The document discusses improving motor coordination in children with Developmental Coordination Disorder (DCD) through soft play equipment. It outlines two approaches to teaching motor skills—task-centered and process-oriented—and includes evidence from various studies. A pilot intervention with three children aged 6-10 years involves an 8-week program that incorporates various activities aimed at enhancing coordination and strength, with assessments conducted before and after the program.

1. Improving the motor
coordination of children with
Developmental Coordination
Disorder using Soft Play
Equipment
Lois Addy
Senior Lecturer

2. 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)

3. 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)

4. Revised criterion A
Observed poor performance in (culturally
exposed) fundamental motor skills evident
in a variety of environments
– Walking Reaching & grasping
– Running Object manipulation
– Hopping Object propulsion
– Skipping Object reception
– Climbing

5. Top-down
The physical task-centred
approach
Teaches a specific skill without emphasising
the underlying processes.
The skill is sub-divided, instructed, and
rehearsed until it has been mastered.

6. 2. Bottom-up
Process-orientated approach
Identifies the underlying processes involved in
acquiring a specific skill; and then focuses on
developing these skills to provide the foundation
from which other skills are built.
The process-orientated approach is based on the
premise that age-appropriate reflexes, postural
reactions, and perceptuo-motor abilities all underlie
functional motor skills and conceptual development
(Pless and Carlsson, 2000).

7. Sensory
Sensory
Integration
Integration
System
System

8. Evidence
Bundy, A. C., Shia, S., Long Qi, L., & Miller, L.J. (2007). How does sensory
processing affect play? American Journal of Occupational Therapy. 61, 201-208.
Kaufman L B, Schilling D L (2007) Implementation of a Strength Training Program
for a 5-Year-Old Child With Poor Body Awareness and Developmental Coordination
Disorder. Physical Therapy. 87 (4), 455-467
Miller, L.J., Schoen, S.A., James, K. & Schaaf, R.C. (2007). Lessons learned: A
pilot study of occupational therapy effectiveness for children with
sensory modulation disorder. American Journal of Occupational
Therapy, 61, 161-169.
Parham, L. D., Cohn, E. S., Spitzer, S., Koomar, J. A., Miller, L. J., Burke, J. P., et
al. (2007). Fidelity in sensory integration intervention research. American Journal of
Occupational Therapy, 61, 216–227.

9. 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

10. MABC-2 Range
Interpretation
Traffic Light system for test total
Child’s Score Total Test Percentile Description
Score Range
Red Zone Up to and At or below Denotes a
including 56 the 5th significant
percentile movement
difficulty
Amber Zone Between 57 Between the Suggests the
and 67 5th and 15th child is ‘at risk’
Inclusive percentile of having a
movement
difficulty;
monitoring
required
Green Zone Any score Above the 15th No movement
above 67 percentile difficulty
detected

11. 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