Coordination Difficulties

Question 1

DCD neuro/infant patterns

Answer 1

Low or variable muscle tone
Depressed DTRs
Infant patterns when fatigued/under challenge
Less common = clonus, tremor, associated reactions, involuntary movements

Question 2

DCD ocular motor difficulties

Answer 2

Eye follow (fast/slow), convergence, fixation, fix/unfix, OKN, Strabismus
Poor visual attention = difficulty with 'fix'
Poor eye tracking = difficulty with follow - reading problems 
Poor convergence/divergence = moving trunk towards the book, difficulty copying from blackboard 
Ocular motor fatigue = rubbing eyes, watery eyes, headaches
Poor timing = affects ball skills, trips, falls

Question 3

DCD proprioception impacts

Answer 3

Assessment - JPS, UL position copy, static hold eyes closed/eyes open
Spontaneous positioning 
Position adjustment in transitions
End point discomfort
Poor position awareness

Question 4

DCD tactile impacts

Answer 4

FM issues
- poor placement of pencil position in hand; poor hand coordination; can’t find objects in school bag
GM issues
- poor foot placement/clumsiness; can’t keep shoes on
Behavioural responses
- tactile sensory seeking - rub/brush hands together, on legs, on you/objects
- avoidance - dislike of being touched by you

Question 5

DCD vestibular impacts

Answer 5

Postural instability (overbalancing/falling) = when moving/turning; when looking at something that is moving/turning (lacks correction) 
Vestibular seeking = excessive movement/activity of whole body; moving head for vestibular input
Vestibular avoidance = dislikes swings/rides/being lifted

Question 6

DCD motor planning impacts

Answer 6

Difficulty following instructions - verbal instructions, visual demonstrations
Disorganised movements - especially complex movements (FM - using utensils; GM - dressing)
Information seeking - over reliance on one cue (visual/verbal)

Question 7

DCD Posture and balance impacts

Answer 7

Asymmetry/slumping, leaning, restlessness
Instability - result of fatigue or dual tasking
Using breath to support posture not speech
Poor isolation of distal movements; slow responses, immature strategies

Question 8

Common atypical gait/stance patterns - DCD

Answer 8

Recruiting tone 
- toe walks, bouncy gait
- may have arms up, neck extended, to counter balance reduced AP BOS
- may have problems standing still as tone will fade
Heavy flat footed position 
- often low tone/rigid
- sinking posture when still
- little spring or push off
- slumped thoracically
Asymmetric pattern
- weight shift/prop problems
- ATNR 
- uneven leg length, scoliosis
- visual perceptual problems

Question 9

Muscle tightness - DCD

Answer 9

Underlying low tone - muscles tighten into slumped posture
Muscle imbalance
Joint ROM translation - W sitting
Abnormal motor patterns

Question 10

Muscle weakness/recruitment - Lower body function

Answer 10

Glute max/med; quads (poor hip/knee extension, especially eccentric action such as walking down stairs)
Gastrocs (poor through range concentric/eccentric function)

Question 11

Muscle weakness/recruitment - upper body function

Answer 11

Mid traps and rhomboids
Isolated extension control Cx-Tx-Lx spine
Poor hand function

Question 12

Muscle weakness/recruitment - hands

Answer 12

Lumbricales (pencil grasp)
Long finger flexors (e.g. power grip)
Supination, pronation repetition

Question 13

Muscle weakness/recruitment - spine/trunk

Answer 13

Poor isolated extensor control Cx-Tx-Lx spine

Abdominals - weak, poorly timed and recruited