July 28, 2015

Dynamic Core for Kids – Questions From the Field: Developmental Coordination Disorder (DCD)

Here’s another Q & A regarding our Dynamic Core for Kids approach to central stability in children:

Q: I work on a diagnostic team and unfortunately have no opportunity to implement the (Dynamic Core for Kids) strategies with my kids over time. Presently, we are being confronted with many kids for whom the question is DCD, but they are very weak and in my view, they lack the foundation from which to refine and coordinate movement. Do you have a perspective on this question? Can clumsiness = “DCD”, when foundational power is lacking?

A:  That’s a really interesting question and my answer would be yes and no 🙂  Recently there was a study regarding push off power and increased hip flexion in boys with DCD.   I was disappointed that the study only looked at distal alignment issues and didn’t include any comment on the trunk alignment or activation because all of the children I have seen with DCD have significant alignment issues at pelvis and rib cage. When I treat proximal alignment and inner core/outer core recruitment and timing (the foundation of the Dynamic Core for Kids approach), the distal issues are significantly positively impacted. So yes, I totally agree with you that the presence of central stability affects the activation and timing of recruitment of the postural synergists and distal musculature, which are essential pieces of coordination of movement.  “Clumsy” children improve their motor performance in general when we address central stability and restore the relationship with the postural synergists.  But clinically I don’t always see  that clumsy = DCD.  For children with DCD,  although improvement in central stability also improves performance in activities that are organized/predictable, it does not translate into significant improvement in activities/sports that are unpredictable.  For instance, you will see a great improvement in running or skating (and indeed we can train these quite well) but it will not translate into improvement in basketball or hockey, both of which involve a great deal more integration of sensory information for anticipation/planning and unpredicatability.

 

 

 

Comments:

2 thoughts on “Dynamic Core for Kids – Questions From the Field: Developmental Coordination Disorder (DCD)”

  1. I think DCD is an umbrella term – much like CP. It does not differentiate between the different types of children who are diagnosed with DCD, although weak core is a common, shared finding. I would love to know if others agree with these “sub-categories” I use to help guide my treatment focus
    1. Motor Planning Difficulties
    2. Sensory Processing / Integration Difficulties
    3. Low muscle tone – Neurological basis
    4. Generalized muscle weakness – experience basis
    4. Asymmetrical / abnormal tone (often very mild hemi / dystonia / ataxia) ie have some hard neurological signs
    5. A mix of the above

    • So interesting! I see the variability in the children with DCD too. There was a paper a few years ago that pondered whether or not DCD was actually on the same continuum as CP. Have you ever seen any discussion along those lines?
      I really like your sub-catgeories. In my area, a DCD diagnosis cannot occur in combination with a general medical condition so our kids cannot be diagnoses as having CP/MD/PDD and DCD (http://dcd.canchild.ca/en/AboutDCD/overview.asp).
      Observations and opinions, anyone?