Characteristic features of DCD classified according to the ICF
Health Condition Body Structure and Function Activity Limitations (primary impairment) (often secondary consequences) DCD is a neurodevelopmental disorder (DSM-­‐IV) DCD is present when... • Motor impairment or motor skill delay is impacting on a child’s ability to perform age-­‐appropriate complex motor activities • Adequate opportunities for experience and practice have been provided • There is no other explanation for the motor impairment DCD is usually not present when there is a history or findings of: • Recent head injury, trauma • Evidence of deterioration in skills • Increased or fluctuating muscle tone • Headaches, blurred vision • Asymmetrical tone, strength • Musculoskeletal abnormalities • Gower’s sign Other possible causes for in-­coordination: • Genetic (e.g., Down Syndrome) • Neurological (e.g., cerebral palsy) • Degenerative (e.g., muscular dystrophy, brain tumour) • Musculoskeletal (e.g., Legg-­‐Perthes) • Physical (e.g., impaired visual acuity) • Cognitive (e.g., developmental delay) • Pervasive developmental disorder (e.g., autism) • Injuries (e.g., traumatic brain injury) Participation Restrictions -­ Personal Factors Participation Restrictions -­ Environmental Factors • Weakness • Awkward, slow gait • Poor coordination • Variability in movement QUALITY such as speed, timing, force, distance • Low muscle tone • Joint laxity Difficulties with: • Muscle co-­‐contraction and joint stabilization • Delayed and reduced quality of fine and gross motor skills, such as hopping, jumping, ball skills, and writing • Delayed oral-­‐motor skills • Spatial organization • Multi-­‐sequence tasks • Withdrawal from activities when skill and performance are highlighted • Difficulties participating in ball games • Difficulties understanding game play, poor ability to ‘keep up’, fatigue • Depression • Quit trying to participate, unmotivated • Low self-­‐esteem • Poor fitness • Vocational anxiety • Extra time needed to dress and undress reduces participation in recess and readiness for home and community activities • Predominant use of vision to guide motor actions • Slow and messy written communication in class limits academic performance • Failure to transfer and generalize motor tasks to new activities or contexts • Peers don’t wait to try to understand conversations • Reduced efficacy of the feedback & feed forward motor control mechanisms • Difficulties with short-­‐ and long-­‐term memory ©Rivard, Missiuna, Pollock & Camden, 2013 Adapted from Rivard, Missiuna, Pollock & David (2012) & Missiuna, Gaines & Soucie (2006) Rivard, L., Missiuna, C., Pollock, N., & David, K. (2011). Developmental coordination disorder. In S. Campbell, M. Orlin, & R. Palisano (Eds.), Physical therapy for children (4th ed.)
(pp. 498-538). St. Louis, MO: Elsevier.
McMaster University, Hamilton, Ontario DCD PT workshop Available at : www.canchild.ca © Camden, Rivard, Missiuna & Pollock, 2013