Issue 17, Page 10-11: DCD - Developmental Coordination Disorder

Josh’s story

Our charity first became involved with supporting Josh when his mum contacted our helpline for support after concerns were expressed by his teacher at parents’ evening.

At the time he was 9 years old and in the summer term of year 4. Josh was described as “bright”, giving excellent verbal responses in class, but his knowledge was not reflected in his written work. The teacher also commented that he quickly lost focus in class and needed bringing back to task frequently.

His mum described him as clumsy and disorganised, with no sense of time, but most concerning was the fact that he had changed from being a happy, chatty child to being quiet, withdrawn and reluctant to go to school. She described his development as “on the late side of normal”. He walked at 17 months and struggled with many things like dressing and feeding himself. He seemed to be constantly falling over and breaking things. Whilst his brother learnt to ride bikes and kick footballs easily, Josh found this very difficult and needed support. When she asked Josh what he thought he was good at, he looked at his feet and replied, “Nothing really”. At this point, Josh had not been assessed by any professionals.

I observed Josh during a literacy lesson. He was at the back of the classroom sitting side on to the interactive board. He initially listened well and gave a couple of good verbal replies, but he quickly lost focus, especially when the class were given a written task. He was observed to fiddle with items from his pencil case and on several occasions, he flopped his head on his arm and did no work at all. He yawned frequently and, compared to his peers, his work was poor in quantity, legibility, quality and spelling. His writing seemed to take considerable effort on his part and many letters were incorrectly formed and/or reversed.

From the classroom window, I observed him at playtime and noticed he had a slightly awkward run. Whilst his brother readily joined in football games, Josh never attempted to kick the ball, but when it went offside, he ran after it and threw it back into the game. This seemed to be his role. He looked generally low muscle toned (hypotonic) and he didn’t engage much with the other children.

Following my observation of Josh, I discussed his main areas of difficulty with his mum and school staff and we agreed a plan of strategies to address these. Firstly, it was felt that Josh needed further assessment to fully understand his needs and I recommended a referral to the Community Paediatrician plus an Occupational Therapist. His mum decided to pay for a private Educational Psychologist to assess him with regard to his spelling, letter reversals and focus.

As DCD presents very differently in different children and can be further complicated by the high co-occurrence with other conditions, it is important that support strategies are developed on an individual basis. There are, however, some golden principles for supporting pupils with DCD:

Training: Understanding DCD and co-occurring conditions through training is essential for supporting pupils
Break it down: Children with DCD often struggle to process more than one thing at a time and can quickly become overloaded.

Definition of Developmental Coordination Disorder

Developmental Coordination Disorder (DCD), also known as dyspraxia in the UK, is a common disorder affecting fine and/or gross motor coordination in children and adults. Children may present with difficulties with activities such as self-care, writing, typing or riding a bike. In adulthood, many of these difficulties will continue, as well as difficulty learning new skills such as driving a car and DIY. These difficulties can significantly affect an individual’s ability to function at home, in education and in employment.

This applies to all tasks related to learning or home. For example, if asked to write a story, a child with DCD will find it very difficult to create a story, remember punctuation and manage the motor skills of writing. Breaking down the task into recording their spoken story and then writing it can support with this.

Regular practice: Provide opportunities for frequent practise of skills so that children can regularly revisit what they have learnt, for example within daily exercises for 15 minutes.

A plan to support Josh in school was devised focusing on the following areas:

Handwriting and spelling

Josh completed the ‘Jimbo Fun’ programme (an intervention to support the development of handwriting skills, including gross and fine motor skills) and completed daily handwriting practice, with a focus on accurate letter formation. Various pencils and pens were tried, and Josh selected one he found easy to use. The emphasis was on quality not quantity for handwriting and rewarding effort, rather than the final result. For longer pieces of work, he used a laptop to record his story and then write it down.

Maintaining focus

Josh was given a fiddle toy to help him concentrate and his mum bought him a hug vest which he found very helpful. He was relocated to the front of the classroom face-on to the interactive board and was given regular “get up and move breaks” during lessons.

Tiredness

Children with DCD need to work harder than other children to complete tasks and therefore often become very tired. Josh and his mum agreed a deal to reduce his screen time in the evenings and to establish a good bedtime routine. She also recognised the need to balance his workload during the week well and teaching staff agreed more flexibility around homework.

After nearly 6 months Josh was seen and assessed by an Educational Psychologist, Community Paediatrician and Occupational Therapist. He received diagnoses of DCD and dyslexia and was found to have some challenges with working memory. It is important that key adults understand and recognise DCD in order to support children effectively. For Josh this meant that he improved academically, but he was also happier, grew in self-confidence and was more engaged with his learning. In his own words, he’s “not in trouble anymore”.

Cathy Parvin, Director Dyspraxia Education

http://www.movementmattersuk.org | https://www.jimbofun.co.uk/