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-hidden
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.
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.