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Helping Children Achieve And Become Competent Motor Performers It seems easy for some children, they just seem to master new skills presented to them every day with such ease. These children appear to acquire these skills without even trying. Then there are those children that struggle and find mastering new skills to be very difficult. These children may be still trying to stay upright on a bike while watching their friends take off and have such fun. For a small minority of children learning a new skill is so difficult that they give up in total frustration. When this failure to achieve begins to effect school work and social engagement parents often seek help.by Julie Martin, OTR/L, Ivymount Outreach Programs
Historically, the approach to treatment of motor based performance problems has been focused upon remediation of the child's underlying deficits such as mid-line crossing, muscle tone, and balance without considering the components to performing the whole task. These approaches all aim to establish control of the motor system through a bottom- up approach and include sensory integration, neuro-developmental therapy, perceptual motor therapy, and visual motor therapy. Each of these approaches offer important treatment interventions but all require very intensive, long-term treatment.
Occupational and Physical therapists traditionally offer a combination of these approaches in their treatment programs, including sensory motor treatment, functional specific skills training (using task analysis and reinforcement strategies), perceptual motor, environmental modifications, and sensory processing. A shift in motor learning and performance has occurred that has offered the therapy world a powerful new tool to add to the arsenal of treatment approaches. The acquisition of new motor skills is no longer seen strictly through a neuro-maturational lense but rather through a comprehensive vision that encompasses task performance and emphasizes the interaction between the person, the environment and the task.
This approach is congruent with many of the current imperatives in health care today; the need for children to succeed, the demands of families and therapists for interventions that are proven to be effective, the further demands for cost effectiveness and efficient interventions that are based upon evidence, and the focus upon contemporary learning theories.
Therapists now consider children’s goals as important as their parent’s goals when developing a treatment program. These goals may include learning to catch a ball, ride a bike, cutting with scissors, making a sandwich, shuffling cards and writing. Research has isolated children’s views of what is important to them in their lives and what they consider work and fun. When children’s concerns about themselves are factored into the therapeutic process, motivation is captured with resulting goal achievement. Parent’s concerns are also considered and those goals can be negotiated with the child again resulting in personal ownership in the therapeutic process.
Ashley a 6 year old child recovering from surgery to remove a brain tumor was seen for occupational therapy recently. She came to us with the desire to learn to jump rope so she could play with her friends during recess. Parental concerns included difficulty with handwriting and the impact this was having on her school success. Because we use a child-family centered approach both goals jumping rope and printing neatly were included in the treatment program. Ashley began a weekly treatment program with the first step being an analysis of what she knew and what she needed to learn when jumping rope and printing, where did her performance break down and what motivated her to learn new skills? Through the use of a combination of treatment methods including goal, plan, do, check, guided discovery, and problem solving she learned to jump rope and print her letters neatly and legibly within an 8 week period. Her mother reported that her teachers were happy with her progress at school and Ashley reported jumping rope everyday at recess with her friends.
Our service providers at Ivymount Outreach Programs/Therapeutic and Educational Support Services offer these comprehensive approaches in the treatment of children with developmental coordination disorders. We have observed a significant impact in the lives of children and families when children acquire desired skills and can transfer these skills to their daily routines of work, self care and play. For more information about these and other services please contact Julie Martin at Ivymount Outreach, jmartin@ivymount.org or 301-469-0223, #141.