Odu%20 clinical%20science%20iii%20dcd%202011[1]


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Odu%20 clinical%20science%20iii%20dcd%202011[1]

  1. 1. Developmental Coordination Disorder (DCD) <ul><li>Clinical Science III </li></ul><ul><li>Karen R. Voogt, DPT </li></ul><ul><li>Fall 2011 </li></ul>
  2. 2. DCD <ul><li>Children also described as “low tone”, “mild motor” problems </li></ul><ul><li>Also labeled: </li></ul><ul><ul><li>clumsy child syndrome </li></ul></ul><ul><ul><li>physically awkward </li></ul></ul><ul><ul><li>perceptual motor dysfunction </li></ul></ul><ul><ul><li>developmental dyspraxia </li></ul></ul><ul><ul><li>sensory integrative dysfunction </li></ul></ul>
  3. 3. DCD Definition from DSM IV <ul><li>“Chronic and usually permanent condition characterized by impairment of motor performance that is sufficient to produce functional motor performance deficits that are not explicable by the child's age or intellect, or by other diagnosable neurological or spatial-temporal organizational problems.” </li></ul>
  4. 4. DCD Other Criteria <ul><li>Motor development must differ from their development in other areas and the motor problems must have an impact on academics and/or daily life activities. </li></ul>
  5. 5. DCD <ul><li>Many achieve motor skills at typical times </li></ul><ul><li>May not generalize to other settings </li></ul><ul><li>Motor difficulties continue to be present into adolescence and adulthood </li></ul>
  6. 6. DCD and Other Co-Morbidities <ul><li>Can range from mild to severe </li></ul><ul><li>Gross and fine motor problems </li></ul><ul><li>Learning disabilities </li></ul><ul><li>Speech and articulation difficulties </li></ul><ul><li>Attention deficit disorder </li></ul>
  7. 7. DCD Pathophysiology <ul><li>No specific pathologic process or single neuroanatomic site has been definitively associated with DCD. </li></ul><ul><li>DCD is not related to muscle pathology, peripheral sensory abnormality, or central nervous system damage that produces spasticity, athetosis, or ataxia. </li></ul><ul><li>Possible frontal and parietal lobe area lesions </li></ul>
  8. 8. Relationships Among Body Structures and Function, Activity, and Participation for a Child with DCD <ul><li>See Handout </li></ul>
  9. 9. DCD Pathophysiology <ul><li>Associated with prematurity, low birth weight </li></ul><ul><li>Prenatal, perinatal or neonatal risk factors </li></ul>
  10. 10. Impairments of Body Functions Identified in Children with DCD <ul><li>See Handout </li></ul>
  11. 11. Diagnosis of DCD <ul><li>Usually not made until later in school age when child learns and performs skills that require adaptation in speed, timing, force or distance of the movement </li></ul><ul><li>Slowness of movement </li></ul><ul><li>Decreased reaction time and movement time </li></ul><ul><li>Rely on use of vision more heavily </li></ul><ul><li>Decreased strength and power </li></ul><ul><li>Poor hand-eye coordination </li></ul>
  12. 12. DCD Secondary Impairments/Sequelae <ul><li>Decreased participation in sport and leisure activities </li></ul><ul><li>Decreased opportunities for social interaction </li></ul><ul><li>Decreased physical fitness across the lifespan </li></ul><ul><li>Sedentary lifestyle health risks </li></ul>
  13. 13. DCD Role of Feedback <ul><li>Studies demonstrate children with DCD do not interpret and utilize sensory feedback or feedback from task performance in the same manner as other children </li></ul><ul><li>NO internal representation of the motor action (efferent copy) </li></ul><ul><ul><li>May be responsible for slow, uncoordinated movement </li></ul></ul><ul><li>Don’t learn from their mistakes </li></ul><ul><li>Perform like earlier learning stages </li></ul><ul><li>No pre-movement preparation or “postural biasing” </li></ul>
  14. 14. DCD “Fixing” Strategy <ul><li>Freezing or fixing of joints during task performance </li></ul><ul><li>Deliberate stabilization of joints </li></ul><ul><li>Movements are stiff, awkward, clumsy in appearance </li></ul>
  15. 15. “Fixing” <ul><li>Stabilize so another part can be moved with better control </li></ul><ul><li>Controls excess degrees of freedom </li></ul><ul><li>Less efficient, causes fatigue </li></ul><ul><li>Challenged in timing, duration and sequencing </li></ul>
  16. 16. Treatment Intervention <ul><li>Determine what sports/leisure activities will be successful </li></ul><ul><ul><li>Address specific necessary skills </li></ul></ul><ul><li>Prevent long term effects of inactivity </li></ul><ul><li>Address physical impairments (low tone) </li></ul>
  17. 17. Treatment Interventions <ul><li>Children with DCD have difficulty with activities that require: </li></ul><ul><ul><li>Precision </li></ul></ul><ul><ul><li>Continuous adaptability </li></ul></ul><ul><ul><li>Eye-hand coordination </li></ul></ul><ul><ul><li>Variable environment </li></ul></ul><ul><ul><li>Constant monitoring of feedback during task performance </li></ul></ul><ul><ul><li>High level of unpredictability </li></ul></ul><ul><ul><li>Ex: hockey, baseball, basketball, football </li></ul></ul>
  18. 18. Treatment Intervention <ul><li>Children with DCD may be successful with: </li></ul><ul><ul><li>Sequence of movements that are repetitive </li></ul></ul><ul><ul><li>Swimming, skating, skiing, bicycling </li></ul></ul><ul><ul><li>Lifestyle sports </li></ul></ul>
  19. 19. Intervention