DCD Flashcards
(17 cards)
hallmark criteria for DCD Dx
need all 4:
1. learning and execution of coordinated motor skills is below age
2. motor difficulties significantly interfere with ADLs, academics, activities/play
3. onset is in early developmental period
4. motor coordination difficulties are NOT better explained by intellectual delay, visual impairments, or other neurological conditions
only physician or psychologist can diagnose
prevalance
5-10%
about 2:1 boys:girls
more prevalent in low birth wt, premature infants
co morbid conditions
ADHD
learning disability
speech/language
sensory differences
ASD
pathophysiology
multiple brain areas: cerebellum, basal ganglia, parietal lobe, parts of frontal lobe
poor internal models (cerebellum)
common presentation
Primary Body Functions and Structure Impairments
Poor strength
Poor coordination and motor planning
Joint laxity
Poor visual perception
Poor or slower processing
Poor sequencing
Poor feedback and feedforward (anticipatory responses)
Activity
Awkward gait
Delayed or poor quality of motor skills
Participation
Difficulties at school and home (takes more time, messy)
Longer term social emotional and fitness consequences
characteristics of DCD
communication issues, gross motor skill delay, social implications, ADL limitations, school challenges
prognosis and functional consequences
Don’t usually outgrow DCD, but learn to adapt
Poor fitness
Obesity
Decreased physical activity (encourage individual sports)
Poor self-esteem and self-worth
Emotional and behavioral problems
Impaired academic achievement
At risk for being bullied
movement observation drives exam
observe a few basic tasks such as ball throwing/catching, going up and down stairs
children w DCD present w a variety of comorbidities and body structure and function impairments so observation is important to hypothesize about other test and measures to consider
DCD diagnosis specific tests
DCD-Q: ages 5-15, screener not assessment tool - parent-report
MABC: ages 3-16, gold standard, to evaluates movement deficits and contribute to dx of DCD, administered by clinicians
possible impairments to examine
Strength
Coordination/Balance
Joint laxity/flexibility
Posture
Timing and sequencing
Feedback and feedforward motor control
Cardiopulmonary fitness
intervention
task/activity oriented approaches PLUS body function/structure interventions = most effective !!
individual PT for children < 5-6
individual or group therapy >6 yrs
what do task-oriented interventions have in common?
Task/Activity-oriented
Goal-directed
Motor-learning and motor planning strategies
Feedback
Self-assessment of movements
motor learning concepts for task-oriented training
enhance expectancies: “I think you can do ___” “you did it in _ sec las time, I think you can do it in under that next time”
autonomy: self discovery “I wonder what would happen if you might try ____” or “here’s a tip I would suggest” rather than “do it this way”
external focus of attention “do you think it would work to make the jumprope loop smaller?” rather then “hold your elbows closer”
body structure/function interventions and home suggestions
Trunk strengthening exercises
Endurance exercises
Coordination exercises
Some positive evidence for taekwondo
For Home – Encourage individual sports or team sports with skilled coach
use appropriate dosage
2-5x per week, usually averaged 9 weeks depending on goal
possible school needs
Children with DCD may qualify for a 504 plan or an IEP
They may need:
More time to complete assignments
Less handwriting and more keyboard
More time for testing
Auditory or visual recording of stories or papers
Adapted PE or modifications/adaptations to PE
Assistance with organizational issues
School counseling
key takeaways
There are 4 criteria for the diagnosis of DCD – know them!
DCD-Q an MABC-2 are two common tools used with children with DCD
Combine task-oriented and body function/structure interventions for increased effectiveness
Use observational movement analysis to guide interventions
Motor learning and motor planning principles are key!
