What is Developmental Coordination Disorder? Developmental Coordination Disorder (DCD): is a delay in the development of motor skills or difficulty coordinating movement that causes children to have difficulty performing many daily tasks. This disorder is not caused by any other known physical, neurological or behavioral disorder. It is seen in 5-6% of school-aged children and is more common in boys. Some children have only a coordination disorder, while others have problems with learning, speech or language and attention. How does coordination disorder occur? Research has shown that children with DCD have a variety of difficulties in learning how to plan, organize, complete tasks and/or adjust their movements, have difficulties in learning new motor skills, prefer to use visual and less other types of feedback to guide their movements, cannot anticipate the consequences of their movements, do not easily realize motor errors, learn from them, or correct them . As a result, motor skills are more like those of young children. Coordination deficits in this sick child involve not only learning how to move the body, but also learning how to use strategies and apply problem-solving skills to accomplish motor tasks. Because motor skills are not unconscious for these children, they must devote extra effort and attention to completing motor tasks, even those movements that they have previously learned. Children with developmental coordination disorders often fail to recognize the similarity of specific motor tasks, which makes it difficult for them to transfer learned motor skills from one activity to another (e.g., grasping a large ball and then moving on to grasp a small ball). They also have difficulty generalizing learned motor skills from one situation to another (e.g., a child approaching a sidewalk curb should appreciate that stepping up the curb is similar to walking up the stairs). Having to respond quickly to a changing environment (e.g., when needing to catch or hit a ball in motion, or when trying to avoid others in a team game) adds additional difficulties for children with the condition because they find it difficult to monitor new information from their surroundings and get their bodies to respond in a timely manner. Any one of these problems can lead to the same result: the child appears clumsy and uncoordinated and will have trouble learning and performing new motor tasks. More common characteristics of children with developmental coordination disorder (DCD) Physical Functioning Characteristics 1. May bump into objects, spill liquids, or knock over objects. 2. Impaired gross motor skills, fine motor skills, or a combination of both. 3. Delayed development of specific motor skills, such as riding a tricycle/bicycle, catching a ball, jumping rope, buttoning and tying shoes. 4. There are differences between motor skills and other abilities. For example, intelligence and language skills are strong, while motor skills lag behind. 5. There are barriers to learning new motor skills. Once a motor skill is learned, the person can do well in that sport, but still perform poorly in other sports. 6.It is more difficult to change body positions or to adapt to various changes in the surrounding environment (e.g., baseball, tennis). 7. Have difficulty performing activities that require coordinated use of both sides of the body (e.g., using scissors, jumping in stride, swinging a baseball bat, or using a field hockey stick). 8.Poor postural control and body balance, especially when doing exercises that require body balance skills (e.g., walking up stairs, standing to put on clothes and pants). 9. Neat writing or general dysgraphia. Emotional/Behavioral Characteristics 1. Lack of interest or avoidance in certain specific activities, especially those requiring physical responses. 2. Children show low frustration tolerance, lack of self-esteem and motivation due to difficulties in coping with activities that are necessary in their lives. 3. Avoid socializing with peers, especially in sports settings. 4. Dissatisfaction with their own performance (e.g., erasing written assignments, complaining about performance in motor activities, frustration with what they have accomplished). 5.Resist changes in their daily habits or environment. Other common characteristics 1. Have difficulty in balancing speed and accuracy. For example, writing may be neat, but very slow. 2. Academic disabilities, such as math, spelling, or written language, where writing is inaccurate and untidy. 3. Obstacles in daily living (e.g., dressing, using a knife and fork, brushing teeth, zipping up, organizing a backpack). 4. Difficulty completing tasks within a set time frame. 5.Hurdles with organizing desks, lockers, homework, or writing spacing. 6. Any of the above characteristics are present and prevent children from successfully participating in activities at home, school or in the community, then the child must be taken to see a health care provider at the local children’s hospital or treatment center. Tasks of the therapist Occupational therapists (OTs) and physical therapists (PTs) are specially educated and trained to analyze motor skill development and to determine the child’s ability to cope with the demands and activities of daily living. Only these two types of therapists are appropriate to advise on the management of children with motor disabilities. This includes: various strategies or modifications to assist the child in completing tasks at home, school, or in the community; modifications to the child’s environment; methods to promote physical activity and increase awareness of participation; guidance in selecting community recreational and physical activities that match the child’s interests and abilities; and assistance in setting appropriate expectations to ensure success. Occupational therapists and physical therapists can help parents, educators, and affected children better understand the coordination disorders that children have, identify them early, and learn how to manage them well in order to prevent secondary complications. Children may need to learn strategies to compensate for their motor impairment and must be given appropriate opportunities to practice the motor skills they need to learn. Children with DCD must be educated to recognize their strengths and limitations in order to inform them of possible ways to compensate for their difficulties. In this way, children are more likely to feel successful and more willing to try activities that they find difficult. Whichever of these approaches is taken, the rationale and plan for taking this treatment should be discussed with the parent and child. Although in most cases the coordination disorder does not completely disappear, the children’s skills in completing some specific tasks improve significantly and help them participate successfully in home, school, and community activities. At home 1. Encouraging children to participate in games and sports that interest them allows them to be exposed to a variety of sports and get exercise in them. The emphasis should be on physical activity participation and enjoyment rather than proficiency or competition. 2. Try to introduce your child to new sports activities privately or take them to a new sports venue to acclimate before asking them to participate in team activities. Make an effort to review the rules and procedures associated with the activity when the child is not focused on the sport (e.g., baseball rules, how soccer is played). Ask children simple questions to make sure they understand the concepts (e.g., “How do you do it when you hit the ball?”) . Individual coaching at specific times can help teach them some specific skills. 3. Children may show a preference for individual sports and perform better in these sports (e.g., swimming, running, bicycling, skiing) and not as well in group sports. If this is the case, try to encourage the child to participate in other activities that may yield good results (for example, music, drama or art) and to interact with children of the same age. 4. Encourage your child to wear clothing to school that is easy to put on and take off. Examples include sweatpants, sweatshirts, t-shirts, leggings, sweaters, and Velcro shoes. If possible, use Velcro instead of buttons, snaps or shoelaces. When you have enough time and patience (for example, on weekends or during summer vacation), teach your child how to use hard-to-use fasteners, rather than doing it when you are in a hurry to get out of the house. 5. Encourage your child to participate in hands-on activities that will help improve their ability to plan and organize motor tasks. For example, preparing the dinner table, making lunch, or organizing a backpack. Ask questions that help your child focus on the sequence of activities (e.g., “What do you need to do first?”) . Recognize that if your child feels frustrated, offer help or give specific directions and instructions. 6. Recognize and reinforce the child’s strengths. Many children with disabilities demonstrate strong abilities in other areas.C They may have a high reading level, creative imagination, sensitivity to the needs of others, and/or strong oral communication skills. At school Educators and parents can work collaboratively to ensure that children with DCD experience success at school. Parents may find it helpful to make an appointment with an educator at the beginning of the school year to discuss their child’s particular difficulties and to make suggestions about strategies that work well. For some children, an Individualized Education Plan (IEP) may be necessary; however, the following practices will be sufficient for other ill children In the classroom: 1. Make sure children are sitting correctly. Make sure that desks are at the right height, that children’s feet are flat on the floor, that shoulders are relaxed, and that arms are resting comfortably on the desk. 2. Set realistic short-term goals. This will keep children and educators motivated. 3. Give children extra time to complete fine-motor assignments such as math, neat writing, story writing, hands-on science work, and artwork. If speed is necessary, there is no need to count assignments that are less accurate. 4. When copying is not a priority, provide children with prepared worksheets so that they can focus their energy on doing their homework. For example, give children prepared math worksheets, sheets with problems printed out, or “fill-in-the-blanks” for reading comprehension problems. For the child’s learning purposes, make copies of notes taken by another child. 5. Use the computer early in order to reduce the amount of handwriting required at higher grades. Although keyboarding may be difficult at first, it is a very beneficial skill and one that children with motor problems can become very proficient at. 6. Teach children special writing strategies that encourage them to write neatly or always write letters in a consistent manner. Use fine magic markers or pencil grips if they help children improve their pencil grip or reduce the pressure of the pencil on the paper. 7, the use of paper suitable for children with writing difficulties. For example: wide grid paper for children who write very large letters; paper with raised lines for children who have difficulty writing inside the lines; square paper for children who write too large or have improper spaces between words; paper with large squares for children who have difficulty aligning numbers in math work. 8. Focus on curriculum goals. If the goal of the lesson is to write a creative story, there is no need to worry about scribbles, uneven spaces, and multiple erasure marks. If the goal is for children to learn to answer math problems correctly, give them more time to complete them, even if the math problems are not answered. 9. When having children demonstrate their understanding of a topic, consider using a variety of presentations. For example, encourage children to give oral presentations, use diagrams to express their ideas, type up stories or reports on the computer, or record the story or test answers on a tape recorder. 10. Consider allowing children to use the computer to draft and complete final reports, stories, and other assignments. If it is deemed necessary to see “unedited” assignments, ask children to turn in both drafts and final assignments. 11. Whenever possible, encourage children to dictate stories, book reports, or to respond orally to comprehension questions from the teacher, a volunteer, or another child. For older children, voice recognition software can be used when their voice patterns have matured and remained stable. 12. For tests and exams that require extensive writing, give children extra time and/or provide them with access to a computer. In physical education classes: 1. Break down physical activities into smaller parts, ensuring that each part has a goal and can be achieved. 2. Choose activities that ensure children will be productive at least 50% of the time, rewarding children for their effort rather than their skills. 3. Combine physical activities that require a coordinated response from both arms and/or legs (e.g., jumping forward, bouncing, and catching a large ball). Encourage children to use both hands in a dominant or assisted manner to develop skills (e.g., using a baseball bat or field hockey stick). 4. When teaching a new skill (e.g., placing a baseball on a T-ball stand), keep the environment as predictable as possible. Gradually introduce variations after children have mastered each part of the skill. 5. Participation should be the primary goal, not competition. For fitness and skill-building activities, children are encouraged to compete with themselves rather than with others. 6. Children should be given leadership roles in physical activities (e.g., team captain, referee) to encourage them to develop organizational or management skills. 7. Improve equipment to reduce the risk of injury to children as they learn new skills. For example, soft balls of different sizes can be used to develop children’s catching and throwing skills. 8. If possible, instruct children in a hands-on manner to help them feel the movement – for example, by having children help the teacher demonstrate the new skill to the class. In addition, when teaching a new skill, talk aloud and clearly describe the essentials of each step. 9. Focus on understanding the purpose of various sports or physical activities and their rules. When children clearly understand what they need to do, it is easier to plan an activity. 10. Give positive and encouraging feedback. If giving instructions, be especially specific about the changes in the movement (e.g., “You need to raise your arms a little higher”). In the community 1. Encourage children’s exposure to physical activity for recreational and participation purposes, emphasizing health and fitness. 2. Consider involving children in lifestyle sports, such as swimming, skating, biking, and skiing, to maintain or improve strength and whole-body endurance. 3. Keep in mind the potential need for additional support or individual coaching for children during physical activity, especially when higher skill levels must be achieved. 4. Use protective equipment (e.g., wrist guards, helmets) to ensure safety when performing physical activities. 5. Assist coaches, physical education teachers, and community leaders in understanding children’s strengths and difficulties so that they can support and encourage children to succeed. 6. Encourage children to participate in non-athletic activities such as music, drama, and various clubs to enhance social experiences and gain additional benefits from social participation and interaction. Conclusion 1. Developmental Coordination Disorder (DCD) is a motor skill disorder that hinders a child’s ability to complete many tasks in daily life. Children with DCD vary widely, and each child will exhibit different problems than the others. 2. Educators and parents who spend time with children on a daily basis will be the first to notice the impairment that a child has. It is important to take the child to a doctor as early as possible in order to rule out other causes of their movement disorder. Unrecognized children with the disorder experience failure and frustration because they are often mistaken for lazy or unenthusiastic, which can lead to additional physical, social and behavioral problems. The child’s treatment includes a referral to an occupational therapist or physical therapist. Occupational therapists and/or physical therapists are more successful in helping children learn how to complete daily tasks and will provide parents and educators with many suggestions regarding children’s participation in the home, classroom, playground activities, and participation in community recreational activities. 4. As children get older, new motor skills remain a problem, although with lots of extra practice, children can acquire certain skills. Children with DCD need early treatment to help them learn strategies to compensate for their coordination deficits, increase their confidence, and prevent other secondary problems from developing.