No abstract

Both teachers and parents were able to provide effective intervention for the majority of the children. It is possible that the children who did not improve have difficulties that are of a more complex type which require more specialist therapy to meet their need.

Children with Developmental Coordination Disorder (DCD) have a marked impairment in the performance of functional motor skills required to succeed at school. Longitudinal studies show that without intervention children with DCD often do not improve with development and the poor motor behaviour appears to have a detrimental effect on other aspects of functioning such as school achievement, behaviour and self esteem. Outside of clinical situations, there are only a small number of controlled empirical investigations, and from this small number two types of approaches emerge. The first concentrates on processes underlying motor skills and purports to improve areas such as kinesthesis or sensory motor processes. The second concentrates on teaching functional tasks aiming to specifically intervene in the deficient areas. Evaluations of these approaches show that they both work, producing significant improvements over control groups but show no differences between other approaches. It is hypothesized that more general learning principles are producing the effect, such as accurate assessment and tailoring activities to meet the needs of any individual child. Further, it is suggested that work with non-specialists in the motor area, such as teachers and parents, is a way forward with all but the most severely affected children.

BackgroundThe years from three to six are a time when children develop fundamental movement skills that are the building blocks for the functional movements they use throughout their lives. By six years of age a typically developing child will have in place a full range of movement skills including, running, jumping, hopping, skipping, climbing, throwing, catching, kicking, striking, writing and drawing. These will not necessarily be performed in a competent manner but the rudiments are there to be developed through later refinement, combination, adaptation and exploration. However, some children on entry into school do not have a full range of these fundamental skills and this lack of competence in motor skills often affects their academic work and activities of daily living. MethodsThis study concentrates on the years three to six and aims to examine the efficacy of graded intervention programmes for children identified with coordination difficulties and involved working with nurseries, schools and parents. A total of 35 children with coordination difficulties were identified and individual profiles mapped out. The study lasted for 2 years, including assessment and periods of intervention and no intervention. The children were assessed regularly throughout the project using the Early Years Movement Skills Checklist together with diaries and comments from teachers and parents. ResultsThe children as a group made significant improvement in their motor skills giving cautious optimism to a graded intervention approach. At the end of the study, 32 children had improved their motor skills and, although, the remaining three children improved their coordination skills, their test sores remained below the 5 t h percentile of the Early Years Movement Sills Checklist. Profiles of individual children illustrate the different progression children made. Conclusion 2This study has shown that graded intervention programmes for children identified with coordination difficulties have been found to be effective.3

The study has confirmed that children with DCD show varying profiles over a period of time and that the profiles have distinct characteristics related to events in the child's life. This approach to examining stability and change in the progressions of children's difficulties is in keeping with an ecological approach to explaining development with its multilayered influences creating changes.