Mazeau M
SESSAD Ladapt, 75018, Paris, France.
Arch Pediatr. 2010 Mar;17(3):314-8. doi: 10.1016/j.arcped.2009.10.016. Epub 2009 Nov 25.
Despite its frequency, little is known about dyspraxia. Dyspraxia, which represents disorders in development and learning movements, within the context of a deficiency in the management of spatial information (in children whose verbal intelligence is spared), is often a severe handicap at school and in social life. Dyspraxia must be distinguished from "common" difficulties of unmotivated children at school, with which it is often confused. Hence, the diagnosis must correspond to rigorous methodology. And one should avoid proposing endless training for the deficient action (writing, getting dressed...); indeed such strategies only lead to short-term 'pseudo' progress, without any long term efficacy on the educational success of these intelligent children. To the contrary, the child should be rapidly oriented in two therapeutic directions: (1) a battle between the "double-task" effect stemming from the graphical and spatial difficulties; (2) the use of palliatives (including computing). In conditions of early diagnosis (at 4-8/9 years of age) and well-coordinated management with the school, the prognosis would be excellent in terms of schooling, choice of a profession and social insertion. If not, or if (as is the case in almost a third of cases) dyspraxia is not isolated (associated with dyslexia, hyperactivity, attentional deficit and psychotic traits), the child should be oriented towards a specialised classroom and care.
尽管失用症很常见,但人们对它却知之甚少。失用症表现为发育和学习动作方面的障碍,在空间信息管理能力不足的情况下(对于语言智力未受影响的儿童),在学校和社交生活中往往是严重的障碍。失用症必须与学校里缺乏学习动力的孩子所面临的“常见”困难区分开来,它常与这些困难相混淆。因此,诊断必须符合严格的方法。而且应该避免为有缺陷的动作(书写、穿衣等)提供无休止的训练;实际上,这样的策略只会带来短期的“虚假”进步,对这些聪明孩子的学业成功没有任何长期效果。相反,应该迅速引导孩子朝着两个治疗方向发展:(1)应对由图形和空间困难引起的“双重任务”效应;(2)使用辅助手段(包括计算机)。在早期诊断(4至8/9岁)并与学校进行良好协调管理的情况下,在学业、职业选择和社会融入方面的预后会非常好。如果没有做到这些,或者如果(几乎三分之一的病例都是这种情况)失用症不是孤立存在的(与诵读困难、多动、注意力缺陷和精神病特征相关),则应让孩子进入特殊班级并接受照料。