Children with balance problems are less proficient than typical developing children in
playing the Wii games. Training with the Wii improved their motor performance
(Jelsma, Geuze, Mombarg, & Smits-Engelsman, 2014). Although more research is
needed on neuromotor task training, task-oriented treatment approaches were shown to
have positive effects on children with DCD (Niemeijer, Smits-Engelsman, &
Schoemaker, 2007). During a group motor skills intervention, participants demonstrated
gains in movement skill proficiency. Parent satisfaction and perception of their childs
performance also improved. These results were maintained three weeks after the
intervention (Kane & Staples, 2014). Children with DCD perform manual actions
differently than typically developing children. After using a sensorimotor approach on
16 children with DCD, it was shown that these children are able to learn more complex
motor skills when given an appropriate learning environment (Snapp-Childs, MonWilliams, & Bingham, 2013). Sensory integration, in conjunction Le Bon Depart, has
been shown to be beneficial in improving motor performance in children with DCD.
Motor performance of children with DCD improved significantly on all dependent
variables after the combination of treatments. Le Bon Depart led to more improvement
than sensory integration (Leemrijse, Meijer, Vermeer, Ader, & Diemel, 2000). Unlike
the positive relationship between sensory integration and Le Bon Depart, sensory
integration used with perceptual motor interventions were not as successful. The
combined interventions were found to be ineffective at a 12-month follow up.
Significant improvements were found only for fine motor skills and visual-motor
integration (Davidson & Williams, 2000).
Summary of Level IV and V:
Level IV
Neuromotor task training and using the Nintendo Wii were found to be very beneficial
interventions to use with children with developmental coordination disorder. Both
interventions were useful in improving motor and anaerobic performance from baseline
to post-measurement. Also, the children with DCD who were in the neuromotor task
training group showed greater meaningful changes in motor proficiency compared to the
Wii group. This study demonstrated that the neuromotor task training approach is an
effective approach to address motor coordination, functional strength, and
cardiorespiratory fitness in children with DCD when used in a group format (Ferguson,
Jelsma, & Smits-Engelsman, 2013).
No Level V studies were appraised
Contributions of Qualitative Studies:
may be used in the school setting if this type of equipment is available for use. Use of clinical
reasoning should always be used to determine the best intervention strategy for each child with
DCD. Not one specific intervention should be used, rather multiple interventions should be used
in conjunction with one another. Research should be funded to further the understanding of
different interventions that may be beneficial in increasing motor performance in children with
DCD.
Education and training of OT students:
Occupational therapy students need to be educated in numerous areas for the diagnosis of DCD.
First, students need to be educated on the prevalence of DCD. They need to know there is
research that states children with DCD are capable of learning complex motor tasks. This will
help the students learn how to set realistic goals for children with DCD. Second, evidence based
interventions need to be taught. These interventions include using virtual reality games, NTT
training, task-specific training, and motor skills training. This will give the future clinicians the
tools necessary to treat children with DCD. Students also need to be educated that sensory
integration currently does not have the necessary research to conclude it is a significant effect on
children with DCD. Sensory integration interventions have only been shown to have a minor
effect in improving motor performance with children with DCD. Since there is a lack of research
in the area of DCD, students can conduct their own research using interventions with children
with DCD.
Refinement, revision, and advancement of factual knowledge or theory:
Currently there is not a lot of research supporting interventions and treatment for children with
DCD. The sample sizes of current research are relatively small and the level of research is low.
Further research needs to be conducted using a larger population of children with DCD at a
higher level. By conducting higher level research it will help determine that the outcomes are
more correlated with the interventions being conducted. Specifically conducted research on
virtual reality games, NTT training, and task-specific training need to be conducted. Research
needs to focus on determining what the best frequency and duration is for these interventions
when working with children with DCD.
Review Process:
Comprehensive literature search was completed and submitted for instructor review
Revised inclusion/exclusion criteria for evidence table were identified
Evidence table completed and submitted to instructor
Instructor provided feedback for evidence table
Summarized information into CAT
Completed CAT and submitted to instructor for review
Procedures for the Selection and appraisal of articles:
Inclusion Criteria:
Exclusion Criteria:
Non-English publications
Articles below Level IV were not appraised
Search Strategies:
Categories
Patient/Client Population
Intervention
Outcomes
PubMed
CINAHL
Google Scholar
Authors identified key terms used to conduct a comprehensive literature review using
known databases
Results of Search:
Summary of Study Designs of Articles Selected for Appraisal:
Level of
Evidence
I
Number of Articles
Selected
2
0
7
1
0
0
10
Au, M. K., Chan, W. M., Lee, L., Chen, T. M., Chau, R. M., & Pang, M. Y. (2014). Core stability
exercise is as effective as task-oriented motor training in improving motor proficiency in
children with developmental coordination disorder: a randomized controlled pilot
study. Clinical Rehabilitation, 28(10), 992-1003.
Davidson, T. & Williams, B. (2000). Occupational therapy for children with developmental
coordination disorder: A study of the effectiveness of a combined sensory integration and
perceptual-motor intervention. The British Journal Of Occupational Therapy, 63(10),
495-499.
Ferguson, G.D., Jelsma, D., & Smits-Engelsman, B.C.M. (2013). The efficacy of two taskorientated interventions for children with developmental coordination disorder:
Neuromotor task training and nintendo wii training. Research in Developmental
Disabilities, 34(9), 2449-2461. doi: 10.1016/j.ridd.2013.05.007
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, 404-418.
Kane, K. J. & Staples, K. L. (2014). A Group Motor Skills Program for Children with
Coordination Difficulties: Effect on Fundamental Movement Skills and Physical Activity
Participation. Physical & Occupational Therapy In Pediatrics. doi:
10.3109/01942638.2014.978934
Leemrijse, C., Meijer, O., Vermeer, A., Ader, H., & Diemel, S. (2000). The efficacy of Le Bon
Depart and Sensory Integration treatment for children with developmental coordination
disorder: a randomized study with six single cases. Clinical Rehabilitation, 14(3), 247259.
Niemeijer, A. S., Smits-Engelsman, B. M., & Schoemaker, M. M. (2007). Neuromotor task
training for children with developmental coordination disorder: A controlled
trial. Developmental Medicine & Child Neurology, 49(6), 406-411.
Pless, M., Carlsson, M., Sundelin, C., & Persson, K. (2000). Effects of group motor skill
intervention on five- to six-year-old children with developmental coordination
disorder. Pediatric Physical Therapy, 12(4), 183-189.
Snapp-Childs, W., Mon-Williams, M., & Bingham, G. P. (2013). A sensorimotor approach to the
training of manual actions in children with developmental coordination disorder. Journal
Of Child Neurology, 28(2), 204-212. doi:10.1177/0883073812461945
Other References:
OBrien, J. & Williams, H. (2010). Occupational therapy intervention: Performance areas. CaseSmith, J., & OBrien, J. C. (Eds) Occupational Therapy for Children (6th ed.) (pp.245270). Maryland Heights, MO: Mosby.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author.