Understanding Motor Skills in Children with Dyspraxia, ADHD, Autism and other Learning Disabilities: A Guide to Improving Coordination

Lisa A. Kurtz

In a little over 100 pages, this book provides an overview of normal motor development, the ways in which motor development can go awry, and how these deficits affect children’s lives. It also provides descriptions of effective interventions. The book is balanced and positive as it explains the role of the various professions involved with habilitating these deficits.

Therapies must achieve several goals. The patient must be motivated even when tasks must be repeated for the skills to become automatic. Techniques which isolate specific skills may be used, but skills learned explicitly are not useful until they can be applied in more complex situations. Therapy that involves games or everyday activities has the advantage that the skills are necessary for an applied task, making their importance evident. In this situation, the learning may be implicit and relatively painless. In most instances, therapy uses a blend of prescribed activities which are focused on developing specific skills and using these skills in meaningful activities. When possible, the “Karate Kid” approach can be effective and mimics how skills are learned naturally.

The author, who is an occupational therapist with years of experience, prefers a practical approach. She has developed an awareness of the importance of visual skills and visual perception to a child’s over-all development and academic success as demonstrated by the following excerpt.


Visual efficiency disorders occur when there are problems with eye muscle control that impact upon such skills as keeping the eyes focused on a line of print, or adjusting eye position to stay focused on a ball as it comes closer to the child. Thus, functional vision problems relate to an inability to plan and execute eye muscle movements efficiently, as opposed to a health or structural problem with the eyes, and may frequently occur in children with Developmental Coordination Disorder. Functional vision disorders, especially when mild, can be hard to detect, since they may fluctuate over time and can occur in children who have perfectly normal visual acuity. Some children may complain of eyestrain, or blurred or double vision, but others fail to report problems to parents or teachers because they do not understand that those symptoms are abnormal.

Most eye doctors do not routinely screen children for these visual efficiency disorders, but focus more on eye health and visual acuity (being able to see clearly when looking at stationary visual targets at near point and far point). Symptoms of these problems may relate to the appearance of the eyes, to behaviors observed in the child, especially during reading or other close visual work, and to complaints made by the child who experiences eyestrain as a result of inefficient vision. The presence of one or more of these symptoms combined with poor school achievement suggests the need for a formal vision assessment by a developmental-behavioral optometrist, who has specialized training in this area.

Dr W at work
Even if vision is intact and works efficiently, the visual information that is transmitted to the brain must be understood and correctly interpreted by the brain. Problems with this interpretation are called problems with visual perception, and are common among children with autism, ADHD, and learning disabilities.


Visual perception (or visual information processing) is dependent on accurate, consistent, and effortless visual information acquisition and in its synthesis with prior experience and other sensory input. Past models of visual perception were passive: input > processing > output. Recent research reveals that the brain is sending more information to the eyes (top-down processing) than the eyes are sending to the brain (bottom-up processing). Perception is proactive, not reactive. Function alters structure; the brain changes as a result of how it is used. Learning cannot take place without feedback, attending to the results of our actions and adjusting our anticipations and actions accordingly.

Action in Perception
Active Vision

Attention and Embodied Perception