Developmental Coordination Disorder (DCD)

Question 1

What is the definition of DCD?

Answer 1

A chronic condition involving impairment in gross motor, postural, & fine motor performance that affects a child’s ability to perform the skilled movements necessary for daily living, including the performance of academic and self-care tasks

Question 2

(T/F) DCD is caused by a general medical condition or a pervasive developmental disorder.

Answer 2

FALSE

Question 3

What is the key feature of DCD?

Answer 3

“Clumsiness” and poor motor coordination

Question 4

What is the history of DCD?

Answer 4

First described in 1987 and classified as a motor disorder in the DSM-V

Question 5

What are the different labels of DCD?

Answer 5

Clumsy child syndrome
Physically awkward child
Developmental dyspraxia sensory integrative dysfucntion
Disorder of attention motor and perception (DAMP)
Motor coordination or learning problems
Motor-perception dysfunction
Visuomotor disabilities

Question 6

What are the diagnostic criteria of DCD?
NEED TO MEET ALL

Answer 6

• Motor coordination is markedly below expected levels for the child’s chronologic age and opportunity for skill learning and use (below the 15th)
• Motor skill deficits significantly interfere with academic achievement or activities of daily living, leisure, and play (lasting >6 months)
• Motor skill deficits are not explained by intellectual disability or visual impairment and not attributable to a neurological condition affecting movement
• Onset of symptom is in the early developmental period

Question 7

What is the etiology of DCD?

Answer 7

Etiology is unclear, but may occur with the final neural migration and organization of the CNS during the last trimester of pregnancy

Question 8

What is the prevalence of DCD?

Answer 8

Prematurity risk factor 2.2 times more in children born before 32 weeks or <1500 grams

Males > Females (2:1)
Co-occurring conditions such as ADHD, SLI, Autism

Question 9

When and how is DCD diagnosed?

Answer 9

Diagnosed around 5 years old
Diagnosis of exclusion
Made by physician or psychologist

Question 10

What is the pathophysiology of DCD?

Answer 10

Poor processing of sensory systems
Poor integration of sensory inputs
Poor force control, rhythm, and timing
CNS problems with motor planning and memory
Motor, attention, memory, and perceptual process

Question 11

What brain regions are linked to DCD?

Answer 11

Cerebellum
Basal ganglia
Parietal lobe
Frontal lobe
Corpus Callosum

Question 12

What is the atypical function of mirror neurons?

Answer 12

Ability to imitate and learn new behaviors through observation

Question 13

What are the impairments of Body Structures and Function in DCD?

Answer 13

Neurologic “soft” signs, low muscle tone, Joint laxity
Muscle weakness, motor incoordination
Jerky movement, poor postural control
Poor body awareness, spatial organization, visual perception, inadequate processing
Poor sequencing, memory, motor control
Decreased cardiorespiratory fitness

Question 14

What are the deficits in predictive motor control in DCD?

Answer 14

Deficits in:
Anticipatory postural adjustments
Automatization
Reactive postural adjustments
Fixing joints to reduce degrees of freedom
Need extended periods of practice
Contextually based skills

Question 15

What are the activity/participation limitations of DCD?

Answer 15

Awkward slow gait, rely on vision
Difficulty with sports and on playground
Delayed gross and fine motor skills
Learning new motor tasks that require integration of sensory input and motor planning
Requires extra effort and attention

DISTRACTIBILITY: Leads to walking into doors

Question 16

What are the risks of DCD?

Answer 16

Fatigue
Repeated failure
Excluded from play
Social isolation
Low self-esteem
Bullying
Risk of Obesity

Question 17

What are the Adult difficulties with DCD?

Answer 17

Mental Health Difficulties
Time Management
Organization
Handwriting
Driving

Question 18

Describe the identification for physical therapy with DCD?

Answer 18

Often aren’t identified before age 5
Coordination difficulties aren’t easily observed until they attempt to learn and perform new skills that require adaptations in speed, timing, and grading of force

Question 19

Describe the referral to physical therapy with DCD?

Answer 19

Referral to PT via one of two principal routs
1. Health Care System
2. Educational System

Question 20

DCD Clinical Practice Guidelines

Answer 20

Complete examination, evaluation, and referral
Provide task-oriented interventions combined with body functions and structures
Provide collaborative communication about discharge recommendations for episode of care

Question 21

PT Examinations and Referral by CPGs

Answer 21

1. Complete ahistory and systems review
2. Make appropriate referrals
3. Complete participation outcome measures
4. Examine motor performance through observation
5. Examine activity limitations using questionnaires
6. Examine motor performance using measures
7. Examine impairments of body functions

Question 22

What is the Canadian Occupational Performance measure?

Answer 22

Outcome Measure about self-care, productivity, and leisure

Used for individuals 8 years and older
2 point changes clinically meaningful

Question 23

What is the Goal Attainment Scale?

Answer 23

Degree to which goal was attained

Intended for all ages with aggregated T scores

Question 24

What is the DCDQ 07?

Answer 24

Parent report measures to assist in the ID of DCD in children. It provides a standard method to measure a child’s coordination in everday activities

Question 25

What is the MABC-2?

Answer 25

A questionnaire designed to identify children who may have a movement disorder Completed by teacher, parent, or therapist

Question 26

What is the Developmental Coordination Disorder Questionnaire (DCDQ)

Answer 26

Used for individuals between 5 and 15 years of age With 15 items, graded 1-5 scales Little DCDQ for 3-4 years

Question 27

What is the Movement Assessment Battery for Children-2 (Movement ABC-2)?

Answer 27

Norm-referenced test for children aged 3-16 years Includes descriptors of Motor Behavior 8 items for 3 domains: Dexterity, Aiming, Balance

Question 28

What is performed in Movement ABC-2 Testing?

Answer 28

Manual Dexterity: Placing Pegs Threading Lace Drawing Trail Aiming and Catching: Catching with 2 hands Throwing beanbag onto mat Balance: One-Board Balance Walking Heel-to-Toe Forwards Hopping on Mats

Question 29

What is the Traffic Light System for MABC-2 Testing?

Answer 29

Red Zone = Up to and including 56 (Denotes significant movement difficulty) Amber Zone = Between 57 and 67 inclusive (At risk of having movement difficulty) Green Zone = Any score above 67 (No movement difficulty detected)

Question 30

What are the Task-Oriented interventions by DCD CPGs?

Answer 30

Motor Skills Training (MST) Neuromotor Task Training (NTT) Cognitive Orientation to Daily Occupational Performance (CO-OP) Motor Imagery (MI)

Question 31

What are the Body Function Interventions by DCD CPGs?

Answer 31

Core Stability Training (CST) Cardiorespiratory Training (CRT) Functional Movement Power Training Program (FMPT)

Question 32

What approach does the CO-OP Intervention have?

Answer 32

Cognitive Approach: 4 step self-instructional problem solving strategy Children with DCD are guided in discovering verbally based strategies to solve problems

Question 33

What should PT intervention according to the CPGs achieve?

Answer 33

Lead to functional outcomes (increased participation) Address impairments relevant to the motor skill

Question 34

What does treatment look like according to the CPG?

Answer 34

High number of repetitions Part to Whole practice Increasing demands Reduce practice errors Facilitation of self-discovery Watch themselves on video Mental imagery