Developmental dyspraxia: Symptom or real “dys” disorder?

Just like all the others specific learning disorders, dyspraxia is a key issue for public health and school performance. “Developmental dyspraxia” qualifies specific disturbances of gesture, i.e. the ability to produce a finalized action (goal-directed movement) and to use the objects [1,2]. Even if dyspraxia was described for decades, the value of the concept for diagnosis raises some debates in the international literature. Since 1994, a consensus has been established on the diagnostic entity of Developmental Coordination Disorder (DCD) to describe all children who exhibit developmental deficits of “motor coordination”. Beyond the usual debate of terminology, both the theoretical and the clinical definitions of the gestural dysfunctions in children remain insufficient in various respects. This communication provides a review of current controversies regarding the field of dyspraxia and DCD. Understanding the two entities of dyspraxia and DCD proves problematic, both when defining the concepts of praxis/motor coordination and when providing a theoretical analysis of the deficits they cover. More specifically, we aim at exploring the arguments supporting the hypothesis of a specific deficit in praxis development. We discuss the respective contributions of different impairment levels highlighted by studies of developmental gestural impairment (e.g. knowledge, executive functions, perceptive abilities…). Such a deconstruction of the concept of a specific deficit in praxis development argues in favor of an analysis that does not confuse gestural problems with other deficits made apparent through gesture