06 Missiunaetal

8/18/2019 06 Missiunaetal

1/15

INTERNATIONAL JOURNAL OF SPECIAL EDUCATION Vol21 No.1 2006

“MISSED AND MISUNDERSTOOD”:

CHILDREN WITH COORDINATION DIFFICULTIES IN THE SCHOOL SYSTEM

Cheryl Missiuna

Sanra M!ll

Susanne "in#

and

Mary La$

McMaster University

and

Gillian King Thames Valley Children’s Centre, London, Ontario

Approximately 5-6% of school-aged children have a neuro-developmental condition called Developmental Coordination Disorder (DCD) and are at risk

for a numer of secondary academic! social and self-concept difficulties"

Despite its prevalence! DCD is often unrecogni#ed in the school system! and the

needs of children are not addressed" $n this ualitative study! intervie&s &ere

conducted &ith ' parents of school-aged children &ho met criteria for DCD"

tudy findings highlighted that these! often very right! students struggled hard

to produce in the classroom! &ith varied teacher responses" *utside the

classroom! many children experienced social! self-concept! and emotional

prolems" Despite the support of some excellent teachers! families felt that the

educational system displayed a lack of understanding and responsiveness to

their child+s needs" $mplications of these findings include the importance of

teachers in identifying children and modifying classroom environments! and thenecessity of improving the responsiveness of the educational system to their

needs"

Over the past two decades, there has been a notable increase in students identified with learning

difficulties who are in general education classrooms U!"! #epartment of $ducation, %&&&'!

Teachers are increasingly challenged as they try to provide educational programs that will meet the

uni(ue learning needs of each student! )n order to provide an optimal learning environment,

teachers must be *nowledgeable about the range of challenges or conditions that a child may be

e+periencing! One of these conditions, #evelopmental Coordination #isorder #C#'merican

-sychiatric ssociation -', %&&&', is a physical coordination problem that affects ./01 of

school/aged children and that has a significant impact on school performance -, %&&&2#ussart, 34452 Losse et al!, 34432 "myth, 344%'! #espite its prevalence, #C# is often

misunderstood or unrecogni6ed by professionals in both the health care and educational systems! )t

is often years before there is recognition of the problems that the child is e+periencing hern,

%&&&2 7o+ 8 Lent, 34402 Missiuna, Moll, Law, 9ing 8 9ing, in press'!

#C# has been *nown under a variety of labels around the world Missiuna 8 -olata:*o, 344.'

including developmental dyspra+ia yres, Maillou+, 8 ;endler, 34


2/15


to successfully carry out activities in the home, at school, in the gym or on the playground -,

%&&&'! @y definition, the motor delay and motor impairment must impact negatively on academic

achievement and the child’s ability to perform self/care activities, if a diagnosis of #C# is to be

made -, %&&&'! Long after tas*s have been mastered by other children, children with #C#

continue to struggle with printing and handwriting, copying notes from the board, using scissors,

doing up 6ippers and snaps, opening snac* containers, tying shoelaces, turning door*nobs,

participation in physical education and engaging in games at recess Missiuna, Bivard 8 -olloc*,%&&5'!

#C# is often mista*en for attention deficit hyperactivity disorder #A#'! Children are

disruptive in the classroom as they *noc* things over, drop things and bump into other ob:ects and

children! Their inability to maintain a stable posture means that they fall out of their chairs, bump

into children in lineups and have trouble sitting still at circle time! 7urther, children with #C# are

aware of their difficulties from an early age so they try to avoid written wor* by sharpening their

pencils, see*ing attention from the teacher and interfering with other children! Missiuna, Bivard

8 -olloc*, %&&5'! lthough there is a high rate of co/occurrence of #C# with #A# Tervo,

6uma, 7ogas, 8 7iechtner, %&&%2 9ades:o 8 >illberg, 344illberg, >illberg, 8

$nners*og, 3442 Aellgren, >illberg, @agenholm, 8 >illberg, 34452 Losse et al!, 3443'! ;hat

starts out as a physically based problem seems, in many instances, to develop into other more

comple+ issues! The process by which this occurs, however, is not clear! The influence of

environmental factors, for e+ample, may be important to consider since not all children e+periencethese issues to the same e+tent! )n addition, the value attached to these issues may vary from one

family to the ne+t! )n order to understand the influence of coordination difficulties on children and

their families, a research approach is needed which considers the individual nature of each child

and the conte+t within which he or she lives!

The purpose of this study was to e+plore parents’ perceptions of the early e+periences and

participation patterns of children with #C#! #uring the course of the study, many parents spo*e

at length about their child’s e+periences at school and about their interactions with the educational

system! lthough this was not the original intent of the study, parents clearly had important stories

to share with practitioners in the school system! The focus of this particular paper therefore is on

the findings from the study that relate to the e+periences of children in the educational system, and

the problems that appear to develop in the classroom and on the playground! 7indings regarding

the e+periences of parents in the health care system have been described in a separate paper

authors of this paper, in press'!

Me%h!

)n this (ualitative study, a phenomenological approach was adopted which enables e+ploration of

the meaning of e+periences within an institutional environment such as the school system, and the

influence of the environmental conte+t on children and their families Cresswell, 344


3/15


,articipants

purposeful sample of thirteen families was recruited through service providers in two regions of

south/central Ontario, Canada! "ervice providers included therapists from publicly funded school

health support services, from privately funded therapy services, and a pediatric orthopedic

surgeon! $ach service provider gave information about the study to parents on their caseload who

had a child with coordination difficulties! -arents contacted the researchers and provided

informed consent! There was also one self/referral, a mother who heard about the study and as*edto participate!

$fforts were made to ma+imi6e diversity among participants in terms of the child’s gender and

age! There were ten boys and three girls, a proportion similar to the general population of children

with #C# 9ades:o 8 >illberg, 344


4/15


accuracy and reflect on whether they had any points to add! second interview was scheduled to

follow/up on information that emerged in the first interview andHor the (uestionnaires!

The follow/up interview was designed to further e+plore parents’ insights emerging from the first

interview, as well as review information from the (uestionnaires including? developmental history

data, e+perience with the health care system, and the child’s strengths and difficulties! )nterviews

were conducted either in the parent’s home or at the office of the research therapist, dependingupon parent preference!Ta&le '

(r!)ile !) Chil (ar%i*i+an%s

(ar%i*i+an% ,rae Mei*al

Dia#n!sis

Eu*a%i!nal

Ien%i)i*a%i!n

M!-e.en% A/C 0+er*en%ile1

Manual /all /alan*e T!%al

De2%eri%y S3ills I.+air.en%

I4 Es%i.a%e

0 yr! @oy 3 #C# // I. I. I. 3st bove

average

0 yr! @oy 3 // // I. I. I3. 3st bove

average

0 yr! @oy 3 // // . I3. I3. 3st boveaverage

< yr! @oy // // I. . I3. I3st verage

4 yr! @oy // // I. I. I. 3st verage

4 yr! >irl 5 // // I3 I. I3 I3st verage

4 yr! @oy 5 //

Multiple

e+ceptionalities I. . I. I3st verag

e

3& yr >irl . #C#,#A#,

an+iety

// I3. I3. I3. 33th verage

3& yr >irl . // // I3 I3 I. I3st verage

3& yr! @oy . #A# )ntellectually

gifted

I. I. 3. 3st bove

average

33 yr! @oy 0 #C#,

#A#

// I3 I3 3. I.th bove

average

3 yr! @oy < #C#, mildhearing

impairment

"ensoryimpairment

J J J J verage

35 yr! @oy < #C#,#epression

// J J J J boveaverage

JMovement @C was not completed since these children were above the age limit of the assessment!

Occupational therapy records, however, indicated presence of significant motor impairment!

Data Analysis

)nterviews were transcribed verbatim and reviewed for accuracy by the interviewer! ll five

members of the research team reviewed transcripts prior to developing an initial coding scheme!

7ollowing review of the initial interviews, conceptual categories for the coding scheme were

developed and defined to facilitate descriptive analysis, including broad categories e!g!, child

characteristics' and subcategories e!g!, cognitive, physical, social characteristics'! Two members

of the team compared coding consistency on the transcripts to clarify and refine coding definitions!

The coding scheme was continually revised and refined as analysis progressed and new themesemerged! K’Vivo software facilitated the process of analysis Bichards, %&&&'! nalytic memos

were then written regarding the central emergent themes in order to capture detailed descriptions

and e+amples of child and parent e+periences! Besearch findings were confirmed through member

56


5/15


chec*ing with each parent participant, either through a focus group or telephone follow/up

Lincoln 8 >uba, 34uba, 34oodman, 3444' were consistent with parent descriptions! One section

of the (uestionnaire as*s about negative character traits that might be associated with behavior

problems e!g!, lying or bullying'! -arents reported few, if any, of these traits in their child!

)nstead, they strongly endorsed pro-social items which indicated their belief that their child was

caring towards others e!g!, kind to younger children, or usually does &hat others say'! They also

described their children as being sensitive to criticism and often on the receiving end of teasing or

bullying by peers!

Many parents reported that their child was bright, and that this intelligence was evident from an

early age! "everal parents e+plained that their child had advanced language s*ills, particularly

during the preschool years! s one parent noted? e is right and sometimes the ideas that 8ust

come off the top of his head are not typical of a six year old" nother parent had similar

observations? e is very smart" e can carry on a conversation at an adult level pretty much:

7urther evidence of children’s intelligence was noted in early reading s*ills! Beading was

identified during the early school years as an area of interest as well as ability! Many children

gravitated towards reading boo*s and preferred reading over other more physical tas*s! )n the

*indergarten and primary grades, success at reading was emphasi6ed as a strength! *nce she

caught on to reading! it 8ust sort of took off for her" -arental observations were consistent with

findings from the cognitive screening which showed that all of the children in this study wereaverage or above average in intellectual ability see Table 3 above'!

57


6/15


0he struggling student

lthough they initially emphasi6ed strengths, parents also described their child’s struggles in the

classroom setting! lthough the children were bright, they had difficulty demonstrating their

abilities through written wor*! )n the early school years, for e+ample, many of the children with

#C# avoided fine motor tas*s such as coloring, cutting and pasting! rt continued to re(uire

effort as school progressed! )n the primary grades, as e+pectations for written wor* started to

increase, difficulties became more obvious! -rinting and then cursive writing posed particular challenges! )t too* considerable time and effort for children to complete written wor*, and the

end product was often of poor (uality! One parent of a 3 year old boy described the ongoing

struggles that her son e+perienced?

e &ould e very hard on his pencil and use a lot of penciling and again! going over and

over the letters and ; in the long run he &as slo&" Could never finish his &ork on time"

1hereas another child could proaly &rite a sentence! he &as still &riting his first &ord"

And feeling very frustrated" rades two and three were

described by several parents as a time when their child’s organi6ational difficulties became more

obvious in the classroom! parent of a 3& year old girl actually used the term turning point ?

$n grade it &as a ma8or focus all of a sudden" 0he &hole disorgani#ation - the prolems

she has" 0he printing! the neatness! the sort of keeping her act together! in terms of

kno&ing &hat she is supposed to e doing! &hen she is doing it! not keeping up time-&ise

&ith kids in tasks" $ think grade &as the ig turning point for all of that"

0eacher responses

Besponses of teachers to the strengths and challenges of the children were varied! Children who

were sensitive, (uiet and well behaved were often overloo*ed in the classroom! Three of the

parents e+pressed concern that their child went unnoticed and was lost within the system! "ince

their child was not disruptive, he or she was under the radar screen of teachers and their

difficulties were either not noticed or not addressed!

4or example! she didn+t hand her 8ournal in for 6 or > &eeks" 9veryone &as handing them

in on 4ridays" he didn+t" 0hey never caught her" 0hey never clued into that" 1hen

everyody &ent and dropped off their 8ournal! she 8ust &ent y! ut never ever dropped anything off" he gets a&ay &ith it ecause she never gives them any troule" he doesn+t

give them any troule so she+s not a prolem! you kno&" And her lack of producing

ecomes invisile"

58


7/15


t the other end of the spectrum, the struggles of other children were noticed, but misinterpreted

or misunderstood by teachers! The source of the problem in many cases seemed to be the

discrepancy between the child’s intelligence and his or her motor performance! s outlined earlier,

the childrens’ intellectual abilities were not demonstrated through performance in written wor*!

-arents tal*ed about teachers who noticed the child’s difficulties, but did not understand the nature

of the problems! One parent described a teacher who blamed her son for not meeting academice+pectations!

$ think the grade ? teacher felt she could handle it all and it &as more a uestion of! well,

what’s his problem ! you kno&" $t &asn+t he has difficulties, we have to help him 7 it &as

oh, what’s that *id’s problem $t &as a very difficult year for him"

*utside the Classroom

Over time, as limitations become increasingly obvious to teachers and parents, they became more

evident to the child and their peers as well! s a result, a number of secondary problems began to

emerge outside of the classroom! -arents reported issues that emerged on the playground with

peers as well as at home!

@ast to e picked

ll parents reported concerns about their child’s ability to sociali6e with peers! "ince the childrendid not have the motor coordination to participate in team sports or physically active games e!g!,

hopscotch, s*ipping', this limited their ability to participate in playground activities! Most

children were reported to have had difficulty ma*ing friends and integrating with the other

children! One parent, for e+ample, described the emotional impact of the challenges her ten year

old daughter e+perienced on the playground!

And &hat did she hate aout school2 ecess" ated recess" ated gym class" Anything

that had to do &ith ho& she &ould perform outside of a really restricted environment &ith

other kids" Bust hated" o it &as 8ust very sad to see" =ou kno&! things that kids should

take great pleasure out of! she &ould 8ust find painful"

Bather than playing with peers, many children seemed to either gravitate towards children who

were younger than they were, or play on their own! ;e heard many accounts of children in the primary grades who had trouble ma*ing friends and were victimi6ed and teased by others because

of their limitations! These problems often came to a head in grades three and four!

1hat happened &as he got a little older and kids can e really cruel" e &as al&ays the

last! so he never got picked to 8oin them! ecause you kno&! they kne& that he &ould e

slo&er than they &ere at things" : $n grade four it ecame a real prolem" 4ive it &as

a real prolem" And $ mean to the extent &here my son &ould get eat up"

;ith problems both in the classroom and on the playground, school became a negative and

stressful e+perience for many children! The emotional conse(uences for the child, however, were

not easy to observe! s one parent of a nine year old girl e+plains2 he goes to school and she

seems okay" he manages" $ pick her up and as she is coming across the parking lot! she is

crying! you kno&! all the time" 0he school isn+t a&are of that"

4eeling like a failure

Many parents e+pressed concern about their child’s self/concept! They e+plained that their child

was acutely aware of hisHher limitations and began to see themselves as stupid or a failure at

school! One parent of a 35 year old boy described a negative cycle or pattern that started to

emerge?

$ guess the pattern &as sort of he &ould try something thinking he could do it and then

not e ale to do it and then feel frustrated and then not &anting to do ne& tasks or go to

ne& events or - And assignments - $ guess he 8ust got the feeling that he couldn+t do this

and therefore he &as dum! he &as no good"

These comments were echoed by another parent of an 33 year old boy, who recogni6ed in grade

three that his abilities weren’t as good as his peers2 e kne& ho& to do it and he &anted to do it!

59


8/15


ut &as 8ust not physically capale " " "so that started to ring more frustration! more hatred for

school! more shutting do&n

Anxious and depressed

"everal parents of older children described concerns with their child’s emotional health! 7our of

the si+ children who were over 4 years of age had already received medical treatment or

counseling related to symptoms of an+iety and depression! parent of a 3 year old describes thesevere an+iety that her son e+perienced in relation to school?

0here &ere some days! there &ere some &eeks $+ve got to tell you that &ere so hard

emotionally as a parent ecause $ kne& he had to go to school" $ kne& he &as not going

to have a good day and he+d e egging me to stay home and he+d e saying Emy stomach

hurts! my stomach hurtsF" 0he doctor said he could actually feel pain! ut there &as

nothing &rong" 1hat &e learned &as that he had anxiety related to school and that it

manifested itself in his stomach"

nother mother described her 35 year old son’s :ourney of going emotionally do&nhill" "he related

a story about her son’s struggle with a controlling teacher who was frustrated with her son’s poor

performance! Over time, her son became increasingly resistant to attending school, started to hate

himself, and hate his teacher to the point where he became acutely suicidal!

4amily stress

)n many cases, problems at school led to increased stress in the family home! One parent

described that her 3& year old daughter’s an+iety about school generated stress in all family

members!

eG school pro8ect =ou kno&! it+s such a stressor for her! it hangs over her" And then it

hangs over us ecause she+s 8ust &alking on eggshells" 9verything ugs her" And she+s

8ust so edgy: And she doesn+t &ant to go to school" And then she feels! you kno&! school

makes me too nervous and $ don+t &ant to go" 9very day $ get up $ think *h Hod! $ have

to face her in another 5 minutesI o it 8ust sets the tone of the &hole house" 0his is all

over a stupid science experiment at school" $t is ruining our lives"

"everal families tal*ed about the challenges of trying to help with homewor*! "ince the wor* was

clearly difficult for the child, there was often resistance to completing it!

1e &ould spend hours arguing! rather than accomplishing! school &ork" $ used to say

okay $ do three hours of home&ork a night" o! $ don+t do hours of home&ork a night! $

do ? to t&o and a half hours of arguing and half an hour of getting the actual &ork done"

And that half hour is proaly 5 minutes for the average child" $t+s 8ust that it takes

child longer" $t+s een a long struggle"

Kot all children e+perienced challenges outside the classroom to the same e+tent! Children in the

early grades were typically not as affected by homewor* or peer issues2 over time, though,

problems seemed to emerge and heighten the impact on the family!

ystem $ssues

)n addition to the struggles that the children e+perienced, parents described their own challenges

interacting with the educational system!

@ack of understanding

One ma:or source of problem seemed to be that #C# was not readily recogni6ed or understood by

professionals in either the health care or the school system! Most parents struggled with lac* of

information or support for the concerns that they had about their child’s functioning, and felt that

support from teachers and the educational system was either inconsistent or very limited! "everal

parents e+plained that they spent considerable time and energy advocating for their child in the

school system but that their concerns were not usually recogni6ed! This parent of a nine year old

boy describes the challenges she faces2 $+m right there the first day of school saying look! you+ve got to pay attention to child!

there+s something -! and so they kind of! you kno&! here comes that rs" 4" again" 0hey

60


9/15


&alk the other &ay &hen they see me" .ut $ kne& - $ don+t &ant him to fall through the

cracks"

@imited resources

Many stories were shared about one to two year waiting lists for assessment or therapy services

and frustration about the lac* of resources in the school to support their children " =eah! y the

time &e+d gone through the assessment and gotten the recommendations! and looked at &ho could

help! &e &ere almost at the end of the school year" "everal parents pursued private assessmentsandHor private schooling for their child in an effort to gain increased understanding and support!

parent of an 33 year old boy tal*ed about the stress of constantly having to advocate for her child?

*ne of the reasons &e took son out of the regular school system: &as for selfish

reasons : $+m so tired of fighting" $+m tired of fighting the &hole &orld" : $+m 8ust under

so much stress and &anting the est for him: 8ust &anting to make sure those doors are

open for him and that noody+s slamming doors shut on him at an early age"

@ack of system responsiveness

The overall feeling of parents seemed to be that the educational system was not set up to respond

to the needs of children with #C#! The diagnosis or label of #C# wasn’t recogni6ed as

facilitating eligibility for services! One parent was openly (uestioned by others regarding her

daughter’s coordination difficulties!

0he school vie&ed it initially as someone &ho &as prolem seeking! laeling! over-identifying prolems! an anxious mom" And the developmental coordination stuff! they had

never heard of it" ot one of the people there at the school" o they thought it &as like

a ogus diagnosis that $+d come up &ith to! you kno&! e overly anxious aout this"

lthough a number of the parents had the intellectual, emotional and financial resources to

negotiate supports for their child, they recogni6ed that they were uni(ue and not necessarily

reflective of other parents who may not have the means to get the services that they need! This

highly educated mother of an 33 year old boy e+plained?

1hen you reflect on your sort of path! you reali#e &hat a struggle it has een" *ne of the

things that $ had &ondered aout &as E&hat if $ hadn+t the courage or the resources or

you kno&! some of the skills to ask uestions! to pursue things! ecause at one point! it &as

up to me to pursue getting my son seen! getting a referral to a pediatrician and then going from there! taking additional steps! going to the children+s rehailitation centre" All of

those things happened ecause $ made them happen"

0eachers making a difference

#espite many challenges with the overall school system, parents also described teachers who were

instrumental in helping them pursue services for their child! "everal parents remembered teachers

whose comments were a turning point in their :ourney to understand and see* help for their child!

These teachers too* the time to alert parents to difficulties that they noticed, yet framed concerns

positively! One fourth grade teacher, for e+ample, used the following phrase2 &hat $ see is an

incredily smart child &hose self- esteem is going to start dropping dramatically if you don+t find

a &ay to ring out &hat she+s got in her" There was a sense in the parent descriptions that these

teachers were e+ceptional! lthough the teacher may not have been able to pinpoint the source of

the problem, they encouraged parents to pursue additional assessment!

-arents who were able to arrange for recognition of their child’s difficulties and supports in the

school e!g!, learning resource teacher, use of *eyboard to type assignments, modified e+pectations

for written wor*', found that these accommodations made a difference! This parent of a 3 year

old boy, for e+ample, described the importance of these accommodations?

1hen he ecame an identified student and they started developing an individual plan!

then the programming started to e more in sync &ith &hat he &as capale - his ailities"

0hat+s &hen it ecame a little more tolerale for him" 0hat+s &hen he &as kind of ale to

en8oy things like gym and recess! ecause up till then! he+d e &orking through recess!

&orking through lunch and never catching up and al&ays feeling ehind")n addition, a couple of parents gave e+amples of teachers who designed learning situations that

capitali6ed on the child’s strengths and thereby boosted self/esteem! One parent described a

situation where her daughter was as*ed to teach soccerHbaseball to younger children! This

61


10/15


opportunity not only helped to boost her daughter’s self/esteem, but was also effective for the

younger children since she &ill teach the &ay people need to! &ho aren+t ; &ho don+t find this

easy" he+ll descrie it more accurately and e more supportive of kids &ho aren+t successful right

off the top" nother parent described a teacher who helped her son assume roles in physical

education that helped him to fit in? !!"making him the goalie for soccer if theyJre playing it in gym!

ecause that &ay he doesnJt have to run" *r making him the captain so that heJs not the last one to

get picked"-arents emphasi6ed strongly that they did not want the academic e+pectations for their child

lowered, but that accommodations regarding the production of written wor* enabled their child to

succeed in the classroom setting! Once these were in place, the child was able to meet academic

e+pectations and start to develop increased self/confidence in the classroom!

)n summary, children with #C# were described by their parents as bright children who are

e+periencing many challenges within and outside the classroom! Their struggles may be

overloo*ed or misunderstood since coordination difficulties are often not well recogni6ed in the

school system! -arents reported challenges in dealing with the system in terms of getting their

child’s condition recogni6ed and addressed! lthough some teachers were pivotal in facilitating

identification of the child’s difficulties and enabling the child to succeed, parents often reported a

need for more understanding and supports within the school system!

Dis*ussi!n

The problems e+perienced by children with #C# within the classroom, as described by parents in

this study, are consistent with findings of many other studies! Aandwriting, written e+pression and

organi6ational issues are the most commonly identified school issues in this population

Aenderson 8 Aall, 34illberg, 344illberg,

%&&&', receptive and e+pressive speechHlanguage disorders Aill, %&&32 Aodge, 344


11/15


chose not to play with their uncoordinated children! Children with #C# perceive that classmates

do not support them and they are unli*ely to have a special friend Bose, Lar*in 8 @erger, 344='!

On the playground, where lac* of physical competence is even more apparent, children with #C#

have been observed consistently to be withdrawn and inactive "myth 8 nderson, %&&&' and to

be the target of ridicule and bullying "hoema*er 8 9alverboer, 34452 Mandich, -olata:*o, 8

Bodger, %&&'!

-arents in hern’s %&&&' study also reported that failure e+periences were e+tremely common for their children and that they (uic*ly learned to give up trying! The cumulative effect of failed

mastery attempts has been proposed as one of the ma:or reasons for the development of

psychosocial problems by the middle school years "*inner 8 -ie*, %&&3'! $motional health

problems, particularly an+iety and depression, were described vividly by many parents in the

current study and have been highlighted elsewhere as ma:or concerns for children with #C#

Aellgren, >illberg, @agenholm 8 >illberg, 34452 "hafer et al!, 34


12/15


of the school environment, for all children, includes opportunities to participate in structured

formal activities that challenge the child appropriately and lead to a sense of competence or

mastery Larson, %&&&'! Children with #C# are no e+ception, although they may need

accommodations to enable them to demonstrate their abilities! -roper positioning and modifying

e+pectations for written wor* e!g!, increased time, use of *eyboards, photocopied notes' can be

simple, yet effective strategies within the classroom environment! The cognitive demands of the

tas* do not need to be changed, :ust the motor demands of the tas*! )n physical education,rewarding effort rather than s*ill, graduated e+pectations of performance and clear instructions are

strategies that may lead to increased success! co/operative rather than competitive environment

has been identified as a factor that will promote success in school for children with special needs

9ing, "pecht, 8 ;illoughby, %&&5'! "pecific, practical suggestions for teachers of each grade are

summari6ed in a recent article Missiuna, Bivard 8 -olloc*, %&&5' and can be found in a boo*let

and in a series of resource flyers on the CanChild website www!fhs!mcmaster!caHcanchildH'!

9ducational ystem

)ndividual strategies have been identified that can be used within the classroom2 however, changes

also need to be made to increase responsiveness of the educational system! -arents of children

with #C# need to be heard when they tal* about their child’s self/care difficulties and homewor*

frustrations because these concerns impact considerably on the child’s everyday participation inschool settings! Teachers re(uire support in identifying children with #C# and in referring them to

services that can address their needs! The process of formally identifying children with special

needs may vary from one school board to the ne+t, but it is important to recogni6e the concerns of

children who only have coordination difficulties if we are to prevent the emergence of secondary

academic, physical and emotional health problems!

@imitations of this tudy

The similarities of the findings from this study to studies that were conducted in other countries

provide support for the transferability of the findings! There are, however, still several limitations!

The study was conducted within a limited geographical region in south/central Ontario, Canada!

"ince educational systems vary from one region to the ne+t, recognition of coordination problems

and the availability of supports may differ depending upon the mandate of that system!

ll of the children in this study came from two parent families! Most parents were highly

educated with a moderate to high socioeconomic status! "everal mothers were professionals from

the educational or health care system and may have been more able to identify and access

resources for their children than other parents! Children from more disadvantaged circumstances

may e+perience heightened problems in the school system! They may struggle more in school and

parents may have fewer resources to advocate for their child within the system! dditional

research is needed to e+plore the impact of family demographics on outcomes!

7inally, this study reports the perspectives of parents regarding their children’s e+periences in the

educational system! Observations of classrooms, reviews of school records or interviews of the

children might have contributed different types of information!

C!n*lusi!ns

Children with #C# are present in every classroom, but their needs are often overloo*ed! Many

children who have motor coordination problems subse(uently develop significant academic, social

and self/esteem problems that e+tend beyond the classroom setting! Teachers and special

educators can be *ey players in facilitating earlier identification of these children and in

implementing strategies to address their uni(ue needs!

Re)eren*es

hern, 9! %&&&'! "omething is wrong with my child? phenomenological account of a search

for a diagnosis! 9arly 9ducation and Development! '', 3


13/15


yres, ! N!, Maillou+, P! 9!, 8 ;endler, C! L! ;! 34Cratty, @! N! 3445'! Clumsy child syndromesG Descriptions! evaluations and remediation!

Langhorne, -? Aarwood cademic -ress!

Cresswell, N!;! 344!, 8 ;ilson, @! K! %&&%'! #evelopmental coordinationdisorder? associated problems in attention, learning, and psychosocial ad:ustment! uman

ovement cience! ?', 4&./43

#ussart, >! 3445'! )dentifying the clumsy child in school! .ritish Bournal of pecial 9ducation!

?', eu6e, B! A!, 8 @orger, A! 344'! Children who are clumsy? five years later! Adapted ,hysical

Activity 3uarterly! 'M, 3&/%3!

>illberg, )! C! 34oodman, B! 3444'! The e+tended version of the "trengths and #ifficulties Euestionnaire as a

guide to child psychiatric caseness and conse(uent burden" Bournal of Child ,sychology and

,sychiatry! LM! =43/=44!

>ubbay, "! "! 34=.a'! Clumsy children in normal schools! 0he edical Bournal of Australia! ',

%/%0!

>ubbay, "! "! 34=.b'! 0he Clumsy Child ! London? "aunders!

>ubbay, "! "!, $llis, $!, ;alton, N! K!, 8 Court, "! #! M! 340.'! Clumsy children? study of

apra+ic and agnostic defects in %3 children! .rain! NN, %4./3%!

Aalsey, A!, Matthews, ;!, 8 Byan, ! %&&'! Using functional assessment to promote desirable

student behavior in schools! 0eaching 9xceptional Children! 5(5),


14/15


Aenderson, "! 8 "ugden, #! ! 344%'! ovement Assessment .attery for Children! "an ntonio,

TQ? -sychological Corporation!

Aenderson, "! $! 8 Aall, #! 34!, "pecht, N!, 8 ;illoughby, C! %&&5'! 4ocus *n"""" ,romoting success in school for

children &ith special needs Volume 5 )ssue %'! London, OK? Besearch lliance for Children with

"pecial Keeds!9night, $!, Aenderson, "! $!, Losse, !, 8 Nongmans, M! 344%'! Clumsy at si+ R "till clumsy at

si+teen The educational and social conse(uences of having motor difficulties in school! )n T!

;illiams, L! lmond, 8 ! "par*es $ds!', port and physical activityG oving to&ards

excellency pp! %54/%.4'! London? Chapman and Aall!

9nuc*ey, K! ;!, psimon, T! T!, 8 >ubbay, "! "! 34

in physically aw*ward boys! Adapted ,hysical Activity 3uarterly! L! &./33!

Martini, B!, Aeath, K!, 8 Missiuna, C! 3444'! Korth merican analysis of the relationship

between learning disabilities and developmental coordination disorder! $nternational Bournal of

pecial 9ducation! 'L, 50/.

Ma+well, N! 3440'! 3ualitative research designG An interactive approach! Thousand Oa*s, C?

"age!

McAale, 9!, 8 Cerma*, "! ! 344%'! 7ine motor activities in elementary school ? -reliminary

findings and provisional implications for children with fine motor problems! American Bournal of

*ccupational 0herapy! L6 ,


15/15


Missiuna, C!, Bivard, L!, 8 -olloc*, K! %&&5'! They’re bright but can’t write? #evelopmental coordination

disorder in school aged children! 0eaching 9xceptional Children ,lus! '! rticle ! Betrieved October %=,

%&&5 from http?HHescholarship!bc!eduHeducationHtecplusHvol3Hiss3H!

-ie*, N! -!, -itcher, T! M!, 8 Aay, #! ! 3444'! Motor coordination and *inaesthesis in boys with

attention deficit/hyperactivity disorder! Developmental edicine and Child eurology! L', 3.4/

30.!

Basmussen, -!, 8 >illberg, C! %&&&'! Katural outcome of #A# with developmentalcoordination disorder at age %% years? a controlled, longitudinal, community/based study! Bournal

of the American Academy of Child and Adolescent ,sychiatry! O, 35%5/353!

Bichards, L! %&&&'! vivo ualitative data analysis program! version '"" Melbourne,

ustralia? E"B )nternational -ty Ltd!

Bose, @!, Lar*in, #!, 8 @erger, @! >! 344='! Coordination and gender influences on the perceived

competence of children! Adapted ,hysical Activity 3uarterly! '?, %3&/%%3!

"choema*er, M! M!, 8 9alverboer, ! 3445'! "ocial and affective problems of children who are

clumsy? Aow early do they begin! Adapted ,hysical Activity 3uarterly! '', 3&/35&!

"hafer, "! E!, "to*man, C! N!, "haffer, #!, Kg, "! 9!, OConnor, -! !, 8 "chonfeld, )! "! 34

06 Missiunaetal

Documents

Transcript of 06 Missiunaetal