Developmental Coordination Disorder

Question 1

Developmental Coordination Disorder (DCD) is also known as _______ and characterized by _____.

Answer 1

Developmental dyspraxia

Characterized by clumsiness

Question 2

List 3 characteristics of DCD.

Answer 2

1. Coordination markedly below peers
2. Interferes with academic achievement or ADLs
3. Not due to known physical disorder (i.e. if you have CP you cannot have DCD)

Question 3

List 3 soft neurological signs of DCD.

Answer 3

1. Muscle weakness esp. in hands
2. Lack of cerebral dominance (no hand dominance)
3. Retention of developmental reflexes

Question 4

True or False: Children with DCD will not be on schedule for the development of motor skills/milestones.

Answer 4

FALSE

Will be on schedule and able to complete age appropriate motor skills BUT they will execute motor tasks with poor coordination

Question 5

Describe 2 theories to explain DCD.

Answer 5

1. Cognitive linguistic: poor coordination secondary to understanding the task requirements
2. Motoric production: poor coordination secondary to inability to produce motor output despite having good understanding of the task

Question 6

What are 3 problems that children with DCD present with that lead to poor coordination?

Answer 6

1. Stimulus identification: i.e. State that they can only throw balls that are the color yellow
2. Response selection: cannot vary output (throw all balls in the same way)
3. Response programming (timing, force control, sequencing)

Question 7

Agnosias are problems with _____ perception. Describe 3 types of agnosia.

Answer 7

Problems with SENSORY perception

1. Astereognosis = inability to recognize objects
2. Finger agnosia = inability to differentiate between fingers
3. Agraphesthesia = inability to recognize written number or letter traced on the skin

Question 8

Apraxia is a problem with _____ that affects the UE more than the LE. Describe 3 types of apraxia.

Answer 8

Problem with motor planning

1. Ideation: cannot perform movement on command or automatically
2. Ideomotor: can perform automatically but not on command
3. Constructional: inability to copy shape of object (i.e. build a tower with blocks)

Question 9

List 9 impairments associated with DCD.

Answer 9

1. Inaccurate sensory acuity (intact sensation)
2. Poor body schema (skipping very difficult)
3. Hypotonic if not normal tone (vestibular based)
4. Joint laxity/poor posture (hang into ligaments)
5. Static balance more affected
6. Poor imitation
7. Poor motor planning
8. Inefficient movements
9. Limited variety

Question 10

List 5 functional limitations associated with DCD.

Answer 10

1. Accident prone
2. Immature movement patterns
3. Delayed advanced/skilled motor skills
4. Poor handwriting
5. Problems with ADL skills

Question 11

List 7 cognitive/social emotional limitations characteristic of DCD.

Answer 11

1. Poor self image
2. Emotional lability
3. Immature
4. Avoidance of difficult activities/situations
5. Blames others/environment
6. Complains more about minor physical limitations
7. Plays with younger children

Question 12

List 6 activities that should be assessed in children with DCD.

Answer 12

1. Age appropriate activities
2. Running (toddlers will fast walk)
3. Skipping
4. Gym activities
5. Fine motor (hand writing)
6. Dressing

Question 13

List 4 developmental reflexes that should be assessed in children with DCD.

Answer 13

1. ATNR (7 years = 30 deg; 5 years = 45 deg)
2. STNR (5 years = 5-15 deg)
3. Tonic Labyrinthine (supine flexion and prone extension for 20 sec in 6 year olds)
4. Equilibrium and Righting (ineffective)

Question 14

List 5 assessments of sensory acuity.

Answer 14

1. Localization esp. fingers
2. Double tactile
3. Stereognosis
4. Graphathesias
5. Proprioception/Kinesthesia

Question 15

List 3 coordination tests.

Answer 15

1. Dysdiadokinesis
2. RAMP movements (5-7 sec each, in and out): abduct arms to 90 and flex both biceps
3. Pa-ta-ka (make this sound rapidly to asses movement of tongue)

Question 16

List 7 treatment concepts to consider when treating children with DCD.

Answer 16

1. Allow the child to be successful (allow vision and limited options at first)
2. Monitor sensory input (start with vestibular to increase arousal)
3. Improve sensory acuity
4. Increase strength
5. Practice in limited environmental conditions first
6. Set up the environment to allow self direction
7. Self verbal cueing to remember sequences