diet and exercise. 😮
As always thanks for your content! I recently had a behvioural consultation with my daughter's pediatrician (who is an excellent clinician), and when she was advising me on avenues for further research, yours was the first name out of her mouth. I think she was a little surprised when I shrieked "omigod I LOVE Russ" like some sort of overexcited teenager. 😂
I have dyspraxia. One thing worth pointing out is how being a nerd is often associated with being clumsy. Also, when I was at primary school, there usually was multiple kids who were super bad at PE and it usually overlapped with having larger head and better academic performance.
I have dyspraxia and I was one of these kids who usually absorb a lot of knowledge and have easy understanding when present on lessons. I have only hit the wall when it comes to this I started studying CS in college.
One thing that I think is worth looking at is if there's a significant overlap between giftedness/dyspraxia/ADHD. Like the thing about looking into ADHD as adaptation theory, I think there's not enough of looking into specific human types.
Like there's this whole action ADHD subtype where people excel at fast moving action and end up in sports, EMT, military, etc.
I think they must be inherently different from the dyspraxia type.
One thing I think is really worth looking into is Jungian cognive function and particularly Dario Nardi's neuroscience of personality. The general view in Jungian typology is that people have weak and strong sides and that these weak sides take longer to mature.
Like obviously someone with ADHD who is naturally great at sports doesn't deal with the problem where their motion coordination is maturing slower than in others, it's probably the other way.
I think it's worth looking at Dario Nardi's Neuroscience of Personality book and his Magic Diamond too because some traits of types described sound like forms of ADHD.
Like it could be that ADHD to some degree (I'm talking primary only about the inherited one) is a part of natural human variability in sense that some types of functioning are simply more rewarded by the society than others and some types of dysfunction are more punished than others.
Like for example average person may have "dysfunction of creativity" or "dysfunction of compassion" but won't be punished for it.
I think it's worth looking into primarily because looking at whenever ADHD may be an advantage or adaptation of some sorts to some specific roles, requires separating people into types.
For example a psychiatrist with ADHD will most probably be a different type than athlete with ADHD and will probably also have a different presentation of ADHD.
You are describing the autistic ADHD group. Autistic people typically have larger heads, and 80% have dyspraxia, 70% have ADHD. In other words, most people with autism have all three, and those with an above average IQ are the ones who end up stuck in mainstream schools, often undiagnosed, so those are the ones you see. The academic, unsporty, big headed kids.
Thanks for this interesting discussion of Dyspraxia! If it strikes your interest it would be great to hear your thoughts on the co-occurrence of Developmental Language Disorders and ADHD. I'm in grad school for Speech Language Pathology and I’m finding an interesting disconnect. EF deficits are very common in School SLP caseloads and EF is one of the “Big 9” in our scope of practice according to ASHA, and yet a recent mixed-methods analysis (Senter et al, 2023) found widespread lack of clarity among School SLPs on how/if they should support these skill areas. SLPs are one of the most common specialists supporting ADHDers, yet there continues to be very little focus on EF in grad schools for my field. EF skills are key for language development and language is involved with many EFs, so this strikes me as an important area for improvement - and perhaps a topic I'll explore for a Master’s thesis. There are a handful of SLPs specializing in EFs/ADHD who I believe do great work (and frequently cite your work) - Michael McLeod, Sarah Ward, Kristen Jacobsen, and Tera Sumpter come to mind. If you care to share I'd love to hear any thoughts you may have on language & EFs, as a comment or video. Thanks Dr. Barkley!
this is true. My daughter has adhd and dyspraxia yet because she does not have a specific speech impediment and sometimes gets plurals correct, plus is very articulate and hyper verbal, they say she does not need speech services. I am at a loss for what to tell them to keep services, They just aren't equipped to handle these issues I guess
Getting access is definitely a pain. I was diagnosed as an adult, even so I felt I was not heard with attention. I only got access to better procedures after being financially above average, paying stuff outside the healthcare plan and still finding a good doctor willing to put a good amount of time with me discussing the details of the symptoms and consequences to my life, fighting against the bias for anxiety meds, etc.
Listening this makes me more sure that I need to seek what works for me! Thanks!
Same thing with my assessment and diagnosis. had to go private after 2 traumatic years of public health dead ends
Martin Short & Danny Glover's MOVIE "Pure Luck" portrays this at it's finest.
Would you be comfortable doing something regarding discalcalia? It has negatively affected my life in so many ways.
I've never even heard of DCD before, but this is incredibly helpful for me. Thank you!
This is interesting. As someone with ASD and ADHD I have found the gist of this video to be true. (I'm clumsy, AF).
But, when I'm really interested in something I can get quite good at things that require fine motor control, for example I can play the guitar pretty well. Then there's a friend of mine with similar diagnosis, he really likes guns as a hobby which requires a lot of precise coordinated actions to be executed in success.
I know Prof Russel Barkley thinks cerebellum stimulation programs (like Zing Performance) doesn’t improve adhd symptoms. But I’ve enrolled my son to this program 6 months ago, I don’t see adhd symptoms improvement, but his clumsiness and eye-hand coordination has improved dramatically.
Before he wasn’t able to catch a ball if it was thrown at him, after 6 months he’s one of the best in his waterpolo team.
I believe even if his adhd didn’t improve his self-esteem has improved thanks to this program now he has more friends as boys are inviting him to the soccer games etc.
His handwriting is still not good but I believe that’ll improve as well.
Great topic!
i think you should do more videos about when disorders overlap. A lot of that information is hard to find. None of the doctors or counselors around here seem to be educated in cormorbidities
Always have had terrible handwriting. My fine motor coordination is not good… particularly when I’m tired (e.g., if I try to take my meds first thing in the morning, I can’t open the bottle). Tbh, my lack of fine motor control actually is a big reason I didn’t go to med school (because I wanted to pursue surgery, but struggle with any sort of small movement). My coordination as a kid was mixed. I am and was a little clumsy (tend to accidentally bump into things). And my hand-eye coordination is and was poor (struggle to catch things when tossed to me, slow reflexes when playing things like video games). But in other ways I can be very coordinated (climbing things, balancing, sports that only require me to use my body like martial arts and horseback riding).
Does dyspraxia include issues with swallowing? Because there’s a long line of people in my family having a tendency to choke on basically nothing (like a sip of water), and I regularly struggle to swallow things like pills.
I’m curious about the swallowing issue too! Reading your comment I realized my mom and I both tend to choke on our beverages and I hate drinking because it’s so awkward and I cannot drink fast.
I've always been quite clumsy and i think the only reason why i was able to follow along with things like dance lessons was because i started them at a very young age. But even then i was never the best and definitely somewhere below average (i got held back a year in ballet once)🤣
Keto and ADHD would be another great topic :-)
Interesting, is DCD the usual term in the US? Over the period of the late 2000s - early 2010s, I seemed to hear of many of my peers and then my friends' children getting a diagnosis of dyspraxia in the UK, it almost seemed like the new dyslexia with how many people were getting it (our explosion in ADHD and ASD diagnosis happened next).
It seemed to me like in the 90s and 2000s a lot of children at British schools were automatically diagnosed with dyslexia for any kind of learning difference that didn't affect intelligence - many of them being misdiagnosed and this later being found to be some kind of neurodivergence (whether or not they had dyslexia as well being unrelated).
There was even a character on the TV programme Doctor Who in 2018 who had dyspraxia and was shown struggling to learn to ride a bike - a sure fire sign that it was considered a topical condition they wanted to raise awareness of.
It is interesting to me how in the UK public (uneducated) opinion, conditions like dyslexia and dyspraxia are seen as legitimate issues which aren't moral defects whereas ADHD and ASD are often seen as "labels" or "excuses" for bad behaviour :/
Would metronome therapy help?( with coordination?)
Yes. Always getting in trouble 4 bad handwriting. Hard enough to know what to write much less how to write it.
Very interesting as someone who was diagnosed with pretty severe dyspraxia as a kid, I'm really starting to suspect that there has been some missed diagnosis of ADHD.
Its very likely my dyspraxic friend...
ADHD diagnosis is shyed away from by medical practicioners... due to stigma surrounding stimulant medication (IMHO)
Hi David.
Check these stats from last Decembers issue of Dyspraxia magazine ..
(Article is on Autistism and Dyspraxia but the percentage of concurrent ADHD is staggeringly high)
I'm 62... only found out about my ADD ASD and DCD 4 years ago!
Here's the list
50% of Dyspraxic people are also ADHD (fliers et al, 2011)
50% of Dyspraxic people are also Dyslexic (fliers et al, 2019)
50% of Autistic people are also ADHD (Eaton et al, 2023)
80% of Autistic people show signs of Dyspraxia. Yet, only, 6.9% of Autistic adults are diagnosed with Dyspraxia (Cassidy et al., 2016)
If you have Dyspraxia alongside ADHD, do the ADHD medications help with any of the Dyspraxia symptoms too?
Hmmm I'd say so (using a sample size of one, me). While medicated my adhd symptoms are reduced and I am notably more coordinated.
Get injured way less.
Yes
I was finally able to play my piano with both hands last december. Finally after years I can try intermediary level sheets. Convincing the doctors along the way was hard until I found one angel that actually listened to me, but It's outside my healthcare plan. I'm from Brazil where doctors have bias for anxiety drugs. Including my current doctor (but I managed to convince her to not continue, only specific adhd ones). It still requires effort and specific therapy when you start feeling well.
Sometimes I don't figure out myself when to stop and rest, because I feel something similar to hyperfocus, but failing all the keys and strategies I came up to hit the keys in a reasonable time that you can recognize the song. Following "boring" instructions became easier and feeling the smaller rewards made a lot of difference.
Yes, but not directly (based on a sample size of me). Overall distractions are reduced which lets me focus better on motor tasks.
@@OldManSparkplugoh interesting, I felt as if I got pulled up on top of my head and had lower pace, especially on methylfenidate compared to dexamfetamine which I have now. Also my posture has improved. Ofcourse in only my personal experience. But i also started seeing sharper but have heard no one about this so must have been a unique issue I had hahaha
On the one hand I was terrible at PE in school. Always too slow.
On the other hand I am quite a good dancer thanks to my body coordination and sense of pace.
Slow in reaction time or slow in movement?
@@shuttzi9878 slow movement. Running has never been my strong suit. I've had my reflex tested recently and it's perfect
@@Deus888honestly I ran around so much a kid that there's no way I wasn't gonna be decent at running
Damnit! And here I thought I finally found something that WASN'T linked to ADHD.
I really need to pursue a diagnosis or get it ruled out... literally every single thing, EVERY, SINGLE, THING, I learn about ADHD ends up ticking off some box that fills my life and explains why I do a thing I do.
I’m so confused! This video was released just today, but y’all had already packed the bookshelves-mostly packed that is.
I am not sure the sequencing part of my brain ever developed 😅
Same!
Dr Barkley I truly hope you see this and can answer this. But does high intensity exercise , increase the executive functioning in the brain over time as in the effects accumulate, or is just for that particular day? I was hoping to exercise at least 4-5 days hoping it would help the neurons function better and to help my executive system remember , focus , and just function better in general
It seems to be just for that particular day but there are no long term studies so maybe there could be some sustained benefit. Be well.
I have ADHD and Dyspraxia. For me personally I found Dyspraxia the worst of the two. Usually at school if your not good at academics you may be good at wood work, art or maybe sports. My writing was ineligible and anything that required co-ordination eg wood work, sports or the arts were equally as bad. I was always the last person picked to join teams. I felt that I was trapped in a body I could not control, Being in the early 1980's the only recommendation the school had was getting a typewriter. luckily my parents got me a computer which allowed me to have a career in IT. If it has been 10 years earlier I would have been completely unemployable.
Dys... + autistim + ADHD issues, as I found out, will worsen with age and menopausal estrogen lower production.
Time to get checked for Hormone replacement therapy, ladies.....
Thank you, Dr. Barkley!
Are there any therapies for adults who still struggle with DCD?
Are there known ramifications for children not receiving therapy for their DCD related struggles? I’m quite sure it’s why I never could drive a manual transmission and why my kiddo has been struggling for years with shoe tying.
Other than working with a physical therapist or personal trainer, there are no new therapies. Medications for ADHD also help to some extent with motor speed and coordination. As for how kids who didn’t get therapy turn out in their adult coordination, I am not aware of any studies going on that long that monitored that domain of life. Be well.
@@russellbarkleyphd2023It is so much worse in adulthood if you don't have the option of becoming a homemaker, cos you have to support yourself financially, which children don't have to. When you are so slow at everything except speaking and chewing and swallowing which are fast and clumsy and sloppy, which everyone complains about as the two things you must do slowly but can't, what job exactly are you supposed to get? I am asexual, can't stand living with other people and would not cope as a parent so I have to work or live on government support, but working is so traumatically difficult and full of shame and constant fear of getting sacked and having to start the dreadful cycle of job hunting, starting, fighting to keep, then losing all over again, that I considered leaving home to live on the street, to escape the nagging and shame about employment. There is nothing worse than taking five times longer than everyone else at everything despite getting out of breath with how desperate you are throwing your body and arms around at torpedo speed to catch up with them, cos people see you as utterly worthless and broken and abnormal and a freak
@@russellbarkleyphd2023My prediction is there are four types of dyspraxic/NVLD adult: 1) comorbid with dyslexia instead of being part of NVLD, therefore the person is competent enough in the workplace with enough intact higher cognitive abilities to be full time employed without having nervous breakdowns all the time, 2) financially supporting oneself but struggling with extremely poor subjective feeling states due to the extreme effort required, so constantly at or close to crisis point and frequent psychiatric admissions due to the torment of perfectly justified employment anxiety which gets misdiagnosed as a primary anxiety or mood disorder, 3) full time homemakers or custodial parents who are super slow like me but are not at risk of being sacked cos nobody sacks you for slowness in those roles, and 4) the unstudied majority, who are not included in any studies because they are already homeless or suicided. My prediction is that NVLD is the number one cause of homelessness and suicide. It means you are terrible at everything needed for employment, but nobody sees you as disabled cos your verbal skills and certain non-verbal skills are high. If you don't study homeless and young dead populations you won't see how common the NVLD version of dyspraxia is as a cause of despair and destitution. We are told we are either lazy scroungers for being unemployed and receiving government help, or that we just lack confidence in ourselves and need CBT to stop our nervous breakdowns when employed, cos ppl don't believe we are just that incompetent.
Question: Is it worth it to get a specific diagnosis for DCD and language developmental disorder after having the ADHD diagnosis? It is impossible to find speech therapists who really understand this problem. Besides, there are so many acute problems in the school system that it swallows those with fewer behavioral problems.
How is dyspraxia in kids diagnosed?
Physical therapist can run a battery of motor tests involving balance, coordination, etc to evaluate them against age norms.
what about cerbal palsy and adhd?
The neurodevelopmental disorders come in groups. When someone has one they probably have more
thanks again, sir. i recently has my brainwaves recorded, while awake. one of the comments was that i have little or no drive- does this pertain to this part of the brain? i wonder all the time...regardless, the discovery was a huge validation for me, although society doesn't seem to accept that one could have an issue with drive=lazy, crazy or stupid..
Try thinking of your skills and energy levels in terms of game mechanics
1 to 10 being ur level in knowledge for example
U can do the same when it comes to passion or drive
We have shit amount of dopamine, that's true, but we can always measure it to some level and see what gets us going
Observe and note when you have the most amount energy and drive and try doing those more of those things that u were doin in that time
If 1 was your base DRIVE level then note how u feel after a while of doing those things and your base DRIVE level after (not when your stimulated)
@@shuttzi9878 how kind of you for all this description- i've read it a few times, hee hee, but my take away is that i am always up and active at night..and, there's nothing wrong with night fotos! just wondering how to make a living, as i am disabled (first body part is psyche) and at 52 i feel time is running out- when my mom passes, i am screwed=no advocate, no shelter. anyway, that may sound ungrateful to your response, and i probably am a defeatist at this point, but thank you for caring and reminding me there's a time and a place for me, still. muahs!
@@foxybyproxy It truly sucks to live on this planet with far less energy than the bulk of humanity. Its literally gravity pulls stronger on hypotonic (low muscle toned) dyspraxic bodies.
Way I look at it is we obviously arent all the same, theres a bell curve with some on the high end, some on the very low end (us feeble late walking tiny motored types)
We are forced to look on from the slow lane (or parked lol) as the world whizzes by us...depressing
Sad that those who dont experience the lifelong clumsy tiredness we have by no fault of our own, choose to judge us as lazy "just not trying" etc.
Im 62 btw
Yeah, that's me. Terrible handwriting, can't tie shoe laces, barely able to ride a bicycle. Also, my speech is inconsistent too, but I didn't learn that until I heard myself.
And all if it had affected me seriously in my childhood.
There you go. 50% comorbidity
@@atheistbewildered2987 Damn, that's a nice number.
👍💪🤝👏
can you have have executive dysfunction without having adhd?
Absolutely. A lot of cognitive processes are under the "executive functioning" umbrella, and they can be impaired in many conditions. I know that it happens in ASD and OCD, but there are other diagnosis where executive dysfunction occurs as well.
Yes, and the reasons for it can be numerous. It depends what you are concerned about and the problems you might experience. In general, it'd be best to have it assessed if thats possible for you.
@@ravensong9030 depression, anxiety, and BPD can affect them as well.
Premature birth is a huge risk
conclusion: all doctors have horrible handwriting due to dyspraxia.
kinda sick of learning I have a new disorder every other day haha