Are referrals to occupational therapy for developmental coordination disorder appropriate?

Aims: To assess children referred to the Occupational Therapy Service in Gwent with a presumptive diagnosis of developmental coordination disorder (DCD) in order to investigate the appropriateness of their referral. Methods: Non-urgent referrals to the occupational therapy team for children with coo...

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Bibliographic Details
Published in:	Archives of disease in childhood 2004-02, Vol.89 (2), p.143-147
Main Authors:	Dunford, C, Street, E, O’Connell, H, Kelly, J, Sibert, J R
Format:	Article
Language:	eng
Subjects:	Academic achievement Activities of Daily Living Attention Deficit Hyperactivity Disorder Biological and medical sciences Cerebral palsy Child Child, Preschool Children & youth Cognitive Ability Computer Assisted Instruction Coordination developmental coordination disorder Developmental Disabilities - physiopathology Developmental Disabilities - psychology Developmental Disabilities - therapy Dyslexia dyspraxia Educational Status Ethnicity Female General aspects Goal Orientation Handwriting Humans Intellectual disabilities Intellectual Disability Intellectual Disability - therapy Intelligence Intelligence Quotient Language Impairments Learning disabilities Learning Problems Male Medical sciences Motor ability Motor Skills Disorders - therapy Muscular dystrophy Occupational Therapy Original Pediatrics Professionals Psychometrics Quantitative psychology Referral Referral and Consultation referrals Resistance (Psychology) School Nursing Special Needs Students Special Schools Statistical Data Teaching Methods Therapists Treatment Outcome
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Summary:	Aims: To assess children referred to the Occupational Therapy Service in Gwent with a presumptive diagnosis of developmental coordination disorder (DCD) in order to investigate the appropriateness of their referral. Methods: Non-urgent referrals to the occupational therapy team for children with coordination difficulties in Gwent between June 2001 and February 2002 were studied. Results: Eighty nine children, aged 5–10 years, were identified. Thirteen children who would not meet the DCD criteria were excluded. This left 76 children, 67 of whom were actually assessed. If the 15th centile for the Movement ABC is used, 26 children met and 41 failed one of the four criteria in DSM IV (38%). If the 5th centile is used, 21 children met and 46 failed one of the four criteria in the DSM (31%). Of the major groups of referrers, school nurses did the best with 48% success rate; better than the paediatricians with 32%. The worst success rate was in educational psychologists and teachers, with only 20% of cases referred actually having DCD. These differences did not quite reach statistical significance. Conclusions: Less than a third of referrals to occupational therapy for DCD actually have the diagnosis. This suggests that referrers need further training and guidance. This includes a knowledge and understanding of the DSM IV criteria and their interpretation. This would reduce the number of time consuming, unnecessary assessments being done. A triage procedure with a checklist would be a good way forward and we hope to devise one to assist referrers with this process.
ISSN:	0003-9888 1468-2044