Children with Developmental Coordination Disorder

Strategies for Success

Cheryl Missiuna

• Publisher: Routledge
• Year: 2013
• eBook ISBN: 9781136394751
• Topic: Medicina
• Subtopic: Atención sanitaria

Take a cognitive approach to treating children with DCD!Developmental coordination disorder (DCD) is frustrating for the children who must deal with it every day, for their parents, and for the professionals who work with these children. Children with Developmental Coordination Disorder offers new hope to children who are exeriencing this distinctive movement skill syndrome. It suggests ways they can overcome the challenges they encounter wherever motor skills are needed: in the classroom, on the playground, and at home doing self-care.This groundbreaking volume challenges pediatric therapists to examine the assessment and intervention approaches that are currently being used with children who have DCD. Children with Developmental Coordination Disorder offers new model that draws on research in the fields of motor learning, educational psychology, cognitive strategies, and occupational therapy. In addition to theoretical background, this book provides a detailed protocol for CO-OP (Cognitive Orientation to Daily Occupational Performance), an intervention that has been shown to facilitate problem-solving and enhance motor skill acquisition for children with DCD. Children with Developmental Coordination Disorder offers a comprehensive discussion of the disorder, including:

• identification and assessment of children with DCD
• analysis of the Bruininks Osortesky Test of Motor Proficiency and the Movement Assessment Battery for Children
• the theoretical and empirical basis for current treatment approaches
• new motor learning theories and their implications for treatment
• the systematic development and evaluation of the CO-OP approach, from early case studies through videotape analysis and retrospective chart review Based on six years of systematic, cooperative research, Children with Developmental Coordination Disorder demonstrates the success of a unique cognitive approach to intervention with these frustrated children.

INTRODUCTION

Strategies for Success: Working with Children with Developmental Coordination Disorder

Cheryl Missiuna

Occupational and physical therapists are receiving increasing numbers of referrals for school-aged children who present with handwriting difficulties, fine and gross motor delay, clumsiness and balance problems. While in the past, some might have believed that these children did not warrant intervention, teachers today initiate referrals because they notice the extent to which children with these types of problems have difficulty participating in the classroom and on the playground. This publication is timely because we now accept that many of the children who are experiencing academic and self-care challenges have a distinct movement skill syndrome that is recognized by the World Health Organization, and has been labelled by the American Psychiatric Association as Developmental Coordination Disorder (DCD). Although these children continue to be known by many other labels, including developmental dyspraxia, sensory integrative dysfunction, physical awkwardness, and the clumsy child syndrome, there is now an international consensus among researchers and clinicians that we will use the term DCD whenever we publish our research or clinical observations. In this way, therapists across North America and around the world will be able to access each other’s literature and learn from one another.

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Cheryl Missiuna, PhD, OT(C) is Assistant Professor, School of Rehabilitation Science and Co-Investigator, CanChild Centre for Childhood Disability Research, McMaster University.

Address correspondence to the author at: School of Rehabilitation Science, Institute of Applied Health Sciences, McMaster University, 1400 Main Street West, Hamilton, Ontario, Canada L8S 1C7 (E-mail: [email protected]).

[Haworth co-indexing entry note]: “Strategies for Success: Working with Children with Developmental Coordination Disorder.” Missiuna, Cheryl. Co-published simultaneously in Physical & Occupational Therapy in Pediatrics (The Haworth Press, Inc.) Vol. 20, No. 2/3, 2001, pp. 1-4; and: Children with Developmental Coordination Disorder: Strategies for Success (ed: Cheryl Missiuna) The Haworth Press, Inc., 2001, pp. 1-4. Single or multiple copies of this article are available for a fee from The Haworth Document Delivery Service [1-800-342-9678, 9:00 a.m. - 5:00 p.m. (EST). E-mail address: [email protected]].

© 2001 by The Haworth Press, Inc. All rights reserved.

The papers that have been compiled in this publication primarily represent the efforts of a group of researchers who have worked together for the past six years and who comprise the Developmental Coordination Disorder Research Group. Following an international consensus meeting that was held in London, Ontario in 1994, this group of individuals decided to jointly undertake a series of research studies that would help us answer a few key questions: Who are these children? What are their descriptive characteristics? What types of intervention are currently being provided? What seems to help them learn new motor skills? Based on our understanding of theory, and our observations of the children, what should work? This group of researchers, under the leadership of Dr. Helene Polatajko, has systematically developed and evaluated an innovative approach to intervention, a Cognitive Orientation to daily Occupational Performance. Contributions to this publication have also been made by colleagues from Alberta who share our interest in, and who have worked to further our understanding of, this population.

The articles in this work flow logically to illustrate the process that is followed when one undertakes the development of a new approach to intervention. First one must have a good understanding of the children who are to be served. Dewey and Wilson use the DSM-IV definition of Developmental Coordination Disorder as the organizational structure for their paper. Providing a comprehensive review of the world literature, they address the question “Who are these children?”

Once we have an idea of the characteristics of the children, therapists typically use assessments to identify and describe the problems that are experienced by any particular child. In this paper, Crawford, Wilson and Dewey tackle the difficult process of examining the assessments that are frequently used to identify children with DCD. Their analyses indicate that two of the more common tools, the Bruininks Oseretsky Test of Motor Proficiency and the Movement Assessment Battery for Children, actually identify different children, depending upon the degree to which the children show evidence of concomitant attentional problems. These authors emphasize the importance of using clinical reasoning and multiple sources of information when identifying children with DCD.

As we move toward intervention, Mandich and colleagues outline the evidence, or lack thereof, for treatment approaches that are currently used by occupational and physical therapists in the treatment of children with DCD. Mandich argues that hierarchical models of motor development, which are the underpinnings of “bottom up” treatment approaches such as sensory integration, process-oriented treatment, and perceptual motor approaches, have little empirical research support. Newer motor learning theories suggest that learning results from the interaction of the child, the task and the environment and therapeutic interventions need to reflect that understanding.

The systematic development and evaluation of the Cognitive Orientation to daily Occupational Performance (CO-OP) is described in a three-part series of papers. The theoretical underpinnings of the approach, derived from the fields of motor learning, educational psychology, cognitive strategies and occupational therapy, provide the foundation. The series of studies that contributed to the development and refinement of CO-OP are presented next in order to illustrate the manner in which evidence has been gathered systematically to examine its efficacy. Progressing from single case studies, through systematic replication, videotape analysis, a randomized clinical trial, and retrospective chart review, Polatajko and colleagues present the results that support the use of one particular cognitive approach with children with DCD. In the final paper of the series, the protocol that has resulted from the theoretical discussions and empirical evidence is described. The objectives, key features and techniques of the Cognitive Orientation to daily Occupational Performance (CO-OP) that are believed to be important components of the approach are outlined.

Mandich's paper follows and describes, in more detail, the cognitive strategies that have been found to be useful for producing changes in motor behaviour in children with DCD. Mandich and colleagues elaborate upon the way in which a global cognitive strategy is introduced and its usage facilitated with children with DCD. Using videotape analysis, the specific strategies that appear to facilitate problem-solving and enhance skill acquisition are outlined and examples are provided.

Finally, the “Clinical Concerns” section of this volume presents a description of a small group program that has been developed and run by an occupational therapist in Alberta, Canada. Although this program developed entirely independently of CO-OP, the similarities in the two approaches are striking. Leew describes an intervention program that she designed to help children with DCD who were experiencing organizational difficulties at school. Beginning with a similar theoretical base, Leew also concludes that children benefit from learning cognitive strategies, within a problem-solving framework, and from applying them to everyday activities. Leew's program focuses solely on academic activities and does not yet have systematic research evidence, but it is a creative, and very practical, illustration of the use of a cognitive approach within pediatric therapy.

We would be remiss if we did not acknowledge and thank the many graduate and undergraduate students who have contributed to this work in various ways at many points in time. We are also grateful for the support of foundations including the Edith Herman Research Fund, the Cloverleaf Charitable Foundation, the Hospital for Sick Children Foundation and the other granting agencies, acknowledged in particular studies, who have supported aspects of the work. Contributors to this publication hope that these articles will provide therapists with new suggestions and strategies for intervention that will ultimately improve task performance and school participation in children with Developmental Coordination Disorder.

Developmental Coordination Disorder: What Is It?

Deborah Dewey
Brenda N. Wilson

SUMMARY. This paper begins with a discussion of the historical basis for the concept of developmental coordination disorder (DCD). The definition of this disorder as it appears in the Diagnostic and Statistical Manual of Mental Disorders TV (DSM-IV) is then provided. The four diagnostic criteria proposed by the DSM-IV are used to describe the disorder. Problems associated with the assessment of DCD are discussed and suggestions for further research are identified. This is followed by a discussion of intervention approaches that can be used with children identified with DCD. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: <[email protected]> Website: <www.HaworthPress.com> © 2001 by The Haworth Press, Inc. All rights reserved.]

KEYWORDS. DCD, identification, assessment, intervention

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Deborah Dewey, PhD, CPsych, is Associate Professor, Department of Paediatrics, University of Calgary and Behavioural Research Unit, Alberta Children's Hospital Research Centre, Calgary, Alberta, Canada. Brenda N. Wilson, MS, OT(C), is Research Coordinator, Behavioural Research Unit, Alberta Children's Hospital Research Centre, Calgary, Alberta, Canada.

Address correspondence to: Deborah Dewey, Behavioural Research Unit, Alberta Children's Hospital, 1820 Richmond Road S.W., Calgary Alberta, Canada T2T 5C7.

Support for the preparation of this manuscript was provided by the Alberta Children's Hospital Foundation and the Ruth Rannie Memorial Endowment and the David and Dorothy Lam Foundation Fund.

[Haworth co-indexing entry note]: “Developmental Coordination Disorder: What Is It?” Dewey, Deborah, and Brenda N. Wilson. Co-published simultaneously in Physical & Occupational Therapy in Pediatrics (The Haworth Press, Inc.) Vol. 20, No. 2/3, 2001, pp. 5-27; and: Children with Developmental Coordination Disorder: Strategies for Success (ed: Cheryl Missiuna) The Haworth Press, Inc., 2001, pp. 5-27. Single or multiple copies of this article are available for a fee from The Haworth Document Delivery Service [1-800-342-9678, 9:00 a.m. - 5:00 p.m. (EST). E-mail address: getinfo@haworthpr...

Table of contents

• Front Cover
• Title Page
• Copyright
• CONTENTS
• Preface
• INTRODUCTION
• CLINICAL CONCERNS
• Index