DCD Flashcards
DCD Definition by DSM-4? Manifested how?
- Performance in ADL’s (that require motor performance) is substantially below that expected for a person’s chronological age and measured intelligence.
- This may be manifested by marked delays in achieving motor milestones, dropping things, “clumsiness”, poor handwriting and poor performance in sports.
DCD is diagnosed when? (3)
- The disturbances described previously significantly interfere with academic achievement and/or ADL’s
- The disturbance is not due to a medical condition (i.e. CP, MD,) and does not meet the criteria for PDD.
- Motor difficulties are greater than expected in the presence of intellectual disability
Incidence greater in? 90% of kids are thought?
- Greater in boys than girls
- 90% of Children with learning disorders are thought to have motor coordination problems
Incidence increased in? (4)
- incidence in pre-term infants
- prematurity risk of DCD
- incidence when there are pre or perinatal influences or risk factors
- Incidence greater in boys than girls (or boys may just be identified more as they may act out more in frustration)
Associated Disorders? (4)
- Phonological disorder (speech impairment - difficult making the actual words)
- Expressive language disorder (putting the sounds together to make words)
- Mixed receptive/expressive
- Language Disorder
- ADD/ADHD
Individuals with ADD/ADHD may ?
fall, bump into things, knock things over due to distractibility and impulsivity, however if criteria for both disorders are met, both diagnoses can be given.
Hypothesis for Coordination Difficulties - process 1?
Child may experience difficutly interpreting info received from vision, tactile, balance, proprioception and muscle movement
Hypothesis for Coordination Difficulties - process 2? (2)
- Child may have difficulty choosing the type of motor action that is appropriate for the situation
- In order to select an action the child must consider the context in which the action takes place
Hypothesis for Coordination Difficulties - process 3? (2)
- Process 3: Child may have difficulty forming a plan of action in the proper SEQUENCE.
- Child must organize the motor requirements of a task into a sequence of commands (motor program) that tells the muscles how to perform the required action
i. e. when the child approaches a set of stairs, he must shift weight onto one foot to lift the other
Hypothesis for Coordination Difficulties - process 4? (3)
- Messages sent to the muscles must specify speed, force, direction, distance to be moved.
- When children move in response to stimuli moving in time or space (catching a ball) the messages must also change.
- A child may have difficulty monitoring this information or modifying the messages in order to guide the movement while it is taking place
Overall the child has difficulty with? (5) Result?
- analyzing sensory input
- Using information to choose a plan of action
- Sequencing the movement required for the task
- Sending the right message to produce a coordinated action
- Integrating all of the above to control movement while it is happening (feedforward)
- Result: child appears clumsy and awkward has difficulty learning and performing new tasks
Apraxia characteristics? (5)
- Loss of Praxis
- Usually seen in adults
- Neurologic Basis for problem as evidences on CT or MRI
- Basis not usually tied to somatosensory dysfunction
- Rx is based on use of automatic activities
Dyspraxia characteristics? (5)
- Dysfunctional Praxis
- Usually seen in children
- Neurologic basis for problems NOT usually noted on CT or MRI
- Thought to have tactile proprioceptive basis
- Learning activities for first time; cannot build on previously learn activities
Developmental Dyspraxia characteristics? (1-8)
- Poor motor planning
- Decrease sense of body and what body can do
- Clumsiness makes child appear messy or accident prone
- Problems with ADL
- May learn splinter skills but cannot generalize
- Does things in an inefficient way
- Has low muscle tone that makes them appear weak
Developmental Dyspraxia characteristics? (9-13)
Must give full attention to the task Difficulty with total flexion & extension patterns Decreased rotation Weight shifting problems Gait deviations
Gait deviations can include? (4)
Toe Walking
Slaps foot down
High stepping
Shuffling (bc it increases sensory input)
Developmental Dyspraxia characteristics? (14-22)
- Presence of developmental reflexes
- Vestibular impairment
- Oculomotor deficits
- Lack of cerebral dominance
- Somotoagnosia
- Heaviness when moved
- Visually directed action
- Problems with smooth control of movement
- Decreased postural reactions
Developmental Dyspraxia characteristics? (23 - 29)
- Problems with unconscious movements
- Decreased thumb/finger movements
- Auditory language problems
- Poor proprioceptive set
- Fine motor problems including in-hand manipulation, writing
- Limited number of skills
- Difficulty organizing self
Developmental Dyspraxia characteristics? (30 - 37)
- May have self-image problems (often starts around 6 yrs)
- Needs more protection than other children
- Has trouble growing up
- Emotionally labile
- Thinks own lack of control is due to someone else or the environment
- Emotionally sensitive
- Complains more about minor physical problems
- “Stubborn”
