The topic I chose to study was dyspraxia, or developmental condition disorder (DCD). DCD is marked by poor coordination and development of motor skills. This is a physical disability, which means that the children who receive a DCD diagnosis do not have any cognitive impairments. This is an important topic to study because society has a tendency to dismiss anyone with any kind of physical impairment as just generally “handicapped”, without considering the idea that their cognitive functioning might be just the same as anyone else at the given age. According to O’Dea and Connell (2016), parents with children who have DCD report that their children experience a lot of emotional turmoil as a result of their disorder, from anxiety to depression. To think that people without disabilities may contribute to this emotional distress is alarming and warrants a bit of reflection.
For the past three summers, I have worked as a home-health aide for children who have developmental disabilities. I am extremely passionate about doing whatever I can to close the gap between those with and without intellectual and/or developmental disabilities. I chose to study the effect of physical activity on DCD because one of the children I used to aid struggled with the disorder himself. Additionally, I intend to become an occupational therapist one day and work with children who have disabilities. DCD was a disorder I did not know very much about, and I figured a research review would be a good place to start educating myself.
In the beginning of the search process, I used the UIUC library database to search for “dyspraxia”, but this proved to just be incredibly vague. After skimming through some articles, I found that dyspraxia was more commonly referred to as DCD, so I then began to search for DCD in relation to children. I narrowed the search down to children specifically because that is the age group I intend to work with as an occupational therapist. I then incorporated words like “physical education” and “intervention” to find studies that involved kids with DCD actually being treated for the disorder. After I was able to narrow down my search even more, I came up with a list of articles that met my satisfaction, but one ended up being a meta-analysis so I had to exclude it. I also excluded an article due to its specific studying of children with DCD throughout their schooling with no intervention. The study was excluded because I wanted to examine the effects of some kind of intervention on the children, not just their everyday life.
In first article I analyzed, titled An active video game intervention does not improve physical activity and sedentary time of children at-risk for developmental coordination disorder: A crossover randomized trial, researchers recruited 21 participants, all of which were children ages 10 through 12. Each participant had been previously diagnosed with DCD. The aim of the study was to “assess the impact of an [active video game] intervention on objectively measured physical activity and sedentary behavior in children with DCD,” (Howie, Campbell, & Straker, 2015). Something interesting to note about this study is that the same group of children were assessed during a control period and an intervention period.
During the study, participants wore an accelerometer while awake, which measured all levels of physical activity. The intervention for the experiment consisted of the participants receiving a PlayStation and Xbox360 and being encouraged to “play the AVGs for at least 20 min a day on most days,” (Howie, Campbell, & Straker, 2015, p. 255). The children were also asked to do some self-reporting, by using a daily diary. After conducting the study, the researchers learned that there was really no difference in time spent at each activity level between intervention and control periods. One negative effect of the study was that the children spent less time playing outdoors during the weekends on the intervention period.
The second article analyzed was titled The effects of 8 weeks of motor skill training on cardiorespiratory fitness and endurance performance in children with developmental coordination disorder. The researchers’ goals for the study were “to examine if motor skill training focused on coordination for children with DCD leads to significant improvement in pulmonary function, exercise tolerance, and [cardiorespiratory fitness] using laboratory-based tests,” (Farhat, Masmoudi, Hsairi, Smits-Engelsman, Mchirgui, Triki, & Moalla, 2015, p.1270) 41 boys participated in the study, but 5 of the children did not finish all testing required to be included in the results. Within the study itself, the researchers tested the participants’ pulmonary function twice over the course of an 8-week period, using a spirometer.
Between the control group and the group that received intervention, the latter participated in a motor skill training program during this period. Before and after each test, heart rate and oxyhemoglobin saturation were measured using a finger pulse oximeter for both groups. After the program had been completed, the researchers were able to conclude that the training had a positive effect, and helped to improve the children with DCD’s aerobic endurance.
The next article analyzed was titled Catching-up: Children with developmental coordination disorder compared to healthy children before and after sensorimotor therapy. The researchers came up with a Norm group—a collection of healthy individuals—which included 49 boys and 50 girls, and a DCD group including 147 boys and 52 girls. The researchers’ aim was to explore the differences between healthy children and children with DCD who were originally untreated, both before and after sensorimotor therapy. This kind of therapy helps with reflexes and integration, balance, and hearing. The children’s sensorimotor capabilities were assessed using three tests; physiological (based on motor development), orientation and balance (based on vestibular assessments), and audiometric (involving hearing).
These tests occurred across the duration of 36 months, in 8-week intervals. The DCD group of children participated in sensorimotor therapy for 15 minutes daily. Prior to the DCD group receiving sensorimotor therapy, the researchers found “that the Norm group performed significantly better on all subscales” of each test, except for the audiometric test (M. Niklasson, Norlander, I. Niklasson, Rasmussen, 2017, p.13). However, after the study had been conducted, the DCD group was able to “catch up” to the healthy group with aid from the occupational therapist that conducted the sensorimotor therapy. This is interesting because the researchers had hypothesized that the DCD group would not be able to perform nearly as well as the Norm group after the 36-month period.
The fourth article studied, Performance difficulties, activity limitations and participation restrictions of adolescents with developmental coordination disorder (DCD), was unlike the previous three articles. Instead of the researchers conducting an experiment with a control group and an intervention, this study’s aim was to simply “contribute information to the profile of specific impairments or symptoms of [DCD] in adolescence, activity limitations and participation restrictions experience,” (O’Dea & Connell, 2016, p. 542). O’Dea and Connell (2016) studied 141 teens with DCD in Ireland through the National Physical and Sensory Disability Database.
The researchers obtained a collection of participants between the ages of 16 and 19 with a diagnosis of DCD, and studied their “barriers and challenges” though a MAP, or a measure of activity and participation (O’Dea & Connell, 2016, p.545). After performing the study, O’Dea and Connell found that teens with DCD are plagued by a plethora of challenges that require treatment. The range of these challenges is so wide that it covers “education and training, socializing, sports/physical recreation, leisure/cultural pursuits, family life and shopping,” (O’Dea & Connell, 2016, p. 547). This really makes you gain a sense of appreciation for the everyday activities that you are able to perform that others might not.
The following article I studied is titled Role of physical activity and perceived adequacy on peak aerobic power in children with developmental coordination disorder. 122 individuals between the ages of 12 and 13 participated in the study, 61 of which were healthy individuals, and 61 of which had “probable” DCD (Silman, Cairney, Hay, Klentrou, & Faught, 2011, p. 674). Using the Movement Assessment Battery for Children, the researchers examined both the participants’ gross and fine motor coordination. The children’s peak aerobic power was also measured using an ergometer, and all of the participants completed a survey regarding their adequacy in physical activity. After assessing their data, the researchers found that the participants with DCD reported more inadequacy, and were also just generally less active than healthy children.
The final article examined was very similar to the first study in the sense that both incorporated technology as a means of intervention. This study, titled The impact of Wii Fit intervention on dynamic balance control in children with probable Developmental Coordination Disorder and balance problems, involved studying the effects of training using a Wii Fit on children with probably DCD. Throughout the course of the study, participants were instructed to use the Wii Fit, and were simultaneously tested at their schools on the basis of coordination, balance, running speed, and agility (Jelsma, Geuze, Mombarg, & Smits-Engelsman, 2014, p. 409). The researchers found that the Wii Fit effectively improved balance through a series of motor tests. Although children with DCD were found performing worse on the Wii than the healthy children, all children saw an improvement in balance ability.
All of the articles studied consistently claimed that children with DCD are less active than healthy children. Children with DCD have been found to feel discouraged and inadequate, which lessens their self-efficacy for exercising and being active. The articles also consistently explained that although progress may be slow for children with DCD, it takes time—sometimes many months—and patience. The most effective way of getting children with DCD to be physically active is guided intervention, specifically from an occupational therapist. Intervention falls short in showing progress when it is not well-guided, as was shown in the studies involving tech-based interventions. The only improvement those studies exhibited was in balance. An interesting place to continue doing research for this topic would be to examine the effects of a combination of occupational therapy and at-home intervention through a gaming system. The research on DCD and its management with physical activity has been extensive, but there is always more to learn.
References
- Farhat, F., Masmoudi, K., Hsairi, I., Smits-Engelsman, B. C., Mchirgui, R., Triki, C., & Moalla, W. (2015). The effects of 8 weeks of motor skill training on cardiorespiratory fitness and endurance performance in children with developmental coordination disorder. Applied Physiology, Nutrition, and Metabolism, 40(12), 1269-1278. doi:10.1139/apnm-2015-0154
- Howie, E. K., Campbell, A. C., & Straker, L. M. (2015). An active video game intervention does not improve physical activity and sedentary time of children at-risk for developmental coordination disorder: A crossover randomized trial. Child: Care, Health and Development, 42(2), 253-260. doi:10.1111/cch.12305
- Jelsma, D., Geuze, R. H., Mombarg, R., & Smits-Engelsman, B. C. (2014). The impact of Wii Fit intervention on dynamic balance control in children with probable Developmental Coordination Disorder and balance problems. Human Movement Science, 33, 404-418. doi:10.1016/j.humov.2013.12.007
- Niklasson, M., Norlander, T., Niklasson, I., & Rasmussen, P. (2017). Catching-up: Children with developmental coordination disorder compared to healthy children before and after sensorimotor therapy. Plos One, 12(10). doi:10.1371/journal.pone.0186126
- O’Dea, Á, & Connell, A. (2016). Performance difficulties, activity limitations and participation restrictions of adolescents with developmental coordination disorder (DCD). British Journal of Occupational Therapy, 79(9), 540-549. doi:10.1177/0308022616643100
- Silman, A., Cairney, J., Hay, J., Klentrou, P., & Faught, B. E. (2011). Role of physical activity and perceived adequacy on peak aerobic power in children with developmental coordination disorder. Human Movement Science, 30(3), 672-681. doi:10.1016/j.humov.2010.08.005
