for educational purose

1. LEARNERS WITH
DIFFICULTY
MOVING/WALKING
Presented by: Ma. Maiden Heart M.
Cabundoc

2. The previous section presented the strengths,
difficulties, limitations, and educational
strategies in working with and helping children
with difficulties/disorders in communication. This
section now focuses on learners with difficulty
moving and/or walking, thus focusing on
physical and motor disabilities, their learning
characteristics, abilities, and the support they
need in an inclusive classroom.
A. Definition
When a child has difficulty moving and/or
walking, the physical domain of development is
affected. Examples of physical disability are
developmental coordination disorder or
dyspraxia, stereotypic movement disorder, tics
and cerebral palsy. Each one is defined in the
succeeding sections.

3. Developmental coordination disorder as
described in the DSM- (American Psychiatric
Association 2013), refers to significant and
persistent deficits in coordinated motor skills that
are significantly below expected typical
development. Difficulties are manifested as
clumsiness (e.g., dropping or bumping into
objects), slowness, and inaccuracy of motor skills
(e.g., catching participating an object, using
scissors or cutlery, handwriting, riding a bike, or in
sports). These observed deficits impact academic
performance and other activities of daily living,
which do not result from intellectual disability,
visual impairment, or any neurological condition
affected movement (e.g., cerebral palsy).
Dyspraxia, used synonymously with
developmental coordination disorder, is a term
often used by occupational therapists.

4. Another type of motor problem, Stereotypic movement disorder, is characterized by
repetitive, seemingly driven, and nonfunctional motor behavior (e.g., hand shaking or
waving, body rocking, head banging, self. biting, hitting own body). These behaviors
interfere with social, academic, or other activities and may result in self-harm or injury
(American Psychiatric Association 2013). Such motor behaviors do not result from any
other neurodevelopmental or mental disorder.
Cerebral Palsy refers to a disorder of movement and posture that results from damage
to the areas of the brain that control motor movement (Kirk et al. 2015). This damage to
the brain can occur before, during, or after birth due to an accident or injury. Muscle tone
(tension in the muscles) affects voluntary movement and full control of the muscles that
results in delays in the child's gross and fine motor development. There are different
classifications of cerebral palsy, depending on which parts of the body are affected and
the nature of the effects on muscle tone and movement. The term plegia, from the Greek
word meaning "to strike," is used with a prefix that indicate the location of limb movement
(see Table 6.4).

5. CLASSIFICATION DESCRIPTION
Monoplegia Only one limb is affected {upper or lower}
hemiplegia Two limb on the same side of the body affected
triplegia Three limb are affected
Quadriplegia All four limb, both arms and legs are affected;
movements of the trunk and face may also be
impaired
Diplegia Legs are affected, less severe involvements of the
arms
Double hemiplegia Impairment primarily involves the arms, less severe
involvement of the legs

6. B. Identification
Developmental Coordination Disorder. Identifying children with motor difficulties
begins with family members and early childhood practitioners. Upon noticing that
their child is showing difficulties and delays in fine and/or gross motor
movements, parents oftentimes consult their general pediatrician who in turn may
refer them to other specialists such as a developmental pediatrician, a physical
therapist, or an occupational therapist. Some signs that a child may have
developmental coordination disorder, that is more than just typical difficulty in
moving or walking, are presented in Table 6.5 (Nordqvist 2017).

7. Developmental stage Signs
Early Childhood Difficulty in tying shoelaces, buttoning, using
spoon and fork, and getting dressed;
problems in jumping, skipping, catching, and
kicking a ball; a higher tendency to bump into
things, to fall over, or to drop things
School-Age The difficulties in early childhood become
more pronounced; tries to avoid sports; works
on writing tasks for a longer period of time in
comparison to typically developing peers

8. In conducting an assessment, a specialist determines
the child's developmental history, intellectual ability, and
gross and fine motor skills. To differentiate between the
two, gross motor skills involve the use of large muscles
in the body to coordinate body movement, which
includes throwing, jumping, walking, running, and
maintaining balance. On the other hand, fine motor skills
involve the use of smaller muscles that are needed in
activities like writing, cutting paper, tying shoelaces, and
buttoning.
The evaluator needs to know when and how
developmental milestones are achieved. Assessment is
conducted to check the child's balance, sensitivity to
touch, and performance in other gross and fine motor
activities (Nordqvist 2017).
Oral motor coordination in doing activities like blowing
kisses or blowing out birthday candles may also be
reported, moreover, an evaluator will check for the
following: (1) strength and flexibility by palpating muscle
bulk and texture, assessing flexibility of joins, and the
quality and intensity of grasp and (2) motor planning
which includes observing functional fine and gross motor
skill and determining hand dominance or lack
thereof(Harris et al. 2015).

9. Stereotypic Movement Disorder. Similar steps are followed in the identification of the presence of Stereotypic
Movement Disorder (SMD) among children. Typically developing children may display stereotypic movements, or
behaviors, often referred to as stereotypies, between two and five as well as children with other neurological conditions
such Autism Spectrum Disorder and other developmental disabilities. Because of this, specialists classify SMD as
"primary" when it occurs in an otherwise typically developing child, or "secondary" if it exists alongside other neurological
disorders (Valente et al. 2019).
C. Learning Characteristics
Motor difficulties and disabilities are known to significantly affect a child's ability to perform daily activities, which include
memory, perception and processing, planning, carrying out coordinated movements. Speech may also be affected as
motor control is needed in articulation and production. Moreover, developmental coordination disorder also affects
psychosocial functioning as children report to have lower levels of self-efficacy and competence in physical and social
domains, experience more symptoms of being depressed and anxious, as well as display externalizing behaviors (Harris
et al. 2015). Children with stereotypic movement disorder also tend to have low self-esteem and have been reported to
be withdrawn (Valente et al. 2019).
On the other hand, a "range of strengths" needs to be acknowledged in every child with a disability (Armstrong 2012).
Students with motor movement disorders may excel in other areas of intelligences that are not controlled by motor
functions. They may have adequate intelligence, creativity, and language skills depending on the severity of the disorder
and the presence of a supportive adult. In fact, some children and adults who are physically handicapped or have
cerebral palsy have learned to paint with their mouths or feet to compensate for their rigid limbs and have done so
successfully. Some children may do well in logical thinking and comprehension and even in writing using assistive
technology. Hence, for children with motor difficulties and disabilities, support systems are needed to ensure that they
are given equal opportunities to access learning experiences in school alongside their typically developing peers.

10. D. General Educational Adaptations
First and foremost, children with motor difficulties and disabilities need primary intervention with
specialists such as physical and occupational therapists. These professionals are responsible for setting
goals in motor development, planning, and mobility as well as in providing teachers and others with
information about the child's physical conditions, limitations, and abilities (Kirk et al. 2015).
Physical accessibility of a school and classrooms to children with motor difficulty/disability is essential.
Ramps and elevators for schools with multiple levels of buildings is necessary, as well as the provision
of wheelchairs. Providing such structures and supports ensure that children with motor
difficulty/disability would be able to access as well as move around the classroom safely.
The type of accommodations given will always be relative to the strengths, abilities, and difficulties of the
child. For a child with developmental coordination or stereotypic movement disorder who struggles or is
unable to write but has adequate articulation and language skills, he/she may benefit from being given
accommodations in the way understanding is demonstrated (i.e., response). Some of the
recommendations for a child with such a profile may include the following: (1) assigning an adult or a
peer to be a scribe when accomplishing written tasks may be an option and (2) being given a pencil or
pen grip and different size/ diameter for a pencil for those with poor fine-motor control.
Table 6.6 presents practical classroom accommodations for children with developmental
coordination/movement disorder (Pollock & Missiuna 2007; Beech 2010).

11. Type of accommodation Description
Response • Assign a peer/adults as scribe for note-taking
• Use different sizes of paper and graph paper to align numbers
• Try different writing tools and pencil grips
• Use a word processor/computer
• Use text-to-speech programs
• Allows for oral recitations/test taking to supplement written tests
Setting • Allow for preferential seating near the teacher
• Adjust chair and/or desk height to maximize posture and stability
• Place a non-skid mat on the chair
• Provide opportunities for movements breaks
Schedule • Allow for extra time to complete tests and writing assignments
• Provide extra time to change for physical education classes
Others • Photocopy notes and homework reminders for the child
• Allow to take photos of notes and homework reminders
• Give advance organizers before a lesson/ lecture to
lessen/remove writing task
• Send lecture handouts via email

12. Thank you
very much!