Chapter 7: Motor Disorders and Developmental Frameworks

Motor Disorders and Neurodevelopmental Frameworks

• Motor disorders encompass a range of difficulties related to fine motor, gross motor, and visual-motor skills, impacting learning and development.
• Examples of motor disorders include developmental coordination disorder, dyspraxia, stereotypical movement disorder, tic disorders, and Tourette disorder.
• Piaget's sensorimotor stage highlights the importance of developing neuromotor functions in the first two years of life, emphasizing the role of sensory perceptions and motor activities in early learning.
• Neuromotor functions remain crucial throughout development and the lifespan, integrating with cognitive processes in various tasks.
• Tasks such as writing, playing musical instruments, and athletics involve complex integration of neuromotor functions and cognitive processes.

Developmental Coordination Disorder

• Developmental coordination disorder is characterized by impairments, immaturity, or disorganization of movement, impacting learning.
• This disorder encompasses various specific terms such as motoric deficiency, minimal brain dysfunction, and clumsy child syndrome.
• Individuals with developmental coordination disorder often experience problems in other areas, including language, learning disabilities, personality, and behavior.
• Motor difficulties can also be associated with neurological conditions like cerebral palsy and muscular dystrophy.

Dyspraxia

• Dyspraxia is characterized by difficulties in planning and organizing movement to achieve a predetermined goal.
• This disorder stems from a disruption in the process of praxis, which involves ideation, motor planning, and execution.
• Praxis connects cognitive processes with physical actions, requiring an integration of cognitive and motor functions.
• Dyspraxia can affect various aspects of development, including intellectual, language, sensory-motor, emotional, and social functioning.

Types of Dyspraxia

• Verbal dyspraxia involves difficulty in producing and formulating speech sounds, affecting speech fluency and word retrieval.
• Sensory integrative dysfunction relates to difficulties in organizing sensory information, impacting the processing of senses like sight, hearing, and touch.
• Dyspraxia often involves challenges in gross and fine motor skills, visual-motor skills, speech and language development, attention, general learning abilities, and social-emotional development.

Case Study: Edward

• Edward, a 9-year-old boy, exhibits a history of developmental delays and academic difficulties, particularly in fine and gross motor skills.
• Despite adequate cognitive skills and language processing abilities, Edward struggles with reading comprehension, written language, and math calculation.
• Occupational therapy assessment reveals evidence of dyspraxia.
• Edward's dyspraxia involves difficulties in ideation, motor planning, and execution, impacting his ability to plan and execute movements.

Educational Interventions for Dyspraxia

• Interventions for Edward focus on perceptual-motor training, sensory integration therapy, and academic accommodations across reading, writing, and math.
• Edward receives support in developing body awareness, motor planning and balance skills, fine and gross motor skills, and functional visual skills.
• Strategies to enhance organization and planning skills are implemented, including the use of visual aids and graphic organizers.
• Accommodations for written language include adjusting the volume, rate, and complexity of written work, providing extended time, and encouraging computer use.

Key Takeaways

• Motor disorders can significantly impact learning and development, requiring comprehensive interventions.
• Dyspraxia, a specific motor disorder, involves disruptions in planning and organizing movement, affecting a wide range of skills and abilities.
• Understanding the nature and impact of dyspraxia is essential for developing effective educational interventions and supports.
• Interventions should address multiple aspects of dyspraxia, including motor skills, sensory processing, and academic challenges, to facilitate positive developmental outcomes.

Edward's Educational Accomodations

• Edward was taught writing strategies to break down writing tasks and organize ideas
• His teachers provided feedback on his work and reinforced these strategies in class and during homework
• Edward received individualized training in using word processing programs
• He was offered alternative methods for presenting classwork and homework
• Edward was allowed to take oral tests instead of written tests
• He was encouraged to give oral presentations in class

Visual and Perceptual Accomodations

• Visual materials for Edward were simple in format and uncluttered
• He was assisted in planning and organizing tasks with visual cues
• Teaching techniques started with individual parts and progressed to wholes
• Edward was encouraged to use kinesthetic, visual, and manual manipulation
• He had opportunities to reproduce three-dimensional objects
• Edward used computer activities for visual-spatial and visual-motor skills

Attention and Focus Accommodations

• Edward was provided with a highly structured learning environment
• Information was broken down into brief, manageable, and meaningful units
• Simple instructions were provided and he was checked for understanding
• Edward's instruction utilized a spiral learning approach that reviewed previously learned material
• A multisensory approach to learning was used to enhance learning

Edward's Interventions and Outcomes

• Edward's IEP was modified to include new interventions, accommodations, and training.
• He showed significant and noticeable gains in reading comprehension, written language abilities, and math skills
• His overall daily performance and functioning in class progressively improved
• Edward seemed to enjoy school more and felt more comfortable in his educational environments
• He was able to connect and interact with peers positively

Stereotypic Movement Disorder

• Stereotypic movement disorder is characterized by repetitive, purposeless movements
• Common movements include body rocking, head banging, hand shaking, and nail-biting
• These movements must continue for at least 4 weeks and interfere with daily functioning
• Atypical stereotypic movements are also seen in individuals with ASD, tic disorders, and other neurological conditions

Tic Disorders

• Tics are sudden, involuntary twitches, movements, or sounds
• Motor tics affect the eyelids, face, and can occur anywhere in the body
• Vocal tics include involuntary grunting, throat clearing, shouting, and barking
• Two types of tics are recognized: motor and vocal

Tic Disorder Classifications

• There are four diagnostic categories of tic disorders: Tourette disorder, persistent (chronic) motor or vocal tic disorder, provisional tic disorder, and other specified and unspecified tic disorders
• Tic disorders differ in type of tic (motor, vocal, or both) and duration of symptoms

Tourette Syndrome

• Tourette syndrome is a neurological and neurodevelopmental disorder that becomes evident in early childhood or adolescence
• Symptoms typically vary from person to person, ranging from mild to severe
• Vocal tics can include involuntary grunting, throat clearing, shouting, and barking
• Other clinical conditions, like ADHD and obsessive-compulsive disorder, may occur with Tourette syndrome
• Tourette syndrome is characterized by both motor and vocal tics, with symptoms lasting at least one year
• The tics occur frequently throughout the day and typically begin before the age of 18
• Symptoms must not be due to medicine, drugs, or other medical conditions

Persistent (Chronic) Motor or Vocal Tic Disorder

• Individuals with persistent (chronic) motor or vocal tic disorder have symptoms present for at least one year
• They have either motor or vocal tics but not both
• Symptoms begin before the age of 18
• The diagnosis is confirmed by ruling out Tourette syndrome and other medical conditions

Provisional Tic Disorder

• Individuals with provisional tic disorder can have either motor or vocal tics, or both
• Observable symptoms must not be present for longer than 12 months
• The diagnosis is confirmed by ruling out other tic disorders and medical conditions