School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.
Aust Occup Ther J. 2023 Aug;70(4):420-433. doi: 10.1111/1440-1630.12864. Epub 2023 Feb 23.
Developmental coordination disorder (DCD), a prevalent neurodevelopmental disorder with motor and psychosocial consequences, can significantly impact children's quality of life. In Australia, most children with diagnosed/suspected DCD have received occupational therapy services, more so than any other health service. As such, occupational therapists are key in identification and treatment and require a sound knowledge of diagnostic criteria and the best evidence for practice. This study explored current occupational therapy services for children with DCD. Areas for development are identified to improve the identification of, and subsequent intervention for, children with DCD.
In this cross-sectional study, an online survey was completed in September and October 2020 by 175 occupational therapists working in Australia.
Although all therapists worked with children who met the criteria for DCD diagnosis, 70% worked with children with no specific diagnosis and 50% worked with children with outdated diagnostic labels. Australian occupational therapists used similar models/frameworks (commonly a multisensory/sensory processing approach) to guide practice with children with DCD, regardless of therapist characteristics, practice setting (clinic/community, rural/urban), how therapy is funded, or the state where the therapists completed their training/currently practiced. Although assessment practices did not differ significantly, therapists with greater years of paediatric practice and those who studied and/or practiced in Western Australia were more likely to assess to identify DCD. Half of the therapists did not assess to identify DCD; however, 60% of assessing therapists reported best practice methods in assessment for DCD, indicating emerging best practices in the Australian context.
The findings from this study suggest that small adaptations to current occupational therapy practice may enhance the early identification of children with DCD in Australia. The existing gaps in evidence to practice must be addressed to improve current Australian practice and increase access to appropriate services and ultimately improve the quality of life for children with DCD.
发育性协调障碍（DCD）是一种常见的神经发育障碍，会对儿童的生活质量产生重大影响。在澳大利亚，大多数被诊断/疑似患有 DCD 的儿童都接受过职业治疗服务，比任何其他健康服务都要多。因此，职业治疗师是识别和治疗的关键，他们需要对诊断标准和最佳实践证据有深入的了解。本研究探讨了目前针对 DCD 儿童的职业治疗服务。确定了未来的发展方向，以改善对 DCD 儿童的识别和后续干预。
在这项横断面研究中，2020 年 9 月至 10 月，175 名在澳大利亚工作的职业治疗师在线完成了这项调查。
尽管所有治疗师都与符合 DCD 诊断标准的儿童一起工作，但 70%的治疗师与没有特定诊断的儿童一起工作，50%的治疗师与过时的诊断标签的儿童一起工作。澳大利亚职业治疗师使用相似的模式/框架（通常是多感官/感觉处理方法）来指导患有 DCD 的儿童的实践，无论治疗师的特征、实践环境（诊所/社区、农村/城市）、治疗的资金来源，还是治疗师完成培训/目前实践的州。尽管评估实践没有显著差异，但儿科实践年限较长的治疗师，以及在西澳大利亚学习和/或实践的治疗师更有可能进行评估以识别 DCD。一半的治疗师没有进行评估以识别 DCD；然而，60%的评估治疗师报告了 DCD 评估的最佳实践方法，这表明在澳大利亚背景下出现了最佳实践方法。
本研究结果表明，对当前职业治疗实践进行小的调整可能会提高澳大利亚儿童发育性协调障碍的早期识别率。必须解决实践证据方面的现有差距，以改善澳大利亚目前的实践，增加获得适当服务的机会，并最终提高发育性协调障碍儿童的生活质量。
