Pediatric Physiotherapy and Developmental Coordination Disorder

by Emma Ashworth, Registered Physiotherapist

What is Developmental Coordination disorder?

Developmental coordination disorder, often referred to as ‘DCD’, is a motor skills disorder that affects approximately 5-6% of all school-aged children. DCD is a condition involving impairment in gross motor, postural and/or fine motor performance that affects a child’s ability to perform the skilled movements necessary for daily living, including the performance of academic and self-care tasks. These movement difficulties are unrelated to specific neurological conditions or cognitive impairments. Research now indicates that DCD is a not just a childhood condition, therefore, early intervention is useful and proactive.

Developmental Coordination DisorderWhat are the signs and symptoms of DCD?

Children with DCD are sometimes referred to as ‘clumsy’ or awkward – you may notice your child falls over their feet or bumps into things more often than usual. Many individuals with DCD have trouble learning new motor skills or transferring skills to other contexts. These children often have difficulty with movement skills such as skipping, hopping, catching and throwing. Activities such as riding a bike may also be challenging. Children with DCD struggle with everyday movements such as handwriting, dressing and tying shoes. They may also show signs of weakness in their core muscles and you might notice an unusual pattern of walking or poor balance. Decreased interest or avoidance of sports and activities may be evident (especially team sports).

These are a few common observations, however the areas of difficulty vary depending on each individual. Each child with DCD will present a little differently!

Understandably, frustration is common for those with DCD and difficulties with motor skills can lead to psychological and emotional concerns including low self worth, anxiety and social isolation.

Diagnosis

Due to the need to rule out underlying medical or neurological conditions, in most provinces a diagnosis can only be made by a Physician. DCD is considered present when 1) motor impairment and/or motor skill delay significantly impacts a child’s ability to perform age-appropriate complex motor activities 2) adequate opportunities for experience and practice have been provided, and 3) no other explanation can be offered for the motor impairment (Palisano et al, 2017). The high correlation between DCD and other developmental disorders indicates the need for a thorough, multidisciplinary assessment.

Who else is involved in the care of these children?

A multidisciplinary approach is crucial and child and family centered care should be prioritized. This team-based approach is valuable to provide strategies to help children with DCD integrative and participate in school and the community. Occupational therapists, Medical Doctors and Paediatricians are often an important part of this team. The involvement of speech and language therapists and psychologists may also be beneficial.

How can Physiotherapy help?

Physiotherapists have an understanding of normal and abnormal movement patterns, motor control, motor learning and development. They play a useful role in helping identify which areas need attention and help develop programs for children with DCD. Physiotherapists are also able to provide education and information for families and caregivers, as well as teachers and community workers.

Physiotherapy can help children get involved in activity, increase balance, improve flexibility, strengthen muscles, improve core stability, develop coordination skills and practice motor skills. Physiotherapy can also be useful in reducing the potential long-term complications of low activity levels, such as obesity and poor cardiovascular health.

Pediatric Physiotherapists are used to working with children and have many tips and tricks up their sleeves to make therapy fun!

What should I do if I suspect my child has DCD?

The best place to start is by discussing your concerns with your family Doctor or Paediatrician. Assessments from a Physiotherapist and Occupational therapist may also be appropriate. In the Vancouver area, BCCH provides research-integrated diagnostic assessments for children with suspected developmental coordination disorder.

Please contact Emma Ashworth, Registered Physiotherapist at Chipperfield Physiotherapy if you have any questions or if there is a child you would like to discuss. Alternatively, you may call (604) 828-2610 to set up an appointment.

Want more information?

For more information on DCD, please visit CanChild research centre of McMaster University

References:

https://www.canchild.ca/en/diagnoses/developmental-coordination-disorder/causes-identification

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1847727/

Palisano, R. J., Orlin, M. N., & Schreiber, J. (2017). Campbells physical therapy for children. St. Louis, MO: Elsevier.

Physio for Kids: Developmental Coordination Disorder