Improving Motor Skills in Children With Developmental Coordination Disorder.

Developmental coordination disorder is a condition characterized by an inability to perform and learn age-appropriate motor skills, in the absence of any known medical condition or neurological dysfunction. According to the study we are going to talk about today, DCD is found in about 10 percent of kids. When it comes to my own patients many of the kids that I work with that have developmental coordination disorder. It is also interesting to note that almost every kid that I work with that has development of delays (ADHD, Autism, Learning disorders, Etc) also have an extreme lack of coordination and motor development. 


I found in my clinical practice that when we improve motor skills in these kids their symptoms improve dramatically. We noticed that their learning gets better, their behaviors get better, their handwriting is better, the balance gets better, along much more. The reason for this is simple, the same areas that coordinate your movement, balance, and eye tracking are also responsible for coordinating your learning centers, behavior centers, and attention networks!


I feel that every child that struggles with one of the above mentioned disorders should have a motor development plan in place. It is simply amazing how much better a child performs in all areas of life when they can move their body well!


In the meta-analysis I am going to talk about today they discuss the types of activities that should be utilized in a motor development program. They also share the frequency and intensity that improves motor and cognitive performance most effectively.  In this article they found improvements in motor skills in 85% of the papers that were published when they utilized a motor development program. 


Title: Motor Skill Interventions in Children with Developmental Coordination Disorder: A systematic Review and Meta-analysis. 

Authors: Jan J. You, PhD, Angus F. Burnett, PhD, Cindy H. Sit, PhD

Journal: Archives of Physical Medicine and Rehabilitation. 


What they found in this analysis is that motor interventions are very beneficial for kids with developmental coordination disorder. They noted that the best time for intervention was around five years of age, and I can relate to this. I have noticed that kids that are younger than this are very difficult to work with due to lack of focus, necessity for parents to be in sight, etc. This study found that the earlier the intervention was done the better, and i have noticed that 5 year olds are willing to do the activities prescribed and in most cases they think the activities are fun! 


 They also noted there is evidence from longitudinal studies suggesting that without appropriate interventions, motor impairment will persist in the adolescence and adulthood. This further emphasizes the importance of getting to these kids early and making sure they develop as early as possible. In the early years of life the brain is very plastic and can change easily! Taking advantage of this normal brain growth with goal directed development activities makes improvements much faster. The older a child gets the more their abnormal neurology has developed, and it is much more difficult to get improvements and takes more training. That doesn’t mean it can not be done, it is simply more work for the child as they get older. This stresses the importance of helping a child develop as early as possible so they do not have long-term consequences.

In the study found that a mixture of bottom up or process oriented, and top down or task specific activities utilize together gave the best results. What that means is that a motor development program needs to have activities that firstly includes sensory integration, kinesthetic training, perception, and muscle strength. This type of training is considered process oriented training.  Secondly it needs to include Neuromotor task training, cognitive orientation, predictive control, rhythmic coordination, and executive function. This is considered top down or task specific training.


The study found that when using both training methodologies together the children had the best results. I completely agree with these results, the developmental programs that I put together for kids include an at home bottom up approach, mixed with in office top down approaches. I have noticed this to get better results than just bottom approaches, which is what I originally started doing with patients. 


The training frequency that they recommended was 4 to 5 times per week, done in a group setting. The reason for the group setting was simply for cost effectiveness. They also recommended the training should be done no less than three months, and the longer training was performed the better the patients did.


They found Improvement in motor performance in at least 85% of all of the studies that were analyzing in this meta-analysis. Not only did they notice motor improvements, but they also noted improvement in cognition, emotions, and other psychological factors.


This was a very interesting study, because many people don’t understand how big of an affect gross motor training has on a child’s physical, emotional, and cognitive wellness. By helping your child develop their physical abilities it improves every aspect of their life. The reason for this is because the same areas of the brain that help you to coordinate movement are also the same areas that coordinate learning, attention, and behaviors.


If you need help developing a physical development program for your child please don’t be afraid to reach me at drjosh@iowainfinity.com or on Facebook @infinitychiroia 
God Bless, Dr. Josh Madsen

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