Occupational therapists are the health professional most likely to be involved with children with dyspraxia/DCD
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Occupational therapists are interested in how people manage the everyday activities that occupy them or keep them busy during the day – at home, at school or at work and during their leisure time. Their role is to help people overcome the challenges that make it difficult to carry out the everyday activities that matter to them, fulfil their potential and lead full and happy lives.
Occupational therapists are the health professional most likely to be involved with children with dyspraxia/DCD (Cleaton et al 2020) and play an important role in the assessment and support of dyspraxic adults.
The occupational therapy role includes:
- Identifying the daily activities that are important to an individual. What does a person do well, and which activities are difficult?
- Assessing a person’s movement, planning and other abilities. Which skills help a person carry out daily activities, and which cause them a problem?
- Understanding the context in a person’s lives, works and plays. Which environmental factors (physical, social, cultural, economic, institutional) help or make it difficult for a person to thrive and fulfil their potential?
- Creating a plan of intervention, support and adjustments based on the needs and priorities of an individual to enable them to master and carry out the activities that they need, want or are expected to do
Occupational therapy and diagnosis of DCD
Occupational therapists contribute to the diagnosis of dyspraxia/DCD by:
- Gathering information demonstrating the effect that movement difficulties have on a person’s life
- Carrying out a standardised assessment of a person’s movement abilities
This document, produced by the Royal College of Occupational Therapists describes the role of occupational therapy in the assessment and diagnosis of dyspraxia/DCD Quick Guide DCD Jul 2021.pdf (rcot.co.uk)
Occupational therapy intervention and support
Top-down approach: Current thinking about occupational therapy for people with dyspraxia/DCD favours a strengths-based, “top-down” approach to assessment and support. The focus is on enabling people to take part in the daily activities that matter to them, rather than on treating underlying ‘impairments’ with the expectation that this will lead to improvements in how they carry out daily tasks.
Goal setting: Interventions should have a clear goal describing the daily activities the person will be able to do because of occupational therapy intervention/support.
Tiered model of support: Occupational therapists use a tiered approach to intervention, tailoring support to meet the needs of an individual. People move between levels as their needs and circumstances change.
The tiered approach
Interventions/support used by occupational therapists with people with dyspraxia/DCD include:
- Education: Helping people close to an individual with dyspraxia/DCD (including parents/carers/partners/teachers/employers) understand why they struggle with activities that others manage easily, and how they can help. Methods of delivery include webinars, training sessions and website resources.
- School-based approaches: Working closely with colleagues in education builds teachers’ capacity to identify children’s needs early and create opportunities to promote their development and wellbeing at school. Partnering for Change is one approach through which occupational therapists work with teachers to create classroom environments that enable students with dyspraxia/DCD to achieve their personal and academic potential.
- Parent support: Providing information and support, through websites, webinars, workshops and support groups to enable parents/carers to understand and promote young people’s development and independence.
- Workplace support: Occupational therapists can help people with dyspraxia/DCD remain in, return to or obtain work. They can advise on reasonable adjustments to ensure dyspraxic employees can do their job as well as possible.
- Cognitive approaches: The Cognitive Orientation to Occupational Performance is an evidence-based approach that enables people, including those with dyspraxia/DCD to discover and develop strategies that help them carry out tasks they have prioritised, such as riding a bike, using cutlery, getting dressed and typing. Occupational performance coaching is another cognitive approach, often used with parents/carers. It aims to help parents improve their child’s ability to carry out activities that matter to them at home or in community contexts.
- Task-orientated interventions: Occupational therapists use a range of interventions to help people master specific skills for example preparing a meal, handwriting, managing time, or using public transport.
- Health and well-being support: Occupational therapists are uniquely trained to consider a person’s physical and mental health. Advice and support may be offered to help with anxiety, mood, confidence and self-esteem. Occupational therapists also promote healthy lifestyles by encouraging people with dyspraxia/DCD to take part in sports and physical activities and to establish a healthy balance of work, self-care and leisure activities.
Camden, Wilson, Kirby, Sugden, Missiuna (2015) Best practice principles for management of children with developmental coordination disorder (DCD): Results of a scoping review. Child: Care, Health and Development 4 (1) p147-159
Cleaton, Lorgelly, Kirby (2020) Developmental coordination disorder in UK children aged 6-18 years: Estimating the cost. British Journal of Occupational Therapy 83(1)
Izadi-Najafabadi, Ryan, Ghafooripoor, Gill, Zwicker (2019) Participation of children with developmental coordination disorder. Research in Developmental Disabilities 84, p75-84
Payne, Ward (2020) Conceptual framework of developmental coordination disorder in adolescence: Findings from a qualitative study British Journal of Occupational Therapy 84 (4)
Scott-Roberts, Purcell (2018) Understanding the functional mobility of adults with developmental coordination disorder through the International Classification of Functioning (ICF) Current Developmental Disorders Reports 5(1) p26-33
Zwicker and Lee (2021) Early intervention for children with/at risk of developmental coordination disorder: A scoping review. Developmental Medicine and Child Neurology 63(6) p659-667
Zwicker, Suto, Harris, Vlasakova, Missiuna (2018) Developmental coordination disorder is more than a motor problem: Children describe the impact of daily struggles on their quality of life British Journal of Occupational Therapy 81(2)