Developmental dyspraxia: which future in the adulthood ?
Dr Sibylle GONZALEZ MONGEa
a CHU LYON
Dyspraxia is defined as a neuro cognitive développemental disorder mainly involving the development of the gesture. If it is now well recognized thanks to the consensus on diagnostical criteria (1) and extensively studied through an abundant literature (2), its physiopathological mechanisms, its neurobiological bases and its evolution still remain insufficiently explained. The heterogeneous symptomatology, the frequency of the associated motor and cognitive disorders primarily focusing on the language, the attention and the executive functions, the evolution of the symptomatology over time make it a complex pathology with little reliable prognosis in the adulthood. It is, however, a frequently raised question by the parents, as soon as the diagnosis is assessed during the childhood: « what future for her or him when growing?»
In order to answer this question, it seems important to develop, in this domain, case studies with longitudinal follow up. It is probably a way to assess a neuro cognitive developpemental model of the function by studying several individual trajectories taking into account the change of the ifferent components of the praxic function as well as other cognitive functions involved and their evolution as time goes on. Of course the effect of rehabilitations has to be taken into consideration as well as the difficulty in making a difference between natural evolution and what depends of the evolution modified by treatments.
Currently, the reference hospital centers for language and learning disorders since the promulgation in March, 2001 of the action plan for the children with specific language disorder can follow-up these children in partnership with the liberal professionals and/or establishments of the medical and social sector as well as the Education system. Today, it is, thus, possible to lean on their experience, their expertise and their capacity to coordinate care with their partners in order to carry on such studies.
To illustrate this approach, we shall present, here, several clinical situations.
1 Blank R (EACD): Recommendations on the definition, diagnosis and intervention of developmental coordination disorder DMCN 2012, 54: 54-93
2 Wilson PH Understanding performance deficits in developmental coordination disorder: a meta analysis of recent research DMCN 2013, 55(3):217-28.
Keywords : developmental dyspraxia, longitudinal follow up, adulthood, différent trajectories