developmental coordination disorder

key criteria to diagnose

motor performance deficits, participation and ADL deficits, early onset of symptoms, no exclusionary conditions

the acquistion and execution of coordinated motor skills are substantially below the expected given the individual’s chronological age and opportunity for skill learning and use. difficulties manifest as clumsiness, slowness and inaccuracy of performance of motor skills

motor performance deficits

motor skill deficits significantly and consistently interfere with ADLs appropriate to chronological age and affect academic/ school productivity, prevocational and vocational activities, leisure, and play

participation and ADL deficits

onset of symptoms is in early developmental period

early onset

motor skill deficits are not better explained by intellectual disability or visual impairment and are attributable to a neurological condition affecting movement

no exclusionary conditions

cause of DCD

combo of genetics and environment lead to difference in brain activation and development

brain regions involved in DCD

cerebellum, basal ganglia, parietal lobe, areas of frontal lobe, and potential corpus collosum

co occurring conditions

autism spectrum disorder, ADHD, joint hypermobility, hypotonicity, dyslexia, speech language learning disorder

primary impairments

sensory and perceptual deficits, motor learning and cognitive deficits, motor control and balance deficits

sensory and perceptual deficits

perception of tactile and proprioception inputs are impaired, visuospatial processing is impaired

motor learning and cognitive deficits

more variable performance and impaired rate of adaptation, less efficient learning strategies for new tasks

motor control and balance deficits

poor predictive/ anticipatory motor control, rely on slower feedback based strategies

participation and activity limitations assessments

canadian occupational performance measure, developmental coordination disorder questioniarre, movement assessment battery for children checklist

motor performance assessments

movement battery assessment, bruininks osteretsky proficiency 2 or 3

physical exam

strength testing via MMT, joint mobility, tine, proprioception, retention of primitive reflexes

functional impact of hypotonia

need to recruit more fibers and takes long to achieve normal action

test ATNR

in quadruped, turn the child’s head to one side then the other

positive ATNR

the side opposite the child’s head collapses

testing STNR

in quadruped, have child look up and down

positive STNR

weight will shift back when they look up and weight will shift forward when they look down

task oriented interventions with strong evidence

motor skill training, neuromotor task training

task oriented interventions with moderate strength

cognitive orientation to daily occupational performance, motor imagery

body structure and function interventions

core stability training, cardiorespiratory training, functional movement power training program