Lecture 6: Developmental Coordination Disorder Flashcards
Developmental coordination disorder is not a common disorder
Explain the 4 peices of the criteria for diagnosiing developmental delay
A) Learning and execution of coordinated motor skills is below age level given the child’s opportunity for skills learning
* can’t do whats typical to the age group, given the opportunity - meaning if they cant do stairs by a certain age they were not given the oppotunity so that doesnt count.
B) Motor difficulities significantly interfere w/ ADL’s academic productivity, prevocational and vocational activities, lesiure and play
* when talking about 2-3 years old were talking about play
C) Onset is in the early developmental period
D) Motor coordination difficulties are NOT better explained by intellectual delay, visual impairment, or other neurological conditions that affect movement.
Excluding criteria for developmental coordination disorder:
The disturbance is not due to a general medial condition such as cerebral palsy, hemiplegia, or muscular dystrophy
* So if its not due to something else causing symptoms
The disturbance does not meet criteria for pervasive developmental disorder
If mental retardation is present, the motor difficulties present must be in excess of those usually associated with mental retardation alone
* so they have to be more retarded
* if they have a lower IQ, those motor skills would have to be worse than what you would expect of someone just w/ a low IQ
Abbreviated developmental coordination disorder diagnostic criterial (memorize this one!!!)
Name all 4 items
Criteria A- Motor performance deficits
Criteria B- Participation and ADL deficits
Criteria C- Early onset
Criteria D- No exclusionary conditions
Because Developmental Coordination Disorder is a newer term they used these instead
* Specific developmental disorder of motor function
* Clumy child syndrome
* Developmental Dyspraxia
And lumped them all into this
What percent of shcool age children get developmental coordination disorder?
Which sex has more?
5-6% of school age children (thats a lot)
Boys > Girls
Co Occuring Conditions:
* ADD and ADHD-50%
* Specific learning disabilities
* Speech and language disorder
* Autism spectrum disorder
* Conduct disorder (oppositional defiant disorder-ODD)
Things that go along w/ Developmental COordination Disorder
* Low muscle tone - so this low tone is many diagnosis now
* Persistence of infant reflexes - think ATNR later in life. If testing ATNR in an older kid you would test them in quadruped and turn their head and there arms going to bend if they have this. However, they can typically learn to override these reflexes. But tell them not to when testing
* Difficulties maintaining balance
* Awkward running pattern
* Falls frequently
* Difficulty imitating body positions - not that they can’t do it, but they can’t do it well
* Difficuty following 2- to 3-step motor commands
* Drops items
* Difficulty with handwriting or drawing (most frequently mentioned motor problem) - most frequently reported problem, thats why the kids who are borderline don’t get diagnosed until later when their hand writing doesnt keep up. We would often get an OT refferal to work on hand writing
* Difficulty gripping
* Difficulty using utensils for eating
* Difficulty dressing
Psychosocial:
* Learning Difficulities - this can lead to some behavioral issues, its really hard to be the kid that doesnt understand
* Reading problems
* Behavior problems
* Poor interactive play skills
* Lower self-esteem
* Lower self-worth
* Increased anxiety
* Avoids physical activity - if they’re bad at physical activity they just stop trying. Last one picked isnt even going to want to participate
Characteristics of Developmental Coordination Disorder:
* ADL limitations
* School challenges
* Social implications
* Communication issues - may not understand language the same way. May suck at jokes.
* Physical and motor issues
Functional Consequences of Developmental Coordination Disorder:
* Poor fitness - don’t want to participate
* Obesity - due to decreased movement
* Decreased physical activity (encourage individual sports - think swimming)
* Poor self esteem and self worth - get picked last for things
* Emotional and behavioral problems - frusterated they arent doing better
* Impaired academic achievement
* At risk for being bullied
Role of team in developmental delay
What the clinical Practice Guidelines Covers:
* PT patient management and awareness as role as team member - so we do treat this
* Applications to individuals suspected of DCD or any coordination difficulties
* Does not address handwriting
* Does not specifically address co-occuring conditions - so if they also have an autism diagnosis it doesnt cover this. It covers the coordination part but not the other part
- Guidelines for best clinical practice based on the current review of literature
What tow things do the guideliens for developmental coordination disorder not cover?
Does not address handwriting
Does not speciically address co-occuring conditions
What works for developmental coordination disorder
* Physical therapy / OT
* Individualized treatment plans
* Task specific training - if you want to learn how to go up and down stairs they need to walk up and down stairs
* Strengthening - because they have low tone
* Balance and proprioceptive training
* Individual sports - think swimming/tennis where they work individually, team sports don’t work well
* Soccer drills - think isolated
* Team sports focusing on practice skills versus competitive games - so they like the skill portion but not the actual games. if the team only scrimmages, thats not going to help their disoder, the drills do though
can children outgrow clumsiness?
No
Intervention has been shown to positively affect the development of gross and fine motor coordination when a specific skill is motivating, meaningful, and practiced extensively
* which means they need some bit of saliency/ it has to be fun for them to actually do well in it
kids have to want to do it, cant be passive
Treatment ideas:
* working on single leg stance while throwing shit at them - has to be fun
* make everything a game
* limbo - works on balance/coordination
* twister
* hop scotch
Anything thats working on motor and its fun
