Is intervention important for children with DCD?
Coordination difficulties do not usually go away. But children can learn how to successfully execute many of the motor tasks that they need to perform everyday. With practice and effort, gradual improvement will be seen in specific skills. However, it is important to select the motor skill interventions carefully (e.g. tying shoelaces, learning to keyboard, riding a bicycle), as they will be difficult for the child to master. In addition, intervention aimed at minimizing the effects on DCD on everyday life can be helpful. Today, the overall objective of most intervention approaches is not to change the child's motor abilities but rather to emphasize the development of specific skills in order to promote successful participation in the typical activities of childhood, and to prevent the onset of secondary academic, social and emotional problems.
What do we know about current interventions and their effectiveness?
A growing body of research demonstrates the value of an individualized, task-oriented approach which focuses on the direct teaching of functional skills that children need or want to perform in order to address activity and participation goals. As the child attempts to solve a movement problem, they may discover several ways to complete a motor task and are encouraged to experience the resulting effects of using different aspects of their bodies or the environment. While there is good evidence for children learning the tasks that are taught through this task-oriented approach, to date there has not been much evidence for transfer or generalization of skills, which are important for the child with DCD.
Like the task-oriented approach, cognitive approaches are intended to increase activity and participation in the child with DCD. Cognitive approaches use direct skill teaching in their approach and combine this with a unique problem-solving framework which guide the child in discovering verbally based strategies to help them solve problems during the learning of motor activities. This approach is intended to help children generalize from the learning of one skill to the next and stresses the importance of children learning to monitor their performance and use self-evaluation. Children are guided to discover problems, generate solutions and evaluate their success independently. Emerging research examining one specific cognitive approach, the Cognitive Orientation to Occupational Performance, is showing promise. This cognitive approach has been shown to be effective in a research clinic setting and, of note, has shown some generalization and transfer of skills. Ongoing research will determine if this approach can be used effectively in other settings.
How can we encourage children with DCD to be active?
Encouragement of an active lifestyle will go a long way toward ending the cycle of withdrawal from activity, diminished opportunities for physical and social development, and decreasing fitness over time, a pattern so common for children with DCD. When making recommendations about participation in sporting and leisure activities, it is, however, important to understand that children with DCD may encounter more success with certain activities than with others. Some activities require constant monitoring of feedback during task performance and others, once learned, do not require adaptations in response to environmental feedback. As one might expect, tasks with a heavy reliance on integrating feedback from the senses will be more challenging for children with DCD. Sports that have a high degree of spatial uncertainty or unpredictability such as baseball, hockey, football and basketball are less likely to be successful for children with DCD. Activities should be encouraged that do not require constant monitoring of feedback during the performance of the task but rather incorporate the learning of a repetitive movement sequence. Once learned, children with DCD can become quite successful in these activities. Lifestyle sports such as swimming, cycling, running, skating and skiing are activities that are worth the extra time and effort to learn as children with DCD can participate in these activities and reap the health benefits throughout their lifetime.
Several resources on encouraging children with DCD to participate in sports and leisure activities are available.
These resources have been developed for parents, service providers, coaches and community leaders.