Occupational Therapy Assessments

What is Occupational Therapy (OT) for children and young people?

Occupational therapists (OTs) - such as Hannah Jeffery who works on an Associate basis with SEND Pathways - help children and young people take part in the daily activities (occupations) that are important to them – at home, at school and elsewhere. Some children and young people have difficulty doing the things they want or have to do because they have physical, learning or mental health needs. Others struggle due to illness or family circumstances, or because of changes that happen as they grow and develop. OTs help children and young people take part in the activities that give purpose and meaning to their lives. These may include:

• self-care activities – e.g. getting dressed, brushing teeth, using cutlery, using the toilet, sleeping.
• productivity (education, work) – e.g. writing, using scissors, being regulated enough to learn and pay attention, taking part in PE.
• play and leisure – e.g. playing with friends, riding a bike, doing sports or hobbies.

OTs help children and young people grow, thrive and reach their full potential by identifying:

• activities they do well and those they find difficult
• personal, environmental and task-specific factors that help or limit their ability to take part
• different ways of doing things, teaching new skills or changing the environment to make it easier for them to participate, have fun and achieve.

https://www.rcot.co.uk/explore-resources/children-young-people-families/OT-children-and-young-people

Assessment for Developmental Coordination Disorder (Dyspraxia)

Developmental Coordination Disorder (DCD), also known in the UK as dyspraxia, affects movement and coordination in children, young people and adults, with symptoms present since childhood. DCD is distinct from other motor disorders such as cerebral palsy and stroke and occurs across the range of intellectual abilities. This lifelong condition is formally recognised by international organisations including the World Health Organisation.

The person’s coordination difficulties will affect their functioning in everyday activities, including in the classroom, at work and in leisure activities. Difficulties may vary in their presentation and will also change depending on environmental demands, life experience, and the support provided. There can be a range of co-occurring non-motor difficulties which can have a substantial adverse impact on daily life. These may include social and emotional difficulties as well as problems with time management, planning and personal organisation, and these may also affect a person’s education or employment experiences. Many of the movement and coordination difficulties will continue into adolescence and adulthood. Although the motor difficulties persist throughout life, non-motor difficulties may become more prominent as expectations and demands change over time. With appropriate recognition, reasonable adjustments and support, people with DCD can be very successful in their lives. DCD can co-occur with other developmental and specific difficulties such as Dyslexia.

Diagnostic Criteria

DCD in children is identified on the basis of motor difficulties as described in DSM-5 (APA, 2013) and ICD-11 (World Health Organisation, 2018). For a diagnosis of DCD to be made, your child will need to meet all of the following criteria:

A. their motor skills are significantly below the level expected for their age and opportunities they have had to learn and use these skills. To assess this, we use a standardised motor assessment such as the Movement ABC-3 (Henderson, Sugden & Barnett) or the Bruininks-Osteretsky Test of Motor Proficiency 3^rd Edition (Bruininks & Bruininks).

B. their lack of motor skill significantly and persistently affects their day-to-day activities and achievements in education. To assess this, we use a standardised caregiver (parent/teacher) questionnaire, or if the young person is old enough, a self-report questionnaire. 

C. their symptoms first developed during an early stage of their development. To assess this, we will ask about the child’s early years and motor milestones such as when they sat, crawled, walked etc.

D. their lack of motor skills isn't better explained by long-term delay in all areas (general learning disability) or other medical conditions, such as cerebral palsy or muscular dystrophy. To assess this, we must refer to a paediatrician.

Although DCD may be suspected in the pre-school years, it's not usually possible to make a definite diagnosis before a child is aged 5 and therefore OTs would not complete a diagnostic assessment before this.

References:

Developmental Co-ordination Disorder (Dyspraxia) in children - NHS

Dyspraxia (DCD) - British Dyslexia Association