Developmental Disorders

Question 1

Definition of development coordination disorder:

Answer 1

Impairments in the development of motor coordination,
delays in gross and fine motor skills, and
difficulty learning new motor tasks that
significantly interfere with academic achievement
and activities of daily living

Question 2

Comorbidities of DCD:

Answer 2

Attention deficit hyperactivity disorder (ADHD).
Dyslexia.
Speech/language impairment.*

Question 3

Early Signs of DCD

Answer 3

Parents report child is clumsy, falls frequently, drops things, difficulty using utensils, dressing
May appear inattentive, avoid motor activities from an early age.
Difficulty learning or retaining new motor skills

Question 4

Delayed developmental milestones in DCD:

Answer 4

walking, hopping, skipping, riding a tricycle, cutting with scissors, using a pencil

Question 5

Diagnosis of DCD:

Answer 5

after 5 years of age

Question 6

Child Characteristics in DCD

Answer 6

Uncoordinated, slow to complete motor tasks.
Motor difficulties significantly interfere with ADL and impact play, leisure, academics.
Limited interest in physical motor activities on playground, sports, frustration.
May be socially immature, behavioral problems.
May slump in desk, difficulty organizing deskwork

Question 7

Performance Impairments

Answer 7

Postural control.
Visual attention.
Visual-spatial perception.
Proprioceptive or kinesthetic deficits.
Sensory motor deficits.
Motor execution.
Internal representation of movements

Question 8

Impairments in DCD

Answer 8

Slower reaction, movement response times.
Timing and force control.
Responding to unpredictable environments.
Variable motor performance.
Over-reliance on vision, proximal muscle control for balance.
Poor integration of visual and proprioceptive information.
Tendency to ‘fix’ during task performance.
Difficulties with imagery

Question 9

Motor Difficulties in Children with DCD

Answer 9

Hopping, skipping, balancing.
Pedaling a tricycle.
Throwing, catching, kicking balls.
Handwriting.
Self-care tasks, i.e., dressing (zippers, buttons, shoelaces), toileting.
Organizational abilities

Question 10

Considerations for Intervention

Answer 10

Coordinated movement – process and interpret sensory information accurately to select, plan, and execute movements.
Adjust movement – interpret environmental feedback

Question 11

Sensory systems involved in motor coordination

Answer 11

Visual
Tactile
Vestibular
Proprioception
Kinesthesia

Question 12

General Approach to Intervention

Answer 12

Functional activities, relevant and meaningful to child, family, teachers.
Activities to improve motor performance, confidence, self-esteem.
Child involvement in prioritizing tasks, establishing targets for success, monitoring progress.
Collaboration among parents, teachers, therapists, coaches to enhance generalization

Question 13

Autism Spectrum Disorder, ASD

Answer 13

Developmental disability caused by a disorder in brain

Question 14

Symptoms of Autism

Answer 14

Wide range of symptoms, skills, and levels of impairment in social interaction, communication, behaviors and interests, perceptuo-motor impairments.
Symptoms must be present in the early developmental period (usually first 2-3 years).

Question 15

Autism

Answer 15

abnormalities in social interaction, communication, and imaginative play before age 3, stereotypical behaviors, unusual interests

Question 16

Pervasive Developmental Disorders-

Answer 16

not otherwise specified (PDD-NOS)

Question 17

Asperger syndrome

Answer 17

significant impairment in social interaction without delays in language or cognitive development. May have unusual interests

Question 18

Early Signs and Symptoms of ASD in infancy:

Answer 18

Rare eye contact.
Overly focused on certain objects.
Limited babbling.
Failure to engage in typical back-and-forth play.
Reduced spontaneous movement exploration.
Limited change in body postures.

Question 19

Social & Communication Impairments

Answer 19

Misread or fail to notice subtle social cues, i.e., smile, grimace, gestures, tone of voice.
Vague or mismatched body language, voice make it hard for others to understand them.
Delayed language, use of gestures, slow response to name.
Use single words, repeat words or phrases, i.e., echolalia.
Trouble with empathy, unable to understand or predict others’ actions.
Communication difficulties may contribute to behaviors, anxiety, depression.

Question 20

Stereotypical, Repetitive Behaviors

Answer 20

Arm flapping, characteristic gait, visual regard of finger movements.
Overly focused interest in moving objects or parts of objects, i.e., wheels, fans.
Unusual play, i.e., lining up toys, spinning.
Intense preoccupation with trains, vacuum cleaners, train schedules.
Interest in numbers, symbols, science.
Inflexibility in daily routines

Question 21

Associate Health ConditionL

Answer 21

sensory
sleep
intellectual disability
seizures
tuberous sclerosis
GI problems
mental disorders

Question 22

Sensory:

Answer 22

atypical reactions to certain sights, sounds, smells, textures, touch, taste, pain

Question 23

Sleep

Answer 23

disturbances may affect attention, daily functioning, behaviors, family stress and well-being

Question 24

Intellectual disability

Answer 24

relative weakness in cognitive and language abilities. *Asperger’s exception

Question 25

Seizures

Answer 25

1 in 4 children with ASD

Question 26

Tuberous Sclerosis

Answer 26

1-4% of children with ASD

Question 27

Mental Disorders

Answer 27

higher risk for anxiety, depression, ADHD

Question 28

How often should intervention happen?

Answer 28

minimum of 25 hours/wk, 12 mo/yr, measured, recorded, and adjusted

Question 29

Motor Impairments in Children with ASD

Answer 29

bilateral coordination, 
motor planning/praxis (dyspraxia),
postural control (RPAs, APAs), 
gait – ataxic, toe-walking
Infants/Toddlers – delays in gross motor abilities, postural control, walking, reaching/grasping, fine motor abilities.

Question 30

Assessment of children at risk for ASD:

Answer 30

Gross motor ‘milestones’.
Quality of movement, repetitions.
Anti-gravity transitional movements.
Postural control in sitting, standing.
Sensory system: tactile, proprioceptive, kinesthesia (movement sense, heavy work). 
Mobility on floor.
Mobility on feet, gait parameters.
Play appropriate for age.
Fine motor object manipulation.

Question 31

Activities for

Coordination and Motor Planning

Answer 31

Ready the system – follow child’s lead for vestibular input, i.e., swinging in all directions.
Whole body sensory input through swinging in hammock, ramp rolling, submersion in ball bath.
Break down activities for practice, e.g., jumping jack.
Ball bounce/catch to person, repetitive sequencing; use rhythm, repetitive sounds.
Obstacle course – motor planning.
Individualize intervention based on child response, interest.
Need for routine, tolerance for changes

Question 32

Outdated terminology of DCD:

Answer 32

Perceptual motor dysfunction.
Sensory integration dysfunction.
Developmental dyspraxia.
Minimal brain dysfunction.
Clumsy child syndrome

Question 33

Cognitive ‘Top Down’ approach

Answer 33

Child-centered – emphasizes problem identification, motor planning, monitoring.
Task-specific intervention – direct teaching of task.

Question 34

Bottom Up” approach

Answer 34

focused on remediation of impairments.
perceptual-motor training.
sensory integration.
process-oriented treatment (kinesthesia).

Question 35

Floortime Model

Answer 35

follow child’s interests to build relationships.

Question 36

TEACCH

Answer 36

build on child strengths through environmental adaptation, visual cues.

Question 37

Applied Behavioral Analysis, ABA

Answer 37

intensive intervention to shape and reinforce new behaviors, extinguish undesirable behaviors.