Developmental Disorders Flashcards
Definition of development coordination disorder:
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
Comorbidities of DCD:
Attention deficit hyperactivity disorder (ADHD).
Dyslexia.
Speech/language impairment.*
Early Signs of DCD
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
Delayed developmental milestones in DCD:
walking, hopping, skipping, riding a tricycle, cutting with scissors, using a pencil
Diagnosis of DCD:
after 5 years of age
Child Characteristics in DCD
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
Performance Impairments
Postural control. Visual attention. Visual-spatial perception. Proprioceptive or kinesthetic deficits. Sensory motor deficits. Motor execution. Internal representation of movements
Impairments in DCD
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
Motor Difficulties in Children with DCD
Hopping, skipping, balancing. Pedaling a tricycle. Throwing, catching, kicking balls. Handwriting. Self-care tasks, i.e., dressing (zippers, buttons, shoelaces), toileting. Organizational abilities
Considerations for Intervention
Coordinated movement – process and interpret sensory information accurately to select, plan, and execute movements.
Adjust movement – interpret environmental feedback
Sensory systems involved in motor coordination
Visual Tactile Vestibular Proprioception Kinesthesia
General Approach to Intervention
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
Autism Spectrum Disorder, ASD
Developmental disability caused by a disorder in brain
Symptoms of Autism
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).
Autism
abnormalities in social interaction, communication, and imaginative play before age 3, stereotypical behaviors, unusual interests
Pervasive Developmental Disorders-
not otherwise specified (PDD-NOS)
Asperger syndrome
significant impairment in social interaction without delays in language or cognitive development. May have unusual interests
Early Signs and Symptoms of ASD in infancy:
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.
Social & Communication Impairments
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.
Stereotypical, Repetitive Behaviors
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
Associate Health ConditionL
sensory sleep intellectual disability seizures tuberous sclerosis GI problems mental disorders
Sensory:
atypical reactions to certain sights, sounds, smells, textures, touch, taste, pain
Sleep
disturbances may affect attention, daily functioning, behaviors, family stress and well-being
Intellectual disability
relative weakness in cognitive and language abilities. *Asperger’s exception
Seizures
1 in 4 children with ASD
Tuberous Sclerosis
1-4% of children with ASD
Mental Disorders
higher risk for anxiety, depression, ADHD
How often should intervention happen?
minimum of 25 hours/wk, 12 mo/yr, measured, recorded, and adjusted
Motor Impairments in Children with ASD
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.
Assessment of children at risk for ASD:
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.
Activities for
Coordination and Motor Planning
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
Outdated terminology of DCD:
Perceptual motor dysfunction. Sensory integration dysfunction. Developmental dyspraxia. Minimal brain dysfunction. Clumsy child syndrome
Cognitive ‘Top Down’ approach
Child-centered – emphasizes problem identification, motor planning, monitoring.
Task-specific intervention – direct teaching of task.
Bottom Up” approach
focused on remediation of impairments.
perceptual-motor training.
sensory integration.
process-oriented treatment (kinesthesia).
Floortime Model
follow child’s interests to build relationships.
TEACCH
build on child strengths through environmental adaptation, visual cues.
Applied Behavioral Analysis, ABA
intensive intervention to shape and reinforce new behaviors, extinguish undesirable behaviors.
