Developmental Co-ordination Disorder
What is Developmental Co-ordination Disorder?
Developmental Coordination Disorder (DCD), also known as Dyspraxia in Ireland, is a common disorder affecting fine and/or gross motor coordination in children and adults.
It refers to children whose acquisition and execution of motor skills is substantially below expected for their chronological age and opportunity for skill learning and use. Difficulties are manifested as clumsiness, slowness and inaccuracy of performance of motor skills. Children may present with difficulties with self-care, writing, typing, riding a bike and play as well as other educational and recreational activities. Many of these difficulties will continue on into adulthood while they may also struggle with learning some independent living skills, driving a car and managing education and employment. There may be a range of co-occurring difficulties which can also have serious negative impacts on daily life, these include social emotional difficulties, challenges with planning and organisation, as well as problems with time management, all of which may impact an adult’s education or employment experience.
In order for DCD to be diagnosed,the motor skills deficits cannot be explained by intellectual disability, visual impairment, or neurologic conditions affecting movement.
DCD is believed to affect 5-6% of school-aged children and tends to occur more frequently in boys. DCD can exist on its own or it may be present in a child who also has specific learning disabilities, speech and language difficulties, and/or other developmental disorders.
How to recognise Developmental Co-ordination Disorder?
The child with Dyspraxia/DCD may have a combination of several problems in varying degrees. These include:
- Poor balance
- Poor fine and gross motor co-ordination
- Poor posture
- Difficulty with throwing and catching a ball
- Difficulties with planning and organisation
- Poor awareness of body position in space
- Poor sense of direction
- Difficulty in hopping, skipping or riding a bike
- Confused about which hand to use
- Difficulties with dressing including buttons and laces
- Difficulties using cutlery or pouring drinks without spilling
- Difficulty with reading and handwriting
- Speech problems – slow to learn to speak and speech may be incoherent.
What happens during the assessment process for Decelopmental Co-ordiation Disorder?
Generally an assessment for a formal disgnosis of DCD will be carried out after a child turns 8; this gives the child a chance to develop their fine and gross motor skills and the opportunity to catch up with peers. Assessments can be carried out with younger children but it is recommended that they receive intervention prior to any assessment to give them the best opportunity to to learn skills and catch up with peers. If they continue to stuggle after intervention, then there may be a need for an assessment for DCD. A parent consultation is generally carried out prior to the assessment to get an overall idea of the difficulties the child is having.
Standardised assessment is then completed by an Occupational Therapist who can assess a child’s planning and general movement skills, including their gross and fine motor skills. If these assessments indicate that DCD may be present then the child should be referred to a GP or Paediatrician to rule out any possible medical conditions which could impact co-ordination and to give a formal diagnosis of DCD if indicated.
It is also important to note that if the child has learning difficulties, then it would be expected that their motor skills would be below that of their chronological peers and this needs to be taken into account when completing and analyzing assessments.
How can an Occupational Therapist help your child?
Occupational therapists can help parents, educators and the child to develop a better understanding of the coordination difficulties that the child is experiencing. The child may need to be taught strategies to compensate for his/her motor problems and must be given adequate opportunities to practice those motor skills that need to be learned.
It is important to educate children with DCD, so they become aware of their strengths, as well as their limitations, and so that they gain an understanding of ways in which they may compensate for any difficulties. Occupational Therapy aims to empower children to work within their strengths and build on their achievements.
An approach such as the Cognitive Orientation to Daily Occupational Performance (Co-op) may be of benefit to the child. This will teach them a new way to approach tasks that they find challenging and give them the skills to analyse these themselves and find the best ways to achieve their individual goals.
Tips for Helping Childen with Developmental Co-ordination Disorder
- The child may benefit from being seated at the top of the class and facing the board as this will allow him full view of the board and will limit any visual distractions during the class.
- Acknowledge and praise tasks completed correctly.
- Help the child indentify their strengths and work from these.
- Prioritise activities that the child is motivated by as they will get a better sense of achievement when they achieve these.
- Find an activity that the child can achieve in and encourage this so they can experience success.
- Talk to the child and help them to problem solve around areas that they are finding difficult. Often we are not aware of all the things children struggle with.
- Encourage their independence. Don’t step in too soon and once they have a skill stop doing it for them. They need to experience success in their everyday living skills to give them a sense of purpose.
- Allow extra time for work tasks. Processing speed can often be slower in children with DCD.
- The child may benefit from being given a hard copy of homework or any additional work to be taken down from the board.
- Breaking the skill down step by step and focusing on the child completing one step at a time can be of benefit.
- Dyspraxia Foundation USA. (n.d.). Retrieved March 2, 2018, from http://www.bing.com/cr?IG=0B229221816E449FB6A1F1C88D35B725&CID=2B0FE691274C6F6D1CAAED37264A6EF8&rd=1&h=28zPAPJ1B9UHeEe-2btpjBqF0aLJrbc5dNDgUlthGOM&v=1&r=http%3a%2f%2fwww.dyspraxiausa.org%2f&p=DevEx,5069.1
- Dyspraxia/DCD Ireland – Home. (n.d.). Retrieved March 2, 2018, from http://www.bing.com/cr?IG=A7D373C62BBF4EF0B1CCFBD7B7A4383C&CID=1FBD83A31D146537075F88051C1264B5&rd=1&h=2HuRL9DSJK3o5k73QAgt7IcK4fse2pJFUisnREBKfx0&v=1&r=http%3a%2f%2fwww.dyspraxia.ie%2f&p=DevEx,5061.1
Rebecca Duff, Occupational Therapist at Sensational Kids
Sensational Kids CLG 2018