Developmental Coordination Disoder Flashcards
Define DCD
A condition where poorly developed fine motor and/or gross motor coordination has a substantial effect on motor skill performance and can affect ADLs and academic performance
How many children can it impact?
5-6% of school-aged children
What gender is it more common in?
Males
Children diagnosed with DCD
High variability on a spectrum of severity
Increased prevalence
Preterm/low birth weight populations
Does not outgrow with age
Lifelong condition
Underlying medical or neurological conditions?
None identified
How are children with DCD seen as?
‘clumsy’ or ‘awkward’
When do they reach milestones?
In time they will reach milestones, but have more subtle motor coordination problems
What do children have difficulty with?
Generalizing learned motor skills across settings or transferring skills to other contexts
What do children struggle with?
Everyday functional task such as
- handwriting, dressing, throwing/catching ball, riding bike, etc
Additional difficulties children with DCD have
Poor perceived competence
Social isolation
Low self-worth
Anxiety and depression symptoms
Pathological process or specific anatomic location associated with DCD
None
Difficulty with
Dual tasking d/t cerebellum possibly being involved bc it plays a role in motor learning
Motor imagery deficits
Difficulty in generating efference copies of motor commands through feed-forward models
Posterior parietal cortex may be involved
Internal models
Neural representations of the visual-spatial coordinations of intended motor actions
Poor online error correction
Body structure and Functional Impariements
Power and strength
Coordination
Visual perception
Spatial organization
Inadequate information processing
Slow reaction and movement time
Motor sequencing
Visual memory
Feedback and feedforward motor control
Joint laxity
Activities DCD struggle with
Self-care
Academic activities
Sports and leisure
Diagnosis: DSM criteria
Acquisition and execution of coordinated motor skills is below expected given the individual’s chronological age and opportunity for skill learning and use
Diagnosis: DSM criteria
- how would difficulties manifest
Clumsiness (dropping or bumping into objects)
Slowness and inaccuracy of performance of motor skills (catching an object, using scissors or cutlery, handwriting, riding a bike, or participating in sports)
Role of PT
Establishing eligibility for services
Improving motor function
Treatment setting
Role of PT
- improving motor function
Motor control and coordination
Developmental delay
Dynamic postural control
Role of PT
- treatment setting
Early intervention
School-based
Outpatient
PT evaluation
- Subjective
Pregnancy
Birth and developmental hx
Past and current health and functional status
PT Evaluation
- Subjective: questions to ask
Is there evidence of change in tone?
Are there more global delays affecting multiple systems?
Are the difficulties present from an early age?
Any signs of progression?
Loss of previously acquired skills?
PT Evaluation
- objective
Muscle tone
ROM
MMT
Sensory assessment
Motor Coordination
PT Evaluation
- Objective con’t
Observation of motor skills
Screening tools
MABC
Objective
- observation of motor skills
In school
At home
Objective
- screening tools
Parent report: DCDQ questionnaire
Movement ABC
Objective
- MABC
Norm-referenced
Multi-item
School-aged children
3 sections, each contain 8 items
3 age bands: 3-6 y/o, 7-10 y/o and 11-16 y/o
Manual dexterity, aiming and catching and balance
Threading beads, pegs in a pegboard, balancing on one leg, jumping, hopping, and heel-to-toe walking
PT Management
Using task-specific interventions and cognitive approaches
Identify the motor learning difficulties and design the interventions accordingly
Target generalization and transfer of motor skills, while emphasizing motor learning
Task Specific Interventions
Direct training for fxn motor skills in relevant env’t, with a goal to reduce limitations and improve participation
Encourage children to explore different ways to solve a motor problem
Guide them towards developing the most optimal way, specific to their needs and abilities
Use verbal feedback, visual feedback or physical demonstration
Neuromotor task training
