RAJIV GANDHIUNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
1.
Name of the Candidate
VINANTHI RAI K
LAXMI MEMORIAL COLLEGE OF
And Address
(in block letters):
2.
Name of the Institute :
PHYSIOTHERAPY.
MANGALORE- 575002.
LAXMI MEMORIAL INSTITUTE OF
PHYSIOTHERAPY.
3.
Course of study and subject :
MASTER OF PHYSIOTHERAPY
(PEDIATRICS)
4.
Date of Admission to Course :
5.
Title of the topic:
2/05/2012
EFFECTS OF MOTOR SKILL TRAINING
PROGRAM ON MOTOR PROFICIENCY IN
SCHOOL CHILDREN WITH
DEVELOPMENTAL COORDINATION
DISORDER.
6.
Brief Resume of the Intended Work:
6.1 NEED FOR THE STUDY:
Developmental Coordination Disorder, a chronic and usually permanent condition found in
children, is characterized by motor impairment that interferes with the child's activities of daily living
and academic achievement. In order for a child to be diagnosed with DCD, these motor impairments
must negatively affect some other aspect of his or her life. Impairment alone, however, does not
qualify a child for the diagnosis of DCD; the motor impairment must not be caused by or have the
symptoms of an identifiable neurological problem. That is, the child must not have any disturbances
of muscle tone (ataxia or spasticity), sensory loss, or involuntary movements.
The current prevalence is estimated to be between 5% and 8% of all school going children with
more boys than girl(2:1)
Due to the heterogeneity of DCD, finding its cause has been difficult. Several theories speculate
that the etiology of DCD is part of the continuum of cerebral palsy is secondary to prenatal, perinatal,
or neonatal insult or is secondary to neuronal damage at the cellular level in the neurotransmitter or
receptor systems. Later several theories and models were formulated in to explain the exact cause of
DCD. But all those theories failed to state the exact cause.
Children with DCD may have a wide range of dysfunctions. These dysfunctions can be grouped
into 3 areas: gross motor, fine motor, and psychosocial. Gross motor problems such as awkward
running pattern, frequent falls, dropping items etc and fine motor problems such as difficulty with
hand writing or drawing etc. learning disabilities and reading problems may also be present. A child
with DCD feels that body will not move correctly1.
It is important to assess the children with DCD and provide treatment for the same. Some of the
assessment tools are of Bruininks- Oseretsky test of Motor Proficiency,Movement Assessment
Battery for children, Development Coordination Disorder Questionnaire, Children’s Self Perception
of Adequacy in Predilection for Activity(CSAPPA) Subscale etc.
Also, It is important that parents and educators learn to manage these disorders early in order to
prevent secondary complications. Early recognition of children with this disorder can lead to
education and guidance that will encourage their engagement in typical activities of childhood,
thereby reducing the risk of decreased self-esteem, self efficacy and social participation that have
been noted at an early age2.
In the normal scenario, the society believes that children going to normal school are physically
and mentally normal without any neuromotor disturbances like in other specially abled children
going to special school. In normal school, teachers are more likely to believe that poor academic
performance and inactive participation in extracurricular activities is mainly due to negligence and
lack of interest from the children. But the actual cause of this awkward behaviour in the children left
unnoticed by the parents or caregivers and teachers due to lack of knowledge of such hidden
problems like DCD, LD, ADHD categorized under a term of ‘minimal brain damage’ whose etiology
remains unclear. Exercise training may be viable way of improving motor skills in children with
DCD.
This study intends to find out children with DCD and make an exercise regime which can be
incorporated in different schools so that children with such hidden neuromotor disturbances can be
benefited.
HYPOTHESIS:
NULL HYPOTHESIS (H0):

There will be no effect of motor skill training program on motor proficiency in children with
DCD.
ALTERNATE HYPOTHESIS (H1):

There will be effect of motor skill training program on motor proficiency in children with
DCD.
6.2 REVIEW OF LITERATURE:

Tsai CL etal (2012) conducted a study on effects of exercise intervention on event related
potential and task performance indices of attention networks in children with Developmental
Coordination Disorder. Thus the collected data concluded that soccer training resulted in
significant improvement in Event related potential (ERP) and task performance indices for
children with DCD3.

Bulent Elbasan, Hlya Kayihan, Irem Duzgun (2012) conducted a study on sensory
integration and activity of daily living in children with Developmental Coordination Disorder
and the study concluded that special education including sensory integration therapy and
motor performance in activities of daily living showed improvement in children with DCD4.

M Mitsiou et al (2011) conducted a study on Effect of Trampoline based intervention
program in static balance of children with DCD and concluded that trampoline based
intervention program is effective in improvement of DCD.5

Winnie W.Y Hung and Marco Y.C Pang (2010) conducted a study on effects of group
based versus individual based exercise training on motor performance in children with
Developmental Coordination Disorder. Thus the study concluded that group based training
produced similar gains in motor performance to individual based training. group based may
be preferred treatment due to associated cost saving6.

Margaret K.Y.Mac(2010) conducted a study on reaching and grasping a moving target is
impaired in children with Developmental Coordination Disorder. The study concluded that
the children with DCD were slower and generated a large force to reach and grasp a moving
target than their age matched- peer however the ability to modify the MT and grip force
appeared to remain in them7.

Lingam R et al(2010) conducted a study on the association between DCD and other
Developmental traits and concluded that Children with probable DCD had an increased risk
of difficulties in attention, social skills, reading, and spelling. These additional difficulties
need to be screened for during assessment and considered when formulating interventions.8

Kane, Kyra (2009) did a case study on core stability group program for children with DCD:3
clinical case trail thus this study concluded that physical activity in this population has the
potential to improve strength and reduced health risks related to sedentary lifestyle9.

Tsai CL (2009) conducted a study on the effectiveness of exercise intervention on inhibitory
control in children with developmental coordination disorder: using a visuospatial attention
paradigm as a model and demonstrated that exercise intervention employed within the school
setting can benefit the inhibitory control and motor performance in children with DCD10.

Peens A et al (2008) conducted a study on effects of different intervention programmes on
the self concept and motor proficiency of 7 to 9 year old children with DCD. Thus concluded
that exercise intervention employed within the school setting can benefit inhibitory control
and motor performance in children DCD11.

Schoemaker MM et al (2006) conducted a study on Evaluation of Developmental
Coordination Disorder Questionnaire as screening instrument. The DCD-Q is reliable and
valid in the age range for which the questionnaire was developed (8 y-14 y 7 mo) and in a
younger age range (4-8 y)12.

Missiuna et al (2003) conducted a study on early identification and risk management of
children with Developmental Coordination Disorder. Thus the study concluded that physical
therapisits can play a unique role in early identification and risk managements of children
with developmental coordination disorder2.

Hassan MM (2001) conducted a study on validity and relaiability of Bruininks- Oseretsky
test of Motor Proficiency-short form as applied in United Arab Emerites.thus the study
provided positive support for construction and reliability of the test13.

In the Diagnostic and statistical manual of mental disorders 4th edition(2000) it was
mentioned that approximately 6% of all school- aged children are affected by DCD14.
6.3 OBJECTIVES OF STUDY:
 To screen children between the age group of 5 to 15 years for DCD.
 To find the effectiveness of motor skill training program in children with DCD.
7
MATERIALS AND METHODS:
STUDY DESIGN: Experimental study.
7.1 SOURCE OF DATA:

Canara High School (main) Dongarkery

Kerala Samajam High School, Pandeshwar.

Sharada Vidyalaya Kodialbail.
 Sri Ramakrishna High School, Bunts Hostel Road
SAMPLE SIZE: 30
7.2 METHOD OF COLLECTION OF DATA
SAMPLING TECHNIQUE: Purposive sampling.
INCLUSION CRITERIA:
 All the children with DCD screened under Developmental Coordination Disorder
Questionnaire.
EXCLUSION CRITERIA:

Children with musculoskeletal problem (recent injuries like fracture, in sprain/strain etc)

Children with neurogenic lesion

Children with mental retardation.

Children with any traumatic brain lesion

Children with cardiac problem on medication

Children with severe respiratory problem and on medication

Children with visual problem.
MATERIALS:

Developmental Coordination Disorder Questionnaire

Ropes

Obstacles

Rocking board

Balance beam

Ball

Coins

Cards of different shape

Peg board.
TECHNIQUE OF APPLICATION:

Developmental Coordination Disorder Questionnaire by BN Wilson (2007)15 will be given to
the parents/teachers/caregivers of the children of the selected schools for screening children
with DCD.

According to the scores of the questionnaire subjects who fulfill the inclusion and exclusion
criteria will be taken for the study. Prior to the intervention BOTMP scoring will be done for
children with DCD. According to the scores children will be put on motor skill training
program which comprises of:
Agility and Balance:
Activity
Repetition/chance
Jumping- jumping into squares
20 repetitions
Hopping activities
On a 5 meter line 2 turns for
Time(in seconds)
each leg.
Walking activities
On a 5 meter line with 5 turns
to each child.
Balancing on a rocking board
5 repetitions
10 seconds hold.
Repetition/chance
Time (in seconds)
Core Stability:
Activity
Trunk curls in prone and
Hold fore 20 seconds
supine.
Lying prone on a therapy ball as many bean bags lifted at one
while performing upper limb stretch.
activities.
Sit ups
10 repetitions
Bilateral coordination:
Activity
Repetition/ chance
Jumping jacks.
In a 5 meter distance. Note
number of jumps
Galloping
On a distance of 5 meter. Note
number a gallops
Time(in seconds)
Eye-hand coordination:
Activity
Repetition/ chance
Time (in seconds)
Throwing a ball/ beanbag to 10 chances to each child to aim
different targets and catching
at a target.
Bouncing a ball and catching
10 chances to catch and throw.
Eye-foot coordination:
Activity
Repetition/ chances
Time(in seconds)
Kicking a ball to different 10 chance for each activity
targets and stopping a moving
ball
Touching
different
objects 10 chances to touch each
placed in different positions
object.

The intervention will be given for 3 weeks, 45 minutes 4 days per week.

A consent form will be given to each parent before the intervention is started.
STUDY DURATION: Six months
OUTCOME MEASURE:
 Bruininks- Oseretsky test of Motor Proficiency( BOTMP) Score.
STATISTICAL ANALYSIS:

Diagrammatic

Graphical

Paired t-test.
RESEARCH QUESTION:

Will Motor skill training program be effective on children with DCD?
7.3 Does the study require any investigations or interventions to be conducted on
Patients or other humans or animals? If so, please describe briefly.
Yes, this study requires a investigation and intervention to be conducted on school
children.
7.4 Has ethical clearance been obtained from your institutions in case of
7.3?
Yes ethical clearance has been obtained.
8
List of References:
1) Robert C Barnhart, Developmental Coordination Disorder Physical Therapy August 2003 vol. 83
no. 8 722-731.
2) Missiuna et al Early Identification and Risk Management of Children with Developmental
Coordination Disorder Pediatr Phys Ther 2003; 15:32–38.
3) Tsai CL etal Effects of exercise intervention on event-related potential and task performance
indices of attention networks in children with developmental coordination disorder. Brain Cogn.
2012 Jun;79(1):12-22. Epub 2012 Mar 1.
4) Bulent Elbasan, Hlya Kayihan, Irem Duzgun sensory integration and activity of daily living in
children with Developmental Coordination Disorder Ital J Pediatr. 2012; 38: 14.
5) M Mitsiou etal Effect of Trampoline based intervention program in static balance of children
with DCD Br J Sports Med 2011;45:e1 doi:10.1136/bjsm.2010.081554.52
6) Winnie W.Y Hung and Marco Y.C Pang effects of group based versus individual based exercise
training on motor performance in children with Developmental Coordination Disorder- a
randomized controlled pilot study. J Rehabil Med 2010; 42: 122–128.
7) Margaret K.Y.Mac.
Reaching and grasping a moving target is impaired in children with
Developmental Coordination Disorder. Pediatr Phys Ther 2010;22:384–391.
8) Lingam r etal the association between DCD and other Developmental traits 2010 by the
American academy of Pediatrics.
9) Kane, Kyra etal A Core Stability Group Program for Children with Developmental Coordination
Disorder: 3 Clinical Case Reports Pediatric Physical Therapy:Winter 2009 - Volume 21 - Issue 4
- pp 375-382.
10) Tsai CL The effectiveness of exercise intervention on inhibitory control in children with
developmental coordination disorder: using a visuospatial attention paradigm as a model. Res
Dev Disabil. 2009 Nov-Dec;30(6):1268-80. Epub 2009 Jun 3.
11) Peens A etal The effect of different intervention programmes on the self-concept and motor
proficiency of 7- to 9-year-old children with DCD. Child Care Health Dev. 2008 May;34(3):31628. Epub 2008 Feb 22
12) Schoemaker MM etal Evaluation of Developmental Coordination Disorder Questionnaire as
ascreening instrument. Dev Med Child Neurol. 2006 Aug;48(8):668-73.
13) Hassan MM validity and relaiability of Bruininks- Oseretsky test of Motor Proficiency-short form
as applied in United Arab Emerites. Percept Mot Skills. 2001 Feb; 92(1):157-66.
14) American Psychiatric Association. Diagnostic and statistical manual of mental disorder, fourth
edition, text revision. Washington, DC: American Psychiatric Press; 2000.
15) Wilson B.N etal Psychometric properties of the revised Developmental Coordination Disorder
Quetionnairer.Phsical and Occupational Therapy in Pediatrics, 29(9):182-202; 2007.