DCD

Question 1

Motor coordination markedly below expected levels for the child’s chronologic age and intelligence, which significantly interferes with academic achievement or ADL’s; Does not meet criteria for Autism; Not due to a general medical condition
If intellectual disability is present (IQ must be greater than 69); motor difficulties are in excess; Motor impairments need to (-) affect other areas of life

Answer 1

DCD

• can occur alongside CP, PDD, LD, ADD/ ADHD
• only recognized as a problem when it results in failure to satisfy environmental demands

Question 2

What is likely to be a comorbid condition with DCD?

Answer 2

Learning Disability

- 90% of children with LD have motor coordination and visuomotor problems

Question 3

Difficulty in acquisition of language, reasoning, and/or social skills

Answer 3

Learning disability

• Listening, speaking, reading, writing, reasoning, and or math
• CNS dysfunction: Not the result of environmental influences or social/emotional issues
• when it involves motor skills, it is DCD

Question 4

What are the possible impaired brain structures responsible for DCD?

Answer 4

1. Parietal lobe (holds internal copy of past movement)
2. Supplemental motor area
3. Cerebellum
4. Basal ganglia
5. Anterior 1/ 2 of periventricular white matter and frontal lobe

Question 5

What are body structure and function impairments with DCD?

Answer 5

1. Neurological soft signs
2. Visuoperceptual, visual-spatial, visual motor
3. Slow performance relying on feedback instead of feed forward
4. Slow reaction time and movement time
5. Response latency
6. Poor timing, rhythm and force control
7. Reduced power and strength
8. Reduced ability to successfully inhibit and action
9. Clumsiness - do NOT outgrow clumsiness

Question 6

What are soft neurological signs of DCD?

Answer 6

1. Low muscle tone
2. Muscle weakness - Esp. hands (or core)
3. Poor coordination - Positive Rhomberg
4. Choreiform movements- Tremor
5. Right-left discrimination- Finger agnosia
6. Visual tracking problems
7. Extinction of simultaneous stimuli
8. Exaggerated associated movements

Question 7

How do you differentiate whether the child’s problem is a developmental delay versus a developmental coordination disorder?

Answer 7

with DD, all primary domains are impaired

Question 8

What standardized tests are used in DD?

Answer 8

1. PDMS-2
2. BOT-2
3. Battle developmental inventory

Question 9

What standardized tests are used for DCD?

Answer 9

M-ABC

• screening checklist and norm-referenced exam
• best test for DCD
• BOT-2 under identifies, and M-ABC over identifies

Question 10

Why do you need a team approach for diagnosing DCD?

Answer 10

Need to test all domains in order to rule out other diagnosis

Question 11

What might a parent say in an interview for a child with DCD?

Answer 11

1. Messy when eating and dressing
2. late walkers
3. late talkers
4. falls a lot
5. excessive frustration
6. take to longest to get into or out of an activity
7. poor handwriting
8. unable to ties shoes
9. last one picked for physical activity teams, etc

Question 12

What impairments might you see with joint stability in kids with DCD?

Answer 12

poor joint stability:

1. Joints hyperextensible: Leans on hands all day-much energy goes into sitting up
2. Fixing patterns
   - Elevated and internally rotated shoulders
   - Internally rotated hips and pronated feet
   - Knees hyperextended

Question 13

What things might you assess for postural control in DCD?

Answer 13

1. low m tone
2. poor joint stability
3. sitting/ standing = lordotic back, knees positioned close together or hyperextended
4. Quadraped = scapular winging, flexed wrists, lordotic back

Question 14

What characteristics of dyspraxia are seen in children with DCD?

Answer 14

1. Motor performance is inconsistent
2. Motor performance is easier if self-directed - Spontaneous (ie PE suffers, may do better on the playground)
3. Motor performance is often labored and time intensive
4. Successful performance often times requires visual or verbal cues

Question 15

What is the sequence for motor planning/ praxis?

Answer 15

• ability to organize, plan, and execute skills
  1. Imitation
  2. Ideation
  3. Construction
  4. Feedforward/Feedback
  5. Grading
  6. Timing and Sequencing