What is developmental coordination disorder?
Not diagnosed by PT
- poor motor coordination & quality of movement that interferes w/ academic performance, self-care, and participation in leisure activities
What is the gold standard outcome measure for DCD?
Movement ABC
What is the CPG for those with DCD? (how do the present/how are they diagnosed)
- 5-18yrs old
- Males>females
- decreased motor quality, coordination, imagery, and prediction
- poor dual tasking
- S/S begin before age 5 (Wilgens said 5-8yrs)
- S/S can’t be explained by another disorder
What is likely damaged with DCD?
Cerebellum
What is the likely etiology of DCD?
no specific neuropathology
- some cases could be related to anoxia at birth or grades I or II IVH
What usually happens with the trunk and anterior tib muscles in kids with DCD?
- transverse abd. & oblique muscles activate half, or even a fourth, when compared to normal kids
What is often also associated with DCD when it comes to cognition?
- also have speech or learning issues
- attention deficit disorder as well
What are some “buzz” words that could lead to thinking a child has DCD?
- execution of motor skills is substantially below age
- clumsiness
- slow & inaccurate with motor skills
- interferes with ADLs
- onset of symptoms in early development
Do children with DCD have hypotonia?
Yes
- likely have mild hypotonia
What is the primary movement systems diagnosis for those with DCD?
- movement pattern coordination deficit
What are some outcome measures to use for those with DCD?
- Movement ABC*
- Observational movement assessment*
- BOT-2
- 6 MWT
- PDMS-2 (LESS than 8 yrs)
- Goal Attainment Scaling (GAS): tracks change in performance
What does the Movement ABC do?
- questionnaire used by a teacher/parent/PT + a motor test by a PT
- identifies a movement disorder & change over time
NOT great for participation limitations
What is included in the observational movement assessment?
- symmetry
- balance
- speed, initiation, execution
- range/quality
- control (timing, sequencing, mobility upon stability, clumsiness)
What is the desired score for the M-ABC?
0
What is the BOT-2 good for?
ages 4 yrs to 21 yrs 11 months
- good for diagnosing those with DCD
What is the Canadian Occupational Performance Measure good for?
GREATER than 8 years
- goal oriented for QoL
- good for goal setting
What is the Perceived Efficacy & Goal Setting good for?
LESS than 8 years
- younger kids
- has photos to see if they can do the skills pictured or not
What is a timed obstacle course good for?
- determining ambulation capacity by measuring stability & speed during gait
What is the Pediatric Balance Scale good for?
5-15yrs
- off shoot of BERG
- functional balance for kids
- good for risk of falls assessment
What are the 5 big skills kids need by preschool?
- rhythmic galloping (by age 4)
- single limb balance (8-10 sec by 5 & >10 by 6)
- Hopping (8-10x on 1 foot by age 5)
- skipping (by age 5)
- riding a 2-wheeled bike (by age 6)
What is the prognosis for those with DCD w/o intervention?
- poor academic/physical performance/self-esteem
- social isolation
- behavioral problems
- depression/anxiety
What is the recommended frequency & duration of intervention for someone with DCD?
3-5x/week for 9 weeks
What are some Top-down approaches for therapy?
helps address dyspraxia
- motor skill training (Main option for top-down)
- neuro-motor training
- cognitive orientation to occupational performance (focused on knowledge of results) Goal-Plan-Do-Check
- motor imagery
What is an example of motor skill training?
Kicking a ball and slowly adding degrees of freedom for the child
- stand and kick ball
- run to ball and kick
- run to ball, kick ball, run to ball
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Atypical Development and movement blocks23
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Cerebral Palsy54
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Prematurity51
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Autism28
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Developmental Coordination Disorder31
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Down Syndrome & Hypotonia18
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Gait impairments9
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Myelomeningocele32
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Duchenne Muscular Dystrophy (DMD)17
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Spinal Muscle Atrophy (SMA)15
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Peds Oncology27
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Congenital Muscular Torticollis22
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Educational Law11
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Wellness and Health10
