Children with developmental coordination disorder (DCD) have a motor impairment that affects their ability to perform everyday tasks. Although severity of motor impairment can be measured, methods for assessing the perceived impact of DCD on daily activities have not been established. The purpose of this study was to use a child-focused approach to understand children's views of the impact of DCD on the activities that they perform daily. Children aged 5–10 years, referred with coordination difficulties to occupational therapists, were assessed using the Movement Assessment Battery for Children: children who received scores below the 15th percentile were included. The Perceived Efficacy and Goal Setting System (PEGS), a pictorial scale validated as a method for engaging children with disabilities, was administered to examine the children's perceptions of their competence in performing everyday activities and to identify goals for therapy. Parent and teacher concerns were collected by a questionnaire. The children, parents and teachers shared many concerns about the impact of DCD on physical tasks and on academic activities such as handwriting. The children expressed additional concerns, however, about their ability to perform daily self-care tasks and leisure activities, which were rarely recognised by the adults. Children require specialised methods to enable them to express their views and the PEGS appears to be suitable for this purpose.
This study measures the effectiveness of a goal-orientated group intervention using concentrated practice schedules for children with developmental coordination disorder (DCD). The study design is repeated measures. The sample comprises eight children with DCD, aged 7-11 years. Outcome measures are the Movement Assessment Battery for Children (MABC), the Canadian Occupational Performance Measure (COPM), Harter's Scale of Perceived Competence/Harter and Pike's Pictorial Scale of Perceived Competence, and clinical observations. The children set goals with the perceived efficacy and goal setting system with parents/caregivers input. The intervention used a goal-oriented approach combining motor learning and cognitive strategies consisting of eight 50-min sessions over 2 weeks. The results show significant improvements in the COPM and MABC scores following intervention but no changes in Harter's scores. Fifty-six goals were identified with 34 met totally, 12 met partially, and 10 remained unmet. A goal-oriented group intervention shows potential as an effective intervention method.
Aims: To assess children referred to the Occupational Therapy Service in Gwent with a presumptive diagnosis of developmental coordination disorder (DCD) in order to investigate the appropriateness of their referral. Methods: Non-urgent referrals to the occupational therapy team for children with coordination difficulties in Gwent between June 2001 and February 2002 were studied. Results: Eighty nine children, aged 5-10 years, were identified. Thirteen children who would not meet the DCD criteria were excluded. This left 76 children, 67 of whom were actually assessed. If the 15th centile for the Movement ABC is used, 26 children met and 41 failed one of the four criteria in DSM IV (38%). If the 5th centile is used, 21 children met and 46 failed one of the four criteria in the DSM (31%). Of the major groups of referrers, school nurses did the best with 48% success rate; better than the paediatricians with 32%. The worst success rate was in educational psychologists and teachers, with only 20% of cases referred actually having DCD. These differences did not quite reach statistical significance. Conclusions: Less than a third of referrals to occupational therapy for DCD actually have the diagnosis. This suggests that referrers need further training and guidance. This includes a knowledge and understanding of the DSM IV criteria and their interpretation. This would reduce the number of time consuming, unnecessary assessments being done. A triage procedure with a checklist would be a good way forward and we hope to devise one to assist referrers with this process.
Functional impairments can limit the participation of children with disabilities in childhood occupations, which can be detrimental to their overall development and social and emotional wellbeing. The primary goal of occupational therapy for children with disabilities is to facilitate and enable active participation in meaningful occupations. Computer-based assistive technologies can be used as an enabler, allowing children with severe disabilities access to a variety of activities. The aim of this study was to establish how computer assistive technologies can have an impact on the participation of children with complex and multiple disabilities in childhood occupations and in the development of their occupational roles.A comprehensive and systematic search and review of contemporary literature pertaining to computer use by children with severe and complex disabilities and its impact on a child's participation was undertaken. Articles included were critically appraised and analysed using a conceptual model of occupational therapy, with findings relating to the occupational performance areas of productivity, self-maintenance and leisure (a summary table is included). The findings supported the use of computer technologies for participation to a varying degree in all occupational performance areas, but were particularly positive in the areas of education, communication and play activities for children with disabilities.Reference: Chantry J, Dunford C (2010) How do computer assistive technologies enhance participation in childhood occupations for children with multiple and complex disabilities? A review of the current literature.■ Computer assistive technologies have the potential to enhance the participation of children with complex disabilities in a range of occupational performance areas, particularly education, communication and play.What the study has added The study provides a unique occupational therapy perspective on how children with multiple and complex disabilities can use computer assistive technologies.
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