family focused tele intervention for developmental coordination disorder v.2
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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)
0
10
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60
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90
100
Pre Post
MA
BC
-2 P
erce
nti
le
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