Children with DCD need help learning new skills

Typically developing children learn new, age-appropriate skills with little formal instruction.

They observe and imitate, experiment with different ways of doing things (trial and error learning) and learn quickly from instructions. Young children learn new skills at an amazing rate and and in such an easy manner that many of  the underlying processes that contribute to such learning are taken for granted.    

The basic skills that contribute to learning any new skill include:

  • Sustained attention 
  • Paying attention to a demonstration and noticing how a task is performed. 
  • Picking up the most important visual cues from the environment - what do I need to see and notice for this task
  • Knowing how to explore doing a new task in different ways until a solution is found
  • Using past experience to solve a new movement problem
  • Persistence in achieving a goal
  • Trying a different solution to the motor problem when the first attempt fails 
  • Knowing when a failed attempt is due to one's own actions - rather than blaming something or someone else for the failure.

Children with DCD and developmental delay need a little extra help learning new skills 

Children with motor learning difficulties ( DCD)   and have difficulties learning new skills in the same easy way that typically developing children do. For more complex skills they may need additional coaching to learn to perform a task. 

Coaching a child with motor learning difficulties includes: 

  • Simplifies the task to allow the child to succeed.and over time increases the difficulty in a graded manner.
  • Sets very clear goals for a task. Makes sure that the child understands what is expected and how to judge success
  • Helps the child pay attention to important aspects of the task. 
  • Supports and helps the child persist and stay on task
  • Helps the child to identify mistakes .

Learning to walk through doorways without bumping into the door frame

Take a simple task such as walking through a doorway with a low lintel.  We take it for granted that the child will not bump into the side of the door or trip over the lintel. We are not surprised when the child can do it when carrying a ball, having a conversation or even when running.

What are the underlying skills? And why do children with  DCD often bump into the door frame or trip over low obstacles?

There are a few basic motor planning abilities needed for avoiding obstacles.

Firstly, the child needs to pay attention to where she is going – look at what is ahead and plan her path. This requires transforming the visual information about the position of the doorway into a set of body centered coordinates which are used to adjust the direction of leg actions so as to walk in a line that goes through the middle of the doorway.

We also pre-plan our footsteps so that the one foot lands just before the obstacle so that it is easy to lift the other leg over and place it on the floor without having to take a large step.

Very young children know that the door lintel is a hindrance and will approach the doorway slowly, adjust the position of the feet and maybe even touch the door frame for balance.

Over time they learn to plan their walking path as well as adjust their footsteps to allow for easy stepping over the lintel with increasing levels of accuracy. 

The movement brain learns from errors

This ability is built up with repeated experience of  planning a path through a gap: when the plan is good and the obstacle is avoided, the movement brain registers a success.

But when the plan is not so good, and the child bumps into the side of the gap the movement brain registers an error and this information is used to adapt the motor plan next time round.

This error detection and adaptation of the plan happens implicitly, that is without conscious awareness.

Children with DCD tend not to learn from their errors.

Children with DCD do not register an error and adapt the movement plan in order to achieve a more successful action.  They repeat the same error over and over again. 

A child with DCD may need explicit instructions with repeated practice of planning their movement path around obstacles and through gaps in order to walk without bumping and tripping. 

A coaching strategy for training Nick not to bump into things

Nick is an active, on the go  6-year-old who is full of bruises on his legs because he falls and bumps his shins at least once a day, and will often bump into furniture or walk into the door frame as he moves from one place to another in the house.

Today Nick and his mum are practicing a stop-look-notice-plan strategy

Nick has planned a route through the house walking from one room to another. The game is to walk through all the doorways in the house without bumping into the door frame or furniture.  

Before Nick sets off he reminds himself to look ahead and notice what is in the way.  He  then walks at a moderate speed across a room and through the first doorway. Once through the door he stops again and looks ahead before he sets off on the next leg of his journey through the house.  

Today he achieves his goal of walking through all the doorways and around  all the rooms in the house. 

Speeding up and planning a path

Next Nick and his mum think about ways they can make this game more difficult. Nick decides that he wants to walk a little faster and that he wants to time himself. Together they plan a course:  from the kitchen to living room, then into the bathroom and from there into Nick's bedroom and back into the kitchen.  They write down the plan and Nick practices remembering the sequence. 

Then he sets out on his journey using the stopwatch on mum's cell phone to time himself.  The first trial he sets off at speed and develops a speed wobble turning into the passage and bumps into the doorway. 

The next trial he goes a little slower and finishes the the whole course without bumping into anything. 

What has Nick learned and what next? 

Nick is learning to look ahead, moderate his speed and change his expectations. Falling is an error and he should stop and consider what went wrong. Now he expects to walk around the house without falling.

In the days that follow Nick and his mum create new games - they add extra obstacles to walk around and over. They go for a walk in a busy mall where Nick practices not bumping into people.

At school Nick's teacher introduces a game for the whole class that involves all the children moving around the classroom and not bumping into or even touching each other. 

What can be learned from this coaching example

  • Select an activity that the child needs to improve 
  • Think about how the activity can be made more simple or easier so that it can be performed successfully
  • Involve the child in planning practice sessions
  • Provide incentives and rewards
  • Teach the child to recognize error and expect to succeed 
  • Practice the simplifies task until it can be done  successfully
  • Next make the task a little more difficult and provide opportunities for practice
  • Provide opportunities for performing the task in different places and spaces