Clumsy child

Developmental apraxia

Motor Coordination that is: 

Below expect levels for the child chronological age & intelligence

Significantly interfering with academic achievement or ADLs

Not due to a general medical dondition (i.e. child does not have CP

Does ont meet criteria for pervasive developmental disorder

If intellectual disability (mental retardation ) is present the motor difficulties are in excess of  those typically manifest in the disability

Difficulty perceiving and interpreting information

Producing efficientmovements

participating in recreational activities w/ peer or family

might have issue with hand writing

General non-specific etiology

More common w/ ADHD & LD

Cerebellum and Basal ganglia involved

M>F

Premature birth

Low birth weight

Delay of motor development

Balance and coordination issues

handwriting

Slower response time

Visual/Perception challenges

Muscle weakness (especially in the hands

Poor coordination (i.e. finger to nose or opposition)

Choreiform movements (small jerky twitches of UE)

Visual/Perception issues

Lower Muscle tone

Akward slow gait

Difficulty dressing/tying shoes/Zippers

Complex coordination tasks- skipping, dribbling (soccer or basketball) then transitioning to shooting

Learning new tasks then require both sensory and motor planning intergration

Delayed oral motor skills (eating could be an issue)

Preschool or early grade school years

manifested in lack of coordination

difficulty following commands

Poor fine motor control

What are some of the mental difficulties that children with a developmental delay might demonstate?

What are some ways that you can help the child with this?

identifying important details of a task

Analyzing the task to uderstand it component parts

using ast experiences to plan new strategy

Executing the task as planned

Using feedback to make chagne for next attempt

Help them by:

Taking extra time to have them do the movement

doing things slowly

Retrieving info from memory to perfomr task agian (limited rention after performance)

No it is secondary to no moving

Cooridination is a direct impairment though

DCD Questionnaire- Screening tool

M-ABC 2- outcome measure

BOT 2- outcome measure (strength and agility, balance/coordination subtest)

Quality of life measure (CHild health Questionnaire)

Measures of Participation (CAPE)

6-21

Measures recreation, physical activity, social, and self-improvement

5-18

Measure physical and psychological health

The DCD questionnaire Revised

is for what ages?

What are the categories?

Sen/Specificity?

who is fills out the questionaire?

5-15 yo

Catagories: Control during movement

Fine Motor/Handwriting

Planning an activity

Sen: 84 Spec: 71%

parents

<8 yo <= 46

8-10 yo 55 or below

>10 yo 57 or below

M ABC

WHat is the age range?

Reliability

Catagories of Testing

3-16 yo

Good reliability ICC .94

Categories:

Manual Dexterity

Aiming & catching

Balance

What is the general theory of approaches of PT intervention the best for treating  DD or DCD, which ones are best?

An ecletic approach including:

Body orientaed and task-oriented are the most effective

What are the age ranges for DCD or DD for either individual or group therapy?

Are there any stipulations to this?

Indivdual therapy <=5-6 yo

Group Therapy for >6 years if can follow directions

Strengthening

Endurance

Coordination

NTT (Neuromotor Task Training)- how to instruct a child, practice skill provide feedback

CO-OP (cognitive Orientation to Daily Performance)

What are the four main objective to  CO-OP cognitve Orientation to daily Preformance)?

Does the CO-OP approach sink well with Developmental delay disorder?

1> SKill acquisition

2. COgnitive Strategy

3. Generalization to other setting

4) Transfer of learning-use of skill for basis of other skill development

CO-OP approach does sink well with developmental delay disorder.

What the missing component is, bc this is the reason they cannot do the skill

i.e. if a child cannot pull to stand is it bc of balance strength flexor spasticity etc

They came up with the development of guidelines for therapy frq in peds setting

there is a table in the PP

and a note card for each amount of therapy

Potential to particpate and benefit from the therpay process

Critical period for skill acquisition or for potential regression related to development or medical condition

Amount of clinical decision making and problem solving needed from a licensed therapist

Potential for rapid progress or decline or loss of skills due to current medical condition

Extremely critical

requires the clinical skills and problem solving of a licensed therapist

why would a child recieve Weekly or Biweekly therapy?

who would often be the

Patient demonstrate continued progress towards goals

condition is critical

Requires the clinicial skils of a PT for a significant time

Patient show slow attainment of goals in identified areas and or does not regress for reasons unrelate to their disease process

NOt in a critical period or critical period of development, change in life stage or medical condition

Requires the clinical skills and problem solving of a PT periodically

Patient/caregiver is able to meet new challenges associated with a change in life stage or medical condition

Specific challenges identified by patient and or caregiver or have a need for specific adaptive equipement

HEP can be carried out by the patient/caregiver. Clinical skilling only needed for specific things

Neimeijer research article show what?

ANother Neimeiger research article showed what?

Inteventions with children who were the most sever had the most improvements

Evidence for neuromotor tx approach

Second article:

if Teaching strategies effect the motor preformance in children with DCD. It would shown that teaching principles may be associated with succes in therapeutic situations

Not related to the article but in notes (teaching skills are important to the CO-OP approach)

That PT intervention in children with ADHD and DCD significantly improved motor performance of these children

this was assessed by the Movement Assessment Battery for Children M-ABC)

CO-OP: Cognitive Orientation to Daily Occupational Performance

Focuses on increasing performnace of the child using a problem-solving approach with task specific strategies

If they are still wearing diapers ask if it is difficult to put the diapers on the child or are they stiff when they are held or floppy

Age range

Setting (home, outpatient, school)

Characteristics of the test for what you want to measure