Dyspraxia & Cerebral Palsy – The similarities and differences

As someone with both dyspraxia and cerebral palsy, a question I’ve been asked before is “What is the difference between cerebral palsy and dyspraxia?”

I thought I would write a blog post which looks at the similarities and differences between dyspraxia and cerebral palsy, to try to make it a bit clearer for others as well as for myself! I must firstly point out that obviously I’m not an expert at all and I am writing this purely through my own experiences and research.

In many places where a definition of dyspraxia is given, it states that dyspraxia is diagnosed in the absence of any other neurological abnormality. However, this isn’t true as myself and many others have both dyspraxia and cerebral palsy!

There is a lot of overlap between dyspraxia and cerebral palsy, and as someone who has both it is often hard to tell which symptoms are due to which condition. In fact, there was a study on dyspraxia which I wasn’t able to take part in due to this reason. In addition to this, I don’t know when it was carried out but some research suggests that dyspraxia and CP could actually be on a continuum of a ‘movement disorder’ rather than being two separate categories. I can understand this to some extent. On the other hand, despite the similarities there are also a number of differences.

A lot of people might think “Well of course the main difference is that cerebral palsy is severe and dyspraxia is hidden!” In fact, that’s not the case at all as I pointed out in my last blog post: https://theblogwithonepost.wordpress.com/2015/09/14/visible-disabilities-can-also-be-hiddencerebral-palsy-4-728
The main difference between dyspraxia and cerebral palsy is that while dyspraxia is where the signals from the brain to the body get muddled, cerebral palsy is where a specific area of the brain is damaged affecting the movement of muscles in certain limbs. This means that dyspraxia affects the whole body, whereas cerebral palsy can affect any number of limbs depending on which area of the brain is affected. Dyspraxia affects the planning and execution of movement, whereas cerebral palsy affects the actual movements themselves. For those of you who don’t know a lot of cerebral palsy, I thought I would outline the different types. There are three main types of cerebral palsy: spastic, ataxic and athetoid/dyskinetic.

Spastic cerebral palsy is the most common type. Just to point out, yes ‘spastic’ is often used as an offensive term but in medical terms ‘spasticity’ literally just means muscle tightness. Spastic CP affects 70% of cases of cerebral palsy, and causes muscle tightness and muscle spasms. There are also sub-types of spastic cerebral palsy, depending on the number of limbs affected:

  • Diplegia – the most common type of spastic CP. The lower body is affected, with little or no effect on the upper body.
  • Hemiplegia – one side of the body is affected.
  • Quadriplegia – all four limbs are more or less equally affected.
  • Triplegia – three limbs are affected.
  • Monoplegia – one limb is affected.

Athetoid/dyskinetic cerebral palsy is a less common type of CP, and affects roughly 10% of cases of CP. It is characterised by a mixed muscle tone and involuntary movements.

Ataxic cerebral palsy is the least common type of cerebral palsy, and is the type of CP I have. It affects 5-10% of cases of CP and causes low muscle tone, shaky movements and a wide based gait.CP.47160630_std

Not only are there different types of CP, but people may also have mixed CP which is where they have symptoms of more than one type of CP at the same time.

I’ve just given a brief outline as to what the different types of CP can be mainly characterised by. Obviously there are many more symptoms than just the ones I’ve listed. All types of cerebral palsy affect a person’s balance and co-ordination, which is one of the ways in which CP is similar to dyspraxia. Ataxic CP in particular can also affects a person’s spatial awareness and depth perception which again are overlaps with dyspraxia. Out of all types of CP, ataxic CP seems to be the most similar to dyspraxia. Ataxic CP can also cause hypotonia, which means weak muscle tone – something that can also occur due to dyspraxia. Although I think that hypotonia is more commonly associated with CP than it is with dyspraxia

Cerebral palsy can also affect a person’s speech, just like dyspraxia can. However, I’m not sure whether it’s to do with the same reason. People with dyspraxia often find speech difficult due to the muddled signals which means words get muddled up. On the other hand, when someone with CP is affected in their speech it is normally due to the muscles than control speech. If someone with dyspraxia does have difficulty with their speech due to the muscles that control speech and this difficulty is significant, then they are usually diagnosed with verbal dyspraxia.

Both CP and dyspraxia can also affect a person’s thought processing speed. This doesn’t mean that our intelligence is affected, it just means that it takes us a bit longer to process things than it does for other people. For example, it can take us longer to interpret exam questions and understand what is being asked, and it then can take us longer to organise the ideas and get them onto paper.

Fatigue can be an issue for both people with dyspraxia and cerebral palsy. For those of us with dyspraxia, it takes our brains 10x more effort to do things than it does for others. Similarly, for those of us with CP we use 3 to 5 times the amount of energy that other people use when moving around.

Due to fatigue, CP can also affect a person’s concentration. Dyspraxia also can make concentration difficult, but in a different way. Those of us with dyspraxia can find it difficult to concentrate for long periods of time and often find ourselves daydreaming. In addition to this, concentration can be made even more difficult (impossible for me) if there is any background noise.

Some of the things that dyspraxia affects but CP doesn’t include: organisation, not liking changes in routine, difficulties in social situations and sensory sensitivity. While dyspraxia affects a whole range of things other than just the physical aspects, CP is primarily a physical disability.

As I mentioned earlier, while dyspraxia can have an effect on a person’s muscle tone cerebral palsy definitely has a lot more involvement in the muscles. It can cause muscles to be tight and it can cause involuntary movements. Some of my muscles are tight, including my hamstrings and in particular the muscles in my lower back, which makes sense as I cannot touch my toes at all! Ataxic CP in particular can cause a person to have a loss of full control over their muscle movements. This means that we can appear to be ‘shaky’ at times. I’ve been asked a few times why I’m shaking. One time I was actually asked if I was cold because of this. Despite the fact that I do get cold easily, I wasn’t actually cold at that point – it was just my CP!

Due to difficulties with balance, a person with ataxic CP may also walk with a wide based gait. According to the notes from my disability athletics classification (carried out by a physiotherapist) I walk with an ‘ataxic gait’. During the disability athletics classification they look at the way your muscles work by getting you to lie down and relax your muscles (which can be quite hard when you’ve got CP!) while they move your arms and legs and test your reflexes etc. For someone with CP the effect on the muscles can be recognised when doing this. However, as far as I know you wouldn’t notice anything when carrying out this test on a person with dyspraxia. This is because unlike CP, dyspraxia does not have a direct involvement on a person’s muscles as it is more to do with the signals sent to carry out certain movements.

The effect CP has on a person’s muscles often means that we have a weaker side. Of course everyone has a dominant hand, but for those of us with CP this difference is more significant. On the other hand, people with dyspraxia often have a poorly established hand dominance and may use different hands for different tasks at different times. My right side is my dominant side and my left side is my weaker side. One of the times this is most noticeable is when I am typing. I know most people use their dominant hand slightly more than their other hand but I use my right hand for the majority of typing even sometimes for keys on the left side of the keyboard, only using one finger on my left hand. Due to the fact that my left side is my weaker side, it tends to get tired/ache more quickly than my right when I am typing even though I use it less.

While the type of cerebral palsy I have affects the whole body anyway, other types of CP only affect a certain number of limbs. Cerebral palsy differs from dyspraxia in this way, because dyspraxia doesn’t affect specific limbs, it affects the whole body.

As cerebral palsy affects a person’s muscles, this can also have an effect on the bones. This means that some people with CP will require surgery. This isn’t the case for dyspraxia. However, it is quite common for people with dyspraxia to have hypermobile joints. For me this means I can bend my fingers back further than they’re meant to be able to bend. Most people’s reaction is “Ew, that looks weird” but it honestly feels completely normal to me!

This blog post was quite a complicated one to write, as having both dyspraxia and cerebral palsy means that it can be hard to distinguish between them but hopefully it’s made some sense to you! I do consider dyspraxia to be my main diagnosis as that’s what I was diagnosed with first and my CP is very mild.

10253823_792643680774009_1003424277308221453_ncerebral_palsy

Natalie 🙂

Advertisements

25 Comments

  1. This is so informative, I’d never realised there were different types of CP and how similar some symptoms are to dyspraxia but for different reasons.

    Like

    • Thank you! Glad you found it informative 🙂

      Like

    • Kate

      As a mum to a dyspraxic who was also assessed for CP, I can now see why they think he has CP and I now think he has the type which affects one side of the body more thanthe other a bit and he has very low muscle tone, particularly in his core body muscles and tegs, while also having very tight/short muscles in his lower legs. Thank you for this, it all becomes much clearer for me and now perhaps I should go back and say perhaps we should get the cp diagnosis too. What do you think?

      Like

      • That’s alright. I think if you still feel like your son has CP then it’s worth going back to see. Maybe find a list of symptoms online and highlight the ones that are relevant to your son, that may help (although you may have already done that previously)

        Like

      • See I don’t know about CP but with my Dyspraxia I naturally have very week upper/back core muscles and arms (like spaghetti lol) but very compact strong abdominals and thigh muscles, so I don’t know how exclusive that type of muscle tone is to CP x

        Liked by 1 person

  2. Reblogged this on Heba vs Reason and commented:
    Dyspraxics unite

    Liked by 1 person

  3. Hi Natalie –

    You say you’re not an expert at all but that’s simply not true. For your unique combination (and both Dyspraxia and CP vary wildly from person to person, let alone if you have both), you’re the ultimate expert. Only you, not any scientist or medic, can know exactly how you feel and in what way these things affect you. I do occasionally wonder whether my daughter has a small degree of CP because she is so very, very right-handed. She would ignore her left hand (and left side generally) completely, if we didn’t constantly pick her up on it.

    Thanks for the analysis!

    Like

    • Aw thank you 🙂
      Yeah that sounds like a possibility, sounds similar to me. Although the odd thing is, for me my right shoe somehow wears down a lot more than my left despite my left being my weaker side.
      No problem, thank you so much for your comment!

      Liked by 1 person

  4. Mandy

    Thank you…my daughter has been diagnosed with dyspraxia…she also has had a stroke as a baby and has spasticity in her right lower leg and ankle region….however, she also has shakiness, the hypermobility you talk of too…un fact all you talk of she has….her spasticity is mild…wow…she is 14…we only found out less than two years ago she had a stroke and only late lastvyear she has spasticity, dyspraxia etc…sadly drs didnt listen to me and my concerns….your post is another aha momentt for me..thank you..

    Like

    • No problem, thank you for your comment! Sounds similar to me, although I was diagnosed with dyspraxia when I was 3 I wasn’t diagnosed with CP until I was 13!

      Like

  5. brilliant post , I in my googling away for group or personal info /answers/pointers I have often wondered the DCD (Dyspraxia ) – C.P link……. This is the first really well written clear break down so Thank you 🙂 ….

    The Weak / Low muscle tone is as far as i am aware as frequent in DCD as C.P, I believe the level of weakness is greater with C.P in most cases ??? but the muscle tone itself is down to the proprioception sensory system which is also connected with vestibular & hypermobility
    ( if thats any use to you at any point ? not that your not doing an amazing job )

    Liked by 1 person

    • Thank you Sam! Glad you found it helpful! That’s interesting to know regarding muscle tone, thanks 🙂

      Like

  6. Emma holmes

    Just doing research for my daughter she is 11 and has CP which affects her legs she has had a few surgeries to help recently I think she has dispraxia we went to her paediatric doctor who said it’s all down to her CP it’s not her dyspraxia but I really disagree I’m worried because she goes to high school next September and needs a lot of help with this I don’t no what to do?

    Like

    • That sounds very frustrating with the doctor disagreeing. Maybe if you get in contact with the the SENCo at the school your daughter is going to they might be able to help. Even if you are still trying to get a diagnosis, hopefully the school will still be able to provide the support your daughter needs

      Like

  7. Lottie

    The description of your symptoms sounds very similar to my 6 year old daughter’s. She has generally low muscle tone affecting her arms and legs, but can walk unaided. She has poor balance, struggles with writing (left handed writing back to front) and has continuous jerky movements. We saw a consultant, physio, orthotics etc until she was 4, then she was signed off as she was slowly progressing and they felt they couldn’ t help anymore. Now at school things are difficult and she doesn’ t like PE and is finding it hard to fit in as she is seen as clumsy by other kids. She is very stubborn and getting angry at everyone as she can’t do things. The consultant thought she had mild CP or dyspraxia, but I really couldn’ t say which one, so interesting that you have both conditions. I am now seeing the special needs coordinator to get some help at school, but feel I need to get a diagnosis even though my GP is not willing to refer us back to the consultant as we were discharged. Did you have to have an MRI scan to get CP diagnosis? My daughter had one but moved around too much to see much! I don’ t want her to have a general anaesthetic, but am worried how she will explain why she is the way she is if we cannot put a name to it…so frustrating.

    Like

    • I didn’t have an MRI scan done. I know what you mean, it is easier to understand and get access to support when you have a diagnosis. That sounds really bad that your GP won’t refer you, maybe the SENCo could write a letter to your GP?

      Like

      • lottie

        Thanks Natalie for your reply, yes I agree that does seem the best thing to get a letter and I will see what I can do. I don’t think MRI scans are needed to diagnose CP either but the hospital seemed to think it was important. Thanks again for your blog, I feel so much more positive about getting a diagnosis and know she will find her own ways to adapt, but also realise that without help, school life may be hard. x

        Like

      • No problem, I hope it all goes okay and you manage to get a diagnosis!x

        Like

  8. when I write or type very often i forget to write some word Teachers told me that this is due to cerebral palsy because I think more rapidly than i write. i want to know if this is possible

    Like

    • Although I don’t really miss out words, I do often write the wrong word instead of the one I intended to write. I don’t know for definite but that would certainly make sense what your teachers are saying about your CP and missing words out

      Like

  9. roshandromeian

    Hey Natalie, I’m the person who commented on fb about having a cp, dyspraxia and autism related issue that I’d like help with.
    Basically, I have a diagnosis of diplegic CP, (it affects my legs; I can’t stand or walk without holding on to something), I was diagnosed age 1, although apparently I was never given an MRI to actually see the brain damage. This February, after a lot of research on my part I was given a professional diagnosis of Autism (Asperger’s presentation).
    I have since researched dyspraxia and seen many similarities to my own experience. The academic difficulties particularly stand up to me as unexplained by any of my current diagnoses: poor handwriting, bad motor planning, difficulty planning essays and editing myself, poor problem solving skills, difficulty applying skills to different contexts, difficulty processing new material, particularly if it is very visual/spatial, difficulty with perception of quantities like time, depth, distance, weight e.t.c. general lack of spatial awareness and motor skills, even in my dominant (right) hand which I feel is completely unaffected by my CP, (my left arm is a bit twisted, idk why or if that changes anything though). The link below is to the most accurate visual representation of my thought processes and why I’m struggling in school now that I have ever found:

    My main question to you is are diagnoses of autism and cerebral palsy, like I described, essentially equivalent to dyspraxia, or do you think there are things that are unique to dyspraxia? Also, I don’t understand how you have both diagnoses (CP and Dyspraxia) ? I though doctors weren’t allowed to diagnose one if you had the other?
    With this in mind, in my current situation, how would you go about perusing a DCD diagnosis if you thought if fit?

    Sorry this is so long, any input you (or anyone with the relevant knowledge), can provide would be much appreciated. Thanks in advance!

    Like

    • Hi, it is really hard for me to say as I’m not a professional – I can only talk about my own personal experiences. But it is possible to have both dyspraxia and CP, as I know a few others who are diagnosed with both. I believe there are things that are unique to dyspraxia but at the same time there is so much overlap across conditions that I think it can even be hard for doctors to distinguish where one ends and the other begins. For example, due to CP being caused by damage to the brain it can also affect a person’s thought processes – part of which is similar to dyspraxia. I guess the person to go to would be the SENCo at your school, to see if they can support you in the areas you are struggling with. In terms of the diagnosis, though, I think it would be your GP. Or you could speak to your SENCo about it and perhaps they could request an assessment to be done by an educational psychologist (although I’m not sure entirely how it works)

      Like

      • roshandromeian

        Well, thanks for your input, it’s really helpful to hear from someone in a similar position to me. I guess I’ll just have to try and separate the Asperger’s from the CP and possible dyspraxia somehow.

        The GPs in my area are pretty useless, when I went for an autism referral, one genuinely thought that all the issues were because I was being a difficult teenager and told me to “grow up”, one said there was nothing they could do, one referred me to the wrong place. We even tried privately, but, within 15 mins they said “I clearly wasn’t crippled by autism or Asperger’s because I could have a conversation” and that they “don’t believe in people having more than one diagnosis” (I already had CP).
        When I finally saw one who took me seriously, (different area), they said that the chance of ASD is increased in people with CP and that they were “surprised it hadn’t been considered before”!

        Unfortunately, the only support school has been able to offer me is a maths tutor, (I’m doing the A level), which is great; I understand him pretty well, but, (see the image above), he recognised that thought process in me, only to go on and say he has no idea how to help it having never taught a student with remotely similar issues before.

        Although school have provided me with a laptop, (my handwriting is hit and miss and I want to be a computer programmer anyway, so typing is important), they got it outside of the local authority so they wouldn’t have to pay to get someone to teach me to touch type, (after this they said they had no one to teach me in school).
        Also, I’ve basically been completely refused an educational psychologist, despite requesting one for months, having all the papers signed, having a new diagnosis, (ASD), and being so stressed and behind with the work that I almost dropped out, and now I’ve had to drop half of my subjects. All this on the grounds that they now only work on priority cases, which I don’t count as because I’m not “transitioning”.

        Tl;dr: thanks so much for your help, but it looks like I’m pretty much stuck, short of a miracle.

        Like

      • So sorry to hear that you haven’t been getting the support you need! That’s really bad! Hope you’re enjoying the break from school over the summer though and have the chance to relax a bit

        Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: