Academic journal article British Journal of Occupational Therapy

The Effectiveness of Occupational Therapy for Children with Developmental Coordination Disorder: A Review of the Qualitative Literature

Academic journal article British Journal of Occupational Therapy

The Effectiveness of Occupational Therapy for Children with Developmental Coordination Disorder: A Review of the Qualitative Literature

Article excerpt

Introduction

The aim of the review was to support evidence-based practice by identifying and describing interventions that were perceived to be effective by children with developmental coordination disorder (DCD) and their parents. DCD is a common diagnostic term used internationally to describe children who have a motor skills disorder that interferes significantly with their successful participation in everyday activities at home and school (American Psychiatric Association [APA] 1994). It is estimated that up to 6% of children aged 5-12 years, mostly boys, are affected (Sutton Hamilton 2002). Children with DCD are a heterogeneous group, frequently presenting with symptoms that differ in range and severity or coexist with other learning, emotional and behavioural disorders (Sutton Hamilton 2002). This multifactorial condition has gained public recognition because longitudinal studies suggest that the long-term prospects for adolescents and adults with a lack of coordination are poor (Wilson 2005). There is growing evidence that motor deficits persist and are commonly associated with social and emotional problems, which is contradictory to a common assumption that has been long held that over time children outgrow their difficulties (Sutton Hamilton 2002).

The aim of reviewing the literature is to provide guidance for practitioners to ensure that interventions for this heterogeneous group are effective and evidence based, reflecting the needs of service users. It is important that findings from qualitative literature are considered in order that therapists acquire a better understanding of how children and parents make sense of therapeutic experiences. Their unique perspective on contextual and environmental issues, which support family-centred care and partnership working, is vital to a rounded understanding. Additionally, this paper focuses on increasing awareness of the outcomes of occupational therapy and illustrates an occupation-based approach to intervention, which achieves outcomes that are valued by children and parents. This guidance, considered in conjunction with evidence from quantitative literature reviews, could assist clinicians to meet the needs of children with DCD and their parents more comprehensively.

Method

The Patient Intervention Comparison Outcome (PICO) method was used to refine the search question for the literature review more clearly and concisely: 'In children diagnosed with DCD, what is the most effective occupational therapy for decreasing core symptoms of the condition and improving occupational outcomes?' (University Library, University of Illinois at Chicago 2011). Selected search terms, shown in Table 1, reflected the most commonly used terminology in studies post-1994 (Stephenson 2004). Core symptoms of DCD were defined as two inclusion criteria: criterion A, performance in daily activities that require motor coordination is substantially below that expected given the person's chronological age and measured intelligence, and criterion B, the disturbance in criterion A significantly interferes with academic achievement or activities of daily living (APA 1994).

Inclusion and exclusion criteria

Published professional knowledge in journals was targeted. Studies outside the scope of 'therapy' were excluded, as defined by the International Classification of Functioning, Disability and Health (World Health Organisation 2001). By employing this definition, interventions that decreased activity limitation, increased participation in occupation or were remedial in nature were included. An age range of 5-14 years (inclusive) was selected. Children with coexisting conditions were excluded to minimise confounding factors, such as poor attention. Terminology was limited to DCD criteria in recognition of the historical change in the use of terminology and to allow for comparison of samples (APA 1994, Polatajko et al 1995). Studies after 1996 were reviewed, which coincided with the standardisation terminology for children with DCD. …

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