Following an assessment, a child is normally seen on a weekly basis for 8 sessions and treatment is supplemented by a daily home programme of exercises, games and activities (generally taking no longer than 20 minutes each day). Each treatment session takes approximately one hour and parents are asked to stay during the session and join in with some of the activities. It is advised that the child wears a T-shirt and shorts for each session.
Treatment sessions consist of carrying out specific exercises and activities to improve those issues highlighted in the assessment. Therapeutic exercises, games and activities can be targeted at improving gross motor skills, fine motor skills, co-ordination, spatial awareness, sequencing, interpretation, visual and verbal recall, bilateral integration, midline crossing, motor planning, organisational skills, directional awareness, social skills, eye-hand/foot co-ordination and ball skills as necessary.
I use a combination of the following treatment methods and physiotherapeutic techniques to treat children with Dyspraxia and Developmental Co-ordination Disorder (DCD):
The Lee Method
The “Lee Method” of physiotherapy has proved very successful in the treatment of Dyspraxia and Developmental Co-ordination Disorder (DCD). Research shows that these children improve significantly and continue to do well 3 years following treatment, and that self-esteem and confidence also improve dramatically. Studies have shown that, on average, each patient made 69% improvement at the end of treatment and this had progressed to 73% by the review three months following the completion of treatment.
Developmental Movement Exercises
When children are born, they emerge from the womb with primitive reflexes – physical responses that are initiated without conscious thought or intention. These reflexes allow the child to cope with the influx of new sensory information from the post-utero environment. These initial reflex patterns should, within the first few years, be overtaken and inhibited by voluntary actions – these are referred to as postural reflexes or postural control. It has been found that problems with neurosensory integration may be attributed to uninhibited primitive reflexes. Each primitive reflex has its own set of consequences if it has not been fully inhibited by its postural equivalent. The rationale behind Developmental Movement Exercises is that any existing partially retained primitive reflex can be actively inhibited by exercising the postural reflexes. Developmental Movement Exercises consists of a series of movements designed to stimulate and open up the sensory system and relive the experience of sensory development so that partially retained primitive reflexes are revisited and overtaken as they ideally would have been during the child’s infancy.
Kinesio Taping®
Kinesio Taping® involves the application of tape over and around specific muscles to provide joint support and muscle re-education. It can effectively facilitate optimal movement patterns and improve motor skills development and function.
Get On The Ball™
Using the Swiss Ball, an array of techniques are applied to the treatment of Dyspraxia, DCD and hypermobility by addressing stability, proprioception, balance, tone, automatic postural muscle activation, sensory integration, co-ordination and strength. Neurological and musculoskeletal principles are integrated in order to address stability in a fun, child-accessible manner.
Handwriting Interventions
Specific handwriting deficits which have been identified in the assessment process (such as fine motor skills, postural and upper limb control, bilateral integration and midline crossing) are targeted through a combination of remedial exercises and well recognised programmes.
At the End of Treatment
During the last session, we will discuss with the parents a programme of activities to continue with until the child is reviewed 3 months later. The amount of activities is not as intense as during the treatment but it is necessary as it assists with the long term maintenance of improvement. In addition, if some areas of residual weakness remain, these can be improved upon. As it is obviously more difficult to carry out the activities when there is no regular input from the physiotherapist, I provide a chart for parents to use in order to assist with this. During this time, it is also more important that additional sports and activities are encouraged not only to maintain the improved muscle strength and skills but also to promote social skills and interests.
The Review
This takes place 3 months following the completion of treatment and the tasks and activities carried out in the original assessment are reviewed. This will ascertain the amount of improvement and from the scores taken a percentage of improvement can be calculated. A long term management programme is then devised. This involves a checklist which the family are asked to complete on a monthly basis to ensure that the scores in key areas are maintained at an age appropriate level. Further advice is also given for activities, games and strategies to assist the child in as many situations as possible. It should be remembered that during sudden growth spurts, difficulties may manifest themselves again and a further (although often shorter) course of treatment may be required.
Liaison with Schools
I consider liaison with schools to be an important part of the overall management. For this reason a copy of the summary is sent to the school via the parents, with a short leaflet on advice within the classroom and P.E. setting. In addition, there is a liaison diary which the class teacher, parent and physiotherapist use in order that there can be good communication between them. The school is also informed of the progress made at the review and reports are sent following annual reviews. I am always happy to receive calls from teachers who require further assistance.
Treatment sessions last approximately 1 hour and cost £50.
