Term
| What is the best standardized test to evaluate DCD? What scores will be low on this test? |
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Definition
| Bruininks Oseretsky. The running and bilateral coordination scores will be low. |
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Term
| What are the clinical signs of cerebellar trauma? (7) |
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Definition
| 1. Ataxia 2. Decomposition of movement. 3. Dysmetria. 4. Dysidadochokinesia. 5. Hypotonia. 6. Intention Tremors. 7. Nystagmus |
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Term
| Decomposition of movement is a sign of Cb trauma. Describe it, and use an example. |
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Definition
| The movement is not smooth. Shoulder, elbow and hand move choppily, rather than fluidly together. |
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Term
| What is dysmetria? How do you test it? |
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Definition
| Past-pointing. Point with one finger back and forth between another finger held in front of the face, and your nose. |
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Term
| Why is hypotonia a Sx of cerebellar dysfunction? |
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Definition
| Because Cb is the moderator of vestibular info. |
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Term
| Will you see a big difference between eyes open and eyes closed tests w/ cerebellar disorders? |
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Definition
| Nope. Vision doesn't compensate very well for Cb disorders, so performance on the two tests doesn't look much different. |
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Term
| Which sensory inputs pass through the Cb? |
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Definition
| All of them: tactile, auditory, visual, vestibular, proprioception and muscle spindle info all goes through Cb. |
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Term
| DCD is very common in young children. It has an incidence of ?% in children ages ?-? |
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Definition
| Incidence = 20% in children 5-11 years of age. |
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Term
| DCD is considered a heterogenous pool. What does that mean? |
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Definition
| There are no two kids with the same impairments. Every case presentation is different. |
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Term
| What are the major characteristics that can be seen in a DCD child? (5) |
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Definition
| 1. Difficulty judging distance and timing. 2. Difficulty coordinating complex sequences or combinations of body segment activity. 3. Difficulty w/ manipulation skills. 4. Significant interference w/ academic and/or ADLs. 5. No other diagnosable condition. |
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Term
| DCD cannot be given as a Dx UNLESS: |
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Definition
| The child has NO other diagnosable condition. |
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Term
| What happens to the DCD child's reaction time? |
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Definition
| It's longer and more variable than a normal child's |
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Term
| What happens to the DCD child's timing and rhythm mechanisms? |
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Definition
| They have poor internal timing, and very poor rhythm. |
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Term
| How can we help with the DCD child's timing problems? |
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Definition
| Teach them to make their own rhythm. Start w/ auditory cues (particularly helpful for gait). You can also use a treadmill, so the pace is set for them, clap and sing a rhythmic song, hold dowels and chug like a train while swinging their arms in rhythm with the dowels, ride a tricycle to get food rhythm in the pedals. |
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Term
| What system to DCD children depend on for balance and postural control? What does this indicate? |
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Definition
| Vision. They have slower processing of proprioceptive info, or a slower capacity to integrate proprioceptive and visual information. |
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Term
| Will DCD patients demonstrate a difference between eyes open and eyes closed tasks? |
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Definition
| Yes. They will do worse w/ eyes closed because they depend on vision for balance and posture control. |
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Term
| When presented w/ a DCD child, the pediatrician will often say things like: |
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Definition
| They'll outgrow it. Or, They'll compensate. They don't usually Dx DCD. |
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Term
| How can PT help the DCD child? (3 Major ways) |
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Definition
| 1. We can teach them to learn and attend to their body movements and compensate for the areas they lack. 2. Dx can help reduce inappropriate expectations, self-image, behavioral and stigma issues. 3. Accommodations and adaptations can be made to keep the child gratified and engaged in healthy levels of physical fitness. |
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Term
| Describe the three major postural control issues w/ DCD. |
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Definition
| 1. Significant difference in SLS w/ EO vs EC. 2. Greater latency in postural reactions with unexpected forward perturbations. 3. Reverse postural synergies of LE noted in 1/3 of all children w/ DCD. |
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Term
| What is a reverse postural synergy? |
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Definition
| They tighten the thigh and flex the hip rather than reacting distally with ankle strategies w/ perturbations. (hip strategy instead of anke) |
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Term
| Why can't DCD kids maintain a running pattern? |
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Definition
| Because they don't have the internal rhythm necessary to pace running. |
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Term
| What does DCD gait look like? |
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Definition
| Heavy, flat-footed plodding gait. |
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Term
| Why do DCD kids have a heavy, plodding gait pattern? |
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Definition
| They can't control heel strike very well. |
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Term
| DCD kids will sometimes toe walk. Why? |
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Definition
| Because they want to move faster than their plodding gait will allow. |
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Term
| Describe the problems w/ hopping and jumping. |
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Definition
| They have trouble propelling themselves forward and upward. There is a greater asymmetry in hopping between the R and L. They have poor utilization of UE momentum to propel their jump - they lack the coordination for it. |
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Term
| Describe the throwing problems seen w/ DCD kids. (6 major characteristics) |
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Definition
| Head and eye control is poor, so they can't keep their eyes on the target. They wind up their throw over the shoulder, lead with the forearm and elbow, and release prematurely. The follow through is absent or out of alignment, and their opposite arm is flail. |
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Term
| Why do DCD kids have trouble w/ catching? (4 major reasons) |
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Definition
| 1. Poor visual tracking - so they can't follow the target and their body isn't prepared to receive it. 2. Poor visual attention - easily distracted. 3. Poor proprioceptive hand and elbow placement. 4. Poor adaptive and preparatory responses because of decreased perception of speed and trajectory. |
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Term
| There are two major treatment categories for DCD. What are they? |
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Definition
| 1. Process Oriented. 2. Task Oriented. |
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Term
| Describe the process oriented treatment approach to DCD. Give an example. |
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Definition
It addresses the underlying systems of sensory reception, perception and integration. It relies heavilyon generalization and is thought to impact academic development.
Ie: Brain Gym |
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Term
| Describe the Task oriented approach to DCD Tx. |
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Definition
| Uses sensory integration principles within the context of a task. Uses motor learning and control theories. Has a biomechanical basis, breaks tasks down into successful components. |
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Term
| Which of the two treatment strategies does Pam think makes more sense? |
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Definition
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Term
| How do the two treatment strategies differ in their ability to measure change? |
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Definition
| Process-Oriented has no measures sensitive enough to show change. Task-Oriented effectiveness is linked directly to a quantitative result. |
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