Introduction[edit | edit source]
Developmental disabilities (DD) includes conditions such as:[2]
Movement Difficulties - Hypermobility[edit | edit source]1. Muscle Tone[edit | edit source]Muscle tone is defined as: “the tension in the relaxed muscle”[5] - i.e. the amount of tension or resistance to stretch in a muscle.[2] 2. Hypotonia[edit | edit source]Hypotonia is defined as: “poor muscle tone resulting in floppiness. It is abnormally decreased resistance encountered with passive movement of the joint.”[6] There are different causes of hypotonia:[2]
3. Benign Joint Hypermobility Syndrome[edit | edit source]BJHS is a hereditary condition[7] that causes musculoskeletal symptoms in hypermobile patients, without other rheumatological features being present. It appears to be caused by an abnormality in collagen or the ratio of collagen subtypes.[8] Figure 1. Beighton score. Diagnosis is made based on a medical examination and use of the Beighton score (see Figure 1). Children with BJHS are susceptible to joint injury or dislocation, reduced stability, and a decreased ability to build muscle strength. They may tire easily, complain of pain or digestive issues, but symptoms are variable. They tend to be exacerbated during growth spurts, adolescence and hormone changes.[2] 32 percent of children with BJHS also present with movement and coordination disorders.[9] For more information on the clinical assessment of generalised joint hypermobility, please see the Ehlers-Danlos Society website. 4. The Good News About Hypermobility[edit | edit source]
Social, Behaviour and Movement Difficulties[edit | edit source]Social Communication Disorder and Autism Spectrum Disorder[edit | edit source]Social (pragmatic) communication disorder (SCD) is a relatively new diagnosis, described in the DSM-5. It is characterised by problems with verbal and non-verbal social communication,[11] but individuals with this condition do not display any restricted and repetitive interests or behaviours.[12] People with SCD may, for example, have difficulty taking turns to speak, adapting their voice, making small talk, and making eye contact.[2] Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects how individuals communicate and interact with others. Conditions that were previously seen as separate disorders (i.e. autism, Asperger’s) are now included under the umbrella term ASD.[13] There is a very broad spectrum of affect in ASD – from mild to very severe.[2] Individuals with ASD also display restricted, repetitive patterns of behaviour, interests or activities.[14] Other signs of ASD are:[2]
[16] The Good News[edit | edit source]
Learning and Behavioural Difficulties - Attention Deficit Hyperactivity Disorder[edit | edit source]Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects the functioning of the brain. It seems to be due to abnormalities in the dopamine system and a change in frontal lobe development.[2] While its cause is unknown, it is considered a genetic disorder, with environmental factors (e.g. diet, physical and social environments) playing a small role in its aetiology.[2][18] The following factors can increase the risk of ADHD:[2]
These motor problems are often ignored due to behaviour difficulties, but children typically struggle with:[2]
The Good News[edit | edit source]
Sensory Difficulties[edit | edit source]1. Sensory Processing Disorder[edit | edit source]Sensory processing disorder (SPD) is characterised by “chronic and significant impairments with the modulation and integration of sensory stimuli.”[28] It is important to note that opinion is divided on whether or not SPD is a specific diagnosis on its own,[29][30] but presenting features of SPD are listed in Table 1. Table 1. Symptoms of SPD[2]
2. Intervention - Sensory Integration Therapy[edit | edit source]Sensory integration therapy (SIT) was initially proposed as a treatment for SPD in 1972 by Jean Ayres. It is primarily used by occupational therapists (OTs). Children are provided with various sensory experiences. Each experience is matched with a “just right” challenge - i.e. an activity that requires an adaptive response from the child.[30] However, the evidence for SIT is considered weak at best.[30] OTs also use other interventions based on SIT, but with some key differences. While they tend to use a sensory integration framework to understand/explain the child’s behaviour, the focus is not on fixing an underlying impairment. Rather, they work with the child, parents and teachers to help change the environment to enable greater participation. Modifications might include:[30]
The Good News[edit | edit source]
Developmental Coordination Disorder[edit | edit source]Developmental coordination disorder (DCD) / dyspraxia is a common neuromotor condition, which affects around 5 to 6 percent of school-aged children, but it often goes unrecognised by health professionals.[32] In the DSM-5, DCD is specifically characterised as a neurodevelopmental motor disorder. Other neurodevelopmental motor disorders include stereotypic movement disorder and tic disorders.[2] Individuals with DCD have problems acquiring and executing coordinated motor skills. As defined in the DSM-5:
The most obvious difficulties are physical:[2]
Interventions[edit | edit source]Previously, deficit oriented approaches were used to address these issues. This approach aimed to address underlying deficits in one system (e.g. the nervous system) with interventions that were targeted at specific structures (e.g. the cerebellum or sensory processes, such as vision or proprioception)[33] in order to improve the performance of the entire system (reading, writing, movement etc).[2] However, contemporary theories suggest that motor performance results from a dynamic relationship between the environment, body and task. In this approach, motor deficits are seen in terms of motor learning and motor control.[2] Performance or task-oriented approaches are, therefore, used to encourage motor learning. In task-orientated interventions, there is a focus on teaching functional skills that are necessary to complete/participate in a certain activity.[34] Children are given the opportunity to try to solve a movement problem. During this process, they may work out a number of ways to complete a task. They are also encouraged to experience the impact of their different solutions on their bodies or the environment.[34] The interaction between the task, environment and child is, therefore, the key to the treatment.[2]
The Good News[edit | edit source]
References[edit | edit source]
Which of the following is an accurate representation of how children's vocabulary changes over time group of answer choices?Which of the following is an accurate representation of how children vocabulary changes over time? the biggest increase in vocabulary occurs once children enter school through around age 11.
Which of the following statements best illustrates coregulation quizlet?Which of the following best illustrates coregulation? A child is able to prepare himself breakfast, provided that he follow his parents' rules and not use the stove.
Which of the following is true of motor development in children between the ages of three and six years?How does motor development change between ages 3 and 6? Fine motor skill development allows children to become more independent by doing things such as putting on a coat and using a knife to cut soft food.
What percent of obese children remain overweight as adults?Around 55% of obese children go on to be obese in adolescence, around 80% of obese adolescents will still be obese in adulthood and around 70% will be obese over age 30.
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