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November 2005 # 8 |
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The New P.E. & Sports Dimension
The column that opens your day by opening your mind
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Movement difficulties.
Identifying and supporting children with Developmental Co-ordination Disorder. |
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Jonathan Doherty
Carnegie Faculty of Sport and Education,
Leeds Metropolitan University, Leeds, UK. |
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The articles of our authors are indexed in |
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| Movement is at the heart of Physical Education experiences for all children |
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Movement is at the heart of Physical Education experiences for all children. Writers continue to articulate its importance from the natural play of young children through to the formalised contexts in areas of activity such as dance, games and gymnastics in the school curricula (Doherty & Bailey, 2003). That the foundations for a lifetime of movement are laid in the experiences of children below the age of seven are commonly documented, whilst the ages seven to eleven are classed as the “skill hungry” years due to the desire from many children to develop their generic movement skills of ball rolling, kicking, throwing, striking, and so on (ibid). Set against this, however, is alarming evidence of the numbers of children with specific movement difficulties, for whom performing these skills (as well as many everyday motor skills) is something of a nightmare and who latterly have been labelled as suffering from the condition known as Developmental Co-ordination Disorder (DCD). This article provides some popular definitions of the condition, explains its key characteristics and contributes some strategies for helping educators deliver meaningful movement experiences for children in PE lessons.
To illustrate this particular disorder and its association with mainstream school PE lessons, consider the following brief case study:
Thomas is eleven years old. He is looking to his second PE lesson of the week in school with the usual feelings of dread. His teacher has decided that the class will go outdoors today and that their lesson will involve basic throwing and passing activities leading up to a modified game of basketball towards the end of the 40 minute period. Getting changed he struggles to undo the buttons on his shirt. He manages to take off his jumper OK but the effort and time involved in putting his training shoes on the correct feet and tying the laces has meant that the rest of the class have to wait for him and are getting impatient. Often his teacher helps Thomas, but today she is too busy organising the balls, cones and other equipment ready for the lesson to assist him.
Eventually he is ready and the class go onto the outdoor area to begin the lesson. In the warm-up, he manages to run the few laps of the court (although very awkwardly) and perform some of the mobilising exercises but has difficulty in the movements that involve alternating arms and legs. These difficulties are small compared with the skill drills of sending and receiving the basketball to his peers. He appears unable to judge where the ball will be coming from and at what speeds. His own passes are often inaccurate which causes further frustration to his partner.
The lesson continues and Thomas is now faced with small-sided games with opposition. He appears totally uncomfortable with the whole experience. |
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| Not an uncommon experience for a child with DCD |
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Not an uncommon experience for a child with DCD. In this small cameo I have introduced an experience of a Physical Education lesson for a child with DCD. Let us now consider the condition in more detail and begin by defining it. As a condition DCD is not new and clearly the difficulties that Thomas has shown have been around in the past. Derogatory terms like “clumsy child”, “motor morons”, “maladroits” were heard while professionals used terms like “motor learning difficulties” and “sensory integrative dysfunction”. Other definitions have stressed the nature of the difficulties more precisely. Poustie viewed it as “a specific learning difficulty in gross and fine motor planning which is not caused by muscle or nerve damage” (1997, p.57) and Penso referred to it as “a difficulty in planning and organising movements at a cerebral level” (1999, p.86). The term is often synonymously used with “dyspraxia” and is associated with motor co-ordination difficulties, although this perhaps does not highlight the inherent and associated perceptual and organisational difficulties of the condition adequately. The most commonly accepted definition of DCD is from the American Psychiatric Association who defined it as a:
“marked impairment in the development of motor co-ordination that is not explainable by mental retardation and that is not due to a physical disorder. The diagnosis is only made if this impairment significantly interferes with academic achievement or with activities of daily living”
(APA, 1994, p53) |
| The characteristics of DCD |
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This definition and its accompanying explanation in the Diagnostic and Statistical Manual (DSM-IV) implies difficulties in planning and execution of motor actions which manifest themselves in the everyday lives of children as well as in school contexts. Naturally the context that most strikingly illustrates the condition is in the domain of Physical Education. Within its varied activities, the characteristics of DCD are quite easily identifiable. Commonly these include:
- Postural problems
- Low muscle tone
- Poor awareness of personal space
- Performance difficulties in most sports skills
- Difficulties with co-ordinating motor skill actions
- Problems in planning movement skills
- Balance problems
- Hyper-sensitivity to body contact from others
- Uncertainties about handedness
- Poor sense of direction
- Difficulties in following instructions
- Discomfort with certain clothing
- Rejection by peers
- Emotional outbursts and often behavioural problems
- Reluctance to participate in social activities such as games
- Poor self image
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| The list is not limited ... |
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Think back to Thomas and a number of these signs are recognisable in his case. The list is not limited to a sparse minority of children. Findings from Hall (1994) quote figures for the number of individuals with DCD in the UK as being between 5% and 18%. More recently Portwood (2002) talks of movement disorders such as this as being an epidemic in early childhood. Surprising therefore that the causes of DCD are still far from clear. DCD children have no neurological abnormality although it is believed that their difficulties arise from immature neuronal development. Kirby (1999, p.177) writes that problems occurring at one level may well have an impact at other levels in the “cycle of DCD” and suggests that one cause might be hereditary where there could be an underlying predisposition to laxity (or simply muscle floppiness) that is passed on from parent to child. Other speculated causes include lack of opportunities to crawl as babies that fail to develop appropriate strength in upper body and important cross-lateral patterns to be established (Goddard, 1996). The general literature suggests that difficulties might be grouped into three:
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• Perceptual. This arises from difficulties in attending to and processing appropriate stimuli in the environment. In order that the final movement response is efficient, input via the different senses must be accurately interpreted. Five senses come into play here. Firstly and most importantly, vision to focus on relevant cues (such as other players), tracking to follow movement (such as the flight of a ball), visual discrimination to estimate distances of objects and their position in relation to their background (such as reading maps in orienteering). Hearing is the second most important sense as it alerts individuals to the sounds in the immediate environment. Top athletes are able to filter out irrelevant noise from spectators or other players to assist their focus. Sound is also important in allowing movement pattern rhythms to be identified, such as in the stepping patterns in rope-skipping or in learning new dance steps. The third sense, tactile has important associations with children with DCD since they tend to be heavy footed and cannot easily move around lightly. Grips on rackets tend to be too rigid and tight which prevents looseness and flexibility in the arm action.
Proprioception allows movement actions to be co-ordinated and permit a sense of placement. This system provides important feedback on such elements as the position of the body and its limbs (Magill, 1998). A proficient student dribbling a basketball does not need to look down at the ball to know it is there because information is relayed from the finger tips to the central nervous system that provide the necessary feedback. The DCD student needs to look at the ball and often at the floor to place his feet in preparation for shooting. The final sense, is the vestibular sense that governs the crucial skill of balance. Through receptors in the inner ear, this sense moderates changes in the position of the head, co-ordinates the eyes with the body and identifies the body's midline for movements that involve directionality. |
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• Motor planning and organising. Immaturity of the cortex in the brain results in fewer pathways being established so that messages from the environment are not properly processed. As Portwood (1996) explains, “There is evidence to suggest that in the case of the child with dyspraxia the reinforced interconnections between the nerve cells in the cerebral cortex are reduced in number. The cortex persists in a state of immaturity….” (1996, p.8).This explains why a child with DCD in a PE lesson tends to take longer in selecting a movement response (i.e. Which shot will I play?), or produces many unnecessary movements. It is also why a child often fails to reproduce the same action and because of this failing, consistency in movement reproduction of sports techniques is rarely achieved. Organisation difficulties relate to many of these children being unable to visualise what comes next in the movement sequence. Lacking movement memory, these children are unable to visualise the particular movement or its outcome. Creating gymnastics sequences or dance composition prove extremely demanding for children with DCD. |
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• Execution. Relating to the actual carrying out of a movement or set of movements, this aspect is most easily observable in different PE contexts. It is immediately apparent how successful (or otherwise) a movement was: was the goal scored? was the final balance position reached and held? Closed skills in games where the environment is stable and predictable (Schmidt, 1991) such as the golf swing, the penalty kick or free throw, for example, make this observable to teachers and coaches but to the performer with DCD, lack of intrinsic feedback from the senses provide limited information and hence the performer will still have problems in future movement responses. A practical example of this can be seen when executing a skill like striking a tennis ball. In preparation for this action information as to movements of the feet as they move into the correct position to hit the ball, turning of the hips and then the shoulders in preparation should be felt by the player. The player may also see the racket head move and hear and feel the ball as it contacts the racket but the player with DCD will find these important messages delayed or at worst not coming through at all. The implications for performance are obvious. |
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| There are strategies to help educators |
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There are strategies to help educators in relation to the difficulties highlighted above. Here are twelve practical strategies relevant to any PE lesson:
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• Motor skills need to be taught to these children as they are unlikely to develop proficiency without sound instruction.
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• With younger children, marching, hopping on different legs, games of “Simon Says” and musical statues, parachute games, crawling through tunnels are recommended activities. With older pupils, individual challenges using large foam balls to throw and catch, locomotion games involving left and right directions, rope skipping, rolling and balancing are essential. |
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• Be prepared to modify equipment. Use large headed bats, larger balls of bright colours, etc. |
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• Organise so that changing for PE does not have to be the nightmare it is for many of these children. |
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• Use clear boundaries for outside playgrounds and fields to clearly set out the working areas. Hoops, cones, lines drawn on the ground with chalk are helpful. |
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• Keen observation of children’s movements reveals individual strengths and areas of concern. |
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• Regular questions like, “What are you going to do next?” help with planning and organising movement responses and prompting “ First I will…. and then I am going to….” type answers. |
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• Use clear guidelines in appropriate language that the pupil will understand. Clearly explain the task and later prepare with a phrase such as, “only five minutes more on this” will assist with their organisation. |
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• Allow more time for these children who need ample opportunities to practise their motor skills. |
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• Break down instructions. Single instructions are best. |
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• Listen to them. |
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• Provide regular praise and feedback to encourage them! |
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In conclusion, Developmental Co-ordination Disorder as a condition that adversely affects the organisation and performance of motor skills has significant implications for the teaching of Physical Education. In addition to the execution of gross and fine motor skills, areas of difficulty appear in language, perception and the organisation of thoughts that might be best served from early specialist multi-modal interventions but modifications to regular teaching in PE will provide lessons in which children with DCD can thrive, learn from and enjoy.
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| American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders. 4 th edition, Washington, DC
Doherty, J. & Bailey, R. (2003) Supporting physical development and physical education in the early years. Open University Press: Buckingham, UK
Goddard, S. (1996) A teacher's window into the child's mind. Ridge Press: United Kingdom
Hall, C. (1994) Clumsiness in children “a medical condition”. Independent newspaper. 13 th January. p12
Kirby, A. (1999) Dyspraxia. Developmental Co-ordination Disorder. Souvenir Press: London
Magill, R. (1998) Motor learning. Concepts and applications. McGraw-Hill: Singapore.
Penso, D. (1999) Keyboarding skills for children with disabilities. Whurr Publications: United Kingdom
Portwood, M. (1996) Developmental Dyspraxia: a practical manual for parents and professionals. Educational Psychology Service: Durham, UK
Portwood, M. (2002) Research into dyspraxia and DCD 2000-2002. The Dyspraxia Foundation Professional Journal. Issue 1. United Kingdom
Poustie, J. (1997) Solutions for specific learning difficulties . A Next Generation Publication: United Kingdom
Schmidt, R.A. (1991) Motor learning and performance. USA: Human Kinetics |
1. Have you recognised children with DCD in your lessons? What characteristics were evident to you in the context of their PE lessons?
2. Approximately four times as many boys as girls have been identified as having this disorder. Does this raise particular instructional problems in movement classes?
3. What other appropriate activities can you suggest for these children in PE at
- pre-school age and/or
- school age
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