Lois Addy Presentation- Improving the motor coordination of children with DCD using Soft Play Equipment
Improving the motorcoordination of children withDevelopmental Coordination Disorder using Soft Play Equipment Lois Addy Senior Lecturer
Terminology• Clumsy child syndrome• Dyspraxia• Sensory integrative dysfunction• Minimal brain dysfunction• Perceptual-motor disorder• Motor learning difficulties• Congenital maladroit• Developmental apraxia• Minimal cerebral palsy• Executive apraxia• Deficit of attention, motor and perception (DAMP) Gillberg (1996)• Developmental Coordination Disorder (DCD)
Definition of DCD‘Performance in daily living activities that require motor coordination is substantially below that expected, given the person’s chronological age and measured intelligence.’ DSM-IV (2000)
Revised criterion AObserved poor performance in (culturallyexposed) fundamental motor skills evidentin a variety of environments– Walking Reaching & grasping– Running Object manipulation– Hopping Object propulsion– Skipping Object reception– Climbing
Top-down The physical task-centred approachTeaches a specific skill without emphasisingthe underlying processes.The skill is sub-divided, instructed, andrehearsed until it has been mastered.
2. Bottom-up Process-orientated approachIdentifies the underlying processes involved inacquiring a specific skill; and then focuses ondeveloping these skills to provide the foundationfrom which other skills are built.The process-orientated approach is based on thepremise that age-appropriate reflexes, posturalreactions, and perceptuo-motor abilities all underliefunctional motor skills and conceptual development(Pless and Carlsson, 2000).
Sensory SensoryIntegration Integration System System
EvidenceBundy, A. C., Shia, S., Long Qi, L., & Miller, L.J. (2007). How does sensoryprocessing affect play? American Journal of Occupational Therapy. 61, 201-208.Kaufman L B, Schilling D L (2007) Implementation of a Strength Training Programfor a 5-Year-Old Child With Poor Body Awareness and Developmental CoordinationDisorder. Physical Therapy. 87 (4), 455-467Miller, L.J., Schoen, S.A., James, K. & Schaaf, R.C. (2007). Lessons learned: Apilot study of occupational therapy effectiveness for children withsensory modulation disorder. American Journal of OccupationalTherapy, 61, 161-169.Parham, L. D., Cohn, E. S., Spitzer, S., Koomar, J. A., Miller, L. J., Burke, J. P., etal. (2007). Fidelity in sensory integration intervention research. American Journal ofOccupational Therapy, 61, 216–227.
Current Pilot• Sample Group: 3 children with coordination difficulties• Inclusion criteria: 6-10 years old, not currently receiving occupational therapy or physiotherapy• Ethical approval• Pre and post assessment using the Movement Assessment Battery for Children – Second Edition (MABC-2)• Parents perspective
MABC-2 RangeInterpretationTraffic Light system for test totalChild’s Score Total Test Percentile Description Score RangeRed Zone Up to and At or below Denotes a including 56 the 5th significant percentile movement difficultyAmber Zone Between 57 Between the Suggests the and 67 5th and 15th child is ‘at risk’ Inclusive percentile of having a movement difficulty; monitoring requiredGreen Zone Any score Above the 15th No movement above 67 percentile difficulty detected
8 week intervention programme: Activities introduced (a few!)• Circuit Crawling• Pushing and pulling activities• Crab football• Crab walking races• Wheelbarrows• Hand-eye coordination• Strength and endurance i.e. rope climbing, spinning, swinging, monkeys• Squashing and rolling activities• Interspersed with table top activities to reduce fatigue and improve manual dexterity.• Re-test in 2 weeks