Treatment of Adult Dyspraxia
Adult dyspraxia (developmental coordination disorder) requires a multidisciplinary rehabilitation approach centered on occupational therapy with activity-based functional goals, complemented by speech-language therapy for any co-occurring communication difficulties, while avoiding compensatory aids during active rehabilitation phases. 1, 2
Core Treatment Framework
Occupational Therapy as Primary Intervention
Occupational therapy should focus on activity-based (functional) rather than impairment-based goals and interventions. 1 This represents the cornerstone of adult dyspraxia management, with the following key principles:
Strategy training or gesture training may be considered for apraxia/dyspraxia (Level IIb, B evidence), along with task practice with or without mental rehearsal (Level IIb, C evidence). 2
Avoid compensatory aids and techniques during the acute phase or when undergoing active rehabilitation, as these can impede recovery and skill development. 1
Never use splints or devices that immobilize joints, as this contradicts the goal of improving motor planning and coordination. 1
Integrate specific treatment techniques into functional activities and demonstrate how patients can carry these over independently into daily life. 1
Education and Self-Management
Provide education about the diagnosis and symptoms at initial assessment, emphasizing that dyspraxia is a real and disabling condition affecting motor planning and spatial information processing. 1, 3
Introduce the concept of self-management from the first session, as this promotes long-term independence and reduces reliance on ongoing therapy. 1
Involve significant others in education and treatment, as support systems are crucial for carryover of strategies into daily contexts. 1
Addressing Co-occurring Conditions
Recognize that dyspraxia frequently co-occurs with other conditions including ADHD, dyslexia, and communication disorders, which require concurrent management. 4, 5, 6
Screen for and address co-occurring aphasia or communication difficulties, as these can complicate rehabilitation and require speech-language therapy input. 2
Assess for executive function difficulties, attentional deficits, and hyperactivity, which show distinct symptom profiles from pure motor coordination problems. 6
Evaluate for emotional and mental health sequelae, including anxiety and depression related to lifelong motor challenges. 4
Speech-Language Therapy for Communication Components
If communication difficulties are present alongside motor dyspraxia:
Reduce excessive musculoskeletal tension in speech and non-speech muscles affecting articulation, particularly in the head, neck, shoulders, face, and mouth. 1
Consider collaborative treatment with physiotherapy or occupational therapy where there is functional facial weakness, spasm, or trismus. 1
Use distraction techniques such as dual-tasking while speaking, singing, or mindfulness during oromotor tasks to normalize speech patterns. 1
Address psychological factors including abnormal illness beliefs, hypervigilance to bodily functions, and cognitive features related to locus of control. 1
Therapeutic Approach Principles
Positive Reframing
Use variability of symptoms on examination and in day-to-day life positively in treatment, demonstrating to patients that improvement is possible. 1
Recognize and sensitively challenge unhelpful thoughts, beliefs, and behaviors that perpetuate disability beyond the motor impairment itself. 1
Relapse Prevention
Complete a relapse prevention and ongoing self-management plan as part of treatment, as dyspraxia is a lifelong condition requiring sustained strategies. 1, 3
Book follow-up appointments to review progress, troubleshoot issues, and reset goals as the healthcare system allows. 1
Critical Pitfalls to Avoid
Do not propose endless training for deficient actions (writing, dressing) as this leads only to short-term pseudo-progress without long-term efficacy. 5 Instead:
Rapidly orient treatment in two directions: (1) addressing the "double-task" effect from graphical and spatial difficulties, and (2) implementing palliatives including computing technology. 5
Avoid focusing solely on impairment-level exercises (e.g., repetitive motor drills) without functional context, as this fails to address the motor planning deficits central to dyspraxia. 1
Do not confuse dyspraxia with simple lack of motivation or "common" school difficulties, as this leads to inappropriate management and poor outcomes. 5
Prognosis and Long-term Management
With early diagnosis and well-coordinated management, prognosis is excellent for educational success, professional choice, and social integration. 5
The majority of individuals retain motor difficulties into adulthood, requiring lifelong compensatory strategies and accommodations. 3, 4
Peer support organizations serve as an important adjunct to treatment, especially for those with persistent symptoms. 1, 4