Learning Disorders: The Role of the Occupational Therapist
DYS disorders affect 6 to 8% of school-aged children. The occupational therapist plays a key role in assessment, rehabilitation, and implementing adjustments to promote academic success and the development of these children.
Specific learning disorders (SLD) include dyslexia, dysorthographia, dyscalculia, and developmental coordination disorder (DCD or dyspraxia). These disorders, of neurological origin, persist throughout life and significantly impact schooling and daily life. The occupational therapist provides unique expertise on functional aspects and necessary adaptations to enable these children to develop their full potential.
🧠 Understanding Learning Disorders
Specific learning disorders are neurodevelopmental disorders that affect the acquisition of fundamental academic skills. They are not related to intellectual deficits, sensory deficits, or lack of stimulation, but to a particular brain function.
The Different DYS Disorders
Dyslexia / Dysorthographia
Reading and spelling disorders despite normal intelligence and appropriate schooling
Dyscalculia
Difficulties in learning mathematics, number sense, operations
DCD (Dyspraxia)
Motor coordination disorder affecting gestures, writing, spatial organization
Common Characteristics
- Neurological origin: Differences in brain development and function
- Persistence: Disorders last a lifetime, although compensations are possible
- Specificity: The disorder affects a specific area, not overall intelligence
- Frequent comorbidities: Association of multiple disorders in the same child
- Functional impact: Effects on schooling, self-esteem, daily life
💡 Multidisciplinary Diagnosis
The diagnosis of DYS disorders requires a multidisciplinary assessment: doctor, neuropsychologist, speech therapist, occupational therapist depending on the suspected disorders. The occupational therapist is particularly involved in the diagnosis of DCD and the assessment of the functional impact of disorders on academic and daily activities.
✋ DCD (Dyspraxia) and Occupational Therapy
Developmental Coordination Disorder (DCD), formerly known as dyspraxia, is the learning disorder where the occupational therapist has the most central role. It affects the planning and execution of motor gestures, with significant repercussions on writing, autonomy, and school life.
Manifestations of DCD
- Gross motor skills: Clumsiness, coordination difficulties, unstable balance, delay in acquiring motor skills
- Fine motor skills: Difficulties in writing, cutting, buttoning, manipulating small objects
- Spatial organization: Difficulties in orienting on a page, organizing work, navigating
- Motor planning: Difficulty learning new gestures, automating motor sequences
- Daily life: Slowness in dressing, difficulties eating neatly, organizing the backpack
Writing: A Central Issue
Dysgraphia
Illegible, slow, tiring writing, often associated with DCD
Fatigue
Significant cognitive and physical cost to produce correct writing
Academic Impact
Poor grades, unfinished homework, gap between skills and output
Handwriting often represents the main reason for consultation in occupational therapy for children with DCD. The occupational therapist evaluates the quality and speed of writing, identifies limiting factors, and proposes rehabilitation or compensation strategies.
⚠️ Do not confuse rehabilitation and compensation
Rehabilitation aims to improve the child's abilities (e.g., improving writing quality). Compensation aims to circumvent difficulties (e.g., using a computer). Both approaches are complementary and must be adapted to each situation. A child with severe DCD will benefit more from early compensation than from lengthy and exhausting rehabilitation.
⚡ ADHD and Occupational Therapy
Attention Deficit Hyperactivity Disorder (ADHD) significantly impacts learning and daily life. The occupational therapist addresses functional aspects: organization, time management, motor control, compensation strategies.
The Three Dimensions of ADHD
Inattention
Difficulties maintaining attention, distractibility, frequent forgetfulness, loss of items
Hyperactivity
Motor agitation, need to move, difficulty staying seated, talks a lot
Impulsivity
Acts without thinking, interrupts, difficulty waiting for their turn, takes risks
Occupational Therapy Intervention in ADHD
- Work organization: Structuring the workspace, using visual supports, breaking down tasks
- Time management: Time Timer, visual planning, established routines
- Motor control: Strategies to channel the need for movement (dynamic seating, fidgets)
- Attention: Clutter-free environment, noise-canceling headphones, visual isolation
- Executive functions: Planning, checking, self-regulation strategies
💡 Digital Tools in ADHD
Cognitive stimulation applications like COCO can help children with ADHD train their attention and executive functions in a playful way. The integrated sports break meets these children's need for movement while promoting regulation.
🔍 Occupational Therapy Assessment
The occupational therapy assessment of learning disorders is specific and comprehensive. It aims to identify difficulties, their origin, and their functional impact to guide intervention.
Standardized Tests Used
- M-ABC 2: Movement assessment battery for children, screening for DCD
- BHK: Quick assessment scale for writing (quality and speed)
- Beery VMI: Visual-motor integration test, copying geometric shapes
- DTVP: Visual perception test, discrimination, form constancy
- Dunn's Sensory Profile: Questionnaire on sensory processing
- NEPSY-II: Relevant subtests for sensorimotor functions
Clinical Observation
Writing Analysis
Posture, pencil grip, pressure, letter formation, speed, fatigue
School Observation
Work organization, material use, participation, behavior
Daily Autonomy
Dressing, meals, backpack organization, time management
Diagnostic Criteria for DCD (DSM-5)
- Criterion A: Acquisition and execution of motor coordination skills below the expected level
- Criterion B: The deficit significantly interferes with daily life activities and academic success
- Criterion C: Symptoms begin in the early developmental period
- Criterion D: The deficit is not better explained by an intellectual disability, visual impairment, or neurological condition
"The assessment must go beyond test scores to understand the real impact of difficulties on the child's life. It is this functional vision that guides occupational therapy intervention."
— Recommendations for Best Practices
🛠️ Tools Adapted to Learning Disorders
COCO offers fun exercises to train attention, memory, and executive functions in children aged 5 to 10, with an integrated sports break.
Discover COCO →🎯 Rehabilitation and Compensation
Occupational therapy intervention combines rehabilitation of deficient functions and implementation of compensations to enable the child to function despite their difficulties.
Writing Rehabilitation
- Posture and setup: Work on sitting position, desk height, paper orientation
- Pencil grip: Rehabilitation of the gesture, use of adapters if necessary
- Letter formation: Explicit learning, visual and kinesthetic methods
- Fluency and speed: Gradual work on automation, repeated exercises
- Hand relaxation: Techniques to reduce tension and fatigue
CO-OP Approach
The CO-OP (Cognitive Orientation to daily Occupational Performance) approach is particularly suited for children with DCD. It uses cognitive strategies to learn new gestures:
Goal - Plan - Do - Check
Global strategy applied to each motor learning
Guided Discovery
The child finds strategies themselves with the therapist's help
Generalization
Transfer of learned strategies to other situations
Compensation through Computer Tools
- Learning the keyboard: Blind typing to replace handwriting
- Geometry software: GeoGebra to circumvent drawing difficulties
- Voice recognition: Dictation for children with severe graphomotor difficulties
- Prediction software: Assistance with spelling and written production
⚠️ When to switch to a computer?
The decision to compensate with a computer must be considered. It is recommended when: DCD is confirmed, rehabilitation reaches its limits, writing remains illegible or too slow, cognitive cost is too high. A structured learning of the keyboard is then essential.
🏫 School Adjustments
The occupational therapist plays a key role in recommending school adjustments tailored to the child's difficulties. These adjustments can be formalized in a PAP (Personalized Support Plan) or a PPS (Personalized Schooling Project).
Types of Adjustments
- Pedagogical adjustments: Extra time, reduction of writing quantity, photocopies of lessons
- Material adjustments: Computer, adapted software, ergonomic furniture
- Organizational adjustments: Seating in class, presentation of materials, simplified instructions
- Human assistance: AESH for certain children with significant needs
Common Adjustments by Disorder
DCD
Computer, extra time, reduction of written tasks, adapted geometry, photocopies
Dyslexia
Audio reading, adapted font, extra time, reformulation of instructions
ADHD
Strategic seating, allowed fidgets, broken-down instructions, frequent breaks
The Role of the Occupational Therapist
- Needs assessment: Identify necessary and appropriate adjustments
- Justified recommendations: Write recommendations for the educational team
- Teacher training: Explain the child's difficulties and adapted strategies
- Monitoring implementation: Check the effectiveness of adjustments and make adjustments
- Participation in ESS: Follow-up teams for children with PPS
"Adjustments are not a favor but a necessary compensation to allow the child to demonstrate their real abilities despite their disorder."
— Principles of School Inclusion
💻 Adapted Digital Tools
Digital tools offer valuable solutions for children with learning disorders, both for rehabilitation and for compensating difficulties.
Cognitive Stimulation Applications
The COCO application from DYNSEO is particularly suited for children with learning disorders. It offers fun exercises targeting the functions often deficient in these children.
Attention
Exercises for sustained, selective, and divided attention, adapted for ADHD
Working Memory
Training of visual and auditory memory, essential for learning
Sports Break
Integrated physical activities to meet the need for movement
Compensation Software
- Adapted word processing: With efficient spell checker, word prediction
- Text-to-speech: For proofreading written texts
- Voice recognition: Dragon, Word dictation to circumvent writing
- Geometry software: GeoGebra, Geoplan for geometric constructions
- Mind mapping: Organizing ideas visually
💡 Learning the Keyboard
Before being able to use the computer as a compensation tool, the child must learn blind typing. Specialized software (TapTouche, Typing Club) allows for this learning. The occupational therapist supervises this process and ensures that typing speed exceeds that of handwriting.
🤝 Global Support
Supporting a child with learning disorders goes beyond technical rehabilitation. It encompasses emotional support, coordination with other stakeholders, and family guidance.
Psychological Impact of DYS Disorders
- Self-esteem: Repeated feelings of failure, comparison with peers
- Anxiety: Fear of school, tests, writing situations
- Discouragement: Disproportionate effort compared to results
- Behavioral disorders: Sometimes reactive to difficulties
Parental Guidance
Inform
Explain the disorder, its manifestations, its enduring nature
Equip
Provide concrete strategies to help the child in daily life
Support
Assist parents in acceptance and adaptation
Networking
- Speech therapist: Coordination on written language disorders
- Psychomotor therapist: Complementarity on gross motor skills
- Psychologist: Emotional support, cognitive assessment
- Teachers: Implementation of adjustments, pedagogical adaptation
- Doctor: Medical coordination, renewal of prescriptions
🎓 Train Yourself on Learning Disorders
DYNSEO offers training to optimize the use of digital tools in supporting children with DYS.
Discover our training →🎯 Conclusion
Learning disorders affect a significant number of children who, without appropriate support, risk academic failure and psychological distress. The occupational therapist provides unique expertise on the functional aspects of these disorders, particularly for DCD and writing difficulties.
Occupational therapy intervention combines rehabilitation and compensation, always serving the child's participation in their schooling and daily life. Digital tools, whether cognitive stimulation applications like COCO or compensation software, greatly enrich the possibilities for support.
Working in partnership with parents, schools, and other professionals is essential to ensure the coherence of support and allow the child to develop their full potential despite their difficulties.
Want to enrich your practice with children with DYS?
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