Abstract
This study provides a retrospective pre- and posttest study examining the routine practice of OT in the treatment of developmental coordination disorder (DCD). The study provides an example of practice-based evidence in examining medical records of children with DCD who received OT services. The study presents the effectiveness of OT services on improving motor skills of children with DCD.
Primary Author and Speaker: Aimee Piller
Additional Authors and Speakers: Lindsey Kohnert, Lindsey Kohnert, Lindsey Kohnert
Development coordination disorder (DCD) is classified as a learning impairment that impact a child’s ability to perform daily activities in the areas of play, self-care, academics, and social participation (APA, 2013). Children with DCD are often referred to occupational therapy. Interventions for children with DCD vary and include exercises, cognitive strategies, sensory integration/sensory based strategies, and goal-oriented interventions (Armstrong, 2012). Effectiveness studies have mixed results of interventions and only examine each intervention in isolation. Yet, the majority of therapist tend to utilize a variety of interventions in the treatment of DCD (Brammer et al., 2015). A recent study examined the routine occupational therapy interventions to define the interventions utilized within a single occupational therapy practice (Piller & Candler, 2016). This study defined the interventions used, but did not determine their effectiveness. The purpose of the study in this presentation is to examine the effectiveness of the defined routine occupational therapy practice in improving motor skills of children with DCD.
The study used a retrospective quasi experimental pretest/posttest design to examine scores on a standardized motor assessment for children with DCD who received occupational therapy services at a single site outpatient occupational therapy clinic. Participants included de-identified medical records of children ages 6 to 12 years, 11 months, with a diagnosis of DCD who received at least 10 visits of occupational therapy. A total of 73 records were reviewed. Scores from three subtests of the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) were reviewed. The pretest score was gathered from initial evaluation and posttest scores were gathered from reevaluation data. Subtest scores analyzed including fine motor precision, fine motor integration, and bilateral coordination. These subtests were chosen due to their relation to common motor difficulties in children with DCD. Data were analyzed using quantitative methods via frequency counts to determine of length of treatment. A paired samples t-test was used to compare pretest and posttest scores on each of the subtests. Results indicated a significant difference in initial score and posttest scores for fine motor integration and bilateral coordination subtests. The fine motor precision subtest did not show significant difference pre and post intervention.
This study provides evidence as to the effectiveness of occupational therapy interventions on motor skills in fine motor integration and bilateral coordination for children with DCD. The unique aspect of this study is that it builds on a previous study that defined the occupational therapy interventions utilized to treat DCD in this setting. These results now show that those interventions are effective in improving motor skills in at least two areas. Although the results are limited to one setting and are not generalizable to other children with DCD, they do provide evidence that the interventions provided in this setting are effective. This information can be used to promote the effectiveness of occupational therapy in improving motor skills for children with DCD. Future studies will focus on expanding the population for more generalizable results and analyzing length of treatment for cost analysis.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). doi:10.1176/appi.books9780890425596.744053
Armstrong, D. (2012). Examining the evidence for interventions with children with developmental coordination disorder.(report). British Journal of Occupational Therapy, 75(12), 532.
Brammer, W., Malshuk, E., Robertson, L., Rubin, B., Rios, D., & Jirikowic, T. (2015) Improving functional motor skills and confidence in children with coordination challenges. OT Practice, 20(18), 8–12.
Piller, A. & Candler, C. (2015). Gathering evidence from practice: Defining treatment for children with coordination delay. OT Practice, 20(20): 9-12.