Developmental Coordination Disoder

Question 1

Define DCD

Answer 1

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

Question 2

How many children can it impact?

Answer 2

5-6% of school-aged children

Question 3

What gender is it more common in?

Answer 3

Males

Question 4

Children diagnosed with DCD

Answer 4

High variability on a spectrum of severity

Question 5

Increased prevalence

Answer 5

Preterm/low birth weight populations

Question 6

Does not outgrow with age

Answer 6

Lifelong condition

Question 7

Underlying medical or neurological conditions?

Answer 7

None identified

Question 8

How are children with DCD seen as?

Answer 8

‘clumsy’ or ‘awkward’

Question 9

When do they reach milestones?

Answer 9

In time they will reach milestones, but have more subtle motor coordination problems

Question 10

What do children have difficulty with?

Answer 10

Generalizing learned motor skills across settings or transferring skills to other contexts

Question 11

What do children struggle with?

Answer 11

Everyday functional task such as
- handwriting, dressing, throwing/catching ball, riding bike, etc

Question 12

Additional difficulties children with DCD have

Answer 12

Poor perceived competence
Social isolation
Low self-worth
Anxiety and depression symptoms

Question 13

Pathological process or specific anatomic location associated with DCD

Answer 13

None

Question 14

Difficulty with

Answer 14

Dual tasking d/t cerebellum possibly being involved bc it plays a role in motor learning

Question 15

Motor imagery deficits

Answer 15

Difficulty in generating efference copies of motor commands through feed-forward models
Posterior parietal cortex may be involved

Question 16

Internal models

Answer 16

Neural representations of the visual-spatial coordinations of intended motor actions
Poor online error correction

Question 17

Body structure and Functional Impariements

Answer 17

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

Question 18

Activities DCD struggle with

Answer 18

Self-care
Academic activities
Sports and leisure

Question 19

Diagnosis: DSM criteria

Answer 19

Acquisition and execution of coordinated motor skills is below expected given the individual’s chronological age and opportunity for skill learning and use

Question 20

Diagnosis: DSM criteria
- how would difficulties manifest

Answer 20

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)

Question 21

Role of PT

Answer 21

Establishing eligibility for services
Improving motor function
Treatment setting

Question 22

Role of PT
- improving motor function

Answer 22

Motor control and coordination
Developmental delay
Dynamic postural control

Question 23

Role of PT
- treatment setting

Answer 23

Early intervention
School-based
Outpatient

Question 24

PT evaluation
- Subjective

Answer 24

Pregnancy
Birth and developmental hx
Past and current health and functional status

Question 25

PT Evaluation
- Subjective: questions to ask

Answer 25

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?

Question 26

PT Evaluation
- objective

Answer 26

Muscle tone
ROM
MMT
Sensory assessment
Motor Coordination

Question 27

PT Evaluation
- Objective con’t

Answer 27

Observation of motor skills
Screening tools
MABC

Question 28

Objective
- observation of motor skills

Answer 28

In school
At home

Question 29

Objective
- screening tools

Answer 29

Parent report: DCDQ questionnaire
Movement ABC

Question 30

Objective
- MABC

Answer 30

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

Question 31

PT Management

Answer 31

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

Question 32

Task Specific Interventions

Answer 32

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