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This pilot study investigated the feasibility and preliminary effects of an intensive 1-week day camp program for children with Developmental Coordination Disorder (DCD) that focused on vestibular rehabilitation.Ten participants (6-10 years) were assessed twice pre-intervention, post intervention, and at 8-week follow-up. Videonystagmography, Video Head Impulse Tests (vHIT), and Modified Emory Clinical Vestibular Chair Test (m-ECVCT) test were assessed at baseline. Outcomes measures were gaze stability (Dynamic Visual Acuity; DVA), functional gait (Functional Gait Assessment; FGA), balance (Sensory Organization Test), motor function (Bruininks-Oseretsky Test), and participation (Miller Function and Participation).No abnormal results were detected from the videonystagmography, vHIT and m-ECVCT. There was a 100% attendance rate at the camp and assessment sessions. FGA scores significantly improved following intervention and changes were maintained at follow-up. The number of children with abnormal DVA scores decreased from 3 to 1 to 0 between pre-intervention, post-intervention, and follow-up. There were no significant changes in any of the other outcomes following intervention.Intensive vestibular rehabilitation delivered in a day camp format is feasible and show positive preliminary effects on functional gait and dynamic visual acuity in children with DCD.

There is a lack of evidence-based tools for measuring problem-solving in young children with motor delays. The purpose of this study was to evaluate the construct validity and responsiveness of the Assessment of Problem-Solving in Play.125 young children (10.72, SD 2.62 months) with mild, moderate, and severe motor delays were assessed with the Bayley Scales of Infant and Toddler Development, Third Edition Cognitive Scale and the Assessment of Problem-Solving in Play up to 4 times over 12 months. The baseline and change over time assessment scores were compared.The Assessment of Problem-Solving in Play was strongly, positively correlated with the Bayley Scales of Infant and Toddler Development, Third Edition Cognitive Scale raw scores at baseline (Results provide evidence for the construct validity and responsiveness of the Assessment of Problem-Solving in Play scores in quantifying problem-solving in young children with motor delays 7-27 months of age.

Aims: The objective of this case series was to document gross motor function, gait parameter, and bladder control outcomes following physical therapy incorporating hippotherapy in children with Down syndrome (DS). Methods: Four children between three and five years of age received eight-weekly physical therapy sessions incorporating hippotherapy. Outcome measures included the Gross Motor Function Measure-88 (GMFM-88), parental perception of function during every day activities, spatiotemporal parameters of gait and bladder control. Results: Total change scores on the GMFM-88 exceeded the standardized response mean in all four children, while scores on Dimension E improved in two children. From the mothers' perspectives, all children showed at least some improvement in walking, running, and jumping; sitting, kneeling, and standing; symmetry and comfort; balance; coordination and social interactions and there were inconsistent changes in bladder control. Only one child demonstrated changes greater than 20% in any of the gait parameters. Conclusions: Physical therapy incorporating hippotherapy may be a potential treatment to assist in improving gross motor function in children with DS, but eight sessions may not be long enough to show major improvements in gait parameters or bladder control. Further research in the form of larger controlled trials is warranted to provide more support for the intervention in those with DS.

Aims: To examine whether group-based or individual-based treatment programs are more effective for quality of life (QOL) outcomes in children with developmental coordination disorder (DCD). Methods: A systematic search of the literature was conducted, in accordance with the PRISMA guidelines. Quality of the papers was assessed using the Modified Downs and Black Checklist. Peer-reviewed clinical experimental studies of children diagnosed with DCD with any QOL related outcome measure were included, of all years, languages, and approaches of intervention. Results: Sixteen studies were identified for inclusion, of mixed methodological qualities (predominantly low). Improvement of QOL with both group-based and individual-based interventions were shown, though large degrees of heterogeneity were observed in study designs, participants, modes of interventions, durations, and outcome measures utilized. Conclusions: The effectiveness of group-based versus individual-based interventions on QOL of children with DCD is unclear. There is a pressing need for a high quality, powered trials, utilizing the randomized control trial paradigm, comparing both intervention approaches with standardized treatment approaches and outcome measures to determine and compare the effect on QOL of children with DCD.

The purposes were to examine construct validity of the Motor Planning Maze Assessment (Maze) and three items from the Functional Gait Assessment (FGA) that were modified for children (pediatric modified FGA, pmFGA), by comparing performance of children with DCD and age matched peers with typical development (TD); the construct validity of total scores of the Dynamic Gait Index (DGI) and the FGA.Twenty pairs of children with DCD and TD, age from 5 to 12 years, participated in this study. Children in both groups were tested on the Maze, pmFGA, DGI, and FGA. Paired t-tests and agreement tables were used to compare the motor performances between two groups.The DCD group showed higher summary scores in the Maze (p0.001) and demonstrated significantly fewer steps (p ≤ 0.001) while doing the pmFGA items than the TD group. However, the FGA quality scores demonstrated minimal differences between the two groups on all three items. Children with DCD showed significantly lower DGI and FGA total scores (p0.001) than the TD group.The Maze, DGI, and FGA tests are easily applied in clinical settings and can differentiate motor planning and gait coordination between children with DCD and with TD.

This study provides information on how two standardized measures based on different theoretical frameworks can be used in collecting information on motor development and performance in 4- and 5-year-olds with autism spectrum disorder (ASD). The purpose of the study was to determine the concurrent validity of the Miller Function and Participation Scales (M-FUN) with the Peabody Developmental Motor Scales, Second Edition (PDMS-2) in young children with ASD.The gross motor sections of the PDMS-2 and the M-FUN were administered to 22 children with ASD between the ages of 48 and 71 months. Concurrent validity between overall motor scores and agreement in identification of motor delay were assessed.A very strong correlation (Pearson's r =.851) was found between the M-FUN scale scores and the PDMS-2 gross motor quotients (GMQs). Strong agreement in identification of children with average motor skills and delayed motor skills at 1.5 standard deviations below the mean was also found.This study supports the concurrent validity of the M-FUN with the PDMS-2 for young children with ASD. While both tests provide information regarding motor delay, the M-FUN may provide additional information regarding the neurological profile of the child.

Occupational therapists (OTs) often face barriers when trying to collaborate with teachers in school-based settings. Partnering for change (P4C), a collaborative practice model designed to support children with developmental coordination disorder, could potentially support all students with special needs. Therefore, the aim of this study was to explore how teachers experience OT services delivered using the P4C model to support children with a variety of special needs.P4C was implemented at one elementary school in Courtenay, British Columbia. Eleven teachers participated in two focus groups and a one-on-one interview to gather descriptive, qualitative data. Grounded theory techniques were used for data analysis.Four themes (collaborating in the thick of it all, learning and taking risks, managing limited time and resources, and appreciating responsive OT support) represented teachers' experiences of P4C.Teachers strongly preferred collaborative OT services based on the P4C model. Students with a variety of special needs were supported within their classrooms as teachers learned new strategies from the OT and found ways to embed these strategies into their daily routines.

Poor motor performance and reduced physical fitness are characteristic of children with Developmental Coordination Disorder (DCD). These features have also been identified more frequently among children living in low socio-economic circumstances.To evaluate the outcomes of a nine-week health promotion program (HPP) on the motor performance and fitness levels of children (6-10 years) with and without DCD attending a low-income primary school.The HPP was designed and implemented by undergraduate physiotherapy students using guidelines from the World Health Organization School Health Initiative and their physiotherapy curriculum. Children with DCD (n = 22) and a control group without DCD (n = 19) participated in the evaluation. Motor skill, functional strength, aerobic capacity, and anaerobic power were measured at baseline and after nine weeks.Both groups of children improved on all measures at the conclusion of the HPP. Children with DCD showed greater improvement than the control group in motor performance and the control group showed greater improvement on one of the anaerobic fitness outcomes.A school-based HPP that focuses on increasing opportunities for physical activity may be effective in improving motor performance in children with DCD and can increase fitness levels in general.

Awareness and understanding of Developmental Coordination Disorder (DCD) has increased steadily over the last two decades. A series of international conferences, begun in 1995, has offered a forum ...

Aims. In this perspective article, we propose the Apollo model as an ex- ample of an innovative interdisciplinary, community-based service delivery model for children with Developmental Coordination Disorder (DCD) characterized by the use of graduated levels of intensity and evidence-based interventions that focus on func- tion and participation. Methods. We describe the context that led to the creation of the Apollo model, describe the approach to service delivery and the services offered. Results. The Apollo model has 5 components: first contact, service delivery coordina- tion, community-, group-, and individual-interventions. This model guided the devel- opment of a streamlined set of services offered to children with DCD, including early- intake to share educational information with families, community interventions, inter- disciplinary and occupational therapy groups, and individual interventions. Following implementation of the Apollo model, wait-times decreased and the number of chil- dren receiving services increased, without compromising service quality. Conclusions. Lessons learned are shared to facilitate development of other practice models to sup- port children with DCD.

Children with coordination difficulties are at risk of low levels of physical activity (PA) participation. This intervention examined the effects of a multidisciplinary program that emphasized parent participation on motor skill performance and PA.Ten boys (5-7 years) completed a group program consisting of conditioning exercises and activities designed to address child-selected goals. Motor proficiency and PA participation were assessed before and after the program using the Test of Gross Motor Development (TGMD-2) and triaxial accelerometers, respectively. Rating scales captured child and parent perceptions of performance for each child's goals.TGMD-2 subtest raw scores, age equivalent and percentile scores improved, along with parent ratings of their child's performance. Six children reported skill improvements. On average, moderate to vigorous PA improved by 10 min per day although these gains were not significant. Time spent in sedentary activities was unchanged. None of the children met the Canadian PA and sedentary behaviour guidelines.The results support effectiveness of a group program to improve gross motor performance and levels of PA in children with coordination difficulties. Gains in both of these domains also have the potential to impact quality of life and reduce health risks associated with inactivity.

Developmental Coordination Disorder (DCD) affects the learning and performance of everyday motor skills. It commonly co-occurs with other developmental disorders and a range of associated psycho-social impairments. Recent evidence-based guidelines on diagnosis, assessment, and intervention provide valuable information for practitioners. However these are directed primarily at German-speaking countries and focus on work with children.The aim of this project was to consider the application of these guidelines in the UK and to extend them for use with adults with DCD.Individuals with DCD, parents, and professionals from a wide range of disciplines were invited to two workshops to discuss and debate the guidelines, to adapt them for the UK and produce dissemination materials.A working definition of DCD was agreed, minor revisions were made to the guidelines to reflect the UK context, an extension for adults was compiled and a series of leaflets was produced to disseminate this information to health and education professionals, parents, and employers.This work will raise awareness of the condition across different professional groups. It provides information to help those working with children and adults with DCD in the UK to assist in the process of diagnosis, assessment, and intervention.

This study explored the needs of children with developmental coordination disorder (DCD) from an ecosystemic viewpoint as part of a theory-driven program evaluation process. A multiple case study needs assessment was conducted. Participants included ten children with DCD, their parents (n = 12), teachers (n = 9), and service providers (n = 6). Data collection involved semi-structured interviews, validated questionnaires, and a review of the children's records. The results support the relevance of using an ecosystemic model to assess the needs of children with DCD in their life and social contexts. More specifically, the results highlight the need to provide additional services at school, such as occupational therapy and special education, as well as information and training regarding DCD for parents and teachers. The results also point to the relevant variables to consider in an intervention program based on theory-driven evaluations. This study shows how employing an ecosystemic frame of reference provides a better understanding of the needs of children with DCD. Future research should document the ecosystemic profiles and evolution of the needs of children with DCD with a larger sample from diverse socioeconomic backgrounds using a longitudinal study design.

Developmental coordination disorder (DCD) is frequently under-recognized (Blank, Smits-Englesman, Polatajko & Wilson, 2012), but in fact, it occurs in as many as 5–6% of children (Kadesjo & Gillber...

This article presents the experience of a rehabilitation program that undertook the challenge to reorganize its services to address accessibility issues and improve service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical perspective on the planning; implementation; and evaluation phases of the process are described. In the planning phase, the constitution of the working committee, the data collected, and the information found in the literature are presented. Apollo, the new service delivery model, is then described along with each of its components (e.g., community, group, and individual interventions). Actions and lessons learnt during the implementation of each component are presented. We hope by sharing our experiences that we can help others make informed decisions about service reorganization to improve the quality of services provided to children with disabilities, their families, and their communities.

Poor handwriting has been shown to be associated with developmental disorders such as Developmental Coordination Disorder, Attention Deficit Hyperactivity Disorder, autism, and learning disorders. Handwriting difficulties could lead to academic underachievement and poor self-esteem. Therapeutic intervention has been shown to be effective in treating children with poor handwriting, making early identification critical. The SOS test (Systematic Screening for Handwriting Difficulties) has been developed for this purpose. A child copies a sample of writing within 5 min. Handwriting quality is evaluated using six criteria and writing speed is measured. The Dutch SOS test was administered to 860 Flemish children (7-12 years). Inter- and intrarater reliability was excellent. Test-retest reliability was moderate. A correlation coefficient of 0.70 between SOS and "Concise Assessment Methods of Children Handwriting" test (Dutch version) confirmed convergent validity. The SOS allowed discrimination between typically developing children and children in special education, males and females, and different age groups.

Content validity and reliability of the Brief Assessment of Motor Function (BAMF) Upper Extremity Gross Motor Scale (UEGMS) were evaluated in this prospective, descriptive study. The UEGMS is one of five ordinal scales designed for quick documentation of gross, fine and oral motor skill levels. Designed to be independent of age and diagnosis, it is intended for use for infants through young adults. An expert panel of 17 physical therapists and 13 occupational therapists refined the content by responding to a standard questionnaire comprised of questions which asked whether each item should be included, is clearly worded, should be reordered higher or lower, is functionally relevant, and is easily discriminated. Ratings of content validity exceeded the criterion except for two items which may represent different perspectives of physical and occupational therapists. The UEGMS was modified using the quantitative and qualitative feedback from the questionnaires. For reliability, five raters scored videotaped motor performances of ten children. Coefficients for inter-rater (0.94) and intra-rater (0.95) reliability were high. The results provide evidence of content validity and reliability of the UEGMS for assessment of upper extremity gross motor skill.

Smith-Magenis syndrome (SMS), the result of an interstitial deletion within chromosome 17p11.2, is a disorder that may include minor dysmorphic features, brachydactyly, short stature, hypotonia, speech delays, cognitive deficits, signs of peripheral neuropathy, scoliosis, and neurobehavioral problems including sleep disturbances and maladaptive repetitive and self-injurious behaviors. Physical and occupational therapists provide services for children who have the syndrome, whose genetic disorder is frequently not identified or diagnosed before 1 year of age. A comprehensive physical and occupational therapy evaluation was completed in nonidentical twins with one having SMS, using the Sensory Profile; Brief Assessment of Motor Function (BAMF); Peabody Developmental Motor Scales, Second Edition (PDMS-2); and Pediatric Evaluation of Disability Inventory (PEDI). This provides a framework for conducting assessments to enhance early detection and interdisciplinary management with this specialized population.

Home adaptation is essential in increasing independence of children with disabilities and reducing the burden of care for parents. Physical and occupational therapists involved in home adaptations are faced with various challenges in meeting the needs and expectations of parents. This study aimed at exploring the experience of parents throughout the home adaptation process. We conducted an exploratory qualitative study, whereby we interviewed a sample of 11 parents of children with motor disabilities, using focus groups and individual interviews. Dominant themes that emerged were financial and organizational constraints, child's independence/self-esteem, respect of temporal aspects, safety, respect for parent's roles, need for information, and appearance of the home. Parents wish physical and occupational therapists to take on roles that extend beyond provision of home adaptation, such as those of consultants and advocates.

Purpose: We reviewed current practice for children with Developmental Coordination Disorder (DCD) using research evidence and the International Classification of Functioning, Disability and Health (ICF). Characteristics of children with DCD can be described at the levels of body function (impairments), whole body movements (ac- tivities) and involvement in life situations (participation). Summary of Key Points: Descriptive instruments measuring the extent of motor im- pairments or activity limitations can be used to: (1) identify children who might benefit from intervention; and (2) determine the optimal type of intervention and model of service delivery. Evaluative tools that mea- Cheryl Missiuna, PhD, OT Reg(Ont), is Assistant Professor in the School of Reha- bilitation Science and an Investigator with CanChild, Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario. Lisa Rivard, BSc(PT), is a gradu- ate student at McMaster University and a pediatric physiotherapy consultant. Doreen Bartlett, PhD, PT, is an Assistant Professor in the School of Physical Therapy, Univer- sity of Western Ontario, and an Associate Member of CanChild. Address correspondence to: Cheryl Missiuna, PhD, OT Reg (Ont), McMaster Uni- versity, School of Rehabilitation Science, 1400 Main St. West, IAHS 414, Hamilton

The intensity of physical therapy provided for children in early intervention (EI) programs may be influenced by a number of factors. In an individualized program, however, some children and families may benefit from an increased frequency of services. The purpose of this case report was to systematically document and describe an increase in physical therapy frequency over a 4-week time frame for a child receiving EI physical therapy services.The child was a 31-month-old girl with a diagnosis of 18p-, a chromosomal abnormality of the short arm of the 18th chromosome. Physical therapy services were increased from once every two weeks to four times a week for four weeks.Improvement was noted on the Gross Motor Function Measure And Goal Attainment Scaling. Her age-equivalent scores on the Peabody Gross Motor Scales did not change.A targeted increase in physical therapy frequency may be appropriate for some children receiving El services. Careful consideration of the readiness of a child, along with use of appropriate measure- ment tools, may be important for determining whether an increase is appropriate and successful.

This paper begins with a discussion of the historical basis for the concept of developmental coordination disorder (DCD). The definition of this disorder as it appears in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) is then provided. The four diagnostic criteria proposed by the DSM-IV are used to describe the disorder. Problems associated with the assessment of DCD are discussed and suggestions for further research are identified. This is followed by a discussion of intervention approaches that can be used with children identified with DCD.

Kennedy and colleagues have conducted an interesting study about the relationship between motor development, child rearing practices, and positional plagiocephaly (in recent literature also referre...