Hello from Trevor. [OT means Occupational Therapy and SP means Speech Pathology]

I am new to these forums and if you see my profile 1 of my disorders is Dyspraxia. It features balance impairment, fine motor control problems, slow movement, immature behavior, language delay and structural problems in speech, trouble with reading and writing, (comprehension, focus, spelling, understanding, grammar, critical thinking etc.) short-term memory loss, and posture problems (like Scoliosis). Some of these features improve with psychiatric/anti-convulsive medications. SP and OT may and do improve functioning, but usually involve the whole family to overhaul their lifestyle if it is poor. With my anxieties and kidney problems, plus my love for the family as it is and the way things are; [although I am not happy about them], I wonder if its worth continuing therapy?

I am happy to continue SP on an individual basis, as long as I can sustain energy levels with the kidneys at a low level - haemodialysis is working. I haven't had extensive enough language development training to allow me competence and confidence in speech. So far I have had trouble with Inferences, Synonyms, Antonyms, and the basics of creative prose in thinking of sentences. I suppose the SP would want my parents to limit their obligations to me participating in the community without their involvement when I have the confidence to practice my speech.

With the OT I had extensive brain and motor coordination exercises as a child along with plenty of physiotherapy as a toddler/infant to get me to roll and walk at 2 years 3 months. I also had OT as a teenager to help me down public stair-cases, ladders and escalators. I have forgotten how to not go slowly down these things, and I still have to hang on to the railings. I am back to being cautious on stepping on an escalator. Does anyone know the technique for balance when going down a flight or up?

The OT could overhaul the whole house from preventing RSI at a computer desk to building a ramp with railings down the steps. They could also make the Kitchen and Bathroom safer. The National Disability Insurance Scheme rolls in for me next year in Australia, so we would be able to get these things done.

Therapy is also expensive. My Psychologist costs me $130 AUD after the Medicare rebate, my SP $145, the OT and physiotherapist I am not currently provided for but those are affordable if I go to the right provider.

Hi dyspraxia345

Welcome to NeuroTalk - I hope that you find the community as helpful and knowledgeable as I have.

One technical suggestion:

"the OT and physiotherapist I am not currently provided for but those are affordable if I go to the right provider."

Are your OT and physiotherapist registered with the Australian Health Practioner Regulation Agency (AHPRA; www.ahpra.gov.au) ?

If so, they should have been given a "Healthcare Provider Identifier-Individual (HPI-I)" (http://www.ahpra.gov.au/About-AHPRA/...h/eHealth.aspx).

That means that their fees should attract a Medicare rebate (or will be free if they bulk-bill).

Hi Trevor,
If you're eligible for National Disability Insurance Scheme then I imagine you have a valid Centrelink benefit card such as a disability pension or health care card? <<edit: I see you've mentioned Pension card in profile>>

You should be able to find practitioners who will bulk bill if you have a card.

I know Psychologists will bulk bill under certain circumstances even if they don't advertise that they do. You may not need to be paying out of pocket at all. My daughter's psychologist bulk bills her and so does her Specialist who she had to see for diagnostic paper work and medication evaluation.

Maybe that is because she has no income or Centrelink benefits at present. She does just have her health care card because she is a student. All it helps with are medications if needed. They may treat her as a special case. I am not sure.

Added: If your parents have private health insurance that covers children you can stay on their card usually until you're 21, or if full time student 25. That age may depend on the company.

I'm sorry I can't help you with escalators.
I have balance/vertigo issues so can not use them at all.
I have problems with lifts as well but not as bad as stairs and escalators. Makes life very restricting unfortunately.

What is the worst part? Is it anxiety or is it balance or both?

I imagine that a really crowded or an empty escalator would be problematic.
I have seen tips for young children getting on them to hold firmly on the sides and swing feet at the same time onto the top step but that may not be so easy for an older teen or an adult.
Standing close to one side and holding one side only may help as well. The problem with that is that sometimes the railing moves faster than the escalator.

Escalator anxiety is not so much of a problem because if I fear I get tripped over by some criminal then Obsessive Compulsive Disorder (OCD) would kick in and the ability to handle disaster situations would make me slide or run on the escalator!

So its balance; and determining which step to step onto. The latter comes from shaky legs. I may worry on the lead up to the escalator on how I will approach it. As you said empty and crowded escalators are a bit frightening.

You may find more info regarding how to step onto a moving escalator in articles on the net regarding Visual Processing Disorder or visual processing problems.

It's a very complex motor skill for anyone let alone someone with Dyspraxia and also for people with other conditions that might affect their vestibular system. Combine that with all the excess sensory stimulation in areas where escalators are usually positioned, it can be impossible.

I know from memory that Temple Grandin has talked about this problem with escalators in Autism spectrum articles as well.

I know a good technique for walking across uneven or shiny tiled shopping centre floors but haven't a clue how to get down an escalator. Let me know if you figure it out please.

take care there.