Family Focused Tele-Intervention for Developmental Coordination Disorder:

Preliminary Findings

Motohide Miyahara School of Physical EducationJohn E Clarkson School of Medicine, Paediatrics & Child HealthRuth Cutfield School of PhysiotherapyRussell Butson Higher Education Development Centre

Acknowledgements: Kate Heveldt, Robert van der Vyver, Tiffany Cone, University of Otago Research Grant

Background

• Insufficient intervention support for children with developmental coordination disorder (DCD) in New Zealand– Health care systems (OT, PT)– Educational systems (Teachers, PE, GSE)

• Successful home- and school-based intervention in UK (Sugden & Chambers, 2003).

• Effective clinical intervention at the Movement Development Clinic (Miyahara, Yamaguchi & Green, 2008).

• Successful telehealth adaptation of the Lidcombe program of early stuttering intervention (Wilson, Onslow & Lincoln, 2004).

Tele-Intervention• Theoretical models

1. Ecological Task Analysis (Davis & Broadhead, 2007)

1) Structure the physical and social environment to specify the task goal;2) Provide choices to children regarding how to solve the movement problem;3) Manipulate relevant task (environment )variables to elicit further responses;4) Provide direct instruction in skill selection and movement form.

2. Bronfenbrenner's Theory of Ecological Development (Bronfenbrenner, 1979)

Tele-Intervention

• Phase 1 (Apr-Jun, 2008)– Three boys and their

families

• Phase 2 (Jul-Sep, 2008)– three boys, one girl and

their families

• Phase 3 (Oct-Dec, 2008)– Four boys and their

families

Developing, Trialing, and Refining Materials• Workbook

– Theory into practice at home

– User friendly (easy language, cartoons)

• DVDs– Tying shoelaces– Family meetings– Bike riding

• Telephone communication

• Online support network

Telephone Communication

• Weekly contact with each child’s “teacher”

• Aims– To monitor progress– To provide information and advice– Encouragement/motivation

• Positive features– Time efficient– Develop rapport with families– Encourages adherence to the program– Empowers families to problem solve

• Challenges– Making contact with the families– Keeping the conversation focused – Identifying movement difficulties– Relying on parents for all information

• In future…– Have a contract with parents – Encourage increased use of photos, home videos etc– Offer a clinic visit if a child is not progressing with a particular skill

Telephone Communication

Intervention Outcomes:Movement Assessment Battery for Children-2

(Henderson, Sugden, & Barnett, 2007)

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10

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100

Pre Post

MA

BC

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Future Plan and Outstanding Issues

• Future Plan– Feasibility study through a parent support

group (N = 100).– National efficacy evaluation study

e.g., Parent-focused intervention for autism (EarlyBird) administered by Autism NZ, funded by Ministry of Health (Birkin, Anderson, Moore & Seymour, 2004)

• Outstanding Issues– Funding, Access, Motivation, Staffing